Tell us a little about the history of Taymount clinic. How did you get started?
The clinic started back in 2003 as a naturopathic clinic and it focused on colonic health and digestive issues, specializing in colon lavage and training colon Hydrotherapists by 2007. We felt for a long time that we were not really making a lasting difference, trying various commercial probiotics and combinations of them, trying to establish a healthier gut flora, but none of it seemed to work long term. Then we had an enquiry about fecal transplants and the mental light bulb suddenly came on; why keep trying to find a commercially produced, mutated distant cousin of human probiotics when you could go straight to source in a healthy colon and extract the whole microbiome, complete with its delicate exotic minorities, in its original form. So we went into a couple of years of intense research and brought together a lab process which protected the anaerobic bacteria and extracted only the bacteria that we needed from the food waste, mucus and epithelial cells that we didn’t need. From there we developed our safety procedures and protocols and our current clinical practice.
Do you have any limitation on patient such as age, specific conditions or level of illness?
Yes we do. We have found over the last four years and 8000 implants, that trying to use FMT to calm an inflammatory flare is useless and can be counter-productive. If you have any kind of flare up or acute episode, then it is wise to wait until it calms down, using whatever kind of prescription medication will work as an anti-inflammatory to bring about calmness to the tissues in the short term and then we can use the FMT.
We do not treat children under the age of 16; for 16-18 year olds, we need parental consent. Children over the age of 5 can be treated by the pediatrician in our Bahamas clinic in Nassau.
What health conditions do you see?
We never claim that FMT can make a positive difference to any particular disease apart from Clostridium difficile (c.diff). All we can say is that we restore the gut flora to as near normal as possible in a gut where there is a disturbed microbiome (dysbiosis) for any one or more of a number of reasons. Typically we have people coming to us to try FMT for gut problems which coincide with: IBS, IBD, MS, ME and any number of other indistinct conditions like bloating, depression, indigestion and food intolerances. The list goes on but we make no claims for any specific disease apart from c.diff, where we have 100% success rate.
Are there limitations on what you can treat with FMT?
FMT is limited to restoring the gut flora. All other effects are due to the body and the immune system interacting and affecting lots of other systems like the endocrine (hormone) system or the nervous system, etc. We are all still learning what FMT can actually help the body to change.
Are there things that patients can do to increase their success?
Many things; our program is geared towards helping the recipients to understand how to keep their new ‘exotic pets’ happy and healthy and to help them to engraft and stay resident in their new host. The foods we choose, the lifestyle we adopt, even our relationships, can greatly affect the microbiome and the kinds of bugs we support. So our team at the clinic is highly trained in nutrition, stress relief, life coaching and all manner of practical and helpful ways to improve health and maximize the chance of a good outcome from the program long term. Our aim is to support the person to take part in their own rescue, so to speak, or to give them back the power over their own health through knowledge and practical lifestyle suggestions.
How is your treatment center different than others who do FMT?
We only know personally of a couple of places that do FMT. One was in Sydney, Professor Thomas Borody, who is the longest running ‘grandfather’ of FMT, having been using it for over 20 years, but he runs a general hospital for digestive diseases, not a specialist centre for FMT. The other is Silvio Najt in Argentina and we have not visited his establishment. When we started doing FMT as a specialty in 2012, we were the only specialist clinic of its kind.
We believe we are developing the highest safety standards and processing procedures, which will set the standard for other clinics to replicate. We do feel that as we have done the greatest numbers of implants (over 8000), we have worked with insurance companies to assure them of our safety and secured policies for FMT treatment and product insurance, so we feel that we are the most experienced FMT clinic now, as well as the first. We also quarantine our implants for at least 3 months in Ultra Deep Freeze to make sure the donors clear two tests, three months apart to ensure nothing is incubating that may later appear. We believe that we are the only suppliers of FMT who do this.
We have helped the Clinical Coding Group to identify and classify FMT and produce the treatment code for it; we believe we are the trail blazers, the pioneers and we believe our screening, quarantine and processing are the first and the best for quality and patient safety. Our new clinic offers a supremely relaxing and pleasant experience for the patient from the moment they step into the building until they leave two weeks later loaded with information and helpful advice as well as their new microbiome. We like to feel that we have made new friends with each patient that comes through our clinic.
Do you have other services besides FMT?
We offer laboratory tests for analyzing the person’s vitamin and mineral profile (Genova ONE, Optimal Nutritional Evaluation) to see if additional supplementation or certain foods would help support their health better, and we have access to other lab tests if the need arises.
From our experience over the last four years of working with persons seeking gut flora restoration, we have selectively collected together supportive and useful treatments that the patients may opt to choose which will enhance their experience and may help to achieve a good outcome. None of our services are stand-alone, they are all options for our FMT program patients.
How long are the treatment last each day? How many days are the treatment sessions?
