Supplement · graded by use, two uses
Akkermansia muciniphila
Weight regain after diet-induced weight loss, adults with overweight or obesity.
Grade C: human trials exist, but they are small, mixed or not yet repeated. This is not a finding that it does not work. How to read a grade →
Akkermansia is a gut bacterium sold as a probiotic. In one study run by its maker, people who had lost weight by dieting regained less weight while taking it. A larger study tested whether it helped the body use insulin better. It did not reach its main goal. So the weight result rests on one study, and the insulin claim was tested and not shown.
The C belongs to one of the two uses graded on this record. The other one carries its own letter.
As studied, and the trials
Depommier et al. (Nat Med, 2019; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 31263284): proof-of-concept randomized pilot, 32 completers, insulin sensitivity and insulinemia improved; two senior authors co-founded the maker. Suenaert et al. (Gut Microbes, 2026; PMID 42343233): the 142-person scale-up, run by the maker, missed its primary endpoint The one outcome a trial names in advance as its main test. Results on other outcomes carry less weight.. Zhang et al. (Cell Metab, 2025; PMID 39879980): a different strain, no between-group difference. A positive pilot whose scale-up was null on the primary endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. is tested and found wanting: D on Route 2 Human randomized trials have been run and did not show benefit on the stated outcome. One of the two routes to the lowest letter on EBL's scale..
As studied, and the trials
Mount et al. (Nat Med, 2026; PMID 42120725): 90 adults who had lost 8 percent of body weight on a low-energy diet, then 24 weeks of pasteurized MucT or placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received.; weight regain 1.2 kg against 3.2 kg (P = 0.012). One positive randomized trial, unreplicated, run by the product's maker, stated beside the letter: C.
Read the grade that matches your goal. How EBL grades by use →
- Dose studied
- 10¹⁰ CFU/day (10 billion), pasteurized
- Form graded
- Pasteurized A. muciniphila
- Evidence behind the C
- PMID 42120725 →
A letter describes the human evidence, not the product, the manufacturer, or the ingredient's worth.
See the full evidence record →Funding: The single trial this Grade C for Weight regain after diet-induced weight loss, adults with overweight or obesity rests on was funded by the maker of the product it tested. Funder's role, as reported: Mount 2026 (PMID 42120725): not separately stated in the indexed record. The letter is what the trial supports under the grading rules; the funding is stated here so it can be weighed alongside it. Investigators: The single trial this Grade C for Weight regain after diet-induced weight loss, adults with overweight or obesity rests on was run by investigators employed by, founded by, or belonging to the organization that developed, sells or teaches the intervention (the product's maker, whose co-founder and chief medical officer are authors). The funder may read non-commercial; the people who ran the trial are part of the organization whose intervention they tested, which is stated here so it can be weighed alongside the letter.
Gut microbe sold as a probiotic. Less weight regain after dieting in one maker-run trial; insulin sensitivity tested without benefit.
As studied: dose, form, population and duration for every use
A grade describes the intervention that was tested. Where the product on the shelf differs from it, this says so.
How this letter has changed · latest: October 2026 · Corrected
The record held C on a positive pilot (Depommier et al., Nat Med, 2019; PMID 31263284) whose 142-person scale-up (Suenaert et al., Gut Microbes, 2026; PMID 42343233) missed its primary endpoint, with a second trial null between groups (Zhang et al., Cell Metab, 2025; PMID 39879980). Under the written rule a use tested without benefit is D Route 2, whatever the pilot said. The weight-regain trial (Mount et al., Nat Med, 2026; PMID 42120725) is a different endpoint in a different population, one positive randomized trial run by the maker: C on its own row with the funding stated beside the letter. The headline follows the best use and stays C. Applied the written grade definition under the editor's standing instruction of October 2026 (Arnold Sandlow, D.C.).PMID 31263284 PMID 39879980 PMID 42120725 PMID 42343233
The record called Zhang 2025 (PMID 39879980) an RCT Randomized controlled trial: people are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect. confirming metabolic benefit; it reports no significant between-group difference, with benefit only in a low-baseline subgroup. The largest trial, Suenaert 2026 (PMID 42343233, 142 adults), was null on its primary insulin-sensitivity endpoint and was run by the company that makes the product; it is now cited. Perraudeau 2020 (PMID 32675291) tested a five-strain combination and cannot grade Akkermansia alone; its authors are all employees of its maker. The co-founder and patent ties of the Depommier 2019 (PMID 31263284) senior authors are stated. Two trials the search found are added: Mount 2026 (PMID 42120725), company-run, 90 adults, less weight regain after dieting on pasteurized MucT, a different endpoint from the graded use; and Kang 2024 (PMID 39683431), a different strain tested on leg strength. Strains and forms are no longer pooled as one. Headline C held pending editor confirmation.PMID 39879980 PMID 42343233 PMID 32675291 PMID 31263284 PMID 42120725 PMID 39683431
Every change to a letter on this site is dated and published. The full evidence log →
Commercial disclosure
EBL earns no commission on any supplement it grades. A purchase made through the dispensary link below pays EBL nothing, the practitioner discount goes to you in full. The dispensary is Fullscript, a practitioner dispensary, and many of the professional-grade brands in it are sold mainly through practitioners rather than in health food stores. Grades are assigned by published rubric before any commercial relationship exists and are never influenced by one. Full disclosure.
