Constipation is one of the most common and earliest companions of Parkinson's disease, and it is often what spoils everyday life the most. This is the point at which microbiota transfer therapy (MTT) shows a consistent result in the studies. For the motor symptoms, by contrast, the data are contradictory — this page states that, it does not skirt around it.
Parkinson's disease is not only a movement disorder — digestion often gives a signal years earlier.
Most people living with Parkinson's disease live with constipation and in many of them this complaint comes years before the first tremor or difficulty with movement. It is not an incidental symptom: it reduces quality of life, makes the absorption of medicines more difficult, and can upset the whole rhythm of the day.
The mechanism behind this is the gut–brain axis. In Parkinson's disease the protein (alpha-synuclein) that causes the characteristic changes in the brain also accumulates in the bowel wall, and there is a connection between the two along the vagus nerve (nervus vagus).725 In an animal experiment the presence of the gut flora proved necessary for the motor symptoms to develop at all.198
In humans, too, it can be shown that the gut flora of people living with Parkinson's disease differs: certain bacterial families recede, others become enriched, and the extent of the difference goes together with the severity of the symptoms.384, 803
The aim of MTT here is not to halt the disease, but to put bowel function in order: to ease the constipation, the bloating and the digestive discomfort. According to the studies this is the area with the most consistent result. The details are discussed in the evidence section of this page and on the scientific background page.
This is not a diagnosis and does not replace a neurological examination — but in one minute it shows whether it is worth getting in touch with us.
In the case of dysphagia (difficulty swallowing) we do not start a course. The preparation is a capsule, and in Parkinson's disease aspiration — food or drink going down the wrong way — is a real, serious risk. If you have difficulty swallowing your tablets, or you cough or choke while eating and drinking, please tell us in advance: in that case a speech and language therapy and neurological assessment is needed first.
In the same way, specialist care comes first in the case of bowel obstruction or a gastric-emptying disorder with retention, a sudden deterioration in condition, suspected aspiration pneumonia, significant unintentional weight loss or malnutrition, a severe orthostatic drop in blood pressure, or cognitive decline of a degree that rules out informed consent.
So that you know when things happen and where the decision points are.
Recording the patient data, filling in the “Goals and expectations” questionnaire, and a telephone consultation if you wish. Once the decision has been made, the compatibility test starts — and with it the microbiota transfer, since the test itself is low-dose MTT.
We evaluate the test, select the appropriate LOT, and fill in the exposome questionnaire together. The stool and symptom diary shows by this point whether the stool frequency and consistency have changed. Decision: whether we move on to the therapeutic dose.
We determine the dose to be used, and the treatment continues at the full, therapeutic dose: minimum 60-day phase. The dopaminergic therapy continues unchanged.
This is where it becomes clear whether bowel function has meaningfully improved. Decision: can further improvement be expected from continuing? If not, we begin tapering off. If it has not worked, we say so, and we do not recommend continuing.
The same order as on the timeline above. At every stage you will know what the next thing to do is.
Fill in the form or ask for a call back. In a free, 15-minute conversation we clarify whether it makes sense to start in your case — including whether swallowing the capsule can be managed safely.
→We send a link by e-mail with which you can register as a patient. At that point you receive from us a unique identifier in the P0000000 format. We record the patient data, and you fill in the “Goals and expectations” questionnaire.
FindBiome is the compatibility test itself: it shows which donor your microbiota matches best, and screens out a preparation that is poorly tolerated. Since the capsule is low-dose microbiota transfer, the therapy begins with this. It is a paid step, but it does not oblige you to continue.
In week 5 we evaluate the test and select the appropriate LOT. We review the diet, the fluid intake, the physical activity and the medication — in Parkinson's disease each of these has an effect on constipation in its own right.
week 10 we determine the dose to be used, and the treatment continues at the full, therapeutic dose: minimum 60-day phase, with the knowledge of the neurologist and the treating physician.
The stool and symptom diary accompanies the whole process. By week 18 we assess the result. If no further improvement can be expected, we taper the capsule off gradually, reducing by one every 7–10 days.
You do not have to decide about the whole process at once. After every step you have the opportunity to assess the results achieved.
| Step | What we provide | Price | Must you continue? |
|---|---|---|---|
| 1. Call back and pre-screening | A 15-minute conversation, clarifying suitability | free of charge | no |
| 2. FindBiome compatibility test 4×15 capsules | Testing donor–recipient matching, at the same time low-dose MTT, the first phase of the therapy | €1,140 + shipping cost | no |
| 3. Exposome consultation | Assessment of environmental and lifestyle exposures, setting goals together (with a DynaMAP baseline if wanted) | €185 the DynaMAP can be ordered separately: €325 (professional) or €575 (comprehensive) | no |
| 4. TransferBiome course 60 / 3×60 capsules | Personalised composition, full protocol + follow-up (the quantity required is decided during the biological trial) | €1,350 / 60 capsules | – |
| Item | Included? |
|---|---|
| Call back and pre-screening (15-minute conversation) | yes — free of charge |
| FindBiome compatibility test | separate item: €1,140 |
| Exposome consultation | separate item: €185 |
| DynaMAP microbiome profile | can be ordered separately: €325 (professional) or €575 (comprehensive) |
| Appearing in person | is not necessary — the process is remote throughout |
| The capsules in the packaging unit ordered | yes — at the price in the table above |
| Shipping cost | no — the delivery charge is separate |
| Follow-up during the course | yes |
| Joint closing assessment and tapering-off plan | yes |
| Examination by the treating physician, laboratory tests | no — these take place at your own healthcare provider |
The same high-quality donor microbiota, processed in a certified laboratory — in two steps, tailored to your situation.
