2024 In Review: Would You Buy Poop On the Internet?
27:17 Share

This episode is brought to you by LifeLock. The holidays mean more travel, more shopping, more time online, and more personal info in places that could expose you to identity theft. That's why LifeLock monitors millions of data points every second. If your identity is stolen, their U.S.-based restoration specialist will fix it, guaranteed, or your money back. Get more holiday fun and less holiday worry with LifeLock. Save up to 40% your first year. Visit LifeLock.com slash podcast. Terms apply.

This episode is brought to you by AWS. Amazon Q Business is the generative AI assistant that can securely understand your business data, summarize results, and streamline tasks. Learn what Amazon Q Business can do for you at aws.com slash learn more. Hey everyone, it's Lizzie. Earlier this year, Slate's Luke Wienke wrote a story all about poop. Okay, technically, it's actually about what's called FMT, fecal microbiota transplant, which...

To put it as simply as possible is the process of getting someone else's poop inside your body to fix problems with your gut.

What Luke found was an unregulated marketplace for buying other people's poop and a DIY community that was desperate for relief, often after the traditional medical system had failed them. So yes, it is a story about poop, but it's also a story about our broken healthcare system and the lengths people will go to to find the care that they need. I hope you enjoy it. A few months ago, my colleague Luke Wienke met a woman named Alexandra.

Alexandra is a 66-year-old retiree on the East Coast who basically told me that she suffered from a large variety of gastrointestinal problems, your IBS, your cystitis, you know, a bunch of bad gut stuff. Stuff that her doctors couldn't seem to figure out. And...

In her journeys through conventional medicine, she felt she was kind of turned away or ignored, felt like she was kind of regarded as an anxious old woman. And that caused her to look elsewhere. And that caused her to discover FMT. FMT. That's fecal microbiota transplant. It's basically exactly what it sounds like. Putting good microbes into the body of a person whose gut is out of whack.

How they get them in there, though? Meh. Here is a doctor who does it at the Mayo Clinic. One way to restore that is to take the healthy bacteria that normally live in the colon from a healthy person and reimplant those back into the colon of the sick person. A little gross in concept, but fine. It makes sense. Except Alexandra wasn't eligible for FMT in a hospital setting.

So she did what a lot of people do these days. She went online. If you go to certain subreddits or certain Facebook groups, you'll see people posting

You know, doing this completely independently all by themselves. I remember I read a very memorable thread on the subreddit about a guy being like, yeah, you know, so I've been getting my dad's poop. But it goes beyond just gut ailments. There are people you will see on these FMT communities that believe that superior gut health or gut bacteria could solve their schizophrenia or their depression or their...

Just basically any sort of ailment beyond, you know, what you might logically think an FMT might solve, which is, you know, gut problems. And that is how Alexandra found herself paying more than $1,000 to order a stranger's feces off the Internet. Today on the show, inside the online black market for poop.

I'm Lizzie O'Leary, and you're listening to What Next TBD, a show about technology, power, and how the future will be determined. Stick around. This episode is brought to you by Public.com. Did you know you can lock in a 6% or higher yield with a bond account at Public.com?

The Federal Reserve recently announced rate cuts, and there could be more rate cuts in 2025. That's good news if you're looking to buy a home, but it might not be so good for the interest you earn on your cash. So if you want to lock in a 6% or higher yield with a diversified portfolio of high yield and investment grade bonds, check out public.com. It only takes a couple of minutes to sign up. And

And once you lock in your yield, you can earn regular interest payments, even as rates decline. Lock in a 6% or higher yield with a bond account at public.com forward slash what next. But remember, your yield is not locked in until you invest. Brought to you by Public Investing, member FINRA and CIFIC. As of September 26, 2024, the average annualized yield to worst across the bond account is greater than 6%.

Yield to worst is not guaranteed, not an investment recommendation. All investing involves risk. Visit public.com slash disclosures slash bond dash account for more info.

This podcast is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy. Just drop in some details about yourself and see if you're eligible to save money when you bundle your home and auto policies. The process only takes minutes and it could mean hundreds more in your pocket.

Visit progressive.com after this episode to see if you could save. Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states.

The kind of FMT that that Mayo Clinic doctor was talking about is for an infection called Clostridium difficile, also known as C. diff. A fairly common and fairly pretty, you know, gnarly bacterial infection that can be caused by a variety of different things. And one of the things it can be caused by is an antibiotic that you might take that might

kind of purge your guts of this good bacteria. So it's like your gut got nuked by some other antibiotic, and the idea is that the FMT can reseed it with healthy microbes. Yes. And by the way, I think this also adds to some of the mistrust that people that are interested in this stuff might have of conventional medicine, because if I was told that

oh, the reason I'm having this horrible abdominal crisis is because I was prescribed an antibiotic a couple years ago. That just might get you thinking about the medical apparatus in a slightly different way, I think. Is FMT legal? It is legal, but only for treatment for C. diff and only if other treatments have failed. So if you have C. diff and you went through more conventional treatments, those don't work out.

then you might be able to get approved for an FMT. That said, there are a wide variety of experimental, you know, FMT treatment for a huge variety of things. At hospitals in conventional ways? Yeah, at hospitals, done by universities. There's a stool bank called Open Biome that supplies a lot of well-screened poop because this poop does need to be well-screened.

