Antibiotics Carpet Bomb Guts, VLC Diets Starve Them: Case History DIY Fecal Transplant from Karen Pendergrass (#AHS14 Supplemental)

I’ve been razzing AHS a bit last couple of days. There was yesterday’s post on Survival of the Richest, and you can see what sorts of stuff I’ve been putting out on Twitter with the #AHS14 hashtag. Yes: stuff that ought to be being addressed at AHS, but either isn’t or is very underrepresented amongst what’s basically about the same stuff 4 years running now.

This next story was sent to me by Karen Pendergrass, creator of various Paleo Movement initiatives.

Karen Pendergrass is the Author of Eat paleo Save the World!; Founder and Executive Director of The paleo Foundation, Certified paleo, paleo Approved, and Paleo-Friendly Food Certification Labels; creator of the International paleo Movement Group on Facebook, and creator of The paleo Movement Online Magazine.

She’s given me permission to post it. Prepare to have your mind blown.


I sent this as a pm to Robb because I didn’t want you to know that I respected you one iota… I try not to, but I can’t help myself. On a personal level, I think you’re an off-base prick who throws tantrums because nobody really checks you. On a professional level, I’m anxious for the book you’re writing about the gut microbiome because it’s been a huge area of interest for some time now.

Anyway, here’s what I sent to Robb:

I went on a VLC diet for 3 months to “put out the fire” in 2011 (per Mat’s suggestion) to normalize insulin, cool PCOS, and reduce my chronic inflammation (remember when I looked like a balloon?) and to lose the 50lbs that came out of thin air in 2009. My little experiment didn’t work, in fact it backfired–my liver enzymes shot back up to danger zone, I still had glucose days regulation, PCOS, distention, and no change in weight.

Everyone, including myself, threw their hands in the air. But then I gained 9 lbs in a week on antibiotics and decided to research the shit out of why that happened to me, since I knew from previous studies that cows given subtherapeutic doses of antibiotics did the same, but I never asked why… Do you recall this email to you and Mat?

I learned a lot. My new experiment was to focus on gut normalization. I had a DIY, at-home fecal transplant, I went very high carb, high FOS diet for a week (jicama bender) and lo and behold… Loss of 25 lbs in one week. Oh, and I drank a metric fuck ton of orange juice after reading this awesome study about OJ and how it miraculously mitigates an inflammatory response after a high-fat meal. I fucking love OJ.

And much as I hate to agree with Nikoley here… I kind of have to. This is not to negate the clinical, either… This is to say those who are metabolically broken cannot—always—be fixed by carbohydrate limitation, and although this is a currently unfalsifiable hypothesis, I surmise that all people with metabolic conditions would be normalized faster if the focus was on gut normalization first, which may call for higher carbs and, god forbid, less meat. More than one way to skin a cat you know?

Now, I know I’m not the rule, I’m the exception. But even the exceptions must be taken into account when blanket prescriptions are made, like “when glucose regulation is an issue, limit carbs. DONE.” No disrespect love, I find that to be somewhat specious given what we’re learning about the gut microbiome.

And in light of the fact that some nasty, pathogenic, gram-neg groups (usually disproportionately high in T2D) produce 10x the LPS (if I recall correctly, let me double check) as other indigenous species, and how that effects hormonal fluctuations and, of course, glucose dysregulation/insulin resistance… Even red meat, in the presence of hypochloridia (as you know, it’s also common) can exacerbate the condition if it’s fermenting in the gut, breeding specific types of pathogenic bacteria while starving out the regulatory, colonic species.

At least, this explains my success on high-carb focus on FOS paleo and no success on low carb Paleo.


She ads, to me:

“So that’s it. If you want to see my studies/papers that got me to these conclusions I’m happy to share them. I might have some you don’t have yet, I’m not sure. But they are awesome.

“If not, suck it easy.”

I love straight-talkin’ gals.

Memberships are $10 monthly, $20 quarterly, or $65 annually. The cost of two premium coffees per month. Every membership helps finance the travel to write, photo, and film from interesting places and share the experiences with you.


  1. Mart on August 9, 2014 at 18:04

    I’ve said this before Richard: you need a glossary on your site to spell out all the acronyms bandied about in Every Single Post. I remember some of them but invariably forget those which aren’t used the most frequently, and it’s just plain annoying when it’s assumed that everyone knows what, for example, FOS stands for. – And all the rest of them. – Maybe someone can volunteer to make and update that list, though I’m definitely not the right person to do it…

  2. Lanie on August 9, 2014 at 19:00

    Very inspiring – thanks for sharing your story, Karen! Makes me want to do a FOS hack of my own.