The evidence for the two endpoints — movement and digestion — is radically different. This is the most important sentence to take away from this page. Five randomised trials have been carried out, with 157 patients in total; that is few, and the motor results do not point in the same direction.820
Motor symptoms: contradictory. In the Belgian GUT-PARFECT trial, 12 months after a single treatment the motor score showed a greater improvement than with placebo.743 A Finnish trial conducted in four centres, by contrast, found no difference on the primary endpoint, and more side effects occurred in the FMT arm.744 When two such trials give opposite results, it means that the effect is not robust.
Digestive symptoms: here the picture is more consistent. In a Chinese randomised trial the autonomic and digestive complaints improved meaningfully,802 and the systematic review, too, finds this the most consistent signal.820 That is why this service targets bowel function — not because we would not want the rest, but because this is where there are data.
The mechanism is real, but the conclusion is limited. In animal experiments the presence of the gut flora was necessary for the motor symptoms to develop,198 and in humans a difference in the gut flora can be demonstrated.384, 803 But one cannot step across from mouse to human, and the human data show association, not cause and effect.
There is no guideline recommendation. No neurological professional guideline recommends FMT in Parkinson's disease today. We say this even though it speaks against our own service.
Every donor goes through our DSQ donor screening framework.
Every capsule we ship carries a LOT number (a manufacturing batch identifier), so it can be traced back to the donor at any time.
Among the first questions of the pre-screening we clarify whether swallowing the capsule is safe. In the case of difficulty swallowing we do not start a course — aspiration is a real risk in Parkinson's disease.
The dopaminergic therapy we neither touch nor replace. We work with the knowledge of your treating neurologist, and only they can decide about stopping a medicine.
The stool and symptom diary accompanies the whole course. We assess at week 18: if it has not brought a meaningful change, we say so, and we do not recommend continuing.
Mild, transient digestive complaints are common: bloating, abdominal discomfort, transient diarrhoea, slightly raised temperature. Serious events are rare. In one randomised trial, in the FMT arm twice as many side effects occurred as with placebo.
The process breaks down into four stages, and at the end of each there is an exit point. We do not build on automatic continuation.
Step 1 — Compatibility test (FindBiome). 4×15 capsules over 32 days: five-day dosing periods with three-day breaks between them. During this time you keep a stool and symptom diary that we analyse at the end and also share with your treating physician. A change in your condition is not the aim of the test: we concentrate on screening out possible side effects and on selecting the donor. Price: €1,140 + shipping cost.
Step 2 — Exposome consultation and DynaMAP (optional). We go through the diet, the fluid intake, the physical activity and the medication — in Parkinson's disease every one of these influences constipation, and several of them can be improved independently of MTT. The consultation costs €185, and the DynaMAP can be ordered separately.
Step 3 — TransferBiome course. On the basis of the compatibility test result, the treatment continues with the best-matching composition as a minimum 60-day therapeutic course. The diary keeping continues, and the treatment is directed throughout by your treating physician, with the knowledge of the neurologist. Price: €1,350 / 60 capsules.
Step 4 — Assessment, gradual tapering off. We assess at week 18. If bowel function has improved to the extent hoped for, we gradually reduce the daily dose under medical guidance, and maintain the state achieved with lifestyle measures.
If you are a neurologist or a treating physician, or the patient asks you for an opinion: treatment follows the MTT Clinical Protocol Guide v7.1 which sets out patient selection, dose determination, the rules of escalation and gradual tapering, donor screening requirements and the follow-up steps. Referring a patient requires no separate agreement: a single message is enough.
The scientific background page works through, point by point and separately for the motor and the digestive symptoms, what the trials measured, what came out, where the uncertainty lies and what the alternative is. Beside every statement you will find the reference and its summary.
Write briefly about how long you have had the diagnosis, what digestive symptoms you have, and what has been tried so far. We will review whether it makes sense to start in your case — and if we see that it does not, we will say so.
MicroBiome Bank does not sell products; it connects donors and recipients by providing professional medical services: it organises the recruitment of donors and their screening in a certified laboratory, the stool tests, and the processing of the screened donation into capsule form. The contents of the capsules remain the property of the donor until the recipient has paid in full. The brand names of the services serve to make them easier to remember. We deliver the capsules “to the doctor’s hand”, and they are to be used under the guidance of a treating physician. For detailed information, please contact us.
The MicroBiome Bank service is not a substitute for professional medical advice, diagnosis or treatment. The decision to use it rests in every case with the treating physician.