And you can, there, there's been, there's been evidence that FMT could, you know, maybe help with Crohn's disease or even things like, like autism symptoms. Like there has been some legit research to say that this stuff could work. The research is all super early. And again, everything is only approved for C diff. But when you read those studies and you're something like Alexandra, maybe that gets you thinking that, man, if I could only get this, then that's going to solve these problems.

That longing for a treatment combined with frustration with doctors and the open nature of the internet creates the perfect conditions for a DIY community. So the thing that's funny about FMT is just how low tech it is in the sense that the gray market could be as simple as I'm going to go get some poop from someone and they're going to hook me up with that. But human microbes, which is the preeminent gray market for poop on the internet, was founded in 2020 by this guy, Michael Harrop, who has...

Been around in the FMT community for a long time. That's what he told me. He's been on these same forums and places that something like Alexandra has been to. And he got the idea that he could kind of create this network on the internet to hook up prospective donors with prospective buyers where he's going to

send out a lengthy questionnaire to people that want to donate poop. If through this questionnaire, it looks like they have quality poop. If they haven't had an autoimmune disease, if they, you know, all these different factors, if they pass this, this questionnaire, then someone who wants an FMT can go to this big Google doc and be like, that's that guy right there. I want the six foot two guy that's, uh, was a swimmer in high school. I want to buy some of his poop.

Human Microbes also has a pretty killer YouTube channel where they advertise for donors. We want your poop. No, we need your poop. Let me explain. I'm with humanmicrobes.org and your poop could change someone's life. Yeah, so back to Luke.

Who is the ideal fecal donor? According to another website that Michael Harrop owns called humanmicrobiome.info, the ideal donor would be a 16-year-old Michael Jordan, I believe is what he said. Someone who is just this, you know, the peak of the human genome and also who's young enough that has not had any antibiotic treatment. Now, again...

This website is run by someone who does not have a background in medicine, who he told me he dropped out of high school because of a variety of his own kind of gastrointestinal problems. That's the thing that, like, I think colors a lot of this community is there is if when you interact within the medical world, right, you're just told stuff all the time that doesn't add up in your own kind of layman's understanding of medicine. Like, I don't really know how.

my Advil works or how an anti-inflammatory is going to help my headache. I just trust it. In this world, there is like kind of like an A to B to C that I think people find comforting of like, I'm sick. I'm going to just take out, I'm just going to put good bacteria in me from someone who clearly seems healthy and that's going to make me better. There is a, there's like a logic to it that I think people can follow that I think people find kind of calming in an odd way.

Human Microbes even created a Google spreadsheet of all its donors so potential recipients can learn about them. The document lists their age and location, sometimes hobbies like the nurse who does CrossFit, and the all-important, somewhat graphic descriptions of the stool samples they are selling. Like any good internet product, there is a place for user feedback. They have little reviews. The people that purchase stool from Human Microbes can leave a

Basically, they can say how they were feeling, what their symptoms were before they started inserting this poop into their body and how they felt afterwards and what the results were. And that can range from people saying, my gas got way worse. It can be like people saying, all of my symptoms got way better. My libido dropped.

All this difference of a very rudimentary version of like, you know, like a like a clinical test, I guess, is what's what is going on here. When we come back, why doctors think DIY FMT is completely nuts. This podcast is brought to you by Progressive Insurance.

You chose to hit play on this podcast today? Smart choice. Progressive loves to help people make smart choices, and that's why they offer a tool called AutoQuote Explorer that allows you to compare your Progressive car insurance quote with rates from other companies, so you can save time on the research and could enjoy savings when you choose the best rate for you. Give it a try after this episode at Progressive.com, Progressive casualty insurance company and affiliates. Not available in all states and situations, prices vary based on how you buy.

♪ ♪

Bored with your boring cardio? Stop pedaling that snooze cycle to Nowheresville and try some cardio that's actually fun. Supernatural Fitness, available on MetaQuest. Isn't that right, Jane Fonda? Cardio will never be boring again. Sweat to the beat of thousands of chart-topping songs inside stunning virtual landscapes. Bet your stationary bike can't do that. Visit GetSupernatural.com and join the next fitness revolution. Supernatural VR Fitness, only on MetaQuest. Wait a team for team.

