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 WITHDRAWN FROM MARKET 2024 after Phase 3 confirmatory trial failed to show benefit.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 (Paganoni 2020)
PubMed

Phase 2 RCT 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
PubMed

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 (Tauroursodeoxycholic Acid)?

TUDCA is the taurine-conjugated form of UDCA (ursodeoxycholic acid) — a hydrophilic bile acid found naturally in small amounts in human bile.

What does TUDCA (Tauroursodeoxycholic Acid) do?

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. In clinical research, TUDCA (Tauroursodeoxycholic Acid) has been studied for cholestasis / liver support, er stress reduction (endoplasmic reticulum stress), als / neurodegenerative disease adjunct (research).

Who should take TUDCA (Tauroursodeoxycholic Acid)?

TUDCA (Tauroursodeoxycholic Acid) may be most relevant for people interested in liver health. It has been clinically studied for cholestasis / liver support, er stress reduction (endoplasmic reticulum stress), als / neurodegenerative disease adjunct (research). As with any supplement, consult your healthcare provider before starting, especially if you have medical conditions or take prescription medications.

How long does TUDCA (Tauroursodeoxycholic Acid) take to work?

Most clinical trial effects appear over weeks of consistent use; individual response varies. Acute or same-day effects (where applicable) typically appear within hours, but most cumulative benefits — particularly those affecting biomarkers, mood, sleep quality, or chronic symptoms — require 4-12 weeks of regular use to fully assess. If you don't notice benefit after 12 weeks at the appropriate dose, it may not be your responder.

When is the best time to take TUDCA (Tauroursodeoxycholic Acid)?

TUDCA (Tauroursodeoxycholic Acid) can typically be taken with breakfast or dinner — taking with food reduces GI sensitivity for most supplements. Specific timing matters less than daily consistency for cumulative effects. Always check product labeling and follow personalized guidance from your healthcare provider.

Is TUDCA (Tauroursodeoxycholic Acid) worth taking?

TUDCA (Tauroursodeoxycholic Acid) has moderate clinical evidence (Evidence Level 3/5 on NutraSmarts) — meaningful trial support exists, though results are less consistent than top-tier ingredients. Whether it's worth taking depends on your specific goals, what you've already tried, your budget, and your overall supplement strategy. The honest framing: no supplement is essential for most people, and lifestyle factors (sleep, exercise, diet, stress management) typically produce larger effects than any single supplement. TUDCA (Tauroursodeoxycholic Acid) is most worth trying if its evidence-supported uses align with your specific goals.

What is the recommended dosage of TUDCA (Tauroursodeoxycholic Acid)?

The clinically studied dose for TUDCA (Tauroursodeoxycholic Acid) is 250-1,750 mg/day; ALS research used up to 2 g/day combined with sodium phenylbutyrate (Relyvrio formulation). Always follow product labeling and consult a healthcare provider for personalized dosing recommendations.

What is TUDCA (Tauroursodeoxycholic Acid) used for?

TUDCA (Tauroursodeoxycholic Acid) is studied for cholestasis / liver support, er stress reduction (endoplasmic reticulum stress), als / neurodegenerative disease adjunct (research). 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.