Fecal Microbiota Transplantation, or FMT, is a clinical procedure involving the transfer of fecal material, containing a diverse and healthy community of microorganisms, from a carefully screened donor into the gastrointestinal tract of a recipient patient. The primary therapeutic objective is to rapidly restore a balanced gut microbiome, which is known to have systemic effects, including significant influence on the gut-endocrine and gut-brain axes. While primarily used for recurrent Clostridioides difficile infection, its potential in modulating hormonal and metabolic health is an emerging area of study.
Origin
The therapeutic use of human fecal matter has ancient roots, notably in fourth-century Chinese medicine, but its modern clinical application gained prominence through gastroenterology research demonstrating the critical role of gut dysbiosis in disease. The contemporary term and procedure reflect the scientific understanding of the microbiome as a functional organ system. Its relevance in hormonal health is growing due to the identification of the ‘estrobolome,’ a collection of gut bacteria that regulates the circulation and metabolism of estrogens.
Mechanism
The mechanism involves the successful engraftment of the donor’s diverse microbial ecosystem, which re-establishes a stable and functional microbial community that outcompetes and suppresses pathogens. In the context of endocrine health, the restored microbiome can positively influence the estrobolome, altering the pattern of estrogen conjugation and deconjugation, thereby impacting the overall circulating and active levels of sex hormones. Additionally, a healthy gut flora produces beneficial short-chain fatty acids that regulate systemic inflammation and metabolic health, both of which are intimately linked to hormonal homeostasis.
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