UDCA/TUDCA continue to amaze me with their potential health benefits. I’ve recently stopped my SGLT2i because it was elevating my hematocrit too much when combined with TRT, but the anti-fibrotic/anti-arrhythmic potential of TUDCA gives me hope that I’m still getting some similar benefits (albeit via different mechanisms) without the hematocrit elevation. 
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Another benefit of UDCA @Davin8r:
I read this paper back then but didn’t pay attention to UDCA: Statins aggravate insulin resistance through reduced blood glucagon-like peptide-1 levels in a microbiota-dependent manner 2025
Highlights
- Statin alters gut microbiota and dysregulates bile acid metabolism and glucose homeostasis
- Statin causes dysregulated gut microbiota and decrease of the genus Clostridium
- Decreased Clostridium-rich microbiota after statin inhibits HSDH and lowers UDCA
- Transplanting Clostridium sp. or supplying UDCA ameliorates statin-induced hyperglycemia
Summary
Statins are currently the most common cholesterol-lowering drug, but the underlying mechanism of statin-induced hyperglycemia is unclear. To investigate whether the gut microbiome and its metabolites contribute to statin-associated glucose intolerance, we recruited 30 patients with atorvastatin and 10 controls, followed up for 16 weeks, and found a decreased abundance of the genus Clostridium in feces and altered serum and fecal bile acid profiles among patients with atorvastatin therapy. Animal experiments validated that statin could induce glucose intolerance, and transplantation of Clostridium sp. and supplementation of ursodeoxycholic acid (UDCA) could ameliorate statin-induced glucose intolerance. Furthermore, oral UDCA administration in humans alleviated the glucose intolerance without impairing the lipid-lowering effect. Our study demonstrated that the statin-induced hyperglycemic effect was attributed to the Clostridium sp.-bile acids axis and provided important insights into adjuvant therapy of UDCA to lower the adverse risk of statin therapy.
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Interesting! I wish they’d also tested TUDCA…
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Use of Ursodeoxycholic Acid and Cancer Risk for Patients With Primary Biliary Cholangitis 2025
In this study, UDCA treatment was associated with significantly lower risks of gastrointestinal cancer, liver cancer, and breast cancer but not colorectal cancer in patients with PBC.
Our findings suggest a potential chemopreventive effect of UDCA beyond its hepatic benefits, consistent with some prior reports. The underlying protective mechanism of UDCA remains to be elucidated but is presumably related to its anti-inflammatory, antiproliferative, and cytoprotective properties. Confirmation of our findings using prospective studies or randomized clinical trials is warranted, particularly for liver and breast cancer.
More good news @Davin8r.
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I didn’t know anything about UDCA/TUDCA, so I just found this easy to digest article with a great explanation. Those of you who are already knowledgeable about it don’t need to waste your time reading this.
It seems it might be something to learn more about if you don’t have a gallbladder (me). Also, as someone with good labs but poor post prandial glucose control, I looked and AI said they’ve done tests with TUDCA and it did not help with glucose spikes.
Sorry if this has already been shared:
The only part I didn’t understand is it says increasing insulin sensitivity could be a negative vs a positive. (I’ll assume this is something specifically an issue in PD?)
“There is one potential concern regarding TUDCA: it increases glucose-induced insulin release (via the cAMP/PKA pathway), which in turn could increase insulin sensitivity (Click here to read more about this). This could affect people with diabetes or glucose intolerance – a common feature of Parkinson’s “
EDIT:
I also see if you’ve had gallbladder removal, your TUDCA levels might increase so it seems to be a complex issue.
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Thank you for such a deep dive! One thing that ringed a bell is that if TUDCA helped with ALS it should also help protect the neural activation of muscle during aging, ergo reducing sarcopenia and losing respiratory function.
I am curious what the experts here say about reducing the apaptosis of cells or increasing the mithocondria turnover, both effects I understand are not desired for all your life, right?
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TUDCA doesn’t help with ALS: the phase 3 trial failed.
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The difficulties with anything caused by mitochondrial failure is that fixing it requires fixing the mitochondria.
