Ordering FAQ

We curate a list of currently available stool donors. You can choose your donor and order from as many donors as you’d like. However, it costs $1000+ for stool & blood testing for each donor. These costs are split between recipients.

Only “active” stool donors have gone through the blood & stool testing. So in most cases, if you’re not choosing an “active” donor then you would be responsible for the full $1000+ to test that donor.

We generally cannot combine stools/capsules from multiple stool donors into one order. This is because the stool donors are shipping directly to you. So you’ll have to put in a separate order from each donor you want to use.

Recipients who do not need donors to have gone through stool & blood testing can order from “inactive” donors, but it may take time and extra costs to figure out the logistics for new donors.

Stool donors are roughly ranked on our donor list. But rankings are difficult and speculative. There are many unknowns, and FMT is highly experimental. One of the main tools you have is looking through our stool-donor-results spreadsheet on our Orders page.

It’s generally not possible to predict which stool donor will be best for any person or condition. Even people with similar conditions often get varying results from the same stool donor.

We have not yet identified a super-donor that is highly effective for most people.

You’re welcome to join the effort by spreading our flyers in person and on social media.

There are differences between everything. Sex, race, living conditions, living location, diet, race, ethnicity, etc.. And there are even bigger person-to-person differences. The vast majority of these differences in the studies are on the genus level of bacteria, and are merely different percentages of genus-level bacteria.

There is no good evidence that these differences matter for FMT safety or efficacy. Universal stool donors are as effective as any other type of donor. Stool-donor matching is purely speculative, and should not be focused on until basic donor quality criteria have been met (which no study to date has done).

Age-matching may be the one exception, so far as to prefer younger stool donors for everyone: HumanMicrobiome.info/Aging

Please see HumanMicrobiome.info/FMT

We provide anonymized questionnaires & test results. And we’re currently providing anonymized physical fitness & stool pictures, but we may not in all instances.

We also systematically & publicly track and report results.

Generally, there are:

• Premade FMT capsules.

• Stool samples that are split up into small pieces (10+) that can be individually defrosted and used.

• Premade enemas (1 enema = 1 piece of stool mixed with saline or saline+antifreeze).

Generally, this would be all anyone would need. But if you’re interested in some other preparation you can let us know.

We ask donors to try to split up each stool into at least 10 pieces, but ultimately it's up to them. Our donors have leeway to set their own prices, etc.. But we'll try to provide as good of an estimate as possible of what you could expect to receive. A single donor's stool can vary significantly in size.

One teaspoon of stool can be enough for one upper or lower route dose, but you can use more as well.

We can add saline to make a ready-to-use enema, but water crystallizing during freezing is what damages microbes. So it’s probably best to add antifreeze in this case.

It depends on a few things:

• What/how much you order

• The stool donor’s availability at the time

• How many other orders the donor currently has to fill

• What country you’re in

On average it’s about 1-2 weeks, but for recently-activated donors, or donors who are in higher demand, it can be around a month.

We will give you a heads-up if a donor has a long waitlist. You can also request an estimate.

We process orders in the order they’re paid for. So the way to get on the “wait list” is by finalizing your order.

In the US we use “next day air” shipping. To Canada, it varies between 1-4 days. Other countries can be 2 to 9 days.

International recipients may have to wait a little longer since we only ship internationally on Mondays to avoid weekend delays.

Antifreeze is added to protect the microbes from freezing damage. However, it’s not entirely known how important this is for FMT efficacy. And adding antifreeze dilutes the amount of stool you get per capsule. So we leave it up to you to decide.

By default, we’re using maltodextrin, since glycerol/glycerin is a laxative. But you may request glycerol.

The antifreeze mixture makes the end product much softer, so if you intend to make your own capsules, you might find it more difficult. If you let us know beforehand we can make it firmer. We could also do pure glycerol, which should reduce the issue of capsules melting.

