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Akkermansia is notoriously difficult to deliver in supplement form because it is an anaerobic organism that dies on exposure to oxygen

10.1007/s12975-014-0340-3 12 GaoX.ZhangY.BurwinkelB.XuanY.HolleczekB.BrennerH.et al (2019)

doi: 10.1016/j.mcn.2005.10.006 84 Sanchez-MolinaPAlmoldaBGimenez-LlortLGonzalezBCastellanoB

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This is when the plasma concentration of the medication reaches its peak

Many athletes including age-group athletes have legitimate medical indications