TUDCA (tauroursodeoxycholic acid)
Summary
TUDCA is a bile acid closely related to the liver drug UDCA. In a 199-person trial in a bile-duct liver condition it lowered liver enzymes about as much as UDCA did (grade C). A 20-person trial found better insulin sensitivity. A 336-person phase 3 nerve-disease trial found no benefit.
Key facts
- A bile acid: ursodeoxycholic acid (UDCA) joined to taurine; studied mostly as a medicine for liver conditions[1][2]
- Matched UDCA on liver enzyme response in 199 people with primary biliary cholangitis over 24 weeks (no placebo group, grade C)[1]
- 1,750 mg a day for 4 weeks raised liver and muscle insulin sensitivity by about 30% in 20 adults with obesity (grade D)[4]
- A 336-person, 18-month phase 3 trial of 2 g a day in ALS missed its primary and secondary endpoints, after a 34-person pilot had looked positive[5][6]
- 5 graded human outcomes on this page
- October 11, 2026
How it works
ProposedTUDCA is a water-soluble bile acid that shifts the bile acid pool toward less toxic forms, and in lab and animal work it acts as a chemical chaperone that eases endoplasmic-reticulum stress; in the human insulin trial, muscle markers of that stress did not change.[2][4]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Gut | Grade C | Improved | RCT · n = 199 · 2016 | 3 rows |
| Immune | Grade D | No effect | RCT · n = 47 · 2025 | 1 row |
| Metabolic | Grade D | Improved | RCT · n = 20 · 2010 | 1 row |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Liver enzyme (ALP) response compared with the drug UDCA | Improved | Grade C | RCT · n = 199 · 2016 Adults in China with primary biliary cholangitis Form: TUDCA · Dose: 750 mg/day (250 mg three times a day) · Duration: 24 weeks ALP fell by more than 25% in 76% of the TUDCA group and 81% of the UDCA group, a difference that was not significant; itching rose only in the UDCA group. There was no placebo group. | 27893675 (opens PubMed)Source [1] |
| Safety and clinical measures | No effect | Grade D | RCT · n = 47 · 2025 Adults with progressive multiple sclerosis Form: TUDCA · Dose: 2 g/day · Duration: 16 weeks Adverse events did not differ from placebo; blood bile acids rose, but clinical and fluid biomarker outcomes did not differ. | 39447576 (opens PubMed)Source [7] |
| Liver enzymes at three TUDCA doses | Improved | Grade D | RCT · n = 24 · 1996 Adults with primary biliary cirrhosis Form: TUDCA · Dose: 500, 1,000 or 1,500 mg/day · Duration: 6 months Liver enzymes fell within the first month at all three doses with no clear difference between doses; diarrhea was the only side effect. | 8674405 (opens PubMed)Source [2] |
| Liver and muscle insulin sensitivity | Improved | Grade D | RCT · n = 20 · 2010 Adults with obesity (mean BMI 37) Form: TUDCA · Dose: 1,750 mg/day · Duration: 4 weeks Hepatic and muscle insulin sensitivity rose about 30% with TUDCA and did not change with placebo; fat-tissue insulin sensitivity did not change. | 20522594 (opens PubMed)Source [4] |
| Liver enzymes compared with UDCA | Improved | Grade D | RCT · n = 18 · 2013 Adults in China with liver cirrhosis Form: TUDCA · Dose: 750 mg/day · Duration: 6 months ALT, AST and ALP fell from baseline with TUDCA (AST only with UDCA); fibrosis markers did not change in either group. Both were well tolerated. | 23592128 (opens PubMed)Source [3] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| TUDCA (tauroursodeoxycholic acid) | Varies[1] | No head-to-head human absorption data between products in our sources.[1] | Well tolerated in trials up to 2 g a day; diarrhea was reported in the dose-ranging liver trial.[2][7] | Liver enzymes (750 mg/day), insulin sensitivity (1,750 mg/day) |
Studied doses
Doses studied in human trials ranged from 500 mg to 2 g of TUDCA a day, for 4 weeks (insulin trial) to 18 months (a phase 3 nerve-disease trial); the liver trials mostly used 750 mg a day.[1][2][4][6]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
None found in our sources.
Who should be careful
- People with a liver condition
- The liver trials were run under specialist care alongside or in place of a prescription bile acid; changes to liver medicine belong with that specialist.[1][3]
- Sensitive digestion
- Diarrhea was the one side effect reported in the dose-ranging trial.[2]
- Pregnancy and breastfeeding
- No safety data were found in the trials we cite.[1]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
Where to buy TUDCA (tauroursodeoxycholic acid)
Products from brands we partner with that contain TUDCA (tauroursodeoxycholic acid). Listing a product is not a claim that it works; check the amount per serving against the doses studied above, and the label for other ingredients.
- SupersmartPaid linkTUDCA Bile Complex3 capsules: 250 mg TUDCA plus 300 mg taurine, 300 mg choline bitartrate (120 mg choline) and 300 mg artichoke leaf extract; 30 servings. The 250 mg of TUDCA is below every dose studied (500 mg to 2 g a day), and the blend itself has not been tested.Shop at Supersmart (opens in new tab)Price and label checked 2026-10-11 on the brand’s site.
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Frequently asked questions
Is TUDCA the same as ursodiol (UDCA)?
No, but they are close relatives: TUDCA is UDCA bound to taurine. In a 199-person trial in a bile-duct liver condition, 750 mg a day of each lowered liver enzymes by similar amounts.[1]
Does TUDCA improve insulin sensitivity?
One 4-week trial in 20 adults with obesity found about 30% better liver and muscle insulin sensitivity at 1,750 mg a day. It has not been repeated in a larger trial.[4]
Does TUDCA help ALS?
A small pilot looked promising, but the 336-person, 18-month phase 3 trial of 2 g a day found no benefit on function, survival or nerve-damage markers.[5][6]
Sources
- [1]A multicenter, randomized, double-blind trial comparing the efficacy and safety of TUDCA and UDCA in Chinese patients with primary biliary cholangitis.. Medicine (Baltimore), 2016. RCT
- [2]Tauroursodeoxycholic acid for treatment of primary biliary cirrhosis. A dose-response study.. Dig Dis Sci, 1996. RCT
- [3]Efficacy and safety of tauroursodeoxycholic acid in the treatment of liver cirrhosis: a double-blind randomized controlled trial.. J Huazhong Univ Sci Technolog Med Sci, 2013. RCT
- [4]Tauroursodeoxycholic Acid may improve liver and muscle but not adipose tissue insulin sensitivity in obese men and women.. Diabetes, 2010. RCT
- [5]Tauroursodeoxycholic acid in the treatment of patients with amyotrophic lateral sclerosis.. Eur J Neurol, 2016. pilot-RCT
- [6]TUDCA trial did not meet its endpoints. ALS Society of Canada, 2024. review
- [7]Bile acid metabolites predict multiple sclerosis progression and supplementation is safe in progressive disease.. Med, 2025. RCT
What changed
- First draft. Every PMID checked against NCBI E-utilities (title, year and journal taken from the PubMed record) and abstracts read for each cited row. Product details in Where to buy read from the brand page on the date shown. Self-reviewed in a second strict pass (no independent reviewer yet).