TUDCA is a new star in the functional medicine world, quickly advancing as a front- runner amongst supplements due to its many potential benefits.
What is TUDCA?
Tauroursodeoxycholic acid, or TUDCA is a bile acid derivative that’s naturally occurring in the body. It’s been used therapeutically in traditional Chinese medicine for millennia, for hepatic and biliary disordes. We only make small amounts of this health-giving compound in our body, but as you can see from my list above, this bile salt actually influences a ton of bodily functions. Traditional Chinese medical practitioners have known about the benefits of TUDCA for ages, prescribing it to help detoxify the liver, treat “heat illness” such as fever, spasms, and vision problems, and improve many other conditions. It’s only just recently been under the spotlight, becoming the subject of recent clinical studies as scientists examine its many potential and profound health benefits.
What’s the scoop on Bile?
Bile represents a complex fluid made of water, acids, electrolytes, and other organic molecules. Bile acids, the most functional component of bile, help us digest and absorb the fat-soluble vitamins A, D, E and K. Bile also breaks down foods, cholesterol, and destroys some harmful bacteria.
Bile helps the body eliminate waste, excrete cholesterol, and regulate metabolism. Bile acids convert and eliminate around 500 mg of cholesterol from the body every day. This process is called hepatic synthesis. The Liver produces bile, which is concentrated and stored in the gallbladder, then secreted into the digestive system via the duodenum (the first part of the small intestine beyond the stomach).
What is the Role of TUDCA in the Body?
Like many mechanisms in your body, TUDCA is made through a microbial process.
Firstly, bile salts are released into your intestines through your liver bile duct. Microbes in your large intestine then metabolize the bile salts into ursodeoxycholic acid (UDCA). Next, it gets conjugated to a taurine molecule in order to create TUDCA. This whole process happens naturally in your body and is supported when we have a healthy amount of bile salts.
A healthy person produces very small amounts of TUDCA, re-circulating some 95% of their bile salts. However, poor diet, decreased liver function, and certain medications can impair this process.
What’s the Difference between UDCA and TUDCA?
Primary bile acids are made in the liver, using cholesterol as the base. As bile acids circulate (via enterohepatic circulation), UDCA is returned to the liver and conjugated with taurine to form TUDCA. Besides mitigating ER stress, this process also prevents cell death (aka apoptosis).
TUDCA stands for tauroursodeoxycholic acid while UDCA stands for ursodeoxycholic acid. They are both bile salts, but UDCA is a more common form. When intestinal microbiota (the gut flora) produce the “secondary bile acids,” they make UDCA first. When UDCA metabolizes in the lower intestine, it binds to taurine to become TUDCA.
The Benefits of TUDCA Supplements
Nootropics have skyrocketed in popularity recently. If you’re looking at optimizing your cognitive functioning, improving your memory, and supporting your defenses against neurological disease, TUDCA may be the perfect fit. TUDCA crosses the brain-blood barrier and this biological substrate has become a promising subject in the scientific community for its protective effects in the brain. TUDCA is classified in a group of molecules known as chemical chaperones. These are usually described as low-molecular-weight compounds that restore the correct destination of incorrectly localized or aggregated proteins by stabilizing their structure and facilitating their folding.
Research studies show that TUDCA improves apolipoprotein E4 (APOE4) macrophage survival and function.* It also acts as a mitochondrial stabilizer and anti apoptotic agent in several models of neurological disease.* TUDCA is neuroprotective support and studies have revealed that it not only helped to remove plaque, but also helped prevent the production of that plaque.*
Supports Insulin Sensitivity
Stress to the cell’s Endoplasmic Reticulum (ER) may cause many conditions that seem unrelated, as in Diabetes. In lab animals given chemically-induced high blood sugar, for example, one study found TUDCA may have reduced blood sugar by 43%.
It’s well known that bile acids are critically important for the digestive process, but they also act as signaling molecules in many tissues. One of these many tissues is the pancreas, which expresses specific receptors that regulate several cell functions.