  3. Nick on August 9, 2014 at 09:22

    Who’d was her fecal transplant donor?

    • Duck Dodgers on August 9, 2014 at 11:17

      Someone who was relatively thin, I would imagine :)

    • Richard Nikoley on August 9, 2014 at 11:38

      I’ll tell you what, people who’ve never had a round of antibiotics in their life could be sitting on some valuable shit. :)

    • LeonRover on August 10, 2014 at 04:36

      Organized “Sperm Donation” clinics has been available for some time.

      Surely it’s not beyond the wit of a member of Primal Docs to open a clinic which offers the service of providing intended donees with donations from donors of proven healthy donations. :) :)

      There has to be a plethora of potential donors in the AHS & Primal communities.

      After all, this is what happens when someone need a Sperm Donation.


    • gabkad on August 10, 2014 at 10:06

      Actually, they’ve studied the shit of little kids in daycare centres who have never taken antibiotics and their shit was still no good. I guess it’s the residual antibiotics present in meat and their mother’s gut microbiomes are also scrooged. And who knows how many of the little ankle biters were C-section babies. That was never mentioned.

      Maybe collecting shit from those supposedly never exposed to outsiders Amazonian tribes people would work? Try telling them : please leave your shit here. LOL!

    • Richard Nikoley on August 10, 2014 at 10:33

      It’s a good point, Gabs.

      Perhaps the most important thing is:

      Healthy adult, thin, good appetite, real food, omnivorous diet eater.

    • eddie on August 14, 2014 at 12:36

      your right here…….richard !!!!!

      Many who take amoxicillin get raised liver enzymes… <—— due to my genes…I blame antibiotics for 2 months(dental crown/implant) for my crohns diease ( due to the fact I have 4 genes 2 sets of HLA DQ2 gluten genes…. from all my testing on my self… I think its the amoxicillin ( yeast/mold type antibiotic ) every little tike gets growing up… which is causing gluten intolerance and milk intolerance due to the protein looking similar.. and kill off good bacteria…..of course not all are effected but depending on how many genes you have….which no one tests and noone looks at yeast… I know Im crazy :) but —-a non antibiotic user is A GOLD MINE…. the 2.5 years I spent killing yeast– i say from the antibiotic and seeding feeding and re growing my bacteria….. Im better then I was before…… I had crohns —to in lighten you have had some potatos and plantain chips and ZERO issues now…. antibiotics cause CDIFF and yeast over growth….

  4. Nick on August 9, 2014 at 09:24

    Oh, and “lost 25 lbs in one week”

    That’s hard to believe. Unless we’re talking 15 lbs of water, as even if you fasted you’d only lose 5-10 lbs.

    • Richard Nikoley on August 9, 2014 at 09:31

      No doubt it was a lot of bloat. I’ve seen this happen with people on steroid meds in the opposite direction. Unbelievable bloat where they’re not even recognizable.

    • Kyle on August 9, 2014 at 19:39

      @Richard – “No doubt it was a lot of bloat.”
      Bloat ….. or edema.
      Karen said, “…liver enzymes shot back up to danger zone,” Liver problems alone can cause significant lower leg swelling and with PCOS on top of that?


    • GTR on August 10, 2014 at 13:56

      Apparently a human breathes out 1kg of CO2 per day.

  5. Michelle on August 9, 2014 at 12:16

    What on earth is “jicama blender “?

    • Alan on August 9, 2014 at 12:22

      I think she said jicama “bender” … meaning she ate a lot of jicama for its FOS content.

    • Michelle on August 9, 2014 at 15:09

      Gotcha. Thanks!

    • John Es on August 9, 2014 at 17:32

      No, she said “BLENDER”, all part of the DIY FMT (just kidding).

  6. Resurgent on August 9, 2014 at 12:39

    Awesome story..!

    “..On a personal level, I think you’re an off-base prick who throws tantrums because nobody really checks you…”

    I think Richard pricks the inflated egos of many who throw tantrums – he tries and destroys dogma.. His ways are akin to a Zen master’s… almost meditative.

    In his own words – “He just likes straight talking gals” (and guys I suppose)

  7. Logical on August 9, 2014 at 16:07

    Anyone seen a photo of Jimmy at AHS14? If so, post a link here.

  8. WW on August 9, 2014 at 20:25

    How does one do a DIY FT? Enquiring minds want TMI.

