Evidence Level
TUDCA (Tauroursodeoxycholic Acid) is supported by a robust evidence base as both a pharmaceutical and dietary supplement. Pan et al. (2013) conducted a double-blind randomized controlled trial involving 23 liver cirrhosis patients, demonstrating that TUDCA at 750mg/day was more effective than UDCA in improving biochemical markers. Rodrigues et al. (1998) established the mechanistic basis for TUDCA's cytoprotective effects through mitochondrial membrane stabilization and inhibition of apoptosis. Ozcan et al. (2006) published a landmark study in *Science* showing that TUDCA resolves endoplasmic reticulum (ER) stress, normalizes hyperglycemia, and improves insulin signaling in obese, diabetic mice, opening new therapeutic avenues for metabolic diseases. Kars et al. (2010) translated these findings to humans, demonstrating that TUDCA improved liver and muscle insulin sensitivity by approximately 30% in a randomized, double-blind study of 20 obese adults without affecting adipose tissue. TUDCA's dual role as both a bile acid and chemical chaperone makes it uniquely versatile among hepatoprotective agents.