Integrative Naturopathic Gastroenterology: Fecal Transplants, Diet, Probiotics, and Helminth Therapy, Part 1

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Welcome to today's Intelligent Medicine Podcast. I'm your host, Dr. Ronald Hoffman. Today, I'm very pleased to and very much looking forward to a conversation with one of our previous guests. And our guest reminds me that I've interviewed him 8 and 12 years ago.

And it is high time for an update because he is an integrative naturopathic gastroenterologist. We're going to find out what that means, how that is differentiated from an MD gastroenterologist. There's a lot of overlap. Mark Davis is someone who is a pioneer in the field of FMT, fecal microbial transplant.

plant. And we're going to talk about that. We're also going to talk about other issues, issues related to diet and issues related to supplementation and issues related to novel approaches to the treatment of gastrointestinal disorders. And, you know, judging from my conversation with him in the past, he's really at the tip of the spear in terms of innovation.

And we're not talking about, you know, over the bleeding edge of innovation. He's very science based in his approaches while maintaining a very, very creative approach to gastrointestinal disorders. So without further ado, here's Mark Davis. Mark, it's a pleasure having you back on Intelligent Medicine. Thanks very much for joining us. Thank you so much for having me. I'm excited

to be here and chatting with you. Yes, we always have great conversations, as I recall. So first First of all, your initials are ND as a naturopathic doctor, but also you're an FABNG. What in the heck is an FABNG? I think I know, but you can clarify.

So I'm a fellow of the American Board of Naturopathic Gastroenterology. And 14 years ago, maybe, I was one of the co-founders of the Gastroenterology Association of Naturopathic Physicians. and I'm still involved with it to various degrees, but a group that I was not involved with

developed a fellowship process that involves practicing for at least five years, some residency stuff, some case submissions, and then a supervised exam. And if you go through all that, then you are granted that title of fellow of the American Board of Naturopathic Gastroenterology. And I was one of the first cohort to get that about five or six years ago.

And that is a rather rare breed still, is it not? There may be a few dozen of you, a few score of you perhaps throughout the country? Exactly. A few dozen of us. There's not a lot of us. My favorite conference of the year every year is the Naturopathic Gastroenterology Conference. This year it's in Seattle in September. And it's really a group of people that has developed a culture of wanting to stretch the boundaries to find the best for every patient and also being deeply in love with research. And that combination of people just appeals to me so much.

And so I look forward to that conference in that community every year. And it is academically rigorous because you're training now training for modern NDs is very rigorous. You study pharmacology and there's a med school type education, but the emphasis is a little bit, while understanding conventional therapies, more towards applying natural approaches to health problems. Yeah, we're a big tent. I just got back from the AANP, our big national convention last weekend, where I spoke on fecal transplant and other things. And, you know, there's all the way from one end, some naturopathic doctors practice using a lot of pharmaceuticals and a lot of conventional diagnoses.

and all the way at the other end, there's docs. I have a good friend in Baltimore who's never prescribed a pharmaceutical in 25 years of practice.

Some docs do minor surgery. Some never do that in practice. I've done almost 2,000 fecal transplants. Most naturopathic doctors have never even done one.

So big tent with a lot of diverse experiences in the profession. And by the way, these are not illicit DIY transplants. These are rigorous, done under IRBs, institutional research protocols, right?

Well, so yeah. So the way that FDA has given guidelines around fecal transplant is really weird and complicated and not like other substances. So in late 2022, early 2023, they granted FDA approval for two companies to make the first

FDA-approved fecal transplant products. One is enemas. It's called Rebiota and the other is capsules. It's called VALST. And so those products have been on the market for a while, but FDA always carved out an exception for clinicians to be able

to prepare and administer FMT for patients with C. diff infections, not responding to standard therapies. Right. That's the conventional pathway is that officially recognized one condition, you can do it for that, but it's, you know, the off-label applications are for other conditions and quite plausibly, but they haven't achieved the direct FDA approval, correct?

Exactly. And so I've never worked with, IRB isn't the root for FMT, but I am the chair of the