A new class of probiotic supplements claims to help you manage your weight, improve your blood sugar levels, and boost your body’s production of GLP-1, the satiety hormone that drugs like Ozempic and Wegovy are designed to mimic.
These probiotic supplements contain a friendly type of bacteria called Akkermansia muciniphila, which is one of the species of bacteria that make up our gut microbiomes. Research suggests that most people have Akkermansia muciniphila in their guts. But some people have more of it than others, and scientists think that having high levels of this microbe can be exceptionally good for your health.
Studies have found that people who have high levels of akkermansia have lower rates of weight gain, obesity and metabolic disease. And people who have low levels of this gut microbe, studies suggest, tend to be less healthy.
Although Akkermansia muciniphila is one of hundreds of different species that make up the gut microbiome, it has garnered unusual scientific interest. One scientific paper last year that explored its health effects called akkermansia the “shining star of the gut flora.” Other researchers have called it a “next-generation” probiotic that has the potential to help alleviate some chronic diseases.
Some small trials have found that taking akkermansia supplements lowered blood sugar levels in people with type 2 diabetes and reduced inflammation in people who were overweight or obese.
The scientific buzz around akkermansia has led to a burgeoning market of trendy probiotic supplements. The most prominent brand in this space is Pendulum, a company based in San Francisco that has a large following. Pendulum’s ads on social media include endorsements from the actress Halle Berry, who has publicly discussed her diabetes and is also an investor in the company and its chief communications officer.
Pendulum sells several lines of probiotic supplements that contain Akkermansia muciniphila, including one marketed for diabetes management that costs $165 for a one-month supply.
Colleen Cutcliffe, a scientist who co-founded Pendulum and serves as its CEO, said that akkermansia is different from the traditional probiotics found in fermented foods and dietary supplements, such as lactobacillus and bifidobacteria. These species of friendly bacteria are known to help with digestive issues like diarrhea, bloating and constipation, while the “next-generation” probiotics like akkermansia play an important role in things like your appetite, body weight, and metabolic health, said Cutcliffe.
But not everyone is convinced. Some scientists say that while the data on akkermansia and its health benefits looks promising, there hasn’t been enough research on its potential side effects. They say that people should be cautious about taking supplements containing akkermansia or any other probiotics whose safety profiles have not been thoroughly studied.
One study in mice found that high levels of akkermansia made the animals more vulnerable to some pathogens. Other researchers have found that people with neurological conditions such as Parkinson’s disease and multiple sclerosis have a higher abundance of akkermansia in their intestines, though it’s not clear why or whether the bacteria plays any role in the development of these disorders.
While there’s a “much larger body of evidence” suggesting beneficial metabolic effects of akkermansia, the studies pointing to potential downsides should not be ignored, said Federico Rey, a microbiologist at the University of Wisconsin at Madison who studies the relationship between the gut microbiome and cardiometabolic disease.
“The overwhelming data suggests that akkermansia is good for your metabolic health, but there’s also data suggesting that it might not be good for other conditions,” he added. “There’s a lot of moving parts we still have to understand before making general recommendations.”
Discovered in 2004, Akkermansia muciniphila gets its name from the critical role it plays in the gut microbiome. It loves to eat mucin, the thin layer of mucus that lines our intestines and helps to prevent pathogens from leaving our guts and invading our bodies. (The term muciniphila literally means “lover of mucin.”) Its name is also an homage to Antoon Akkermans, a prominent Dutch microbiologist who died in 2006.
Studies have found that a weak and impaired intestinal lining can contribute to inflammation and chronic conditions such as inflammatory bowel disease. But by constantly feeding on the mucin layer, akkermansia does something positive: It stimulates greater mucin production and turnover, which strengthens the intestinal barrier.
Akkermansia has other functions as well. Researchers have found that it causes cells in the intestine to secrete the hormone GLP-1, which induces satiety and helps our bodies metabolize sugar, ultimately protecting against obesity and diabetes.
In healthy adults, Akkermansia muciniphila makes up about 3 to 5 percent of the microbes found in the gut. But studies have shown that it is more abundant in the guts of healthy adults compared with people who have obesity, diabetes, and metabolic disorders. Higher levels have also been associated with lower inflammation, body weight and blood sugar and generally better metabolic health.
These studies show a correlation, which does not necessarily equal causation. But in one randomized controlled trial published in the journal BMJ Open Diabetes Research & Care, Cutcliffe and her colleagues at Pendulum recruited 76 adults with type 2 diabetes and split them into two groups. One group was assigned to take a probiotic supplement containing akkermansia and several other strains of friendly bacteria twice a day for 12 weeks and the other group served as controls. The researchers found that the group assigned to take the akkermansia capsules had greater improvements in their blood sugar levels compared to the control group.
Cutcliffe, Pendulum’s CEO, said the company’s products are relatively expensive because akkermansia is a “challenging” microbe that typically dies when it’s exposed to oxygen. The company built an expensive manufacturing plant in San Francisco so it can grow akkermansia in an oxygen-free environment. The microbes are then freeze-dried and packaged in capsules that can survive the journey through your stomach acid and deliver akkermansia to the distal colon. “We’ve invested in all these things to make the best product that we can, but that does make it expensive,” said Cutcliffe.
Should you take it?
For people who simply want to boost the overall health of their gut microbiome, studies have found that the best thing you can do is to focus on your diet, not on probiotic supplements, said Sean Spencer, a gastroenterologist and clinician scientist at Stanford University who studies the microbiome. Cut back on processed foods and eat more whole foods and fiber. Eating a diet rich in fermented foods including yogurt, kimchi, sauerkraut, kefir and kombucha can increase gut microbiome diversity.
Spencer said that if a patient of his wanted to use one of Pendulum’s products to help with their diabetes, he would encourage them to prioritize diet and exercise. He would also talk to them about first-line diabetes medications like metformin. But if the patient was eager to try Pendulum’s supplements, he would not necessarily discourage it.
“There is clinical evidence to suggest that there is benefit, and I would say that the risk is fairly low,” he said.
Chris Damman, a gastroenterologist at the Digestive Health Center at the University of Washington Medical Center and an expert on the gut microbiome, said he was skeptical of Pendulum’s findings and the notion that akkermansia could have “profound” effects on health. “I think maybe it can help incrementally,” he added. “It’s not a replacement for validated approaches of healthy lifestyle measures including a healthy diet, exercise and stress management.”