Studies carried out with obese, overfed mice show that TUDCA not only improved glucose tolerance, but it also improved insulin sensitivity. Many studies also show that TUDCA lowers endoplasmic reticulum stress, thus supporting insulin sensitivity.
TUDCA is believed to increase energy burned at the cellular level, potentially affecting how the body regulates insulin. High blood sugar levels due to poor insulin use (high glucose levels) can actually damage endothelial cells -- the cells lining blood vessels, lymphatic vessels, and organs. Such damage raises the risk of cardiovascular disease. TUDCA may affect these special cells lining the heart and arteries. Under oxidative stress, TUDCA has been found to help support endothelial cells when too much glucose (sugar) is present.
Mitochondria & Cellular Support
Every single one of your cells has hundreds of little power plants inside them called, mitochondria. These tiny microbes generate roughly 90 percent of our body’s energy. When our mitochondria aren’t functioning properly, we aren’t able to make adequate amounts of ATP. Mitochondrial dysfunction is at the root of all chronic illness and disease, and TUDCA has been shown to protect mitochondria and improve energy output by producing more antioxidants and mitigating reactive oxygen species. Rather than triggering cell death, they did the exact opposite, with TUDCA sparking them to make more mitochondria.
TUDCA may help support healthy cells in other ways. Prevention of cell death may affect us in many unexpected ways, reaching cells in the lining of organs such as the brain, heart, liver, and colon, as well as blood vessels and more. Studies show that TUDCA may support healthy cells and prevent them from dying.* The process of programmed cell death, or apoptosis, is a natural response to stress caused by viruses, free radicals, and cellular mutations. Apoptosis typically helps weed out old and defective cells through cellular disintegration. Sometimes, though, the wrong cells enter apoptosis, or the correct cells start apoptosis at the wrong time. Additionally, too many cells may enter apoptosis at once, or too few. When too few enter, it’s called excessive inhibited apoptosis, a condition associated with several diseases and conditions.
Supports Genetic Expression
Amazingly, TUDCA may even impact your gene expression and DNA in certain ways. The fact that TUDCA also addresses histone deacetylation is an additional, but not surprising, bonus.
TUDCA may support the mitochondria in your cells, too. If the bile duct in your liver tissue becomes blocked, the liver starts to die. When the liver can’t rid itself of the pollutants it is always processing, liver cells produce more free radicals. The mitochondria of these liver cells have to work hard to fight off reactive oxygen species, or the cells can die.
TUDCA supports overall liver health, but has also been shown to fight liver cirrhosis. A study was conducted on a group of people suffering from liver cirrhosis and high liver enzymes, who were given 750 milligrams (mg) of TUDCA for six months. TUDCA lowered one hundred percent of the participants liver enzymes. As a bonus, supplementing with this bile acid was very well tolerated amongst the study participants. Not even one of the people enrolled complained of any side effects.
Restores a Healthy Gut Microbiome
The lining of your intestines has cells that create gates called, tight junctions. These are the gate keepers that determine what get in and out of the gut. When our tight junctions lose integrity, or spread out too far, they allow things that shouldn’t be in the blood stream to pass through our intestinal lining. This condition is called intestinal permeability. Protein messengers in your gut regulate tight junctions, and these messengers signal the junctions to open or close, just like a gate. TUDCA helps these messengers to perform at their optimal levels, helping to maintain gut integrity and health. TUDCA has also been shown to support microbial health by promoting the growth of healthy gut bugs, and weeding out pathogenic bugs that are related to inflammation and obesity.
Mineral imbalances, along with high sodium, in our diets are very common problems in our society. Soil mineral depletion, combined with Frankenfoods (fake food) creates a recipe for a mineral depletion and sodium excess disaster. Supplementing with TUDCA is a wise choice if you want to protect your valuable kidneys from chronic stress that can lead to kidney disease. Studies show that TUDCA protects the kidneys from inflammation brought on by high sodium levels, and protects kidney tissue from damage, by guarding against cell death.