Trials used ~10^10 cells/day (pasteurized or live). Pasteurized form was the one validated in the Depommier RCT.
Pasteurized A. muciniphila outperformed live bacteria in the pivotal trial. Commercial strains vary; look for the trial-validated form.
In the cited trial of a multi-strain product containing Akkermansia, three capsules were taken twice a day within 30 minutes of the morning and evening meals (PMID 32675291). The cited 3-month Akkermansia trial gave a daily dose and does not state a time (PMID 31263284).
Checked against the full published reports. What the cited trials did, not a schedule. Every supplement, by trial timing →
Immunosuppression, active malignancy, and central venous catheters. This applies to live-biotherapeutic products as a class: bacteremia from probiotic organisms is documented in severely immunocompromised patients. Pasteurized preparations do not carry that particular risk.
Antibiotics reduce or abolish the effect of a live organism taken orally, but note which form the evidence here rests on: the pivotal trial used pasteurized Akkermansia, which is not viable, so that reasoning applies to live preparations rather than to the one the grade is built on. Immunosuppressants are a caution on the same grounds as the contraindication above.
The antibiotic caution and the graded form do not quite match. The antibiotic caution is the standard probiotic one: an antibiotic kills a live organism. The complication is that the trial the grade rests on used pasteurized Akkermansia muciniphila, a heat-killed preparation that improved insulin sensitivity in overweight and obese adults, and pasteurisation is not incidental to it. A killed preparation cannot be killed again, so the usual reasoning does not transfer cleanly to the form EBL grades. No trial has given Akkermansia in either form together with an antibiotic and measured anything, so the practical caution stands for live products and is stated with the form attached rather than left as a general rule. Depommier et al. (Nat Med, 2019;25(7):1096-1103; PMID 31263284): randomized proof-of-concept trial of pasteurized Akkermansia muciniphila in overweight and obese volunteers.
The trials measured the outcome targeted in the Akkermansia study rather than any Akkermansia-specific marker.
Primary evidenceSix papers, each linked to its PubMed record.
Depommier et al. (Nature Medicine, 2019; PMID 31263284): proof-of-concept randomized pilot, 32 completers; pasteurized A. muciniphila (strain MucT) improved insulin sensitivity and lowered insulinemia and total cholesterol versus placebo. Two senior authors co-founded the company that makes the studied product and hold patents on its use. Suenaert et al. (Gut Microbes, 2026; PMID 42343233): the scale-up, 142 adults with metabolic syndrome, 4 months of pasteurized MucT; the primary endpoint, whole-body insulin sensitivity, did not differ from placebo. Benefit appeared only in exploratory subgroups, including people with low baseline Akkermansia. Run by that company: its employees, consultants and co-founders are among the authors. Zhang et al. (Cell Metabolism, 2025; PMID 39879980): 58 adults with overweight or obese type 2 diabetes, a different strain (AKK-WST01), 12 weeks; both arms lost weight and HbA1c A blood test that reflects average blood sugar over the previous two to three months. with no significant between-group difference, and benefit was seen only in the subgroup with low baseline Akkermansia. Perraudeau et al. (BMJ Open Diabetes Res Care, 2020; PMID 32675291): tested a five-strain probiotic with inulin that contains A. muciniphila; a combination product cannot grade Akkermansia alone, and all authors are employees and shareholders of its maker. Mount et al. (Nature Medicine, 2026; PMID 42120725): 90 adults with overweight or obesity who had lost 8 percent of body weight on a low-energy diet, then 24 weeks of pasteurized MucT or placebo; weight regain was 1.2 kg on MucT against 3.2 kg on placebo (P = 0.012), a different endpoint from the insulin-sensitivity use graded here, and again company-run (its co-founder, chief medical officer and an employee are authors, with a patent application on the study). Kang et al. (Nutrients, 2024; PMID 39683431) tested a different pasteurized strain (HB05P) on leg strength in 100 adults over 60, with employees of its maker among the authors; a different strain and a different use, not graded here. Strains and forms (pasteurized MucT, AKK-WST01, HB05P, a multi-strain formula) are not interchangeable. Graded by use from October 2026: insulin sensitivity D Route 2 (pilot positive, scale-up null on the primary endpoint, second trial null between groups); weight regain C (one maker-run trial); headline C, the best use. No trial is independent of a product's maker.
Educational use only · Not medical advice · Starting, stopping or changing any supplement or medication is a decision for your physician
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. The grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Who responds: this record's trial reading reports no subgroup that identifies who responds.
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How this is enforced
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How EBL searched for the trials (1 search)
The search that was run, what it returned, and what was left out and why, so the absence of evidence can be checked as well as its presence.
Akkermansia muciniphila[tiab] AND (randomized controlled trial[pt] OR clinical trial[pt]) AND humans[mesh]Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →