Microbiome Transfer

What Is It?

In a microbiome transfer, also called a stool transplant or FMT for short, processed stool from a healthy donor is transferred into the patient's gut, for example by enema, during a colonoscopy, through a tube or as a capsule. The goal is to bring the gut flora back into balance. So far, the procedure is approved only for recurring infections with Clostridium difficile, with cure rates of over 80 percent.

Why the Gut Matters in Parkinson's

Many researchers assume that in some patients, Parkinson's begins in the gut ("body first"). According to this idea, the diseased alpha-synuclein first forms in the gut and travels to the brain along the vagus nerve. A study by the Karolinska Institute (2017) found that people whose vagus nerve had been cut were less likely to develop Parkinson's.

In Parkinson's, the gut flora is often changed:

• Too few bacteria that produce butyrate. Butyrate is the most important energy source for the cells of the gut.
• Too many Desulfovibrio bacteria. They produce hydrogen sulfide and inflammatory substances, and in a study by the University of Helsinki (2023) they promoted the clumping of alpha-synuclein.
• A leakier gut wall that lets bacterial toxins get into the blood.

What Does the Research Say?

The picture is mixed, but promising:

• Belgium, GUT-PARFECT (2024): 46 patients in the early stage. Twelve months after a single transplant through a nasal tube, motor function had improved much more than in the placebo group (Lancet eClinicalMedicine).
• Finland (2024): 48 patients, transplant by colonoscopy. No difference in motor function, and for constipation the placebo group actually did better.
• Australia, Adelaide (2025): repeated doses over six months. Daily off time went down, and the treatment was safe.
• China (2026): 72 patients who, like me, were not yet taking any Parkinson's medication received the transplant in three cycles. After 35 weeks their UPDRS Part III had improved by almost four points, while it stayed the same in the placebo group. Digestion also improved clearly.

The treatment is considered safe and well tolerated. The results are not yet enough for a standard treatment. The way it is given and the number of repeats may be what matters.

My Experience

So far I have had four microbiome transfers:

1. November 12, 2021, Leipzig: enema with 200 ml from a young, healthy donor. The doctor also advised me to avoid foods containing gluten, and I changed my diet to a large extent. By early 2022 my gut flora had improved clearly.
2. September 19 to October 10, 2022, IPPM-Klinik in Slovakia: ten smaller enemas of 20 ml each. Afterward, the results were clearly better again.
3. June 18, 2024, Thüringen-Kliniken Saalfeld: 350 ml with Prof. Dr. Peter C. Konturek, after my results had gotten somewhat worse again in early 2024.
4. May 4 to 20, 2026, Institut IM3 in Wuppertal: for the first time as capsules with freeze-dried donor stool, in three doses of 50, 30 and 20 capsules, one week apart.

I never had any side effects. After the first transfer I felt that things took another step forward. My stool results have been good ever since.

My Values (March 2026)

I have my gut microbiome tested regularly by medivere. You can find all the reports under Microbiome Tests.

• Diversity (Shannon index): 5.38, well above the minimum value of 4.6
• Dysbiosis rating: good
• Butyrate producers: 15.9 (normal range 11 to 19), otherwise typically low in Parkinson's
• Firmicutes/Bacteroidetes: 3.2 (normal range 2.9 to 4.8)
• Desulfovibrio, critical subgroups: not detectable

A microbiologist wrote to me about this: in most Parkinson's patients the butyrate producers are reduced, but in my case they are even strongly represented. "From a microbiological point of view, I would say: looks good."

Effort and Costs

One treatment costs around 1,000 euros. Private health insurers cover part of it. In Germany only a few doctors offer the microbiome transfer for Parkinson's, and some refuse because it is not approved for that. It is important that the donor is thoroughly screened for pathogens. Doing a stool transplant on your own is dangerous and is absolutely out of the question.

My Conclusion

For me, the microbiome transfer is one of the three most important building blocks, together with exercise and TPS. If you are thinking about it, go to an experienced doctor and have your own gut tested first.