TUDCA Warning

Just a PSA about the supplement TUDCA. TUDCA is a bile acid that promotes bile flow. It is supposed to reduce inflammation, improve gut health, support liver and gallbladder functioning, dissolve cholesterol sludge in the gallbladder and small gallstones over time. The very promising list goes on . . . and, I am having a very bad reaction to it.

I have histamine intolerance/MCAS and discovered earlier this year that SIBO was one underlying cause. I've been treating for SIBO and it's made a big difference. I also suspected issues with gallbladder functioning (possible GB sludge and/or gallstones), bc of how my body was digesting fats, diaphragmatic pain, etc. I got abdominal imaging done last year for suspected hernia, but despite a dozen or so calls to view results, no dice.

TUDCA: I thought I'd purchased a low dose variety, and took a capsule before a meal a few nights ago. I later discovered that rather than the basic 250mg capsule it was 1100mg ! Its the first time in years that I did not double check a label after purchasing a supplement. But. T/here we are.

After taking the capsule, I immediately felt systemic inflammation, particularly on the upper right quadrant of my torso, the area over my gallbladder and right wrist and inner elbows - the wrist and elbow are common places for the body to release heat. No visible rash (yet), so all signs pointed to cholestatic pruritis. There may have been a gallstone too large to pass and blocked the bile duct. By evening, I'd read everything I could about pruritis and took my regular Claritin 10mg & Ketotifen 0.50mg to sleep and felt generally well in the morning. I scoured reddit and the web for adverse reactions to TUDCA, but the algorithm mostly directed me to reviews and threads claiming that TUDCA was The Game Changer especially for gallbladder issues and even blockages. So, me being the magical thinker with built-in-forgetter, I took a much lower dose this time - I know, I know, I know.

By evening, the pruritis was no longer invisible but an angry rash all along the right side torso and starting to appear on the left upper quadrant. I applied warmth and gentle massage in hopes that whatever was gumming up my bile ducts and/or causing the reaction, would pass. I felt gurgling in the Liver/Gallbladder areas with warmth and massage and started to feel better, itching was 70% improved by the time I went to bed. Maybe the blockage had passed? Possibly.

I took a homeopathic that helps me when i have an MCAS flare (Rhus Tox 200c - very specific to my constitution. There are other homeopathic remedies out there for allergic reactions and MCAS flares, but I am not expert enough to comment on that). Again, I took my 10mg claritin and .50 ketotifen at night to sleep. Rather than sleeping through or waking at 2-5am, as is my habit when systems are off, I woke at midnight, very itchy and red. Took a benadryl (I take a dye-free capsule for emergency flares), woke at 5am, itching intense, whole body flushing, tinnitus, anxiety and have had 4 bowel movements in the past few hours - less solid each time.

In addition to upsetting the Gallbladder, I'm having an MCAS flare in reaction to the TUDCA. The immune system is fighting fire with fire and trying to get it out as quickly as possible. I will start dry brushing and loofah in the shower and up my vitamin D3 & K and work out harder to sweat - all things that will hopefully help improve Liver and Gallbladder functioning and clear the heat from my system. I'm on a low histamine keto diet, so i'll probably water fast for 24-48 hours and then reintroduce foods slowly and not go for the little cheats I've been getting away with lately (nuts, chocolate, herbal tea). I will also go very easy on fats and oils for a spell. I'll take additional claritin and ketotifen as needed. I applied Castor oil to the rash on my torso and its surprisingly helping, along with my homeopathic remedy. I'd say symptoms are now 35% improved from the insane itching from an hour ago.

I'm doing my best to treat myself gently for my wishful thinking/oversight. The old "you should've known" voices are coming in hot, esp. since I do not tolerate citrus, citric acid, ascorbic acid etc - acids are not my friends. Anyway. It's frustrating and disappointing, especially since my MCAS symptoms were finally becoming manageable. Four months ago, I started a methane SIBO protocol, which has allowed me to reintroduce foods. I feel at the beginning again. Trying to not catastrophize. Hoping this flare will abate soon - and hoping i haven't triggered cholinergic uticaria or have a blocked bile duct!

Please let mine by a cautionary tale. There are other, much more gentle ways to support GB functioning and treat gallstones or high cholesterol, like herbal teas and tinctures, bitters, diet, exercise, oxbile, bile salts, etc (depending on your flavor of gallbladder/digestive needs). If you must go the route of TUDCA please only start very low dose, titrate up slowly and pause if you notice any adverse reactions. I wish I would've done that & it's usually how I work with supplements bc of MCAS. I made a mistake, got a little to cavalier bc I'd seen so much improvement.

Please do not make my same mistake.

Wishing you all the best . . .