TUDCA
TUDCA has been tested in a few small trials. In 199 people with primary biliary cholangitis it matched ursodiol on liver enzymes over 24 weeks. In 20 adults with obesity, liver and muscle insulin sensitivity rose about 30% in 4 weeks. A 34-person ALS pilot reported slower decline. Adverse events matched comparators.
Add to Bio HackChecked 2026-11-09
- Status
- Sold in the US as a dietary supplement. Not FDA-approved for any condition. Ursodiol (ursodeoxycholic acid, UDCA), the related bile acid that TUDCA is a taurine-bound form of, is a prescription drug in the US.
- Also called
- tauroursodeoxycholic acid, tauroursodiol, taurursodiol, TUDCA bile acid
- Taken for
- liver health, liver protection, fatty liver, primary biliary cholangitis, cirrhosis, insulin sensitivity, ALS
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help4
- LimitedOne trial found TUDCA matched ursodiol for lowering a liver marker over 24 weeks in adults with primary biliary cholangitis. There was no placebo group.
- LimitedOne very small trial without placebo found liver enzymes fell over 6 months in adults with cirrhosis. Fibrosis markers did not change.
- LimitedOne small 4-week trial found liver and muscle insulin sensitivity rose about 30% in adults with obesity, with no change on placebo.
- LimitedOne pilot trial found more responders, 87% against 43% on placebo, in adults with ALS on riluzole. A related combination drug showed no difference.
Reported risks0
No risks sourced yet.
What people take it for, and what was found
Shown to help4
Primary biliary cholangitis
One trial found TUDCA matched ursodiol for lowering a liver marker over 24 weeks in adults with primary biliary cholangitis. There was no placebo group.
The numbers and sources
- Effect
- At 24 weeks, alkaline phosphatase fell by more than 25% in 75.97% on TUDCA and 80.88% on ursodiol (p 0.453), and by more than 40% in 55.81% and 52.94% (p 0.699). AST and bilirubin improved similarly in both groups [1].
- Population
- 199 adults with primary biliary cholangitis in China, 250 mg three times a day [1].
- Sources
- [1]
- Caveats
- One trial against an active drug, with no placebo group. It was designed to compare TUDCA with ursodiol, not with no treatment [1].
Liver cirrhosis
One very small trial without placebo found liver enzymes fell over 6 months in adults with cirrhosis. Fibrosis markers did not change.
The numbers and sources
- Effect
- On 750 mg a day for 6 months, ALT, AST and ALP fell from baseline in the TUDCA group and AST in the ursodiol group. Albumin rose in both. Fibrosis markers did not change significantly in either group [2].
- Population
- 23 adults with cirrhosis in China, 18 analyzed (9 per group) [2].
- Sources
- [2]
- Caveats
- Very small, with changes reported from baseline within each group and no placebo [2].
Insulin sensitivity
One small 4-week trial found liver and muscle insulin sensitivity rose about 30% in adults with obesity, with no change on placebo.
The numbers and sources
- Effect
- After 4 weeks of 1,750 mg a day, liver and muscle insulin sensitivity rose about 30% (p < 0.05) and did not change on placebo. Adipose tissue insulin sensitivity and markers of ER stress did not change [3].
- Population
- 20 adults with obesity, mean age 48, mean BMI 37 [3].
- Sources
- [3]
- Caveats
- One small 4-week trial measured with clamp studies. Blood sugar outcomes over time were not tested [3].
ALS
One pilot trial found more responders, 87% against 43% on placebo, in adults with ALS on riluzole. A related combination drug showed no difference.
The numbers and sources
- Effect
- Responders, defined as at least a 15% better slope on the ALS functional rating scale than during a lead-in period, were 87% on TUDCA and 43% on placebo (p 0.021). Function scores at study end were higher on TUDCA (p 0.007) [4].
- Population
- 34 adults with ALS already taking riluzole, 1 g twice a day for 54 weeks [4].
- Sources
- [4]
- Caveats
- A pilot proof-of-principle trial. The authors describe the data as preliminary [4]. A meta-analysis of 2 RCTs (801 people) of sodium phenylbutyrate-taurursodiol, a combination that contains TUDCA, found no significant difference from placebo or standard care in ALS functional decline (MD 1.51, 95% CI -1.01 to 4.02) or survival (HR 0.90, 95% CI 0.73 to 1.11), with very low certainty of evidence [5]. Those results are for the combination, not TUDCA alone [5].
Mixed results1
Liver protection with alcohol, oral steroids or other drugs
Case reports: one person developed drug-induced liver injury while taking TUDCA for protection. In mice, TUDCA eased acetaminophen liver injury, less than standard treatment.