Slate Money is a weekly discussion of the most important stories in the world of business and finance. Over the past 10 years, we've become known as the place to go if you want to understand what's going on in business or if you just want to laugh at some of its successes. So if you want a podcast that doesn't turn CEOs into heroes, listen to Slate Money with me, Felix Salmon, and my co-hosts, Emily Peck and Elizabeth Spires, every Saturday morning, wherever you get your podcasts.

How much are people paying to get poop? And how are they doing this? Are we talking oral capsules or enema? Yeah, so Michael told me that the average order is $1,000 and he splits it evenly between the donor and himself. And...

You can go both routes. There is an upper route and a lower route when you purchase poop from human microbes. The other important thing to know with human microbes is the poop that this guy is selling, this website is selling, Michael Harrop doesn't handle any of it. It is peer-to-peer. He kind of agents it. It's like Facebook Marketplace for poop. Exactly, yeah. So if you are a donor, you are...

harvesting your own poop and then putting it in your freezer until you get an order for someone wants to buy your poop. Then you're going to put that in the mail in dry ice and send it to whoever is buying. So it's an ad hoc third-party situation. Is there any screening or testing or any of that kind of thing? Michael says that he does require his donors to pay for a fecal test to scan for certain, you know,

certain diseases, certain bad actors in the stool, but...

That does not seem like it's a priority to me. It really kind of comes down to if you pass this questionnaire, which, again, it's an online questionnaire. I wouldn't say that's the most bulletproof way to screen for poop. However, I mean, like, I will say within the FMT, the more kind of above-ground FMT world, screening is a huge part of the deal. Like, one of the sources I talked to joked that to be approved to be a poop donor for him, it's, like, as hard as getting into Harvard. Like, it is that difficult to have...

you know, to be qualified as someone who has superior poop. There are two ways to do FMT yourself. You can ingest a little capsule of fecal matter or go the other route, an enema. And I apologize for what you are about to hear. This poop is put on ice in the freezer and, you know, then sent out to, uh,

someone who's buying it. And that can be in the case where they are sent out in the sense that the person who's the donor has very carefully put their poop into a series of capsules they purchased off of Amazon, or it can just be a straight up turd that's been frozen and then defrosted. And then you mix it up in your saline solution and put it into your butt. So you can just be buying a literal piece of poop.

I'm sorry. I really had it together until you said turd. It's true. I mean, that's that. I think that's the best way to, you know, that is, it should be like important to note here that there is literal pieces of poop being put in dry ice and sold through the USPS. And it might work, you know, maybe it, maybe it's going to be great.

When you talked to doctors who do FMT or who study FMT in like a university setting, what did they say about this bootleg community? One of the doctors I spoke to who works at the Mayo Clinic, I believe his quote was, horrible idea, terrible, terrible idea. Yeah.

And for him, it just comes down to the fact that this stuff isn't screened and it's against FDA regulations, all the stuff you'd expect. Another doctor compared getting a bootleg FMT to kind of like getting like a bootleg blood transfusion, you know, where you just aren't going to really know

exactly what the makeup is in someone's body if you're just getting someone else's blood and putting it in you. And there's reasons to worry about that. You know, there have been people who have, you know,

died after getting an FMT. We don't know if it's a... There's debate whether or not it was caused by that. Not from human microbes, but just from FMT in general? Yeah, there was a documented case. It caused the FDA to put out a regulatory warning, kind of reinforcing the need for better screening for this stuff after a handful of people got sick and a couple of people died.

after receiving FMT that caused them to develop an E. coli infection. Now, again, we don't know if they died because of that E. coli infection. That is up to debate. But the fact is that people have gotten sick, I guess, at the very least, from FMT. When you talk to Michael Harrop, who owns Human Microbes, what did he say about the dangerous part of this?

Michael Harrop likes to reinforce that this is all very untested science, that we are in a black box here, that this is all very experimental. Michael Harrop has even told me that he, someone who suffers from a variety of ailments similar to Alexandra, has not found an FMT donor for him that has allowed him to feel better, that he still suffers from all these problems, that he has not found the correct fecal makeup to

assist with all his all his ailments. But he still believes in FMT. Still believes in FMT and even Alexandra when I talked to her she did end up feeling better after getting this treatment but had no idea it wasn't like this poop arrived to her doorstep being like alright take

One capsule every week for five weeks. And that's, you know, and then we're going to check back in. It was just basically up to her to kind of experiment with this stuff. Everyone is kind of on board in the bootleg community that we're all kind of experimenting here and figuring it out on the fly. There is like kind of like a communal understanding of that. And I think that that allows for people to be more okay with the mishaps in a way.

