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Side Effects of Purified Bile Salts

author avatar Dr. Eric Berg 03/07/2024

Bile salts are a crucial part of digestion, playing an essential role in the breakdown of fats and helping with nutrient uptake. However, being aware of potential bile salts' side effects is critical.

Learn about the potential implications on your health of taking purified bile salt supplementation and discover how low bile salts can worsen stomach acid and thyroid disorders.

Benefits of TUDCA

If you're interested in health, nutrition, weight loss, or the ketogenic diet and intermittent fasting, then it's likely that you've heard about bile salts.

Bile salts are essential for digestion as they help break down fats and absorb fat-soluble vitamins such as A, D, E, and K.

However, some people may experience digestive problems due to a lack of bile flow or primary biliary cirrhosis. There are numerous benefits of TUDCA, which we will explore in more detail, but first, what is TUDCA?

Tauroursodeoxycholic acid (TUDCA) is a type of bile salt that has been shown to have numerous benefits for liver function and overall health. The body produces it naturally in small amounts but it can also be taken as a supplement.

woman taking bile supplements

The Benefits of TUDCA:

Here are some reasons you may want to start supplementing TUCDA in your diet:

  • Liver protection: Studies have shown that TUDCA can protect against liver damage caused by non-alcoholic fatty liver disease (NAFLD), alcohol consumption, and other toxins.

  • Bile flow improvement: TUDCA helps increase bile flow, which aids in digestion and prevents harmful effects from excess cholesterol build-up in the gallbladder ducts.

  • Digestive support: By improving bile flow through the intestines, TUCDA helps reduce stomach pain after eating meals high in fat content.

  • Gallbladder health: Taking supplements with chenodeoxycholic acid has been found to improve symptoms associated with primary biliary cirrhosis (PBC).

Side Effects of Purified Bile Salts

While purified bile salts offer benefits like aiding in fat digestion and absorption of fat-soluble vitamins, they can cause issues for some individuals.

Low Stomach Acid

Low stomach acid can be worsened by taking bile salts. Purified bile salts can neutralize gastric acid, impairing digestion and leading to bloating, belching, reflux, or nausea. Still, natural remedies like betaine hydrochloride and apple cider vinegar can help.

A balanced pH level in your stomach is crucial for optimal digestion and nutrient absorption, preventing heartburn and leaky gut syndrome.

Using betaine hydrochloride for balancing pH levels

Betaine hydrochloride (HCl) increases stomach acid production, aiding digestion and reducing symptoms of alkaline conditions.

  • Start with a low dose (around 200-300 mg) per meal.

  • Increase gradually until you notice improvements in digestion without side effects.

  • Consult your healthcare professional before starting any new supplements.

Apple cider vinegar and baking soda

Apple cider vinegar as a natural alternative

Apple cider vinegar (ACV) contains acetic acid, which can help increase stomach acid production and balance pH levels.

  • Mix one tablespoon of raw, unfiltered ACV with a glass of water.

  • Drink before meals to aid digestion.

  • If you experience discomfort or side effects, reduce the amount of ACV or discontinue use.

These natural remedies can alleviate side effects caused by purified bile salts and promote optimal digestive health. However, consult a healthcare professional before significantly changing your diet or supplement regimen.


Individuals with hyperthyroid conditions should avoid taking purified bile salts due to their ability to speed up thyroid function and increase T4-to-T3 conversion rates.

The thyroid gland produces T4 and T3, the former being inactive and the latter active. T4 is the inactive form of the hormone, which gets converted into its active counterpart, T3. Taking supplementary bile salts when you have a hyperactive thyroid may exacerbate your condition by further increasing the levels of circulating T3.

Chronic Diarrhea

Consuming purified bile salts can worsen chronic diarrhea by lubricating the colon, which is helpful for constipation but detrimental for diarrhea sufferers. Bile salts break down fats and fat-soluble vitamins but stimulate water secretion and muscle contractions in the intestines, exacerbating diarrhea.

Here are some steps you can take to manage chronic diarrhea:

  • Dietary modifications: Avoid irritants like caffeine and spicy foods.

  • Adequate hydration: Drink plenty of water and electrolyte-rich beverages to combat dehydration.

  • Probiotics: Restore good bacteria in the gut with Lactobacillus rhamnosus or Saccharomyces boulardii.

  • Over-the-counter medications: Consult a healthcare professional before using anti-diarrheal drugs like loperamide (Imodium).

If you suffer from persistent or recurring diarrhea, it's crucial to consult a healthcare provider to evaluate your symptoms and establish an appropriate treatment plan.


Natural remedies like betaine hydrochloride or apple cider vinegar can help maintain stomach acidity levels for those using bile salts.

Hyperthyroidism patients should exercise caution when taking supplementary thyroid hormones and consult a healthcare provider before making any dietary or lifestyle changes.

Staying aware of potential side effects of purified bile salts, including lack of gastric acidity, hyperthyroid symptoms, and diarrhea, empowers you to make the best decisions for your health.


1. What are the side effects of bile salt supplements?

Bile salt supplements may cause stomach pain, diarrhea, and low stomach acid and should be used cautiously in individuals with hyperthyroidism.

2. Who should not take bile salts?

Individuals with low stomach acid, hyperthyroidism, chronic diarrhea, or those with gallbladder removed should consult a healthcare professional before taking bile salts.

3. What is the problem with bile salts?

Bile salts can worsen certain health conditions and trigger gastrointestinal issues if taken excessively.

4. How safe are bile salts?

Bile salts are generally safe when used appropriately under the guidance of a healthcare professional, but potential interactions and adverse effects should be considered based on individual health conditions.

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