Could TUDCA be a potent protector of eye health? According to a number of research studies, the answer is yes! TUDCA protects against the progression of genetic eye disease, safeguards against diabetic eye complications, and improves the number of dysfunctional eye cells. If you’re looking to maintain peak eye health until you’re a centenarian, TUDCA may be just the support you’re looking for.
TUDCA has been shown to increase bile flow by 250 percent! Not only does the research show that individuals who supplement with TUDCA experienced an increase in bile, the composition of their bile also changed. It morphed into bile that contained higher amounts of compounds that positively assist digestion.
How to take TUDCA Supplements
TUDCA supplements are generally considered safe when taken within the recommended amounts. When exceeding 1500 mg daily, a dosage that exceeds the recommended amount, some people have reported experiencing diarrhea, which is a dosage that exceeds the recommended amounts. Aside from that one complication, there are no other reported side effects for TUDCA.
Given the limited research on TUDCA supplementation during pregnancy and nursing, it’s advised that pregnant or nursing women avoid it, Anyone with underlying medical conditions should speak to a doctor before using TUDCA as it may interact with other medications.
As we always recommend, consult with your health care provider to determine whether TUDCA is the right choice for you.
1. Attenuation of endoplasmic reticulum stress using the chemical chaperone 4-phenylbutyric acid prevents cardiac fibrosis induced by isoproterenol
Experimental and Molecular Pathology, Volume 92, Issue 1, 2012, pp. 97-104
2. Schoemaker MH, Conde de la Rosa L, Buist-Homan M, Vrenken TE, Havinga R, et al. (2004) Tauroursodeoxycholic acid protects rat hepatocytes from bile acid-induced apoptosis via activation of survival pathways. Hepatology 39: 1563–1573
3. Benz C, Angermuller S, Kloters-Plachky P, Sauer P, Stremmel W, et al. (1998) Effect of S-adenosylmethionine versus tauroursodeoxycholic acid on bile acid-induced apoptosis and cytolysis in rat hepatocytes. Eur J Clin Invest 28: 577–583.
4. Colell A, Coll O, Garcia-Ruiz C, Paris R, Tiribelli C, et al. (2001) Tauroursodeoxycholic acid protects hepatocytes from ethanol-fed rats against tumor necrosis factor-induced cell death by replenishing mitochondrial glutathione. Hepatology 34: 964–971.
6. Ceylan-Isik AF, Sreejayan N, Ren J. Endoplasmic reticulum chaperon tauroursodeoxycholic acid alleviates obesity-induced myocardial contractile dysfunction. J Mol Cell Cardiol. 2011;50:107–116. pmid:21035453
7. Chen Y, Liu CP, Xu KF, Mao XD, Lu YB, Fang L, et al. Effect of taurine-conjugated ursodeoxycholic acid on endoplasmic reticulum stress and apoptosis induced by advanced glycation end products in cultured mouse podocytes. Am J Nephrol. 2008;28:1014–1022. pmid:18648192
8. Lo AC, Callaerts-Vegh Z, Nunes AF, Rodrigues CM, D'Hooge R. Tauroursodeoxycholic acid (TUDCA) supplementation prevents cognitive impairment and amyloid deposition in APP/PS1 mice. Neurobiol Dis. 2013;50:21–29. pmid:22974733
9. Turdi S, Hu N, Ren J. Tauroursodeoxycholic acid mitigates high fat diet-induced cardiomyocyte contractile and intracellular Ca 2+ anomalies. PLoS One. 2013;8:e63615. pmid:23667647
10. Ding W, Wang B, Zhang M, Gu Y. Involvement of Endoplasmic Reticulum Stress in Uremic Cardiomyopathy: Protective Effects of Tauroursodeoxycholic Acid. Cell Physiol Biochem. 2016;38:141–152. pmid:26765262