# UDCA For Liver Care



## Brawla (Jun 7, 2011)

Ursodeoxycholic acid

Ursodeoxycholic acid (UDCA) is a chemical called a bile acid. It occurs  naturally in bile and can be used to dissolve gallstones. The liver  produces bile that is stored in the gall bladder. Bile is released by  the gall bladder to aid the digestion of fats. It consists of  cholesterol dissolved within bile salts. Gallstones occur in the gall  bladder as a result of too much cholesterol, or too few bile salts  within the bile. The imbalance causes excess cholesterol to separate out  of the bile and form stones. Ursodeoxycholic acid causes gallstones to  dissolve by a mechanism that is not fully understood. It is known to  reduce the production of cholesterol by the liver and also to reduce the  absorption of cholesterol from the gut. Both of these actions decrease  the amount of cholesterol that passes into the bile. Also, since  ursodeoxycholic acid is a bile acid itself, it increases the level of  bile acids within the bile. The combination of these two factors  reverses the imbalance and stops the cholesterol separating out of the  bile. The gallstones then begin to dissolve.

Besides existing in its natural form, UDCA has been synthesized, and all  pharmaceutical formulations are synthetic. Besides dissolving  gallstones, UDCA exerts other actions of more interest to AAS using  bodybuilders. Oral 17 alpha alkylated steroids often cause a condition  called cholestasis. Cholestasis is any condition in which bile excretion  from the liver is blocked, which can occur either in the liver where  bile is formed, or in the bile ducts.

Extrahepatic cholestasis -- which occurs outside the liver -- can be  caused by bile duct tumors, strictures, cysts, diverticula, and other  damage. Other potential causes for this type include stones in the  common bile duct, pancreatitis, pancreatic tumor or pseudocyst, primary  sclerosing cholangitis, and compression due to a mass or tumor on a  nearby organ.

Intrahepatic cholestasis -- which occurs inside the liver -- can be  caused by sepsis (generalized infection), bacterial abscess, drugs,  total parenteral nutrition (being fed intravenously), lymphoma,  tuberculosis, sarcoidosis and amyloidosis. Other causes of this form of  the disorder include primary biliary cirrhosis, primary sclerosing  cholangitis, viral hepatitis (A,B,C, etc.), alcoholic liver disease,  pregnancy, Sjogren's syndrome and others.

-Symptoms include the following: -Itching -Jaundiced (yellow) skin or  eyes -Inability to digest certain foods -Nausea, vomiting -Right upper  quadrant abdominal pain -Organ failure in cases of sepsis (but not from  cholestasis itself) -Rash or fever in some cases of drug-induced  cholestasis -Clay-colored or white stools -Dark urine

Often times a panel of standard liver function tests will show  cholestasis before the symptoms even manifest themselves, but in general  laboratory tests have limited diagnostic value. Transaminase (ALT,  AST), alkaline phosphate, and bilirubin levels are typically elevated in  proportion to the severity of the disease. AST and ALT can be elevated  by exercise, so those are not particularly helpful in diagnosing  cholestasis (1).

It is intrahepatic cholestasis caused by drugs (i.e.oral 17 alpha  alkylated anabolic steroids) that is of greatest concern to  bodybuilders. It has been proposed that oral steroids interfere with the  pump that exports bile out of liver cells.

UDCA exerts a number of therapeutic effects which prevent and treat  cholestasis. For instance, we mentioned the bile transport pump. UDCA  has been shown to stimulate enzymes that increase the density of these  bile transporters, allowing bile to exit the liver more readily (2,3).  UDCA also protects hepatocytes (liver cells) against bile induced  apoptosis (programmed cell death) (2).

Whatever the primary mechanism is for AAS induced cholestasis, UDCA has  proven effective in treating the condition. Quoting from one study,

"A 28-year-old body builder was admitted because of jaundice. For 80  days, until 3 weeks before hospitalization, he had been taking  moderately high doses of anabolic steroids: metandienone  (methandienone), 10-50 mg daily by mouth, and stanozolol, 50 mg  intramuscularly every other day. Physical examination was unremarkable  except for yellow discoloration of the skin and sclerae...Liver biopsy  was compatible with cholestasis induced by anabolic steroids...The  patient's state improved simultaneously with the administration of  ursodeoxycholic acid and the biochemical values gradually reached normal  levels after several weeks. CONCLUSION: Anabolic steroids can cause  severe cholestasis and acute renal failure. In this case there was a  notable temporal coincidence between the administration of  ursodeoxycholic acid and the marked clinical improvement. (4).

Interestingly, there seems to be a genetic disposition to the  development of drug induced cholestasis (5). This may explain why only  some oral AAS users develop the disease and others can endure heavy  cycles of 17-alpha alkylated orals. Cholestasis as well as hepatitis  caused by non 17-alpha alkylated injectable steroids has been reported,  but is rare.