    • John Es on August 10, 2014 at 07:31

      My first reaction to the DIY FMT idea was that it was pretty dumb. Here is an excerpt of Glenn Taylor of the Taymount Clinic when interviewed by Chris Kresser…

      …but what I needed to do was to understand why the process did and didn’t work in certain cases and why was it that home treatments – and I can understand why people do it; it’s out of complete desperation because it’s not available to them or the cost is prohibitive – why home treatments had relatively poor outcomes. I guess the answer lies in a very simple feature. It’s a simple biological fact that 90% of the gut microbiome is of a group called obligate anaerobes. Now, that quite simply means that they cannot survive in oxygen. If you expose them to an oxygen-rich environment, they die.

      … Of course, Taylor is interested in getting people to come to see him in London, but, he has some good points.

      On the other hand, if your dybiosis is really bad, what are the chances that you’ll make it any worse with a DIY treatment?

      Given some of the grim descriptions of life with IBD, I don’t know what I might do. I guess I should be grateful for my relatively minor issues.

  9. Liz on August 10, 2014 at 00:21

    Never commented before, but here goes…
    “same stuff 4 years running now”

    Yeah that sums it up for my journey. Weston A. Price, Fathead, Wheat Belly, Gary Taubes. Improvements here and there, but still got one life-long-fucker that just won’t go away: migraines. They have improved. Less frequent, less severe. I can even get rid of them sometimes with just ibuprofen. Back in 2003- I had to go to the ER multiple times to get any relief. So Ibuprofen is an improvement…

    But I still get migraines. And reading the same stuff over and over about low-carb, wheat-free, fuck-all just aint cutting it. So I stopped reading. No health blogs for weeks on end. There was a seed that I wanted to check out. PHD and resistant starch. But I was burned out, tired of the hope/disappointment cycle. Ready to just deal with the once a month migraine and give up on ever surpassing the three month goal (longest I ever went without a migraine in my 38 years on this planet).

    Then I returned to two health blogs. Fathead and yours. After weeks of going back and forth, I finally bought Jaminet’s book and am slowly reading it. I have at least three ideas I might try and I’m only on page 100.

    Maybe coconut oil and keto would help eliminate the remaining migraines. Maybe not. Maybe resistant starch. I fucking don’t know. But those ideas have a lot more science and logic behind than other shit I have tried- like magnet therapy. Can’t believe the money I wasted on magnets. Ugh.

    Anyway, I’m heading offline and going out for a bike ride with my hubbie. But just wanted to say that if you were spewing out the same shit as everyone else, I wouldn’t be taking the time to write this comment or read your blog. And I don’t give a shit about the ads on your site either.

    • gabkad on August 10, 2014 at 10:14

      Liz, have you tried those triptan medications? One of my patients uses almotriptan and it works. It’s literally life saver for her because otherwise she is vomiting and has to stay in a dark room for at least 1 day. She has classic migraine with unilateral pain in her forehead plus all the other horrifying stuff.
      It is not cheap but who cares if it works.

    • Gemma on August 10, 2014 at 13:23


      My sympathies, Liz.

      I can only offer my n=1 protocol which cured my life-long migraines (absolutely no attack in more then a year), composed of strict gluten-free diet + keeping the dietary approach described here at FTA: various fibers, no vegetable oils, healthy fats, some probiotics, lots of fruits and veggies, garlic, onions, chocolate, honey, coffee, keeping circadian rhythms, oil pulling with sesame oil, etc.

      Avoiding glutamate of course too, and definitely no ibuprofen never ever, as it destroys the gut endothelium and you are worse in longer term. Stop using it. A very cold shower is better then ibuprofen.

      You must combine fermented foods with some fats as there is natural level of glutamate there, and eating it alone is bad.
      What is 99% pure diet? Can you specify?

    • Richard Nikoley on August 10, 2014 at 14:07


      You need to write up something like “THE FTA DIETARY PROTOCALS according to a reader.

      Would be fun. This blog is such a mishmash of stuff and it would be cool to have a readers perspective on tidbits, putting it all together.


    • Gemma on August 11, 2014 at 05:51


      I apologise deeply, not much time at the moment to write a nutritional article.

      But I really feel with the migraine sufferers — you should know that it is possible to get rid of it completely. I have no problem with red wine now, I would not be afraid of travels or afternoon sun and all those triggers… Though in my case, removing gluten was the key and I do not know what would happen if I started eating a lot of gluten foods again.

      8 migraines a months – that sounds like a nightmare to me.

      There is a good overview on different factors in triggering migraine:

      “Role of magnesium, coenzyme Q10, riboflavin, and vitamin B12 in migraine prophylaxis”

      The full PDF is available from researchgate, just google it. Page 10 shows the complicated set of possible factors, each influencing the other. You need a good balance of all of them: magnesium, riboflavin, homocystein, cobalamin, folate, (vitamins A, D, K, too).

