From the Guidelines
No, ursodeoxycholic acid (UDCA) is not a detox drug. UDCA is a hydrophilic bile salt used to treat cholestatic liver diseases, including primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) 1. It works by replacing toxic bile acids in the body with a less toxic form, improving bile flow, and protecting liver cells from damage caused by bile acids.
Key Points
- The typical dosage for adults is 13-15 mg/kg/day, often divided into two or three doses, though specific dosing depends on the condition being treated 1.
- Treatment is usually long-term, especially for chronic liver conditions like PBC.
- While UDCA does help the liver function better by improving bile flow and reducing inflammation, it does not "detoxify" the body in the way that detox products are marketed to do.
- The concept of "detoxification" as promoted in many health products is largely unsupported by scientific evidence, as the human body has its own sophisticated detoxification systems primarily through the liver and kidneys 1.
- UDCA supports normal liver function rather than providing any special detoxifying properties, and its use in patients with PSC is not recommended for routine treatment, according to the British Society of Gastroenterology and UK-PSC guidelines 1.
Clinical Use
- UDCA may improve serum liver tests and surrogate markers of prognosis in patients with PSC, but available data does not allow for a firmer recommendation 1.
- The use of UDCA in patients with PSC should be reconsidered, and the decision to use it should be made on a case-by-case basis, taking into account the potential benefits and risks 1.
From the FDA Drug Label
Ursodiol therapy has not been associated with liver damage. Lithocholic acid, a naturally occurring bile acid, is known to be a liver-toxic metabolite. This bile acid is formed in the gut from ursodiol less efficiently and in smaller amounts than that seen from chenodiol Lithocholic acid is detoxified in the liver by sulfation
- Ursodeoxycholic acid (UDCA) is not directly referred to as a detox drug in the provided label.
- However, it is involved in the detoxification of lithocholic acid, a liver-toxic metabolite, through sulfation in the liver.
- The label does not explicitly state that UDCA is a detox drug, but it does mention its role in the detoxification process of a toxic metabolite 2.
From the Research
Ursodeoxycholic Acid as a Detox Drug
- Ursodeoxycholic acid (UDCA) is used for the treatment of cholestatic liver diseases, and its mechanisms of action include protection of cholangiocytes, stimulation of hepatobiliary secretion, and protection of hepatocytes against bile acid-induced apoptosis 3.
- UDCA has been found to improve serum liver chemistries, delay disease progression, and prolong transplant-free survival in primary biliary cirrhosis 3, 4.
- The drug has also been used to treat other liver diseases, including primary sclerosing cholangitis, intrahepatic cholestasis of pregnancy, and chronic graft-versus-host disease 3.
- Studies have shown that UDCA has a marginal therapeutic effect for primary biliary cirrhosis, with few side effects 4.
- The mechanisms of action of UDCA involve its physicochemical properties as a bile acid, as well as its effects on signal transduction pathways and intestinal detoxification machinery 5, 6.
- UDCA has been found to induce the expression of key export pumps in the duodenum, including BCRP and P-glycoprotein, which may help to stabilize small intestinal detoxification 6.
- The use of UDCA as a detox drug is supported by its ability to improve bile acid profiles and reduce the toxicity of hydrophobic bile acids in the liver and bile ducts 3, 6.