Like Luke said before, the one organization that is not cool with just figuring it all out on the fly is the FDA. When the agency learned about Harrop's underground FMT business, they sent him a letter telling him to knock it off. The FDA cracks down on the Dallas Buyers Club of Poop. I believe that's what he said to me. And he told me that he received a letter from the FDA investigating his practice. Basically, the FDA, I think accurately, wrote a letter to Michael saying,

listen, you can't be selling this without certain licenses. And also you are selling FMT treatments for things that aren't C. diff, which is, again, that is the core thing with FMT treatment right now. It can only be used for C. diff. Michael Harrop in Human Microbes is not doing that. He told me he's set to meet with the agency in a few months and we'll see where he goes from there. But I don't feel super optimistic about the future of Human Microbes.

You raised the idea of Dallas Buyers Club, right? The idea that an informal group of people can try out a novel treatment. Back then, they were talking about AZT and AIDS, a number of AIDS medications. And that turned out that they were right, that those medications did help with HIV and AIDS.

Is it possible that in 10 years, 20 years, there will be a version of FMT that is used more widely that the FDA stands behind? Over the course of reporting the story, I've become like an FMT believer. Like, I, like, am fully convinced that we actually are on a...

on the cusp of like a medical revolution. A lot of really smart people are excited about there's all this research getting poured into it. Do I think it's going to be via, you know, untested, unscreens, bootleg poop flying around the country? Probably not. But like, I don't know, man. And maybe it's like, I'm probably a little bit more like, I think I have some woo-woo tendencies myself when it comes to medicine. So maybe I'm like more predisposed to believe in this stuff. But like,

You know, I talked to this one dad who has a son who has autism and he flew down to Mexico and got his son an FMT because you read this stuff that maybe FMT can reduce autism symptoms. And he said it worked that his son, you know, became more responsive, all this stuff after getting an FMT treatment. I kind of like laughed it off. You know, that sounds like quackery. I think we encounter that stuff all the time.

And then you do some Googling and you see that, no, there's actually some real studies out here that like FMT has like reduced autism symptoms. One study done by Arizona State University, like a legit university. I kind of want, I find myself wanting to believe it. I want to believe that like that fecal transplants could be the thing that can make us all healthier. It just seems like a

a more natural way to become healthy. If all this stuff becomes, like, true, I'm on board. You're shaking your head. You don't like this idea. Well, you just sound like you're doing your own research on the internet. I mean, a little bit, but also, like, you know, like, the fact that, like, some real medical practices are taking some of the stranger and crazier evidence or research in this field seriously, I don't know. I just...

I find myself more convinced than I expected to be going into the story. Luke, thank you for talking to me about this and making me say poop repeatedly. It's my pleasure. Happy to be here.

Luke Winkie is a staff writer at Slate. And that is it for our show today. What Next TBD is produced by Evan Campbell, Patrick Fort, and Shana Roth. Our show is edited by Paige Osborne and Rob Gunther. Alicia Montgomery is vice president of audio for Slate. And TBD is part of the larger What Next family. And if you like what we are doing here, even with the poop...

I have a request for you. Join Slate Plus. It is the best way to support our work. Just head on over to slate.com slash whatnextplus to sign up. We'll be back next week with more episodes. I'm Lizzie O'Leary. Thanks for listening.

The most wonderful time of the year. Although, let's be honest, around the holidays, things really add up. But here's the good news. Only at Verizon, you can get a single line for $50 per month when you switch and bring your phone. So while ice skating for two is definitely costing more, here at Verizon, you can save. Gifts for your third cousins? Steep.

A single line with Verizon, not so steep. A real tree, pricey. A single line with Verizon, less pricey. Flights to see Meemaw and Pops, those are up. A $50 per month single line, that's down. Even a trip to the San Francisco Holiday Market will cost you more. But with Verizon, you can switch and bring your phone for just $50 per month for a single line on unlimited welcome with auto pay plus taxes and fees.

All this to say, during the holiday season, when everything is costing more, you can get more for less right now at a local Verizon store. $15 monthly promo credits applied over 36 months with a new line on unlimited welcome. In times of congestion, unlimited 5G, 4G, LTE may be temporarily slower than other traffic. Domestic data roaming at 2G speeds. Additional terms apply.

Hey, Slate listener, this is Mary Harris from over at What Next, Slate's daily news podcast. I'm here to remind you that at Slate, we are here to help you make sense of what comes next.

With Slate+, you'll get unlimited access to the tools you need to navigate this moment. That includes exclusive episodes of Amicus, which unpacks the legal battles shaping our future, and Political Gab Fest, where the biggest questions about our political landscape are tackled with depth and a sense of humor.

Plus, you'll get ad-free listening across all your favorite Slate podcasts, including my show, What Next?, where I connect the dots on the day's headlines. It's really easy to join. Subscribe to Slate Plus directly in the Apple Podcasts app or on Spotify. You can also visit slate.com slash podcast plus to get access wherever you listen. We've been here before. We can make sense of what comes next together.