The numbers and sources
- Effect
- A 2026 case report describes liver injury from fenbendazole in a person also taking TUDCA as an intended liver protectant, the first published report of that combination [8]. In mice given an acetaminophen overdose, TUDCA lowered transaminases, liver cell death and oxidative stress markers, to a lesser extent than N-acetylcysteine, and the two together did better than N-acetylcysteine alone [9].
- Population
- One person [8]. Mice [9].
- Sources
- [8], [9]
- Caveats
- A single case cannot show whether TUDCA changed the course of the injury [8]. The mouse study tested acetaminophen only, with treatment given after the overdose [9]. No study of TUDCA with alcohol or oral steroids in people was located.
Claimed, not studied in people1
Fatty liver
Not studied in people. In mouse models of fatty liver, TUDCA reduced weight gain and liver fat and changed bile acid handling and gut bacteria.
No study in people. This rests on animal studies, how it acts in the body.
The numbers and sources
- Effect
- In mouse models of fatty liver disease, TUDCA reduced obesity and liver fat buildup, improved gut barrier function, raised liver bile acids and lowered fatty acid uptake through FXR and FATP5 [6]. A 2026 review describes TUDCA as easing endoplasmic reticulum stress, inflammation, oxidative stress and liver cell death, and states that high-quality clinical evidence is still limited [7].
- Population
- Mice with fatty liver disease [6]. Preclinical studies, reviewed [7].
- Sources
- [6], [7]
- Caveats
- Animal data. The one human metabolic trial on this page measured insulin sensitivity over 4 weeks, not liver fat [3]. No trial of TUDCA for fatty liver in people was located.
Doses studied
Trials used 250 mg three times a day for 24 weeks [1], 750 mg a day for 6 months [2], 1,750 mg a day for 4 weeks [3] and 1 g twice a day for 54 weeks [4].
Risks
Checked, no increase found1
Adverse events in trials
Small trials found adverse events about as common as on placebo or ursodiol for up to about a year.
The numbers and sources
- Effect
- Adverse event rates were comparable between TUDCA and ursodiol. Itching rose from 1.43% to 10.00% on ursodiol and did not change on TUDCA (p 0.023) [1]. No patient in the cirrhosis trial reported side effects [2]. In the ALS trial, adverse events did not differ from placebo [4].
- Population
- Adults in RCTs [1][2][4].
- Sources
- [1], [2], [4]
- Caveats
- Small trials of up to about a year.
Claims tested and not found
Sources
- Ma H, Zeng M, Han Y, et al. A multicenter, randomized, double-blind trial comparing the efficacy and safety of TUDCA and UDCA in Chinese patients with primary biliary cholangitis. Medicine. 2016. https://doi.org/10.1097/md.0000000000005391
- Pan XL, Zhao L, Li L, et al. Efficacy and safety of tauroursodeoxycholic acid in the treatment of liver cirrhosis: a double-blind randomized controlled trial. Journal of Huazhong University of Science and Technology. Medical Sciences. 2013. https://doi.org/10.1007/s11596-013-1095-x
- 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. https://doi.org/10.2337/db10-0308
- Elia AE, Lalli S, Monsurrò MR, et al. Tauroursodeoxycholic acid in the treatment of patients with amyotrophic lateral sclerosis. European Journal of Neurology. 2016. https://doi.org/10.1111/ene.12664
- Jomaa AM, Khalid H, Abozait HJ, et al. Efficacy of Sodium Phenylbutyrate-Taurursodiol in Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis. Annals of Indian Academy of Neurology. 2026. https://doi.org/10.4103/aian.aian_1101_25
- Wang H, Guo Y, Han W, et al. Tauroursodeoxycholic Acid Improves Nonalcoholic Fatty Liver Disease by Regulating Gut Microbiota and Bile Acid Metabolism. Journal of Agricultural and Food Chemistry. 2024. https://doi.org/10.1021/acs.jafc.4c04630
- Chao R, Zhang Y, Hao Y, et al. Hepatoprotective mechanism of tauroursodeoxycholic acid and its therapeutic potential in liver diseases. Frontiers in Pharmacology. 2026. https://doi.org/10.3389/fphar.2026.1949645
- Satinsky A, Mayer N, Swanson C, Sasso B. Fenbendazole-Associated Drug-Induced Liver Injury with Concomitant Use of Tauroursodeoxycholic Acid. ACG Case Reports Journal. 2026. https://doi.org/10.14309/crj.0000000000002222
- Paridaens A, Raevens S, Colle I, et al. Combination of tauroursodeoxycholic acid and N-acetylcysteine exceeds standard treatment for acetaminophen intoxication. Liver International. 2017. https://doi.org/10.1111/liv.13261