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Common reasons for exclusion were probiotic supplementation not specific to Akkermansia, no linking to IR or other metabolic disorders, or using other plant derived supplements to trigger natural Akkermansia growth
Nachnani JS, Bulchandani DG, Nookala A, Herndon B, Molteni A, Pandya P, Taylor R, Quinn T, Weide L, Alba LM
8 , 513520 (2006) Meredith, J.J., Dufour, A., Bruch, M.D.: Comparison of the structure and dynamics of the antibiotic peptide polymyxin B and the inactive nonapeptide in aqueous trifluoroethanol by NMR spectroscopy
While the L-carnitine component targets physical fatigue, the Acetyl-L-Carnitine (ALCAR) in Carnitine Synergy is specifically designed to address the neurological manifestations of Long COVID and ME/CFS
But its not the whole story