Our standard program is 10 days, Monday to Friday, Monday to Friday, with the weekend in between to rest. The program for Clostridium difficile (C.Diff) is five days in clinic. The patients are with us for 2 hours on the first day and thereafter just one hour per day. This leaves them quite a lot of time to rest, relax and generally give their bodies chance to adapt to the new microbiome and get some healing time.
For those who are coming from other countries, will they need to factor in the cost of travel, food and accommodations or are those factored into the prices?
As our patients come from all over the world, we could not factor in such elements in a fair way, so our prices are just for the outpatient treatment and they have the freedom to choose their own methods of travel and accommodation for themselves. Letchworth Garden City and the surrounding area offers options from four star hotels to Air BnB, either self-catering or we help to them find restaurants who are sympathetic to their particular dietary needs.
The building is a stand-alone Edwardian office building dating from 1904, fully refurbished and restored and customized to our needs as a clinic. It was the first factory office suite for the Gresham Engineering Iron Works, in Letchworth Garden City, which was the first Garden City in the UK and we think in the world, in 1903.
Taymount is the first bio-tech company in Letchworth, so there are number of delightful firsts involved! Having the whole building at our disposal, we have made a softly-decorated, period-style, welcoming entrance and waiting area to help patients feel relaxed and at home. The five treatment suites are state-of-the-art and compliant with safety standards, disabled access, for patient comfort and safety. There is free parking around the building and easy access to rail, road and airport links; Luton airport is 15 mins away, Letchworth rail station is 10 minutes’ walk from the clinic and to get to London King’s Cross rail station is just 30 minutes on the train, and the major motorway, A1M is just two minutes away. Heathrow is just a 45 minute car ride for international arrivals and we can arrange a private chauffeured car for transfers if required.
We believe that this new facility will allow us to offer patients an increased sense of being cared for; we can offer more facilities like stress-reduction treatments, information evenings and presentations in our friendly conference room. Additionally, over the next few months we will be constructing a coffee shop and café (“Iron Works – The Food Foundry”) and demonstration area for patients to come and eat, drink and learn about healthy and easy recipes. We aim to be a centre of excellence for helping people to learn about a healthy lifestyle and our team of nutritionist and therapists will be on hand to advise and educate. We believe that will offer people the facilities, support and examples they need to improve their own health. This is not just for our patients – we will be working with a local Food Ambassador to setup classes for local people in the community to help them with the same need for learning about healthy food. We aim to give something back to our community at the same time as serving the needs of our patients.
You now have two locations, one in the UK and one in the Bahamas. Where are your locations in each country?
In the UK, as we said, we are in Letchworth Garden City, Herts, UK SG6 1LB.
In the Bahamas, we are in the Bahamas Medical Centre, Nassau, Bahamas.
There is also Praxis Villa Thal in Germany, where they use Taymount FMT as an adjunct to their comprehensive detoxification therapies.
We are currently in talks with several other countries to operate a Taymount Clinic under license, and we will make this known when the arrangements are complete.
Being in the U.S. we get a lot of questions about the Bahamas location. Tell us a little about the facilities. Are they similar or different from the facilities in the UK?
Do the two locations offer the same treatment options?
The Bahamas are able to offer treatment to children as they are working with a pediatrician who is very open minded to the connection between autism and gut flora. Apart from that difference, Taymount insists that the treatment protocols are the same across all facilities. The standard 10-day program and 5 days for C.diff are the same in all of our clinics and at the moment, they all use our implant material so the quality of the treatment is exactly the same as the UK.
Do they have the same protocols for handling stool?
We have personally trained and certified all members of staff involved in any aspect of the treatment in all locations; however, at the moment, for the two clinics outside the UK, the supply and processing is still done in the UK and implants are shipped via temperature controlled containers within 24 hours to each location.
If patients are traveling to these locations from other countries, are there any special instructions they should know regarding weather, clothing, local dining or things that they should pack or be sure to bring with them (like a passport or visa)?
Each location has a procedure for welcoming patients at the first stage of booking and all the relevant local information should be provided at that point. Of course, some of these things are outside our control and various elements may change from time to time; hotels may close, new restaurants may open, etc. Most people will be familiar with their need for passports and visas and we would refer them to a local travel agent for specific advice as this is outside our area of expertise. The weather in UK is a continual source of conversation and it can change drastically – sometimes giving us all four seasons in one day!
Our Patient Liaison Manager runs a team who will connect with the patients at the point of booking and they liaise all the way through the run up to their attendance. They will help with most enquiries and point the way to answers outside their knowledge and ensure that the patient has a smooth and uneventful lead-up to their attendance at the clinic. Preparation information and guidance are what they are there for.
Now we are in our new location in the UK, we have some members of staff going around looking for interesting things and useful places for our patients to visit during their rest time and for good places to eat where the proprietors will go the extra mile for our patients to make them feel catered for and welcome. Things like art galleries, craft centres, tourist information offices and museums are all listed and we have various leaflets in reception to help people fill their time with gentle occupations, remembering that they are here to rest, heal and recuperate, so they are non-demanding pastimes!