      Supplementing may help but what if you feed some “caged vipers” which steal your precious supplements or prevent their absorption? So in my opinion the way is to set the gut flora in the right balance, and the bugs will produce the vitamins for themselves, will not be forced to steal them and even leave some for you too.

      You cannot have balanced gut flora on restricted paleo diet or god forbid, keto diet. Perhaps you are on a pill, who knows, all that matters and plays a role. And good sleep and exercise and all that is needed too…

      Avoiding glutamates is important as in some people it interferes with folate metabolism. And folate is not the same as folic acid in supplements. Good set of articles here:

      Hope it helps.

    • eddie on August 14, 2014 at 12:52

      some tips….

      do the migraines appear around the time of your period… before or during?>?

      damp day or dry in house….ever do a mold test

      many foods can give you migraines , you may not even know you have a problem to a food.

      Several food proteins are simular to gluten….everyone jumps on the gluten removal bandwagon , it works… but yeasts and gluten hwp1 proteins are simular ….as well soy and milk ….so the next time you get one look at all of the above 2 years of me removing gluten…lowering yeast replacing them –raising bacteria have aloud me to bring some back in my diet along with BEER!!!! again

    • eddie on August 14, 2014 at 12:56

      and I havent had a migraine in over two years….one hangover 4 months ago..

  10. Nancy on August 10, 2014 at 11:54

    Migraines are complicated to cure completely. I’ve been fighting them for 20 years. My diet is 99% pure so I can’t get one from diet any more with that 1% being some sauce I didn’t predict in a rare meal cooked by someone else. I can’t touch anything with a whiff of MSG in it. I can’t have any alcohol except kombucha. I can only eat max 1 tbsp of fermented vegetables.

    But migraines also come from: ill health (an infection or virus will cause one), climate (as in a new one, even leaving my coastal environment for a dry, hot microclimate an hour away), travel (airplane), and weather (a big change of wind). I can’t prevent these.

    I have prevented one of the worst causes, hormonal fluctuations, by regulating my hormones with bioidenticals.

    So even with precautions one can take, I still get about 8 migraines a month. I do use one of the Triptans for each migraine I actually get, and they magically remove them in an hour if I take them soon enough – the first sign the migraine is coming on.

    Triptans are similar to each other but with different side effects; try many and choose the one that has the least side effects for you. The generic one has the most side effects, so try samples of the costlier ones (yr neuro should provide a few). I love Frova – if they had TV commercials I could do them, because they allow me to live my busy life. I have worse side effects from Advil – it makes me sleepy and nauseous. Frova for me makes my joints ache for a few hours, and increases urination for an hour or so, so I try not to take one before a long drive. But the pain is completely gone instead of my thrashing and moaning in a darkened room with what feels like an ice pick lodged in my temple.

    I’m sure they aren’t good for you but they don’t make you feel at all drugged, and they get completely rid of that pain.

    • Richard Nikoley on August 10, 2014 at 12:07

      Wow, feel for you folks—seems disproportionately women—who have these things. As a kid, I watched my mom faint from one.

      I’ll never forget her grasping her head, saying “my head,” and collapsing on the floor.

      She seems to have grown out of them. Me, I get headaches so infrequently that it’s really weird when I do. I think they’re probably mostly what are called “tension headaches.” Anyway, plain aspirin always does the trick 2-3 times per year.

      Hate to seem like gloating but hell, it’s strange to me, haven’t a clue, and knowing how even these small headaches can be, I really feel sorrow for that.

      Wish someone would figure it out.

      If I were you, I’d try everything, even drinking a quart of OJ or something.

    • Craig on August 14, 2014 at 03:27

      I have never personally suffered from migraines, however I have read several times over the years how psilocybin mushrooms can offer profound relief :

      “These sufferers do not want to trip. They want relief. Just a quarter of what would be considered a recreational dose is effective for stopping their headaches.”

      Obviously this might be a rather extreme measure for some, however if someone has been suffereing for years then they might be open to the idea. You could travel to The Netherlands for example and buy psilocybin truffles legally and try it out.

  11. LeonRover on August 10, 2014 at 22:27

    Hmmm – quart of OJ’s what ?

  12. Charlie on August 11, 2014 at 05:09

    LeonRover says:
    Hmmm – quart of OJ’s what ?

    Ray Peat says – what ???

    • LeonRover on August 14, 2014 at 06:25

      RayPeat – what ?? what ??

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