Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.
I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.
>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
The microbiota is passed from mother to son on birth, not totally from the environment.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Often universities do this, they may own the patent and license it to the company or take a cut etc. Arizona State University appear to do this through Skysong Innovations:
It's quite common historically. The Entrepreneurial State by Mariana Mazzucato looks at this phenomenon of companies privatizing the benefits of publicly funded research and, she argues, not giving enough in return
Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria? If so, these could possibly be delivered by a number of small capsules taken in the course of several days.
There really isn't. From the mouth is basically the same distance and it contains teeth and a tongue. Through the rectum is much much much farther through meters of intestine. Through the skin creates a surgical hole that's going to be difficult to keep sterile.
Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
> If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.
I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.
>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
The microbiota is passed from mother to son on birth, not totally from the environment.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
Why did you follow a strict carnivore diet? Health? Accident? Aside from the constipation did it benefit your health?
>I got bad chronic constipation after four years as a strict carnivore.
2 questions:
1) Did your constipation start right after you did strict carnivore? Or was it after 4 years?
2) List all foods that you ate on strict carnivore. (Include salt, water etc. I presume it won't be a long list)
Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
2 questions:
1) Do I detect a note of sarcasm?
2) List all times you’ve been sarcastic on the internet before. (Include social media, message boards, etc. I presume it won't be a long list)
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Often universities do this, they may own the patent and license it to the company or take a cut etc. Arizona State University appear to do this through Skysong Innovations:
https://skysonginnovations.com/startups/list/
It's interesting they got a lot of funding from over 100 families with autism children:
https://skysonginnovations.com/startups/list/
It's quite common historically. The Entrepreneurial State by Mariana Mazzucato looks at this phenomenon of companies privatizing the benefits of publicly funded research and, she argues, not giving enough in return
> So the university researchers use time and money from the university
Don’t worry, the money is usually coming from taxpayers so the universities don’t have to chip away from their endowments
Universities often keep up to 50% of rights over IP in such cases but I am unsure about this specific case.
Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Not a fan of gene / bacteria patents though.
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
I'm guessing that the kids now have less stomachpain, constipation, and are feeling less bloated/nauseous. Thus have less voilent reactions
No, there’s a clear link between gut microbiome and behavioral/mental issues that has nothing to do with physical digestive symptoms. It’s been seen with other disorders, like depression: https://hms.harvard.edu/news/drawing-line-gut-microbiome-inf...
That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
Their first study allegedly resulted in "44% were below the cut-off for mild ASD"- ie, practically cured, from a diagnostic point of view.
If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
Kids got into tech industry and now it’s their spouses that have to deal with their tism, instead of parents
Buzz off. If you were trying to make a joke, it didn't land. It scans as ableist twat.
Self-hatred is not a good look.
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
So all I gotta do is eat some poop and it will save me from becoming a handsome, funny, unique genius?
You don't eat it, don't be silly.... you stick the poop up your butt
I believe the best procedure is actually sticking it in your nose.
(They run a tube through your nose, down your throat, through the stomach to the top of the intestines, and introduce the bacterial slurry there.)
Makes you wonder how hard would it be to just put it in a swallowable capsule that dissolves only in the upper intestine.
Also, "fecal transplant" is marketable only to weirdos. "Probiotic infusion" would work better.
For those who want to gain some artistic talent, there's this (but is expensive):
https://en.wikipedia.org/wiki/Artist's_Shit
From my understanding, the problem is volume.
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
That is a _huge_ amount to put in pills.
Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria? If so, these could possibly be delivered by a number of small capsules taken in the course of several days.
Pretty sure there’s a shorter path to the top of the intestines than through the nose but I’m no Biologist.
There really isn't. From the mouth is basically the same distance and it contains teeth and a tongue. Through the rectum is much much much farther through meters of intestine. Through the skin creates a surgical hole that's going to be difficult to keep sterile.
The shortest safe path is via the nostril.
If you’re implying it is through the rectum, you’ve definitely got some bio to brush up on. The small intestine alone is >20ft long.
... Back and forth, forever?
))<>((
))<>((
Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
> If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
Personally, anyone looking to get a fecal transplant from Sir Demis Hassabis will have to line up behind me. I want to be first in line.
Absolutely outrageous/hilarious clickbait title. It's not for autism but totally opposite.