TUDCA
Tauroursodeoxycholic Acid
TUDCA (Tauroursodeoxycholic Acid) is a bile acid conjugate and endogenous compound found in small quantities in human bile, used primarily as a cytoprotective and hepatoprotective agent. It is widely studied for liver disease, mitochondrial dysfunction, and neuroprotection, and is used clinically in some countries for cholestatic liver conditions. Beyond liver health, it has gained significant interest in the longevity and performance community for its ability to reduce ER stress and support cellular health across multiple organ systems.
Mechanism of Action
TUDCA exerts its primary effects by inhibiting endoplasmic reticulum (ER) stress pathways, particularly by suppressing the unfolded protein response (UPR) and reducing activation of pro-apoptotic signals such as CHOP and caspase-12. It also acts as a mitochondrial stabilizer, preserving the mitochondrial membrane potential and reducing cytochrome c release, thereby protecting cells from apoptosis. Additionally, TUDCA activates the TGR5 bile acid receptor, modulates bile composition to reduce hepatotoxic bile acid accumulation, and promotes autophagy, contributing to its broad cytoprotective profile.
Evidence by Health Goal(18 goals)
Dosing Protocols
With meals
Clinical studies for cholestatic liver disease have used 10-15mg/kg/day. For general liver support and ER stress reduction, 500mg/day is a common starting point; up to 1000-1500mg/day has been used in clinical settings. Take with food to improve tolerability and bile acid co-secretion.
Safety & Side Effects
TUDCA has a well-established safety profile supported by clinical trials and decades of use in Europe and Asia as a prescription hepatoprotective agent; it is generally well-tolerated at doses up to 1750mg/day in clinical settings. However, individuals with complete biliary obstruction, active gallstones, or severe hepatic impairment should use it only under medical supervision, and it is a prescription medication (e.g., Taurolite) in several European countries.
Possible Side Effects
- !Loose stools or diarrhea, particularly at higher doses (>1000mg/day)
- !Mild nausea or gastrointestinal cramping during initial use
- !Increased biliary cholesterol secretion, potentially relevant in gallstone-prone individuals
- !Headache reported in a minority of users during early supplementation
- !Rare: elevated liver enzymes in individuals with pre-existing biliary obstruction
- !Potential alterations in gut microbiome composition with prolonged use
Interactions
- -May reduce absorption of cyclosporine and other lipophilic immunosuppressants by altering bile acid pool — separate dosing by at least 2 hours
- -Can potentiate the effects of other hepatoprotective agents (e.g., silymarin, NAC) — generally synergistic and considered safe in combination
- -May modestly enhance insulin sensitivity, warranting caution in individuals on antidiabetic medications or insulin due to additive glucose-lowering effects
- -Cholesterol-lowering medications (statins, bile acid sequestrants) may have altered efficacy or absorption when combined due to changes in bile acid dynamics
- -Caution with anticoagulants (e.g., warfarin) as TUDCA's hepatoprotective effects may alter hepatic metabolism of clotting factors — monitor INR if combined
Cost & Where to Buy
Cost varies significantly by dose and brand; 500mg/day at 30 days requires 15g total, with quality brands ranging from $25-$70/month. Higher therapeutic doses (1000-1500mg/day) can push costs to $50-$120/month. Pharmaceutical-grade TUDCA from European suppliers is more expensive than US supplement-grade products.
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