High-quality stool donors are rarer than one in a million? AI, funding, and potential.
Since the last “Half a million stool donor applicants” blog a year ago, we've now received over a million applicants and still haven't found one that meets the ideal criteria.
Most of our stool donor applicants are coming from organic social media videos that people are making on their own. Thank you so much to everyone who is helping to spread the word, and to everyone applying!
Unfortunately, these organic videos do not target our ideal demographic. They target people who are looking to make some extra money. The vast majority of applicants we get from them don’t come close to qualifying.
While these videos do help to spread the word about FMT, the microbiome, and the Human Microbes (HM) project, the downside is that they greatly increase the workload without the benefit of obtaining new top-ranked donors, leading to burnout and disappointment.
So after over a million new donor applicants, our #1 ranked, active donor is still an athlete that came from the first ~50,000 applicants. Many of these early applicants were recruited from direct solicitation to hundreds of college and professional athletes.
You can check our previous blogs for more info on our criteria and our results so far.
I originally estimated that an ideal donor may be as rare as one in a thousand. Less than one in a million certainly makes things much more difficult. As I've said in past blogs, my criteria may be wrong, but so far the evidence supports the necessary strictness of it. And since I've found such people in the past I am not chasing something that doesn’t exist.
***
Feedback is welcome from anyone who might have suggestions or ideas. I know there are lots of interesting people who have applied; people from virtually every background and profession imaginable. This includes one surprise for me -- doctors who want to be donors themselves. I first thought they were applying to vet the process, but no, people are either enticed by the possibility of being the source of a cure, or everyone wants that easy poop money :)
I recently set up a forum that can be used for this type of discussion: https://forum.humanmicrobiome.info. I can't have individual email discussions with thousands of people, but I can have one discussion on a forum with everyone. You can sign up completely anonymously.
I recently shared some of my thoughts in a Q&A here. I want to highlight the part where the top athletes in the world are not immune from the rise in chronic disease. Their children are suffering from worse health as well. They could and should be helping by recruiting teammates, non-teammates, and even top athletes from other sports. Our screening system is designed to enable applicants to be as anonymous as possible. You are able to see if you qualify without revealing your identity. But it is educational to be able to learn how close top athletes come to qualifying.
The vast majority of people reading this either did not or would not come close to qualifying due to poor health/gut microbiome status, and thus would benefit personally from a high-quality donor. It is in the vast majority of people's interest that a highly effective donor is found, including everyone over ~40.
***
There are applicants who believe stool testing is the ultimate method to determine donor quality, and thus want to send in stool samples to have them analyzed. I had this mentality decades ago when I was seeing doctors for GI problems. The reality is that current testing capabilities & knowledge are extremely limited.
AI
Humanity is on the cusp of making the biggest transition in its millions of years of evolution.
Similar to people like Martin Blaser warning about extinctions in the microbiome world, Eliezer Yudkowsky has been warning about extinctions due to AI. I agree with Eliezer that a powerful AI is much more dangerous to us if the majority of the population is poorly functioning and malfunctioning. I agree that the best path forward is to first focus on increasing human intelligence. I believe that human stupidity and indifference have been resulting in tremendous damage to ourselves and our planet, and threatening our own extinction in a wide variety of ways. I think that we are in a race to increase our own intelligence before we destroy ourselves with AI or something else.
The gut microbiome is well established to play a major role in cognitive function, and I believe there is large potential for FMT to increase the brain function of most people. I've experienced drastic shifts myself from various microbiome changes, akin to the novel Flowers for Algernon. There are certainly limits to FMT and the gut microbiome, but it's definitely powerful.
I think there is somewhat of a catch-22 when it comes to AI. I've written that the only way to overcome many of our issues is to turn decision-making over to an AI, because humans have thoroughly demonstrated themselves to lack the ability to make intelligent decisions. Either way, it's imperative for the survival of the human race to prioritize the advancement of human intelligence.
***
I consulted with an AI firm about turning the screening over to an AI. It is not simple, and it has the potential to erroneously give high-quality donors a low score, and thus there is the possibility that we may completely miss a "one in a million" donor applicant. It also requires significant funding which we don't have, and applying for that funding can be a full-time job that may not pay off.
Funding and philanthropy
I have thought that this is an ideal project for the Gates Foundation to get involved in, since the potential benefit for the entire human race would be massive, and FMT isn't something that can be patented so it's not going to get invested in by capitalists, and thus requires philanthropy (more on this in the previous blog). Especially considering how rare high-quality donors are looking to be, and with how well-off potential super-donors already are. The Gates Foundation could:
Fund the transfer of the screening process over to an AI so that unlimited amounts of applications can be processed right away.
Expand the reach of donor recruitment worldwide. Currently, 99% of our recruitment comes from social media videos that people are organically creating. They appeal to people looking for work. Most applicants are not healthy and I've had limited reach to the people I think are most likely to qualify.
They could likely reach people like Mbappe, Haaland, Virgil van Dijk, Mohamed Salah, Giannis Antetokounmpo, etc. The more people I screen, the more doubtful I get that even these top athletes would qualify. But there's nothing to lose and so much to possibly gain. It's very simple and doesn't cost anything to try. It should be tried.
Possibly fund small clinical trials and other research to help elucidate the donor quality puzzle.
I have attempted to contact them in the past, but they do not accept applications for funding or support. They reach out on their own.
I am not aware of other philanthropic organizations that might be interested in taking this on, but if you do, please let me (and them!) know.
As is, I've been getting burned out by spending every day screening so many people who don't come close to qualifying, as well as spending years screening over a million people without finding anyone who meets the ideal criteria.
I mention below that pharma companies working on synthetic FMT should be supportive of our work. But I’m also doubtful that they’d be willing to provide significant funding for this project.
Future potential:
As mentioned in the previous blog, The FDA and FMT Regulation, the vast majority of stool donors being used worldwide are dangerously low-quality.
I think that if patients were fully informed about donor quality and the risks and potential benefits of using a low or high-quality donor, they would demand using HM as the source of stool to treat their C. diff, or be used in the clinical trial they sign up for. But HM does not market to recipients, so few of them are aware. If someone wants to partner up and pursue that, feel free. It’s not my area of expertise, nor my focus.
Some people may hear about the new FDA-approved drug alternatives to FMT and think FMT will soon be made obsolete by them. I disagree. While they've been proven to be helpful for C. diff, they are not as effective as FMT, and C. diff is much easier to cure than other conditions. The current FDA-approved drug is little more than a human-sourced multi-strain probiotic with a handful of bacterial strains. Due to extreme technical and knowledge limitations, I believe it will be decades before whole stool can be replaced with a synthetic version. The gut microbiome is an incredibly complex and dynamic ecosystem made up of countless strains of bacteria, fungi, archaea, and viruses. And we have very little idea of what most of them do, or how they interact with each other, our immune system, and our genes.
I don't think you can, or want to, rely on FMT forever. I think we do need to synthesize it. And I would argue that even pharma companies working on synthetic FMT should support our work, as you can't make gold jewelry without gold. Their donors apply to HM and don't qualify. They're trying to make gold jewelry out of iron and mercury.
If I'm right, a donor that meets my criteria will be close to a panacea. If I'm wrong, they'll merely be a treatment for most conditions for a smaller percentage of people. It seems worth pursuing to me... And it’s very dystopian that in a population of 8 billion people, one disabled person is left to do it on their own. Especially when 6/10 Americans have a chronic disease.
How badly do you want a cure for yourself or your loved ones? What are you willing to do for it?