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TUDCA (tauroursodeoxycholic acid)

Endogenous taurine-conjugated bile acid, preliminary RCT signal in cholestatic and metabolic-liver conditions; commonly stacked for liver support.

Why

Tauroursodeoxycholic acid (TUDCA) is the taurine-conjugated form of ursodeoxycholic acid (UDCA, ursodiol, a prescription medication). Used clinically in China for decades; small Western RCTs (Pan 2013 Hepatol Res, Vang 2014 Glob Adv Health Med) report improvements in cholestatic and metabolic-liver markers. TUDCA is also studied for ER stress in retinal degeneration, neurodegeneration, and pancreatic β-cell preservation.

How it works

More hydrophilic and less cytotoxic than other bile acids, protects hepatocytes from hydrophobic-bile-acid-mediated apoptosis. Reduces endoplasmic reticulum (ER) stress via inhibition of the unfolded protein response. Chemical chaperone activity on protein folding.

Expected onset · Hepatic biomarker changes over 8–12 weeks

How to take

Dosage

Liver support: 250–500 mg twice daily. Higher doses (1,000–1,750 mg/day) in published RCTs of metabolic liver disease.

Timing

Divided 2–3 times daily with food

On the label

'TUDCA' or 'tauroursodeoxycholic acid' with stated mg per dose. Distinct from UDCA (prescription ursodiol) and from generic bile salts.

Ideal for

Adults with cholestatic liver complaints or NAFLD/NASH seeking adjunctive support under specialist guidance; people exploring liver-support stacks.

Safety

Generally well tolerated. Mild GI upset (diarrhoea) possible at higher doses. Theoretical interaction with bile-acid-binding resins (cholestyramine). Separate dosing. Pregnancy: UDCA has been used in obstetric cholestasis; TUDCA-specific pregnancy data limited. Coordinate with hepatology for any active liver disease.

Evidence

At a glance

Pan 2013 Hepatol Res small RCT in NAFLD: TUDCA reduced ALT and steatosis markers vs placebo. Vang 2014 review summarised emerging non-liver evidence (retinal, neurodegenerative, β-cell). Preliminary, RCTs exist in non-tier-1 journals but are small or short-duration. No Cochrane review, EMA monograph or EFSA-authorised claim covers the indication.

Limitations

Preliminary, RCTs exist in non-tier-1 journals but are small or short-duration. No Cochrane review, EMA monograph or EFSA-authorised claim covers the indication.

Where to get it

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