Akkermansia Muciniphilia and Metabolic Side Effects of ADT

This study is investigating whether a probiotic supplement containing a specific beneficial gut bacterium (Akkermansia muciniphila) can reduce metabolic side effects — such as weight gain, blood sugar problems, and changes in cholesterol — in men with prostate cancer who are receiving hormone-blocking therapy (ADT). **You may be eligible if:** - You are a man aged 18 or older - You have metastatic prostate cancer (cancer has spread beyond the prostate) confirmed by biopsy - You are about to start hormone-blocking therapy (ADT) for the first time - You have recent imaging (CT scan and bone scan, or PSMA PET scan) - You are able to give informed consent in English (or with an interpreter) **You may NOT be eligible if:** - You have already received ADT within the past year - You have neuroendocrine (a rare, aggressive type) prostate cancer - You are taking chromium or apple cider vinegar supplements and cannot stop - You need antibiotics you cannot stop for the duration of the study - Your liver function is significantly impaired Talk to your doctor to see if this trial is right for you.