Home Ingredients TUDCA (Tauroursodeoxycholic Acid)
Liver Health

TUDCA (Tauroursodeoxycholic Acid)

Evidence Level
Moderate
2 Clinical Trials
5 Documented Benefits
3/5 Evidence Score

TUDCA is the taurine-conjugated form of UDCA (ursodeoxycholic acid) — a hydrophilic bile acid found naturally in small amounts in human bile. Used in Traditional Chinese Medicine for over 3,000 years as 'bear bile' for liver and eye conditions; modern TUDCA is synthesized rather than animal-derived. Distinguished by ER-stress reduction, neuroprotection, and bile acid pool modulation. Increasingly used for liver health, ALS adjunct research, and 'cholestasis support'.

Studied Dose 250-1,750 mg/day; ALS research used up to 2 g/day combined with sodium phenylbutyrate (Relyvrio formulation)
Active Compound Tauroursodeoxycholic acid (TUDCA)

Benefits

Cholestasis / Liver Support

TUDCA (and parent compound UDCA — Actigall, Urso) is established prescription treatment for primary biliary cholangitis (PBC). TUDCA replaces toxic bile acids with hydrophilic versions, reduces hepatocyte injury. Modest evidence in non-prescription supplemental use for general liver support and elevated liver enzymes.

Supported by Trial 2

ER Stress Reduction (Endoplasmic Reticulum Stress)

TUDCA reduces ER stress and unfolded protein response — relevant for diabetes, neurodegeneration, fatty liver, and ischemia-reperfusion injury. Foundational mechanism distinguishes TUDCA from many liver supplements.

Supported by Trial 2, Trial 1

ALS / Neurodegenerative Disease Adjunct (Research)

AMX0035 (Relyvrio®) — TUDCA + sodium phenylbutyrate combination — was approved by FDA in 2022 for ALS based on CENTAUR trial showing slower disease progression. Withdrawn from market 2024 after Phase 3 confirmatory trial failed to show benefit. TUDCA's neuroprotective mechanism remains scientifically interesting; clinical translation for ALS is questionable.

Supported by Trial 1

Eye Health / Retinitis Pigmentosa Research

Animal models of retinitis pigmentosa show TUDCA reduces retinal cell apoptosis. 'Bear bile' traditionally used in TCM for eye conditions — modern TUDCA represents this lineage.

Supported by Trial 2, Trial 1

Gallstone Dissolution (Modest)

Same mechanism as parent compound UDCA which is established gallstone dissolution therapy. TUDCA may provide similar effects; UDCA has stronger direct evidence.

Supported by Trial 2

Mechanism of action

1

Hydrophilic Bile Acid Substitution

TUDCA is a hydrophilic (water-soluble) bile acid — when added to the bile acid pool, it dilutes more toxic hydrophobic bile acids. Reduces hepatocyte membrane injury and apoptosis from bile acid toxicity. Foundational mechanism for cholestasis applications.

2

ER Stress / UPR Modulation

Reduces endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) — pathways activated in many disease states (diabetes, neurodegeneration, NAFLD). Acts as 'chemical chaperone' supporting protein folding.

3

Anti-Apoptotic Activity

Inhibits mitochondrial pathway of apoptosis — protects various cell types (hepatocytes, neurons, retinal cells) from programmed cell death. Mechanism involves Bcl-2 family modulation and caspase inhibition.

4

Anti-Inflammatory Effects

Reduces pro-inflammatory cytokine production via NF-κB modulation and other pathways. Contributes to liver-protective effects.

Clinical trials

1
AMX0035 (TUDCA + PB) for ALS — CENTAUR Trial

Phase 2 clinical trial of AMX0035 (TUDCA 1 g + sodium phenylbutyrate 3 g, twice daily) vs placebo in 137 ALS patients for 24 weeks.

137 ALS patients.

Significantly slower disease progression (ALSFRS-R) vs placebo. Generated FDA approval (2022). However, Phase 3 confirmatory PHOENIX trial (2024) failed to show benefit; product withdrawn from market 2024.

2
UDCA/TUDCA for Primary Biliary Cholangitis

Multiple trials of UDCA (and TUDCA) for PBC over decades.

PBC patients.

Established prescription treatment; significantly improves liver enzymes, may slow disease progression. UDCA stronger evidence base; TUDCA used similarly in some countries.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated.
Mild GI distress (diarrhea, abdominal pain).
Headache.
Constipation paradoxical (rare).
Pruritus (itching) rare.
Hair loss / scalp issues anecdotal at high chronic doses (limited evidence).

Important Drug interactions

Cholestyramine, colestipol — bind bile acids; reduce TUDCA absorption; separate by 4+ hours.
Aluminum-containing antacids — bind bile acids; separate.
Oral contraceptives — bile acids may modify enterohepatic circulation; theoretical.
Statins — theoretical interactions via bile acid pool modulation; minor.
Anticoagulants — minimal interaction.
Cyclosporine — modify cyclosporine bioavailability (well-documented for UDCA); consult prescriber.

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Frequently asked questions about TUDCA (Tauroursodeoxycholic Acid)

What is TUDCA used for?

TUDCA (tauroursodeoxycholic acid) is a bile acid supplement used mainly for liver health (supporting bile flow and protecting liver cells) and is also studied for metabolic, eye, and cellular-stress support. It is popular for liver support.

What is TUDCA good for?

It is studied for supporting liver function and bile flow, easing cellular (endoplasmic reticulum) stress, and for metabolic and eye health. It is used to support the liver during periods of stress on the organ.

How much TUDCA should I take?

Liver-support doses are commonly around 250 to 500 mg per day, sometimes higher under specific protocols; follow product labeling. It is taken with or without food.

Is TUDCA safe?

It is generally well tolerated in studies; mild digestive upset can occur. Because it affects bile and liver function, those with gallbladder or liver conditions or on medication should use it under a doctor's guidance.

What is TUDCA?

TUDCA is the taurine-conjugated form of UDCA (ursodeoxycholic acid) — a hydrophilic bile acid found naturally in small amounts in human bile. Used in Traditional Chinese Medicine for over 3,000 years as 'bear bile' for liver and eye conditions; modern TUDCA is synthesized rather than animal-derived.

What is the recommended dosage of TUDCA?

The clinically studied dose is 250-1,750 mg/day; ALS research used up to 2 g/day combined with sodium phenylbutyrate (Relyvrio formulation) Always follow the product label and check with a healthcare provider for personal advice.

Is TUDCA safe, and does it have side effects?

For most healthy adults, TUDCA is well tolerated at studied doses. Reported effects can include: Generally well-tolerated. Mild GI distress (diarrhea, abdominal pain). It may also interact with some medications. TUDCA is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does TUDCA interact with any medications?

Possible interactions include: Cholestyramine, colestipol — bind bile acids; reduce TUDCA absorption; separate by 4+ hours. Aluminum-containing antacids — bind bile acids; separate. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for TUDCA?

NutraSmarts rates the evidence for TUDCA as Moderate (3 out of 5). It is backed by 2 clinical trials and 1 cited reference summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(1 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Kars M, Yang L, Gregor MF, et al. Tauroursodeoxycholic Acid may improve liver and muscle but not adipose tissue insulin sensitivity in obese men and women. Diabetes. 2010;59(8):1899-905..PubMedUsed to support: Randomized trial showing TUDCA improved liver and muscle insulin sensitivity in obese adults.