Can a healthy adult use taurine to prevent transient ischemic attack or mild ischemic stroke, and what is the safe dosage and contraindications such as renal impairment?

Taurine for Prevention of TIA or Mild Ischemic Stroke

Taurine supplementation is not recommended for the prevention of transient ischemic attack (TIA) or mild ischemic stroke in healthy adults, as there is no clinical evidence supporting its efficacy for stroke prevention, and established guideline-directed therapies (antiplatelet agents, statins, antihypertensives) have proven benefit for secondary stroke prevention. 1, 2, 3

Evidence-Based Stroke Prevention Strategies

The American Heart Association/American Stroke Association guidelines provide clear recommendations for stroke prevention that do not include taurine supplementation 1:

• Antiplatelet therapy with aspirin 50-325 mg daily, clopidogrel 75 mg daily, or aspirin/dipyridamole combination is first-line for secondary stroke prevention 2
• High-intensity statin therapy (atorvastatin 80 mg daily) with target LDL-C <70 mg/dL reduces recurrent stroke risk 2, 4
• Blood pressure control to <130/80 mmHg using ACE inhibitors plus thiazide diuretics reduces stroke risk by approximately 30% 1, 3
• Glycemic control with target HbA1c <7% in diabetic patients 1, 2

Taurine: Biological Properties Without Stroke Prevention Evidence

While taurine is a naturally occurring amino acid with various physiological functions, there is no clinical trial evidence demonstrating efficacy for stroke prevention 5, 6:

• Taurine exhibits antioxidant, anti-inflammatory, and cardiovascular effects in preclinical studies 6, 7, 8
• Animal studies suggest potential benefits for metabolic parameters, blood pressure regulation, and cardiovascular health 8
• However, no human clinical trials have evaluated taurine specifically for TIA or stroke prevention 5, 9

Safety Profile and Dosing (If Considering Use)

If a patient insists on taurine supplementation despite lack of evidence for stroke prevention, safety data exists for general use 9:

• Observed Safe Level (OSL): Up to 3 g/day in healthy adults has been tested without adverse effects 9
• Taurine is obtained primarily through diet (fish, meat, milk) and synthesized endogenously from methionine and cysteine with vitamin B6 5
• Higher doses have been studied, but long-term safety data above 3 g/day are insufficient 9

Contraindications and Cautions

Renal impairment is a critical consideration, though specific taurine dosing guidelines for renal dysfunction are not established 1:

• Taurine and its metabolites require renal excretion 5
• By analogy to other renally-excreted compounds, dose reduction would be prudent in moderate-to-severe renal impairment (CrCl <50 mL/min) 1
• Avoid taurine supplementation in severe renal impairment (CrCl <30 mL/min) due to accumulation risk 1

Clinical Bottom Line

For stroke prevention in healthy adults or those with prior TIA/stroke, focus exclusively on guideline-directed therapies with proven efficacy 1, 2, 3:

1. Initiate antiplatelet therapy (aspirin, clopidogrel, or aspirin/dipyridamole) 2
2. Start high-intensity statin regardless of baseline cholesterol 2, 4
3. Control blood pressure to <130/80 mmHg with ACE inhibitor plus thiazide diuretic 3
4. Optimize glycemic control if diabetic 1
5. Address lifestyle factors (smoking cessation, exercise, healthy diet) 1

Taurine supplementation lacks evidence for stroke prevention and should not replace or delay implementation of proven therapies 1, 2. If patients choose to use taurine for other purported health benefits, limit to ≤3 g/day and avoid in severe renal impairment 9.