A normal gut resident, now available as an oral capsule in living or heat-treated form. The heat-treated form has the better evidence: in overweight adults who handle blood sugar poorly, it helped hold weight already lost and nudged cholesterol and liver markers favourably. Leg strength improved in adults over sixty. Longer life and brain protection rest on animals. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Fasting insulin | 2–5 µIU/mL | The endpoint that moved most in trials |
| HOMA-IR | Below 1.5 | Combines fasting insulin and glucose into one insulin-resistance index |
| Fasting glucose | 75–86 mg/dL | Confirms the insulin reading is not masking early dysglycaemia |
| HbA1c | 5.0–5.4% | Three-month average blood sugar; the multi-strain trial's endpoint |
| Total cholesterol | 160–200 mg/dL | Fell by roughly 9% in the three-month trial |
| ALT | Below 20 U/L (men), below 17 U/L (women) | Liver-stress marker that improved in trials |
| hs-CRP | Below 0.5 mg/L | Tracks the low-grade inflammation the barrier mechanism targets |
| Waist circumference | Below 94 cm (men), below 80 cm (women) | The body-measurement endpoint that improved in the yogurt trial |
| Stool Akkermansia relative abundance | No established target exists; track the change from the individual's own baseline, and treat a sustained rise above roughly 4% as a reason to reassess | The one measure specific to this intervention, on both sides of the ledger |
| Body fat percentage | No established target for this intervention; track the change from the individual's own baseline | Distinguishes fat loss from lean-mass loss during weight maintenance |
Cadence: Digestive tolerability at two and four weeks, then repeat metabolic labs and stool abundance at three months, and then every six to twelve months while use continues.