Trehalose

α-D-glucopyranosyl-(1→1)-α-D-glucopyranoside (mycose)
Evidence Level
Limited
3 Clinical Trials
4 Documented Benefits
2/5 Evidence Score

Natural disaccharide (two glucoses joined α-1,1) found in mushrooms, yeast, and certain plants. Studied as autophagy inducer for neurodegenerative diseases (ALS, Parkinson's) — most evidence from preclinical and ongoing trials. Modest glucose tolerance benefits in human RCTs.

Studied Dose ORAL: 3.3-10 g/day shown to improve glucose tolerance in human RCTs (Mizote 2017 used 10 g/day; Yoshizane 2020 used 3.3 g/day = ~1 teaspoon). 2-month trials with 21 g/day combined with polyphenols in PAD patients (Carnevale 2022 pilot). INTRAVENOUS: Trehalose IV 100-200 mg/kg in ALS clinical trial NCT04297683 (ongoing). LIMITATION: Oral trehalose is largely hydrolyzed by intestinal trehalase to glucose before reaching tissues — most cardiometabolic and autophagy effects in animal studies used IP injection or oral co-administration with trehalase inhibitors. Practical oral dose for general use: 5-10 g/day with meals, recognizing that systemic effects are limited.
Active Compound α,α-Trehalose (trehalose dihydrate in commercial products; ~98% trehalose by weight)

Benefits

Improved glucose tolerance in metabolic syndrome

Mizote 2017 (PMID 28202842, n=34 BMI≥23 subjects, 12 weeks) showed 10 g/day trehalose vs sucrose: significantly decreased post-OGTT glucose at 2 hours after 12 weeks vs baseline. In stratified analysis of those with higher truncal fat percentage, body weight, waist circumference, and systolic BP all improved more in trehalose group. First evidence trehalose may slow progression of insulin resistance in humans.

Maintained glucose homeostasis at low dose in healthy adults

Yoshizane 2020 (PMID 32646428, n=50 healthy Japanese adults, 12 weeks) showed 3.3 g/day trehalose maintained 2-hour post-OGTT glucose unchanged from fasting (no excursion), while sucrose group showed expected post-glucose-load elevation. Effect was strongest in subset with higher baseline 2-h PG/FPG ratios. Suggests even low-dose trehalose may reduce postprandial glycemic excursion in healthy individuals.

Autophagy induction (mechanism with therapeutic implications)

Trehalose is an mTOR-independent autophagy inducer (Sarkar 2007 J Biol Chem PMID 17182613) — activates TFEB and FOXO1 transcription factors driving lysosomal biogenesis and autophagy genes. In animal models, this clears mutant huntingtin, alpha-synuclein, and TDP-43 aggregates. Multiple ongoing human trials for ALS, Parkinson's, and Spinocerebellar Ataxia Type 3 are testing whether this preclinical mechanism translates to clinical benefit.

Lower glycemic and insulinemic response than sucrose

Trehalose's α-1,1 bond produces slower digestion than sucrose's α-1,2 bond, resulting in attenuated postprandial glucose, insulin, and GIP responses. Although it is fully digested to glucose, the slower release rate may have favorable downstream effects on adipogenesis and insulin sensitivity vs. an equivalent sucrose intake.

Mechanism of action

1

Autophagy induction via TFEB/FOXO1 (the dominant therapeutic mechanism)

Trehalose activates the master transcription factor TFEB (transcription factor EB) and FOXO1, both of which drive transcription of autophagy and lysosomal biogenesis genes. This produces: (a) clearance of misfolded protein aggregates relevant to neurodegeneration, (b) reversal of cardiometabolic dysfunction in diet-induced atherosclerosis/steatosis models, and (c) anti-inflammatory effects via macrophage autophagy. The mechanism is mTOR-independent — distinguishing trehalose from rapamycin and explaining its lack of immunosuppressive effects.

2

Protein structural stabilization via vitrification

Trehalose forms a glassy, anhydrous matrix around proteins that prevents denaturation under stress (heat, freeze, oxidation, dehydration) — basis for its industrial use in vaccine and biologic stabilization. In neurodegenerative contexts, this may also protect against protein misfolding and aggregation, an effect distinct from autophagy induction.

3

Slower digestion via α-1,1 glycosidic bond

Trehalose is hydrolyzed by intestinal trehalase (rather than amylase or sucrase-isomaltase). The α-1,1 bond is more thermostable and has slower enzymatic cleavage than α-1,2 (sucrose) or α-1,4 (maltose). This explains the lower glycemic index (GI ~70 in pure trehalose vs ~92 for maltose, ~65 for sucrose) and attenuated insulin/GIP response.

