TUDCA: My Favorite Supplement for Liver, Bile, and Microbiome Health

Have you heard about TUDCA? It’s a powerful and versatile supplement that has been gaining a lot of attention in recent years. TUDCA is a bile acid naturally produced in your body and is also used as a supplement. It has been extensively researched for its benefits for liver health, kidney function, gut microbiome balance, metabolic function, and brain health.

In this article, we’ll dive deep into the world of TUDCA and explore various ways in which it may benefit your health. Let’s jump in.

What Is TUDCA?

Taurourodeoxycholic acid, or otherwise known as TUDCA, is a bile acid derivative or bile salt. Your body makes TUDCA in small amounts to support liver health, kidney health, brain health, cellular function, and other bodily functions.

TUDCA has been used in traditional Chinese medicine (TCM) for the therapeutic reason for hepatic (liver) and biliary (bile and bile duct-related) issues, detoxifying the liver, and heat-related illness, including spasms, fever, and vision problems.

You are probably wondering if these benefits are backed by science. The answer is yes. TUDCA has many science-backed health benefits. But before I get into specific research on TUDCA, I want to go over the role of bile and TUDCA in your body.

What Is Bile?

Bile is greenish-brown liquid made of bile salts, cholesterol, bilirubin, electrolytes, phospholipids, and water. It is made by your liver, stored in your gallbladder, and secreted into your digestive system via the first part of your small intestine called the duodenum.

Just like a detergent that breaks down and washes away grease from dirty dishes, bile helps to break down fats into fatty acids to be absorbed by your body. It helps to break down food and cholesterol (1). Bile also helps your body to digest and absorb fat-soluble vitamins, including vitamins A, D, E, and K (2). It may help to destroy harmful bacteria in your gut (3). Pretty amazing, right?  This little molecule enables us to break down the fats in our diet so we can absorb them AND helps eliminate the bad bugs!

Bile also helps your body to remove waste, eliminate cholesterol, and regulate metabolism (4). Poor bile flow and NOT having enough bile leads to digestive issues, gut inflammation, poor nutrient absorption, gut dysbiosis, and leaky gut syndrome.

What Is the Role of TUDCA in Your Body

Your body makes TUDCA through a microbial process. After bile salts are released into your intestine, microbes in your large intestine can metabolize them into ursodeoxycholic acid or UDCA. Then in your lower intestine, UDCA metabolizes and binds with a taurine molecule forming TUDCA. UDCA and TUDCA are both bile salts. UDCA is a more common form made first.

The Benefits of TUDCA

Not only do bile salts and TUDCA help with digestion, read on to learn what else it can do!  We know from the medical literature that TUDCA supports a number of bodily functions and offers a list of exciting health benefits. Let’s take a look at these potential health benefits of TUDCA!

Insulin Sensitivity

Insulin is a vital hormone. It helps to regulate blood sugar (glucose) in your body. Insulin resistance means that your body cannot respond well to insulin and is unable to sugar from your blood for energy. It may increase your risk of prediabetes, diabetes, and a list of chronic health issues. Insulin sensitivity is the opposite of insulin resistance. It supports your body in using blood glucose effectively and decreases your blood sugar levels.

TUDCA may help to improve insulin sensitivity and reduce the risk of insulin resistance-related issues. A 2019 study published in Frontiers in Physiology found that 15 days of treatment with TUDCA lead to a 43% reduction in blood sugar in mice with chemically-induced high blood glucose (5).

In addition to helping with high blood sugar, insulin resistance, and diabetes, TUDCA may also help to improve the blood vessel health which can decrease the risk of cardiovascular disease and cerebrovascular diseases. According to a 2016 randomized clinical trial published in Clinical Science (London), TUDCA may help to reduce the risk of endothelial dysfunction related to high oral glucose levels (6). According to a 2016 study published in the Journal of Ethnopharmacology, TUDCA may help to reduce postprandial hyperglycemia-induced endothelial dysfunction (7). Endothelial dysfunction is the abnormal changes in the lining of blood vessels that leads to atherosclerosis or plaque formation. It is characterized by low nitric oxide and increased levels of inflammation.   

Cellular and Mitochondrial Health

The mitochondria are the powerhouse of your cells. If you remember anything from high school biology class, it’s probably this sentence. What does this mean?

