All Roads Lead to the Liver

As I always say, all roads lead to the liver and found this new product called TUDCA that looks promising for the liver and gallbladder. Here is some of the info on this very promising remedy.

TUDCA is FDA-approved for the treatment of liver diseases caused by a lack of bile flow (cholestasis) [5, 6]. A growing body of evidence is also supporting the use of TUDCA for diseases beyond the liver.

Mechanisms Of Action
TUDCA increases glucose-induced insulin release via the cAMP/PKA pathway, increasing insulin sensitivity [7].
TUDCA relieves endoplasmic reticulum (ER) stress. The ER makes sure proteins are folded properly [8, 9].
TUDCA reduces programmed cell death (apoptosis) in healthy cells [3]. TUDCA prevents the molecule BAX from reaching the mitochondria. BAX causes mitochondria to release cytochrome C, which causes enzymes (caspases) to initiate apoptosis [10].
TUDCA inactivates Bcl-2-associated death promoter (BAD), a molecule involved in apoptosis [11].
TUDCA removes toxic bile acids from the liver and prevents them from damaging liver cells [12].

Health Benefits of TUDCA
1) Decreases Elevated Liver Enzymes
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are two important enzymes in the liver. Elevated levels of these enzymes can indicate liver problems like primary biliary cirrhosis (PBC: an autoimmune disease that destroys bile ducts) or hepatitis [6, 13].

In one study done on 12 women with PBC over two months, TUDCA reduced liver enzymes by 51% [6].  TUDCA decreases liver enzyme levels even at low doses. A study of 5 liver disease patients found that 10 – 13 mg TUDCA daily for three months was able to reduce the liver enzyme alanine transaminase (ALT) levels [5].  In a study in 23 patients with PBC, TUDCA significantly improved liver enzymes levels (ALT, AST, gamma-glutamyl transferase (GGT), and alkaline phosphatase) [14].

2) Helps Treat Cholestasis
Cholestasis is a condition where bile doesn’t flow properly from the liver to the gallbladder and then to the small intestine [15].  Cholestasis is characterized by a lack of bile in the small intestine and accumulation of bile in the liver [15].  Cholestasis is often associated with other liver conditions, including primary biliary cirrhosis (PBC) [6].

One study found that TUDCA was able to reduce cholestasis caused by liver injury from lack of blood flow [16].

3) Combats Liver Cirrhosis
Cirrhosis is a condition of the liver in which scar tissue replaces healthy cells. It is a common cause of death and illness and is currently the fourteenth leading cause of death worldwide [17].  A study found that TUDCA was safe and effective in the treatment of liver cirrhosis in 18 patients with the disease [18].

4) Helps Treat Hepatitis
A study of 150 patients with hepatitis C found that TUDCA was more effective than placebo and progressively improving chronic hepatitis over the six-month trial period [13].

TUDCA prevents hepatitis B and hepatitis D viruses from infecting cells [19]. TUDCA was the most effective among several bile salts in preventing hepatitis B from infecting cells [19].  In one study, TUDCA reduced liver damage, oxidative stress, and scarring of tissue in mice with fatty liver disease [20].

5) Increases Insulin Sensitivity
Because of its rumored ability to burn fat, TUDCA is often used as a weight-loss drug or a bodybuilding supplement.  TUDCA is also used to treat obesity. Since insulin resistance is commonly associated with obesity, obese individuals may benefit from increasing their insulin sensitivity [21].

In a study of 20 obese volunteers, 1,750 mg TUDCA daily for four weeks increased insulin sensitivity by 30% in muscle and liver tissue [21].

However, in the same study, there was no change in the sensitivity of fat tissue to insulin [21].

Moreover, no effects on blood glucose or insulin levels were seen, and TUDCA had no significant influences on body fat or weight [21].

6) Helps Treat Complications of Diabetes
TUDCA may be able to treat complication due to diabetes [8, 9].

Copper levels are often elevated in diabetic patients [22]. One study found that TUDCA reduced high copper levels to normal levels in type 1 diabetic mice [23].

Diabetic retinopathy (DR) is a complication of diabetes in which the blood cells of the light-sensitive tissue in the eye (retina) are damaged. TUDCA prevented damage to human retinal cells exposed to high levels of sugar [24].

7) May Help Treat Alzheimer’s Disease
Amyloid beta (Aβ) plaques are proteins that play a critical role in the development of Alzheimer’s disease. TUDCA was able to decrease Aβ plaques in the brains of mice with symptoms of Alzheimer’s disease [1].

Another study found that TUDCA was able to reduce neuron cell death (apoptosis), which is involved in Alzheimer’s and other diseases of the brain [25].

TUDCA significantly reduced apoptosis caused by Aβ plaques in mice [26].

Six months of TUDCA supplementation prevented memory deficits in a mouse model of Alzheimer’s disease [27].
 May Help Treat Parkinson’s Disease
TUDCA protected nerve cells in a mouse model of Parkinson’s disease [28].

TUDCA prevented c-Jun N-terminal kinase (JNK) activation. The JNK pathway leads to the death of neurons in Parkinson’s disease [29].

TUDCA reduced cell death in a rat model of Parkinson’s disease [30].

9) May Help Treat Huntington’s Disease
A study found that TUDCA was nontoxic and protected nerve cells in a mouse model of Huntington’s disease [31].

TUDCA reduced cell death by 80% in rats with symptoms of Huntington’s disease [32].

10) May Help Treat ALS (Lou Gehrig’s Disease)
ALSFRS-R is a functional rating scale for measuring disability in ALS patients, with higher scores indicating less disability. A study of 34 ALS patients showed that patients taking 1 g TUDCA daily had higher ALSFRS-R scores after one year [33].

TUDCA was well-tolerated, and there were no differences in adverse effects between the TUDCA and placebo groups [33].

11) Protects Against Strokes
A study in rats gave TUDCA one hour after a stroke and found that TUDCA raised bile acid levels in the brain and that TUDCA may be useful in the treatment of strokes [34].

Another study found that TUDCA decreased blood clot volume and cell death due to stroke [35].

TUDCA reduced both wound volumes and cell death in the striatum (a part of the brain) of rats by 50% after a stroke [36].

12) Reduces Damage From Heart Attacks
TUDCA reduced heart cell death following a heart attack in rats [37].

The study suggested that TUDCA is a viable treatment for heart attacks [37].

13) May Improve Retinal Health
Retinitis pigmentosa (RP) is a disease of the brain (neurodegenerative) that results in blindness [38].

A study done on mice reported that TUDCA is effective and safe in the treatment of a mouse model of RP [38].

The study noted that TUDCA preserved rod and cone (cells of the eye responsible for vision) function, and prevented cell death of rods of cones [38].

TUDCA slowed retinal degeneration in mice [39].

TUDCA slowed retinal degeneration and vision loss in rats [40].

Leber congenital amaurosis (LCA) is an eye disorder that damages the retina. TUDCA was effective in treating a mouse model of LCA [41].

Choroidal neolization (CNV) is the creation of new blood vessels in the choroid layer of the eye, which is a thin layer directly behind the retina that absorbs scattered light. It results in significant and permanent vision loss from the formation of scar tissue [42].

In mice whose eyes were exposed to a laser to cause CNV, TUDCA prevented CNV formation [43].

The study suggested that TUDCA is a potential candidate drug in the treatment of CNV-related retinal diseases [43].