A Traditional Japanese Herb, Akkermansia muciniphila, and Health

One of my regular readers (you know who you are, S.!) has written to me several times asking about ways to increase the probiotic species Akkermansia muciniphila, which is not as yet available in probiotic form. I’ve written before about whatever research I could find on the subject (for example, here), and continue to look out for whatever may pop up.  Thus, today’s post.

I’ve mentioned this species many times on my blog, as it  is associated with many health benefits.  To highlight just a few: this post was about the role it may play in slowing the progression of ALS. It seems to protect against atherosclerosis. Low levels are associated with the development of Alzheimer’s disease and also, autism.

So how’s this for interesting? There is new research out of Japan on a traditional Japanese herb called Bofutsushosan (BTS).[i] A pharmaceutical-grade product has already been shown in animals and humans to help with obesity, which I find interesting enough in and of itself. In this study, researchers tested BTW in mice genetically engineered to become obese to see its effects on obesity, liver damage (i.e. non-alcoholic fatty liver disease (NAFLD), which is often the result of obesity), and the gut microbiome.  Of everything I have ever seen that boosts levels of Akkermansia, none has come close to this.

First a definition for those not familiar:  according to the Mayo Clinic, non-alcoholic fatty liver disease encompasses “…a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.  NAFLD is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population. Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure.”[ii]

The first line of treatment for NAFLD is, of course, life style changes, including weight loss.  As you have read on my blog many times, the development and remediation of obesity is NOT a simply issue of “eat less.”  Many factors are involved, including alterations to the microbiome, inflammation, additives in our foods, and more.  As I have read various bits of research over the years, I’ve more and more come to appreciate just how multi-factorial is this issue, and how difficult it is to fix this growing epidemic.  As these authors write, “Recent research suggests the gut microbiota is deeply involved in human health and various disease states including obesity and NAFLD.”

Akkermansia muciniphila, they go on to state, is “…anticipated to be the next generation of beneficial microbe.”  We are still, however, awaiting it to become available in the consumer marketplace.

Traditional Japanese medicines are standardized with regard to both quantity and quality, according to these scientists, and are approved by the Japanese Ministry of Health and Welfare.  BTS has a long history of being used to treat obesity and obesity-related issues, and has been tested in multiple placebo controlled trials in humans.  It has been shown effective in helping with obesity as well as constipation, and its mechanism of action is believed to be via the gut biome.  This study involved a closer look at that action.

There were 3 groups of mice in this study:  a control group of mice genetically engineered to be obese who were fed a standard diet, a group of mice genetically engineered to be obese also fed a standard diet, and a group of similar obese mice given BTS for 4 weeks.  The obese group fed a standard diet showed a huge increase in body weight.  However, the group fed BTS gained weight much more slowly, similar to the normal “wild” mice group.  The BTS group also had markedly lower levels of liver damage than did the control obese group.

In terms of the changes to the microbiome, what really stood out was the increase in A. muciniphila.  It was present at “minor levels” in the obese mice fed a standard diet, but mice fed BTS had a huge increase in this species:  “Among genera whose relative abundance was above 1% in either group, those of the genus Akkermansia were most altered in the BTS group (93-fold higher).”

The authors go on to state:  “The rapid increase in the level of A. muciniphila was the most interesting finding in this study.  Many reports indicate the positive effect of A. muciniphila in preventing obesity or metabolic disorders.”  They state that it is known to improve insulin resistance, plasma cholesterol levels, and liver health in humans.  It is also known to improve the integrity of the gut epithelial lining (i.e. remediate leaky gut).

The scientists state that the improvement in levels of A. muciniphila are not the sole cause of the improvement in body weight profile.  The picture is, as always, more complex.  (Nothing is ever easy!)  Other gut bacterial levels were also altered, which may play a role, and BTS also seemed to reduce appetite which certainly played a role.  They were, however, able to conclude that in these obese animals, BTS reduced liver injury, attenuated weight gain, and greatly increased levels of A. muciniphila.

I have found that BTS is available for sale via Japanese companies.  Here is one example.    I have never tried it, and until I read this study, I had never heard of it.  If any of you do decide to give it a shot, please let us all know how you fare!

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[i] Nishiyama, M., Ohtake, N., Kaneko, A., Tsuchiya, N., Imamura, S., Iizuka, S., … Kono, T. (2020). Increase of Akkermansia muciniphila by a Diet Containing Japanese Traditional Medicine Bofutsushosan in a Mouse Model of Non-Alcoholic Fatty Liver Disease. Nutrients, 12(3), 839. doi:10.3390/nu12030839

[ii] https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567