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It seems that indeed, in worms at least, UDCA is beneficial at moderate dose while TUDCA is highly detrimental: Ora Biomedical Million Molecule Challenge Results - #452 by adssx
fwiw @Davin8r…
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Thanks for linking to that! I’m looking into prices to potentially switch. It might actually be cheaper than the Nootropics Depot brand TUDCA im taking.
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“TUDCA alleviates AD-related cognitive deficits partly through modulation of the microbiota-gut-brain axis while also acting via microbiota-independent mechanisms, supporting its potential as a promising therapeutic strategy for AD”
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The usual disclaimers: Chinese paper, Tier 3 university, low-quality journal, in mice.
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P-1649. Impact of Ursodeoxycholic Acid on COVID-19 Outcomes: A Systematic Review and Meta-Analysis 2026
We found no statistically significant differences between UDCA and non-UDCA groups regarding mortality (RR = 0.99; 95% CI [0.80, 1.23]; P = 0.94), or COVID-19-related hospitalization (RR = 0.98; 95% CI [0.89, 1.08]; P = 0.74). However, the UDCA group demonstrated significant improvements in COVID-19 symptoms, including cough (OR = 0.43; 95% CI [0.31, 0.60]; P < 0.00001), muscle or joint pain (OR = 0.70; 95% CI [0.51, 0.96]; P = 0.03), and pharyngalgia (OR = 0.28; 95% CI [0.09, 0.82]; P = 0.02).
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“At the molecular level, UDCA activated PPARγ/Nrf2 antioxidative signaling while inhibiting NF-κB-mediated inflammation, and network pharmacology analysis identified 225 potential targets (including TNF-α, IL6, and NF-κB) within lipid/atherosclerosis pathways, collectively underscoring UDCA’s multimodal protective mechanisms against NAFLD.”
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Just sharing a video that sings the praises of TUDCA. I guess I’ll be adding this for insulin sensitivity …
- Video Overview: Nick Norwitz discusses TUDCA (tauroursodeoxycholic acid), a gut-made bile acid supplement, for reducing atherosclerosis plaque via anti-inflammatory mechanisms, not cholesterol reduction.
- Key Mechanism: Western diets trigger ER stress, ATF4 activation, inflammasomes in macrophages, forming foam cells and impairing cholesterol efflux; TUDCA interrupts this by suppressing ER stress/inflammasomes and boosting efflux.
- Evidence: Animal studies show dramatic plaque reduction; human plaques confirm pathway activation; no large human RCTs yet.
- Related Insights: Statins reduce GLP-1 via gut microbiome/UDCA depletion; TUDCA may counteract this, aiding insulin sensitivity.
- Dosing: Start 250mg/day with food, titrate to 500-1750mg split doses; well-tolerated, cycle optionally (e.g., 4 weeks on/2 off); GI side effects possible.
- Caveats: Preclinical promise strong but unproven in humans; not a miracle pill.
I can’t be more convinced that making stuff up is his forte.
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There’s no down side that I know of and I take it and my wife and several friends. But I can say that there’s a difference between brands and I wish I knew somebody that tested them all and could tell us which one is best. Some barely work at all.
Thanks for that @Bicep…. *adds to cart.
I just AI’d and I see Vitality Pro offers it. I could be wrong but it’s my impression they are one of the highest quality brands. Edit: I now see Adssx mentioned them which is probably why I knew it’s a good brand.
At some point I just got it in my head that UK brands are generally of higher quality than the US, but this might not be accurate!
Edit: @Bicep I see @Davin8r uses Nootropics and he is usually pretty good at sourcing. Nootropics is same cost per pill but nootropics is 500mg vs VP at 250mg
When they fill capsules the dust gets on the outside in small amounts. It’s unavoidable. My wife says if they taste like bile (which is awful) then they work. She needs it for her gall bladder. We are currently using Bulk Supplements brand and it does taste bad. It’s cheapest on rapadmin’s list too.
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@Bicep Excellent feedback. I’ll now reach out to Nootropics and Vitality Pro to confirm they have zero residue on their capsules and zero taste… I’ll be back to share what I learn.
I had my gallbladder taken out which was one of the best things to happen to me… . Undiagnosed for many years and felt awful… turns out it was gangrene… lovely!
Glad it’s helping your wife, but if she ever needed the surgery, I’ll share that for me, it was a big nothing…. And I’m even too wimpy to take an icky tasting supplement 