Imagine each of your cells as one little unit that needs the energy to function. Each of these units has a tiny power plant inside them. This is your mitochondria. They are tiny organelles that make up about 90 percent of your body’s energy. Without healthy mitochondria, your cells can’t function properly. Since your body is a sum of many-many cells, without healthy cells powered by healthy mitochondria, you can’t function well either.

Mitochondrial dysfunction is a common underlying factor behind many chronic health issues. You may be excited to hear that TUDCA may help to support mitochondrial and cellular health. It may help to improve energy output by creating more antioxidants and fighting free radical damage. According to a 2014 review published in Global Advances in Health and Medicine, TUDCA may serve as an anti-apoptotic agent and reduce cell death (8).

Apoptosis

Apoptosis refers to the process of programmed cell death. This is your body’s natural response to stress and damage and it happens when the cell danger response kicks in and senses free radical damage, cellular mutations, pathogens, or toxins. Apoptosis removes old and damaged cells through cellular disintegration and creates room for new and healthy cells (9).  Apoptosis supports the regulation and stabilization of the cellular death process and allows it to occur at the right time in the right cells only.  Preventing cell death at the wrong time or when it’s unnecessary and increase the production of more mitochondria.

However, in an unhealthy body, we may notice something called altered apoptosis. This means that healthy cells may start to die at the wrong time or the wrong cells experience cell death at the wrong pace (10). For example, cancer cells fail to undergo cell death at appropriate times. In neurodegenerative diseases like Alzheimer’s and Parkinson’s disease, specific neurons experience apoptosis prematurely. TUDCA has been shown to have anti-apoptotic and protective activities.  Some preliminary studies have shown that TUDCA exerts its effects not only by regulating and inhibiting the apoptotic cascade, but also by reducing oxidative stress and inflammation, protecting the mitochondria, and acting as a chemical chaperone to maintain the stability and correct folding of proteins. This may help to support your brain, liver, heart, digestive system, blood vessels, and other areas of your body (8, 11).

Gut Microbiome Health

A 2015 review published in Current Opinions in Gastroenterology discussed the connection between bile acids and the gut microbiome, which they refer to as the bile acid-gut microbiome axis (12). According to the authors, bile acids may help to regulate the gut microbiome. A 2020 research published in Gut Microbes found that bile acids may play an antibacterial role in the gut and help to shape the gut microbiome (13). Low bile acid levels may be linked to gut microbiome overgrowth, chronic inflammation, and related health issues. Perhaps this could lead to SIBO?

According to a 2012 animal study published in Gastrointestinal and Liver Physiology, TUDCA may increase bile flow up to 250% (14). This increase in bile may support gut microbiome balance, gut integrity, and digestion. According to a 2020 study published in the Annals of Hepatology, TUDCA may help to improve the gut microbiome and reduce gallstone formation (15). According to a 2022 study published in the Journal of Animal Science and Biotechnology, TUDCA may also help to improve intestinal barrier function, reducing the risk of leaky gut syndrome.

Liver and Kidney Health

Your liver and your kidneys are some of your main detoxification organs. They support your body’s natural cleansing processes and help to remove waste and toxins from your body. Unfortunately, exposure to environmental toxins, consuming an inflammatory diet, experiencing chronic stress, not sleeping enough, and practicing poor lifestyle choices may compromise the health of your liver and kidneys. This is where TUDCA comes in.

TUDCA may help to support your overall liver and kidney health. A 1999 clinical trial published in Hepatology found that using 750 mg of TUDCA for 2 months helped to improve primary biliary cirrhosis markers (16). They also found that TUDCA may have significant advantages over UDCA (a prescription bile acid known as Urosodiol) as far as long-term benefits go for liver health.

A more recent, 2013 double-blind, randomized controlled trial published in the Journal of Huazhong University of Science and Technology also found that using 750 mg of TUDCA for 6 months helped to improve liver enzyme markers (17). Researchers found that TUDCA may a safe and effective way to support the treatment of liver cirrhosis.