Cholestasis can be caused by estrogen as well, both synthetic and  endogenous. It is not uncommon for cholestasis to develop during  pregnancy, when estrogen levels are high. It???s possible the rare  reported cases of testosterone induced cholestasis might be due to  elevated estrogen levels in susceptible individuals.

It should be stressed that if one develops the symptoms of drug induced  cholestasis, the first line of treatment is to immediately discontinue  the drug, and begin treatment with UDCA. Although there are no studies  showing UDCA exerts any prophylactic effects against AAS induced  cholestasis, the proposed mechanism whereby it upregulates hepatic bile  transporters suggests it may very well help prevent the disease by  increasing bile flow out of the liver. Once the offending drug is  withdrawn, and UDCA therapy begun, the disease typically resolves.

UDCA has also been shown to lower both total cholesterol and LDL (bad)  cholesterol via at least two different mechanisms. In one study (6)  researchers observed that UDCA lowered the hepatic (liver) production of  cholesterol by interfering with a key enzyme in cholesterol synthesis.

In another study, UDCA was administered to animals with moderately  elevated cholesterol, somewhat typical of what is seen in many people  subsisting on high fat western diets (and typical of what is seen in  oral AAS users). Here UDCA lowered plasma LDL by increasing the number  of LDL binding sites on the liver, allowing for greater LDL uptake by  the liver (7).

So we see an added health benefit to UDCA use, even in those AAS users  who do not experience cholestasis. Most bodybuilders watch their fat  intake, but on a high protein diet that includes red meat, UDCA might be  a worthwhile supplement to consider if one is concerned about  cholesterol (and who isn???t these days).

When bile enters the digestive tract, a certain portion is reabsorbed,  leading to cholesterol reuptake. UDCA seems to block a portion of this  cholesterol reuptake, providing for yet another mechanism whereby UDCA  lowers cholesterol (8).

Dosages of commercial brands of UDCA vary depending on the type and  severity of liver disease. For preventative purposes 500 mg per day  might be sufficient. Once liver disease has developed, one ought to see  their doctor, but a typical recommended dose is 13 to 15 mg/kg/day which  may be given in 2 divided doses, i.e. in the morning and at bedtime,  with food. But again, if any of the symptoms listed above develop, or  liver tests come out showing cholestasis or some other liver disorder,  don???t self medicate; see your doctor, and lay off the orals.



*Not sure if anyone else uses this, please post any other information known.*


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## XYZ (Jun 7, 2011)

I know toothache on the board has used it.

I've read a few different things on it......not too impressed.


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## Brawla (Jun 7, 2011)

*Bile Acid – The Doctors Choice*
Bile  acid is the drug of choice prescribed to anabolic steroids users  admitted for drug induced cholestasis. The drug is known as Ursodiol --  a.k.a. _ursodeoxycholic acid_.  This naturally occurring bile acid is known for its hydrophilic action  and ability to detoxify the liver by cleaning out less hydrophilic bile  acids, among other toxins such as methylated hormone metabolites. (19,  24-27)
Unfortunately, Ursodiol is an expensive prescription drug, and not easily obtainable.
As I  mentioned earlier, there is new and exciting research on milk thistle  that we are excited to present. Research has shown us milk thistle has  the ability to increase production of this protective bile acid -- _ursodeoxycholic acid _(at the same relative dose delivered by Liver Juice) (18-23)




^ *The above is from the actual makers of 'Liver Juice'.* *Who do not sell UDCA.*


_Source: Primordial Performance Primordial Liver Juice 250ml - PRIM-13_


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## XYZ (Jun 7, 2011)

Yeah, because they want to sell it to you.


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## Brawla (Jun 7, 2011)

CT said:


> I've read a few different things on it......not too impressed.



I've not found anything except full medical proof that it works.

Have you read otherwise?


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## Brawla (Jun 7, 2011)

CT said:


> Yeah, because they want to sell it to you.



Actually they're selling liver juice, not UDCA. They say that UDCA is too expensive.


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## Brawla (Jun 7, 2011)

*Endogenous effects*

 Primary bile acids are produced by the liver and stored in the gall bladder.  When secreted into the colon, primary bile acids can be metabolized  into secondary bile acids by intestinal bacteria. Primary and secondary  bile acids help the body digest fats. Ursodeoxycholic acid helps regulate cholesterol by reducing the rate at which the intestine absorbs cholesterol molecules while breaking up micelles containing cholesterol. Because of this property, ursodeoxycholic acid is used to treat (cholesterol) gallstones non-surgically.
 While some bile acids are known to be colon tumor promoters (e.g.  deoxycholic acid), others such as ursodeoxycholic acid are thought to be  chemopreventive, perhaps by inducing cellular differentiation and/or  cellular senescence in colon epithelial cells.[1]
 It is believed to inhibit apoptosis.[2]
 Ursodeoxycholic acid has also been shown experimentally to suppress immune response such as immune cell phagocytosis.  Prolonged exposure and/or increased quantities of systemic (throughout  the body, not just in the digestive system) ursodeoxycholic acid can be  toxic.[3]
*[edit] As a pharmaceutical*