Are patients provided meals at your clinic or will they need to find dining in the area?
Currently we do not offer dining in the UK Clinic – we will be able to do this when our Iron Works – The Food Foundry café is up and running; the Bahamas Medical Centre has a canteen (not particularly geared to healthy options, but salads are available and the staff are very helpful), but as mentioned above, we seek out supportive establishments and will help patients to find what they need locally. In the UK clinic, we can also organize supermarket deliveries and organic food deliveries to the clinic with advance ordering for people who are staying in Air BnB self-catering accommodation.
Are there things that patients should bring to their treatment (medications, something to read, medical documents, etc.)
We advise all patients to continue to take any medications that they have been prescribed and to make sure they bring them along with them; any relevant medical documents are helpful if they relate to their presenting condition or health situation, but there is no prerequisite or definite documentation that they need to bring. We do require patients to have read and be ready to sign the Patient Agreement before treatment can start, and this is sent to them in advance, as soon as they book, so that they have plenty of time to read and understand the protocol. As for reading, we have a large library of very informative books here in the clinic and patients are welcome to browse and borrow.
Our clinic is not residential. We would love to be able to offer that facility as we can appreciate how calming and relaxing it would be to just float downstairs for treatments and then float back upstairs to recline on your bed!
We have made contact with local hotels to ask for preferential rates for our patients and that is on-going. There is a new low-cost Premier Inn planned for Letchworth very soon and we have a 3-bedroomed house available for rental for self-catering. Air Bnb is beginning to offer lots of choices locally so there is ample provision.
What sort of results do you typically see with your patients?
As a very rough guide, we see something like one third having very rapid and encouraging results during their program time. We see roughly another third seeing a slight but encouraging improvement which then continues to progress over the ensuing one or two months following treatment. There is a third group who don’t seem to get good results and we are not sure if this is a time thing, and perhaps given a longer treatment period they would see better results, or if this due to a genetic expression that no amount of gut flora would be able to resolve. On-going long term trials will start to reveal whether we could find markers to predict which group any one patient is likely to fall into and whether we need to be looking at treatment once or twice a month for up to two years (which is what Professor Borody found with some refractive (stubborn) IBD cases). Right now, we are still in pioneering country with FMT and it is not something we can provide any statistical probability figures for at the moment. Each person is an individual and their gut flora is highly varied. There are so many thousands of variables in this equation that we simply cannot make any sensible predictions. We wish we could. What we are finding out is that the more we discover, the more we realise that there is so much that is still to be understood.
We do get some very heart-warming testimonials as to how FMT has improved health to the point where it makes life easier and more enjoyable for the patients. We do stress that it doesn’t work for everybody and we need to be mindful of this.
Will patients need to remain in their rooms during their treatment protocols or would they be able to do sight-seeing and other tourist activities?
Over their 10-day programs, patients are with us for two hours on the first day and thereafter just one hour per day, so they do have quite a lot of free time. We stress that they are to focus on resting and relaxing and giving their bodies a chance to adapt and heal. This is a Health break, not a tourist holiday. Strolling around and shopping, visiting museums and art galleries and maybe sitting by the river feeding the ducks, this is all good. We do advise not to try and cram in loads of visits to tourist spots in London as fighting your way through rush hour traffic and queueing to get into tourist attractions is very stressful and we find stress plays a very detrimental part in anybody’s healing process.
Are their any special recommendations for after a patient completes their FMT procedure?
We go through quite a few helpful recommendations and we spend a lot of time discussing nutrition and diet. Any suggestions we make must be achievable for that person and compatible with their lifestyle, work, budget, etc., and we spend a great deal of time helping them to make small, realistic progress steps towards a greater goal. We feel that we are enabling them to take control of their own health and we are here to assist, educate and enable.
For those who cannot travel to your locations, do you provide fecal microbiota implants?
We have a strict approach to home DIY. We only supply implants to past patients who have been to the clinic, who have been supported through the entire process and who have been taught how to self-administer. We recognise the need for some people to continue to use FMT intermittently to bolster the beneficial effects and to ‘top-up’ their treatment program by having a long, slow taper-off down to perhaps one per month or similar. These people can buy more frozen implants and have them collected for transit, where their import customs will allow the import of such items.
We also recognise that a bout of travel diarrhoea, a food poisoning bug or a course of antibiotics can adversely affect a previous patient’s new microbiome and we are able to send out small quantities of implants and home kits to help restore the gut flora after such an event. But as we said, it is for past patients only.
Author – Enid M. Taylor ND (Doctor of Naturopathy), BSc (Hons) Psych.
Clinic Director at Taymount
The Taymount Clinic prides itself on offering excellent care and solutions for good digestive health. Pioneers in FMT, the Taymount Clinic is leading the way in donor programmes and FMT treatment options to patients with different health conditions. For more information visit www.taymount.com or call 00 44 330 222 1622