A high-salt or high-sodium diet and related mineral imbalances are common issues in our modern packaged food-lover society. Soil mineral depletion and the low mineral content of our supposedly healthy produce only add to the problem. The combination of soil depletion and a high-sodium inflammatory diet may set you up for poor kidney health. Using TUDCA may help to alleviate the issue. A 2019 study published in Acta Physiologica found that TUDCA may help to reduce chronic high-salt-induced renal damage from a high-salt diet (18). You can learn more about soil depletion here.

Brain Health

Though TUDCA may be the most known for its benefits for the liver, it offers a list of protective benefits for non-liver diseases, including brain health and neurodegenerative issues (19). TUDCA seems to be able to cross the blood-brain barrier, which means it may have protective effects on your brain. It may support your cognitive function, memory, and learning. This is great news if you want to stay sharp as you age.

According to a 2014 review published in Global Health Advances in Health and Medicine, TUDCA may show promise as an anti-apoptotic agent reducing the risk of various neurodegenerative issues, including amyotrophic lateral sclerosis, Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease (19). A 2016 randomized controlled trial published in the European Journal of Neurology, TUDCA may support the treatment and slow the progression of ALS (20).

A 2002 animal study published in the Proceedings of the National Academy of Sciences of the United States of America suggests that TUDCA may offer neuroprotective benefits against Huntington’s disease (21). Furthermore, according to a 2018 study published in Molecular Neurobiology, TUDCA shows promise for improving motor symptoms in Parkinson’s disease (22).

According to a 2017 review published in Neural Regeneration Research, TUDCA’s neuroprotective effects may be due to the “inhibition of glia and endothelium activation under pro-inflammatory conditions” (23). TUDCA may help to reduce inflammation which may support neural survival, the restoration of neural function, and overall neural health.

Immune Health

TUDCA may also help to support a healthy immune response and reduce your risk of certain viral illnesses. A 2015 cell study published in the American Journal of Respiratory and Critical Care Medicine found that TUDCA may help to reduce viral replication of the respiratory syncytial virus (RSV) (24). According to a 2020 study published in the Journal of Medical Virology, TUDCA may help to inhibit the replication of the herpes simplex (HSV)-1 virus (25).

Eye Health

Finally, TUDCA may also help to protect your eye health. Photoreceptor degeneration, diabetic retinopathy, and glaucoma, and other eye diseases that may increase the risk of vision loss and blindness affect about 11.8 million people in the United States alone (26). Your vision is precious and TUDCA may be one of the eye protectors you’ve been looking for!

A 2011 study published in PLoS One found that TUDCA may help to protect your photoreceptors and reduce cell death related to experimental retinal detachment (27). Though, according to a 2018 review published in Progress in Retinal and Eye Research, TUDCA may offer neuroprotective benefits for retinal diseases (26).

How to Improve Your TUDCA Levels

Though your body naturally produces TUDCA, it only makes it in a small amount. Natural TUDCA production may be slowed down by gut dysbiosis, liver dysfunction, gallbladder function, systemic inflammation, chronic stress, nervous system dysregulation, and various chronic health issues. Working with a functional medicine practitioner (hint: us), testing for these issues, and following personalized dietary, lifestyle, and supplementation strategies to reduce your risk of or improve any of these issues may help to support TUDCA production. You may also consider TUDCA supplementation to support your body.

TUDCA Supplementation

You may try supplementing with TUDCA to:

• Support digestion and absorption
• Improve insulin sensitivity
• Assist your liver and detoxification
• Improve your microbiome health
• Aid neuroprotective health
• Maintain key cellular processes
• Support eye health

If you are considering supplementing with TUDCA, I recommend buying from a trusted brand. Though there isn’t a standardized recommendation of dosage, 250 to 1,500 mg/day seems to be safe and effective. Though TUDCA is a generally safe supplement, some people reported diarrhea when going over 1,500 mg per day. Due to limited research, we don’t recommend TUDCA during pregnancy or breastfeeding. To ensure that TUDCA is right for you and find the right dosage, I recommend working with a healthcare professional.

Next Steps

If you want to improve your health, I welcome you to schedule a functional nutrition consultation with my nutritionist, Sarah, and functional medicine consults at The Spring Center. Visit our store for products.

And stay tuned for more information to help you uncover the root cause of your health issues, to improve your nutrition, repair your body, and regain your health naturally.

You can schedule your nutrition consultation with our nutritionist, Sarah here. You can schedule a functional medicine consultation here.