How does acupuncture affect the gut microbiome?

In the previous two blogs, we discussed how a healthy gut microbiome helps produce for us short-chain fatty acids (SCFAs) that are important for our gut health, immune system function, and cardiovascular health, among other health benefits. (SCFAs are produced in the gut when beneficial gut microbes ferment the plant fibers that we eat.) We also discussed how SCFAs may affect the gut-brain connection and how environmental factors can influence the gut microbiome and SCFA levels.

In this blog, the third of a three-blog series, we will explore how acupuncture affects the gut microbiome (or, more accurately, the gut microbiota) and SCFA production.

Acupuncture effects on the gut microbiome

Acupuncture treatment is an important part of an integrative and functional medicine approach to health and has been extensively studied across a wide spectrum of diseases and conditions. Research has shown that acupuncture changes the gut microbiome composition in many diseases. Most remarkably, acupuncture appears to change the gut microbiome in the direction that restores the disruption back to a healthy state, rather than indiscriminately changing parameters in only one direction, as conventional pharmaceutical treatments tend to do.

For example, two major groups of bacteria in a normal gut microbiome are called Firmicutes and Bacteroidetes, and in healthy people, they coexist in a balanced proportion, which some researchers characterize as the Firmicutes to Bacteroidetes ratio, or F/B ratio for short. Inflammatory bowel disease (such as ulcerative colitis) is often, but not always, associated with a decreased F/B ratio (that is, there is a lower abundance of Firmicutes bacteria relative to Bacteroidetes) (1). On the other hand, obesity is often, but not always, associated with an increased F/B ratio (higher abundance of Firmicutes relative to Bacteroidetes), and the ratio falls with weight loss (2). (Lactobacillus, often found in probiotic supplements, belongs to the Firmicutes group.)

In a study of studies that reviewed the results from 20 animal studies and 3 human studies on the effect of acupuncture on the gut microbiome, researchers concluded that acupuncture significantly influences the gut microbiome and is able to change the relative abundance of bacteria such as Firmicutes and Bacteroidetes to restore balance in the gut microbiome (3). In animal studies on colitis that investigated the effects of acupuncture, the microbiome F/B ratios changed inconsistently with the disease across studies, but regardless of the direction of the change, acupuncture treatments reversed the changes in the F/B ratio, while improving colitis severity and levels of inflammatory markers. In animal experiments on obesity, acupuncture treatments decreased the relative abundance of Firmicutes in obese subjects (in other words, moved it in the right direction toward normal) (3).

Acupuncture effects on SCFA production

Given the beneficial effect of acupuncture on the gut microbiome, research also shows unsurprisingly that acupuncture therapy improves SCFA production. In a study that enrolled 80 people with functional constipation, acupuncture treatment was associated with an increased abundance of beneficial bacteria such as Lactobacillus and increased levels of the SCFA butyrate in the gut, which correlated with an improved frequency of bowel movements (4). In a mouse model of Alzheimer disease, diseased mice had decreased cognitive ability, decreased SCFAs in feces and blood, and leaky gut, but acupuncture treatments reversed all of these changes, including reversal of the decreased SCFA levels (5).

Healing the body holistically

A skilled physician acupuncturist can make a significant difference in gut health. (To learn more about the anatomical basis of acupuncture, see our previous blog.) As we have discussed in this three-blog series, SCFAs have a remarkably wide range of health benefits. Most importantly, a healthy gut microbiome helps produce them for us. There is currently no single pharmaceutical agent with such a wide-ranging spectrum of health benefits, and yet we can harness the benefits of SCFAs by optimizing our gut microbiome holistically, without potential medication side effects. That’s why supporting a holistic approach to health, using principles of integrative and functional medicine, will continue to move the field of medicine forward to help all of us heal wholly.

References 

1.  Yin Y, Yang T, Tian Z, Shi C, Yan C, Li H, et al. Progress in the investigation of the Firmicutes/Bacteroidetes ratio as a potential pathogenic factor in ulcerative colitis. J Med Microbiol. 2025;74(1).

2.  Sweeney TE, Morton JM. The human gut microbiome: a review of the effect of obesity and surgically induced weight loss. JAMA Surg. 2013;148(6):563-9.

3.  Bae SJ, Jang Y, Kim Y, Park JH, Jang JH, Oh JY, et al. Gut Microbiota Regulation by Acupuncture and Moxibustion: A Systematic Review and Meta-Analysis. Am J Chin Med. 2024;52(5):1245-73.

4.  Yan XY, Yao JP, Li YQ, Xiao XJ, Yang WQ, Chen SJ, et al. Effects of acupuncture on gut microbiota and short-chain fatty acids in patients with functional constipation: a randomized placebo-controlled trial. Front Pharmacol. 2023;14:1223742.

5.  Ding N, Hao X, Zhang Y, Zhang Y, Li Z. Benign regulation of short-chain fatty acids: the underlying mechanism of the beneficial effects of manual acupuncture on cognitive ability and the intestinal mucosal barrier in APP/PS1 mice. Front Neurosci. 2025;19:1509581.