FMT is highly experimental and there are no standards or recommendations in this regard. Dosing and length of treatment vary greatly in clinical trials. There are reports of long-lasting benefits after a single treatment or less than a handful, but most people will probably need many months of daily FMTs.

Anywhere from 1 to 60 capsules per day is a reasonable dose.

I personally do a daily oral dose (about 5-10 capsules) first thing in the morning on an empty stomach with water or saline 1-2 hours before a meal. And a once-per-week deep retention enema. I use around 1 tsp to 1 tbs per dose. With the larger amount being for the lower route.

HumanMicrobiome.info/FMT is kept up to date with the latest research for you to review and decide for yourself what you’d like to try.

There are detailed directions with pictures and videos at HumanMicrobiome.info/FMT.

For FMT capsules, you can simply swallow them with food or water. It may or may not be best on an empty stomach.

You do not need to thaw stool before taking it orally. For the lower route, fast-thaw is best by putting the frozen stool into room-temp water/saline.

For the lower route, you can defrost a piece of stool by placing it into a zip-lock bag with filtered water or saline, and let it sit till it becomes a usable liquefied solution. You can then perform a deep retention enema.

If you would like to make your own FMT capsules, you can defrost a piece of stool by placing it into a dry zip lock bag, removing the air, zipping it shut, and placing the bag in room-temperature water till it thaws. Stool sizes vary, but a medium-sized stool could probably make hundreds of capsules.

Stool donors are trained to make the FMT capsules and samples. They store them in their standard freezer unless otherwise specified/requested. There is the possibility to request things such as putting it on dry ice immediately, using vacuum-sealed bags, etc.. There may be extra costs associated with those options though. For example, dry ice costs around $10 per day. And if you’re going to store it in your standard freezer anyway, it may not be worth the trouble.

For vacuum sealing, you’d either need a $50 kit at home so you can reseal them each time, or we can put each piece of stool in a separate vacuum-sealed bag.

Shipping is generally done with dry ice, which keeps the stool frozen at -80 °C. But we can usually ship fresh stool domestically, via next-day air, using ice packs instead.

Our default FMT capsules are double encapsulated, vegan, delayed release. Size 0 inner, 00 outer. For a child, you could request to forego the 00 outer so it’s easier for them to swallow.

We try to use environmentally friendly, biodegradable, non-toxic options as much as possible.

For example, we’re using compostable zip lock bags for both health (microplastics) and environmental reasons. Unfortunately, they’re not durable or long-lasting, so we have to encase them in a second, stronger plastic bag (and/or cardboard box).

We use small cardboard boxes to protect the contents during shipping, instead of plastic containers.

If you have other suggestions, please let us know!

It is not entirely known. It should stay safe for years, but efficacy may decline over time. Personally, I found that a sample stored for over a year didn’t seem to lose any efficacy.

If you use a vacuum-sealed bag and re-seal it after removing a piece, that should protect against oxygenation/freezer burn. You can find vacuum seal kits for around $50. Our tests have not shown a significant benefit from vacuum sealing.

If you purchase a sample mixed with antifreeze that should provide extra protection as well.

Freeze-thaw cycles damage microbes, so once you thaw any portion, it’s best to use or refrigerate it, and not refreeze it.

Our preferred method of payment for the US is Zelle, which is an instant way to send money that is integrated into most of the big banks and has no fees. We can accept Venmo as well (+2% fee). You can also mail us a check via your online bill pay, but there's some extra delay with that.

Paypal is an option but comes with higher fees.

For people outside the US, Wise.com is a cheaper option than Paypal. Here's a tutorial: youtube.com/watch?v=iiW9vH9RO4k.

It's also possible to do a bank transfer if you prefer.

Almost everything to do with Fecal Microbiota Transplants (FMT) is covered here:

• HumanMicrobiome.info/FMT

If you don’t see an appropriate category in the table of contents try searching the page for a keyword.

Want to engage with other recipients? Join us on the Human Microbiome forum!