4

Nrf2-mediated antioxidant response

Trehalose increases p62/SQSTM1 expression, leading to enhanced nuclear translocation of Nrf2 and induction of antioxidant response element (ARE) gene products including heme oxygenase-1 (HO-1) and NAD(P)H quinone dehydrogenase 1 (NQO1). This represents a fourth mechanism contributing to cellular protection beyond autophagy induction alone.

Clinical trials

1
Mizote 2017 — Trehalose in Metabolic Syndrome Risk Subjects (Pivotal RCT)
PubMed

Placebo-controlled, double-blind clinical trial (Mizote A, Yamada M, Yoshizane C, Arai N, Maruta K, Arai S, Endo S, Ogawa R, Mitsuzumi H, Ariyasu T, Fukuda S 2016, J Nutr Sci Vitaminol 62(6):380-387, doi:10.3177/jnsv.62.380, PMID: 28202842).

34 subjects with BMI ≥23 (metabolic syndrome risk factors). Divided into two groups; assigned to ingest 10 g/day trehalose or sucrose (control) with meals for 12 weeks. Body composition and biochemistry measured at 0, 8, 12 weeks; washout at 16 weeks.

Trehalose group: blood glucose 2-h post-OGTT significantly decreased after 12 weeks vs baseline (sucrose group did not change significantly). In stratified analysis of subjects with truncal fat percentage near upper end of normal: body weight, waist circumference, and systolic BP changes were significantly more favorable in trehalose vs sucrose group. Concluded daily 10 g trehalose improved glucose tolerance and slowed progression toward insulin resistance.

2
Yoshizane 2020 — Low-Dose Trehalose in Healthy Volunteers
PubMed

Randomized, double-blind, placebo-controlled trial (Yoshizane C, Mizote A, Arai C, Arai N, Ogawa R, Endo S, Mitsuzumi H, Ushio S 2020, Nutr J 19(1):68, doi:10.1186/s12937-020-00586-0).

50 healthy Japanese adults randomized to 3.3 g/day trehalose (n=25) or sucrose (n=25) for 78 days (12 weeks). 75-g oral glucose tolerance tests at baseline and 12 weeks.

Sucrose group: 2-h plasma glucose significantly higher than fasting after 12 weeks. Trehalose group: 2-h and fasting plasma glucose remained similar (no postprandial elevation). In subset with above-mean baseline 2-h PG/FPG ratio, trehalose group's 2-h PG was significantly lower than sucrose group's. Established that low-dose (one teaspoon) trehalose may help maintain glucose homeostasis in healthy individuals.

3
Yoshizane 2017 — Acute Glycemic Response Comparison
PubMed

Acute crossover comparison (Yoshizane C, Mizote A, Yamada M, Arai N, Arai S, Maruta K, Mitsuzumi H, Ariyasu T, Endo S, Fukuda S 2017, Nutr J 16(1):9, doi:10.1186/s12937-017-0233-x).

Healthy adults receiving acute oral trehalose vs other sugars with measurement of glycemic, insulinemic, and incretin (GIP, GLP-1) responses.

Trehalose produced significantly lower postprandial glucose, insulin, and GIP responses compared to equivalent sucrose or maltose loads. GLP-1 was preserved or enhanced. Mechanistic foundation for the longer-term metabolic benefits observed in Mizote 2017 and Yoshizane 2020 — slower digestion translates to attenuated metabolic excursion.

About this ingredient

About the active ingredient

Trehalose (α-D-glucopyranosyl-(1→1)-α-D-glucopyranoside, also called mycose) is a non-reducing disaccharide consisting of two α-glucose units joined by a unique α,α-1,1 glycosidic bond. This bond geometry creates the highest hydrogen-bonding capacity per molecule of any sugar, explaining trehalose's remarkable ability to stabilize proteins and membranes against dehydration, freezing, and heat — the basis for its widespread use in vaccine and biologic stabilization. Found naturally in mushrooms (especially shiitake, ~5%), yeast cell walls (~5-15%), honey, certain crustaceans, and seeds of plants surviving anhydrobiosis.

