250–500 mg/day (up to 1,000–1,750 mg in liver studies).
In cholestatic liver disease and cirrhosis it improves liver enzymes; a broad meta-analysis is still lacking.
View the study (RCT) →A small trial improved insulin sensitivity in liver and muscle.
See the study (small RCT) →⏱ 3 min read
TUDCA, or tauroursodeoxycholic acid, is a bile acid conjugated with taurine, present naturally in trace amounts in human bile and in more significant concentrations in bear bile, where its historical discovery is tied to traditional Chinese medicine (which has used bear bile for liver conditions for centuries) and which led to the chemical identification of ursodeoxycholate in the 1950s; TUDCA is the taurine conjugate of ursodeoxycholic acid (UDCA), the most pharmacologically studied hydrophilic bile acid.
UDCA and TUDCA share important pharmacological properties: they increase the hydrophilic fraction of the bile acid pool (making bile less toxic to hepatocytes and biliary epithelia), reduce the endoplasmic reticulum (ER) stress that accompanies multiple pathological processes, modulate apoptosis and cellular inflammation, and improve mitochondrial function in different tissues; these properties make TUDCA an interesting candidate for several indications beyond the liver, a direction that research is beginning to explore with promising preliminary data in neurodegeneration, retinopathy, and metabolic diseases.
UDCA is a drug with established indications in primary biliary cholangitis, primary sclerosing cholangitis, cholestasis of pregnancy, and prevention of gallstones during rapid weight loss; TUDCA has a comparable pharmacological profile (better absorption and a higher taurine proportion) with consistent clinical data in primary biliary cholangitis and in familial intrahepatic cholestasis, where several small trials have shown significant reductions in transaminases and cholestatic markers with supplementation over months.
In nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), several small studies have shown improvements in transaminases, in liver fat measured by MRI, and in insulin sensitivity with supplementation at 750-1,750 milligrams daily for 12-24 weeks; the data are interesting, but the trials are still small and the indication has not entered conventional clinical guidelines.
One of the most interesting lines of research with TUDCA is neuroprotection: in preclinical models of ALS (amyotrophic lateral sclerosis), Alzheimer's, Parkinson's, Huntington's, and stroke, TUDCA has shown significant neuroprotective effects attributed to reduced endoplasmic reticulum stress, modulation of apoptosis, and improved mitochondrial function; in ALS specifically, an Italian phase II trial published in 2016 with 34 patients showed slower progression with high-dose oral TUDCA over 1 year, data interesting enough to have motivated ongoing phase III trials.
In degenerative retinopathies (retinitis pigmentosa, macular degeneration), preclinical models show significant preservation of photoreceptors with TUDCA, an indication with preliminary clinical data at early research stages.
The doses studied range from 250 to 1,750 milligrams daily, split into one or two doses with or without food; for mild liver indications or as a protector during hepatotoxic supplementation cycles (anabolic steroids), 500-1,000 mg/day; for severe indications it should be used under specialized medical supervision; typical commercial products contain 250-500 mg per capsule.
Generally well tolerated; the adverse effects described are rare and mild (digestive discomfort, loose stools with high doses because of a choleretic effect, occasionally headache); in people with mechanical biliary obstruction it is contraindicated because of the risk of worsening from displacement of viscous bile; those taking cholestyramine, colestipol, or other bile acid sequestrants should space out the doses because they interfere with TUDCA absorption; in pregnancy UDCA is indicated for gestational cholestasis and is considered safe; in breastfeeding the data are more limited; people with advanced liver disease should use it only under hepatological supervision.
Information, not medical advice. Scientific evidence reflects the quality of the studies.