Developed in collaboration with Christina O’Connor, RD and Jennifer McManus, RD 


The Pendulum team has created these protocols in collaboration with practitioners to help healthcare partners make decisions when building treatment plans. When using this protocol, you understand and accept that the recommendations in the protocol are for educational guidance only and need to be adapted to meet individual patient needs. This may not be appropriate for every patient. 

This protocol is not a substitute for medical advice or intended to diagnose or treat any medical condition. 


Metabolic dysfunction stems in part from an increase in the permeability of the gut barrier, which separates the contents of the gut lumen from peripheral circulation. (1) The layer of mucus coating the inner wall of the digestive tract protects gut barrier permeability and provides a home for certain mucin-loving bacteria such as Akkermansia muciniphila. When Akkermansia muciniphila consumes mucin, the host compensates by continuing to produce more mucins, helping replenish this protective layer and thus supporting the integrity of the intestinal barrier. (2

Another mechanism by which the gut mediates metabolic health is through the production of certain metabolites, specifically butyrate. Targeted bacterial strains, such as Clostridium butyricum, support butyrate production. Butyrate production triggers host secretion of GLP-1 and PYY, important gut-secreted hormones known to support metabolism, energy balance, and already healthy glucose levels. (3) Restoring the strains that have been shown to have these key functions has the potential to naturally support metabolic health. 

Pendulum supplement plan 

  • Metabolic Daily: 1 capsule, once daily with food 
  • Polyphenol Booster: optional add-on to boost Akkermansia, which may further enhance the benefits


The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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  1. Cani, Patrice D et al. Diabetes vol. 56,7 (2007): 1761-72. doi:10.2337/db06-1491 
  2. Liu MJ, Yang JY, Yan ZH, et al. Clin Nutr. 2022 Oct;41(10):2333-2344. doi: 10.1016/j.clnu.2022.08.029. Epub 2022 Sep 3. PMID: 36113229 
  3. Everard A, Cani PD. Rev Endocr Metab Disord. 2014 Sep;15(3):189-96. doi: 10.1007/s11154-014-9288-6. PMID: 24789701.