The forgotten gut supplement GLP-1 prescribers are suddenly obsessed with
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“Bifidobacteria can influence bile acid composition, which affects insulin secretion and sensitivity… That works in conjunction with Akkermansia, which stalemates GLP-1 but also helps insulin do its thing.” — Joel Greene, gut-health expert and author
Find more of your peers' perspectives and insights below.
With GLP-1s like semaglutide and tirzepatide becoming everyday tools for managing obesity, type 2 diabetes, and even cardiovascular risk, physicians are starting to field a new wave of patient questions: Is there anything I can take to support my gut while I’m on a GLP-1?
And recently, there's a new solution to add to a list that includes things like fiber capsules or probiotic yogurt—it’s Akkermansia muciniphila.
Akkermansia isn’t new. First isolated in 2004, it’s long been associated with mucosal health and barrier integrity.[]But now, in the GLP-1 era, this microbe is re-entering the conversation with clinical relevance, especially around metabolic regulation and GI side effects.[]
GLP-1s meet the microbiome
Patients on GLP-1s often report nausea, bloating, constipation, and other GI symptoms. Many are also aware these drugs alter gut hormone activity, and they’re looking for ways to keep their microbiome in check while still reaping the metabolic benefits.
Akkermansia is now being studied for its role in reducing endotoxemia, reinforcing gut lining, and modulating insulin sensitivity. The kicker? It may also play a role in GLP-1 signaling itself.
In a recent Instagram Reel, author and gut-health expert, Joel Greene, broke down that Bifidobacteria can influence bile acid composition, which affects insulin secretion and sensitivity. He added that this appears to work in conjunction with Akkermansia, which he said “stalemates GLP-1 but also helps insulin do its thing.”
In other words, this isn’t just about bloating or gut lining—it’s about how the microbiome may interact with incretin pathways and broader metabolic tone.
Related: Here’s how a healthy gut lets you live a longer, healthier lifeWhy GIs and PCPs should care
This isn’t just about microbiome hype. If you’re managing patients with NAFLD, metabolic syndrome, or post-GLP-1 GI complaints, Akkermansia might be worth watching. It's already being studied in trials looking at obesity, liver health, and insulin resistance.[]
While no one’s suggesting you start prescribing it, you may want to be prepared when your patients ask. And they are asking, especially the ones who’ve already Googled “best gut health supplement on GLP-1s.”
Because for once, the answer might not be marketing fluff.
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