Commercial trehalose (e.g., Hayashibara TREHA®) is produced enzymatically from starch using maltooligosyl trehalose synthase + maltooligosyl trehalose trehalohydrolase. Sweetness is ~45% that of sucrose. EVIDENCE: 2/5 reflects: (1) two published human RCTs in metabolic outcomes (Mizote 2017 PMID 28202842 and Yoshizane 2020 PMID 32646428) — both relatively small (n=34, n=50), conducted by Hayashibara employees (the manufacturer), with modest endpoint magnitudes; (2) extensive preclinical autophagy/cardiometabolic literature in animals; (3) multiple ongoing phase 2/3 human trials in ALS, Parkinson's, SCA3 (most via IV route to bypass gut trehalase).

The translation of preclinical autophagy effects to oral human supplementation is uncertain — gut trehalase activity is the primary practical limitation. SAFETY: Excellent — FDA GRAS status, no serious adverse events in trials. Trehalase deficiency is a rare genetic exception.

Best positioned as: (a) a slower-glycemic alternative sweetener for those with prediabetes/metabolic syndrome (low-dose 3-10 g/day evidence), (b) cellular stress protection where high-protein-stabilization is desired, (c) speculative use as autophagy inducer pending results of ongoing neurodegenerative disease trials. Not currently a high-evidence product for general consumer use; best positioned for those with specific metabolic or research-grade interest in autophagy biology.

Side effects and drug interactions

Common Potential side effects

Generally extremely well-tolerated; FDA GRAS status as a food ingredient.
Trehalase deficiency (rare genetic condition, more common in some populations like Greenland Inuit) causes osmotic diarrhea after trehalose intake — similar to lactose intolerance.
GI symptoms (mild diarrhea, gas) at doses >50 g/day from osmotic effect.
Potential concern about Clostridioides difficile (some C. diff strains can metabolize trehalose) — debated; current evidence does not support a clinical concern at typical food intakes.
No serious adverse events reported in published RCTs.

Important Drug interactions

No documented clinically significant drug interactions.
Diabetes medications: trehalose still provides 4 kcal/g; counts toward total carbohydrate intake.
Theoretical interaction with autophagy modulators (rapamycin, hydroxychloroquine) at high doses — not clinically validated.
Compatible with most medications.
Treat as a slow-digesting carbohydrate — applies to total daily glycemic load calculations.

Frequently asked questions about Trehalose

What is the recommended dosage of Trehalose?

The clinically studied dose for Trehalose is ORAL: 3.3-10 g/day shown to improve glucose tolerance in human RCTs (Mizote 2017 used 10 g/day; Yoshizane 2020 used 3.3 g/day = ~1 teaspoon). 2-month trials with 21 g/day combined with polyphenols in PAD patients (Carnevale 2022 pilot). INTRAVENOUS: Trehalose IV 100-200 mg/kg in ALS clinical trial NCT04297683 (ongoing). LIMITATION: Oral trehalose is largely hydrolyzed by intestinal trehalase to glucose before reaching tissues — most cardiometabolic and autophagy effects in animal studies used IP injection or oral co-administration with trehalase inhibitors. Practical oral dose for general use: 5-10 g/day with meals, recognizing that systemic effects are limited.. Always follow product labeling and consult a healthcare provider for personalized dosing recommendations.

What is Trehalose used for?

Trehalose is studied for improved glucose tolerance in metabolic syndrome, maintained glucose homeostasis at low dose in healthy adults, autophagy induction (mechanism with therapeutic implications). Mizote 2017 (PMID 28202842, n=34 BMI≥23 subjects, 12 weeks) showed 10 g/day trehalose vs sucrose: significantly decreased post-OGTT glucose at 2 hours after 12 weeks vs baseline.

Are there side effects from taking Trehalose?

Reported potential side effects may include: Generally extremely well-tolerated; FDA GRAS status as a food ingredient. Trehalase deficiency (rare genetic condition, more common in some populations like Greenland Inuit) causes osmotic diarrhea after trehalose intake — similar to lactose intolerance. Always consult a healthcare provider before starting any new supplement, especially if you have underlying conditions or take medications.

Does Trehalose interact with medications?

Known drug interactions may include: No documented clinically significant drug interactions. Diabetes medications: trehalose still provides 4 kcal/g; counts toward total carbohydrate intake. Consult a pharmacist or healthcare provider if you take prescription medications.

Is Trehalose good for metabolic health?

Yes, Trehalose is researched for Metabolic Health support. Mizote 2017 (PMID 28202842, n=34 BMI≥23 subjects, 12 weeks) showed 10 g/day trehalose vs sucrose: significantly decreased post-OGTT glucose at 2 hours after 12 weeks vs baseline.