TUDCA/UDCA?

[Rafael Henrique]

Hi, peaters!
I have thalassemia minor, so my red blood cells breakdown easily, which causes a build-up of bilirubin frequently. One common problem of this rbc breakdown is the gallbladder sludge. Recently, for two weeks more or less, I have been feeling a little pressure on the right quadrant and that pressure in the middle of the chest (and my stools are tan).
I have a "peat diet" and take taurine, glycine every day with little to no improvement.
I am planning to take milk thistle or UDCA or OX BILE. Is that a good idea? Is there any significative difference between UDCA or TUDCA?

 

[Peater]

My understanding is that the cheap and widely available TUDCA is (For once) the best option.

 

[Chophouse360]

What is the best ox bile brand?

 

[aliml]

Increasing UGT1A1 enzyme activity helps to clear bilirubin.

Dietary compounds that modify bilirubin levels
...Several studies refer four botanical groups as associated to changes in bilirubin concentrations Cruciferae (e.g., broccoli), Rutaceae (citrus), Liliaceae (e.g., onions), and Leguminosae (legumes). In a hyperbilirubinemic condition, the best approach would include the increasing UGT1A1 expression and this can be achieved with foods from the botanical families Cruciferae, Rutaceae, Liliaceae, and Leguminosae.
https://bibliotecadigital.ipb.pt/bitstream/10198/13811/1/Dietary Compounds that Modify Bilirubin Levels_final.pdf

 

[cs3000]

Hi, peaters!
I have thalassemia minor, so my red blood cells breakdown easily, which causes a build-up of bilirubin frequently. One common problem of this rbc breakdown is the gallbladder sludge. Recently, for two weeks more or less, I have been feeling a little pressure on the right quadrant and that pressure in the middle of the chest (and my stools are tan).
I have a "peat diet" and take taurine, glycine every day with little to no improvement.
I am planning to take milk thistle or UDCA or OX BILE. Is that a good idea? Is there any significative difference between UDCA or TUDCA?

hi milk thistle can inhibit thyroid so i would avoid
TUDCA works better than UDCA for bile blockage in the liver but idk about gallblader. something worth knowing if taking them long term is they can be carcinogens in the stomach if you take them with low stomach acidity e.g after eating or on suppressors or have an issue with acidity. but normal empty stomach acidity inactivates them
In a patient with normal gastric acidity in the 1 to 3 pH range, bile acids precipitate into harmless insoluble molecules (Fig. 10.25). At a pH above 6, the bile acids remain in an ionized form, which precludes their entry into cells. Between a pH of 3 and 6, the bile acids and their metabolites are converted to un-ionized soluble molecules that can penetrate cell membranes and enter epithelial cells.
Acid suppression, particularly when it is incomplete as in the vast majority of patients who take these medications, both over the counter and prescribed, has the effect of increasing gastric pH into the critical 3 to 6 pH range where it promotes the generation of carcinogenic molecules from the endogenous bile acids when these are present in the stomach.

 

[Validus]

My understanding is that the cheap and widely available TUDCA is (For once) the best option.

TUDCA, cheap? lol?

 

[Rafael Henrique]

My understanding is that the cheap and widely available TUDCA is (For once) the best option.

TUDCA in Brazil is expensive, like the 2x the price of UDCA.

 

[Rafael Henrique]

Increasing UGT1A1 enzyme activity helps to clear bilirubin.

Lentils would be a good choice? They are rich in folate, which i need a lot.

 

[Rafael Henrique]

hi milk thistle can inhibit thyroid so i would avoid
TUDCA works better than UDCA for bile blockage in the liver but idk about gallblader. something worth knowing if taking them long term is they can be carcinogens in the stomach if you take them with low stomach acidity e.g after eating or on suppressors or have an issue with acidity. but normal empty stomach acidity inactivates them
In a patient with normal gastric acidity in the 1 to 3 pH range, bile acids precipitate into harmless insoluble molecules (Fig. 10.25). At a pH above 6, the bile acids remain in an ionized form, which precludes their entry into cells. Between a pH of 3 and 6, the bile acids and their metabolites are converted to un-ionized soluble molecules that can penetrate cell membranes and enter epithelial cells.
Acid suppression, particularly when it is incomplete as in the vast majority of patients who take these medications, both over the counter and prescribed, has the effect of increasing gastric pH into the critical 3 to 6 pH range where it promotes the generation of carcinogenic molecules from the endogenous bile acids when these are present in the stomach.

UDCA+ Taurine maybe? I do not plan to take it long-term. Actually, I will do some scans first just to make sure.

 

[Gypsumking]

hi milk thistle can inhibit thyroid so i would avoid
TUDCA works better than UDCA for bile blockage in the liver but idk about gallblader. something worth knowing if taking them long term is they can be carcinogens in the stomach if you take them with low stomach acidity e.g after eating or on suppressors or have an issue with acidity. but normal empty stomach acidity inactivates them
In a patient with normal gastric acidity in the 1 to 3 pH range, bile acids precipitate into harmless insoluble molecules (Fig. 10.25). At a pH above 6, the bile acids remain in an ionized form, which precludes their entry into cells. Between a pH of 3 and 6, the bile acids and their metabolites are converted to un-ionized soluble molecules that can penetrate cell membranes and enter epithelial cells.
Acid suppression, particularly when it is incomplete as in the vast majority of patients who take these medications, both over the counter and prescribed, has the effect of increasing gastric pH into the critical 3 to 6 pH range where it promotes the generation of carcinogenic molecules from the endogenous bile acids when these are present in the stomach.

Hi @cs3000. Could you elaborate on this a bit or put it into plain English for us mere mortals. Do you recommend against the use of bile acids ? What about conjugated bile acids like tudca?

 

[cs3000]

Hi @cs3000. Could you elaborate on this a bit or put it into plain English for us mere mortals. Do you recommend against the use of bile acids ? What about conjugated bile acids like tudca?

hi that post mentioned they can be damaging / carcinogenic if taken with low stomach acidity. so i wouldnt take them with food which lowers acidity. and would be wary if have a condition with poor stomach acidity . personally any benefits were mild if at all for inflammation/constipation so i stopped (not a bacterial issue)