 Ursodeoxycholic acid goes by the trade names *Actigall*, *Ursosan*, *Egyurso*( Egyphar Egypt), *Urso*, and *Urso Forte*. In Italy and Switzerland, it is marketed under the name *Deursil*. In Mexico it is marketed in capsules of 250 mg under the name *Coric* by Mexican pharmaceutical Landsteiner Scientific.
 Ursodeoxycholic acid can be chemically synthesized and was brought to market by the Montreal-based Axcan Pharma in 1998,[_citation needed_] which continues to market the drug.
 The drug reduces cholesterol absorption and is used to dissolve (cholesterol) gallstones in patients who want an alternative to surgery.  The drug is very expensive, however, and if the patient stops taking  it, the gallstones tend to recur if the condition that gave rise to  their formation does not change. For these reasons, it has not  supplanted surgical treatment by cholecystectomy.
 It is the only FDA approved drug to treat primary biliary cirrhosis.[4][5]
 A Cochrane review to evaluate if ursodeoxycholic acid has any  beneficial effect in primary biliary cirrhosis patients included 16  randomized clinical trials with a total of 1447 patients. The primary  outcome measures were mortality and mortality or liver transplantation.  Although treatment with ursodeoxycholic acid showed a reduction in liver  biochemistry, jaundice, and ascites, it did not decrease mortality or  liver transplantation.[6]
 In children, its use is not licensed, as its safety and effectiveness are not established.[7][8][9]
 In double the recommended daily dose ursodeoxycholic acid reduces  elevated liver enzyme levels in patients with primary sclerosing  cholangitis, but its use was associated with an increased risk of  serious adverse events (the development of cirrhosis, varices, death or  liver transplantation) in patients who received ursodeoxycholic acid  compared with those who received placebo). After adjustment for baseline  stratification characteristics, the risk was 2.1 times greater for  death,transplantation, or minimal listing criteria in patients on  ursodeoxycholic acid than for those on placebo (P = 0.038). Serious  adverse events, were more common in the ursodeoxycholic acid group than  the placebo group (63% versus 37% [P < 0.01])).[10]


_Source: Ursodiol - Wikipedia, the free encyclopedia_


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## Brawla (Jun 7, 2011)

I think this stuff sounds good to be used maybe for a set amount of time each year. Especially with such high cholesterol diets/oral AAS.

Probably not best to use for every cycle though after reading the Wikipedia info.


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## XYZ (Jun 7, 2011)

Brawla said:


> I've not found anything except full medical proof that it works.
> 
> Have you read otherwise?


 

Well, take it for what it's worth.  

I have read up on it and there were too  many questions not answered for my liking.  I can't recall the exact reasons why.  I was looking into this at least a year ago so I just don't remember.

Personally I like Tyler's.  Hospitals use it when a patient overdoses.  Plus I've seen blood work results which proves it works.  That's just me.

If you've found nothing negative about it why not just use it?  Or use this liver juice stuff?


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## Bubbles! (Jun 7, 2011)

Nice read.  I think I may give it a shot next cycle.  I see the sponsor, CEM Products, sells it.


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## Brawla (Jun 7, 2011)

Bubbles! said:


> Nice read.  I think I may give it a shot next cycle.  I see the sponsor, CEM Products, sells it.



Didn't know that, good stuff.


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## Brawla (Jun 7, 2011)

CT said:


> Well, take it for what it's worth.
> 
> I have read up on it and there were too  many questions not answered for my liking.  I can't recall the exact reasons why.  I was looking into this at least a year ago so I just don't remember.
> 
> ...



I'm not actually in any need of using it. Not even thinking of taking any orals yet, just a general discussion.

Never heard of Tyler's? I take it that's a brand name?


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## Bubbles! (Jun 7, 2011)

Yea...what's Tyler's?


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## XYZ (Jun 8, 2011)

Tyler's liver detox factors

www.theafstore.com


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## toothache (Jun 16, 2011)

CT said:


> I know toothache on the board has used it.



Yes I do.....will always use it.


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## bulldogz (Jun 16, 2011)

I tell ya what...I always have my ast/alt (liver) values elevated...after takin liver juice from PP they went down significantly after a 25 day cycle (1 bottle)...I have bloods since I always get bloods to check on them myself...

That shit works for me...but I might look into and try out that Tyler's


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## Milas (Jun 17, 2011)

UDCA is great stuff for liver protection, especially for PH/DS related damage IMO.  I still look for the all-in-one cycle support, stuff like Need 2Guard by Need To Build Muscle.  That stuff has all that you'd need for cycle support.  You can get it at Need To Build Muscle (dot) com (no spaces) and get 15% off and free shipping with code "need to139" (no spaces again).


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