Children with cystic fibrosis frequently have steatorrhea (high levels of fat in their stools due to impaired fat
absorption), which has now been linked in part to a deficiency of taurine in their bile acids. Bile acids emulsify fats
as part of the fat digestion process. Cystic Fibrosis patients secrete normal levels of pancreatic enzymes and thus,
their inability to absorb fat stems from some other defect. Studies have shown that taurine supplementation can
ef ectively reverse steatorrhea in cystic fibrosis patients.3,4 The study by LJ Smith et al, used a daily dosage of 30
mg/kg body weight per day, in thirteen children with cystic fibrosis. They showed a significant reduction in
steatorrhea with a reduction of fecal fatty acid excretion dropping from 26.5g/24 hours to 15.4g/24 hours. Taurine
appears to improve the micellar phase of fat digestion as an essential component of the bile complex.4
4. Liver Protective Effect (Hepatoprotection) and Detoxification
Animal studies show that taurine supplementation can reduce the toxic ef ects of cadmium, acetaminophen and
carbontetrachloride on the liver and other organs. Under these test conditions, taurine appears to help maintain
normal levels of glutathione (in a similar fashion as N-acetyl cysteine, the anti-dote for acute acetaminophen
poisoning), which is otherwise greatly depleted by these toxic compounds. Liver cell damage is also minimized to a
significant degree and increased fecal elimination of cadmium has been noted with taurine supplementation in
these experimental studies.9,10,11 In general, the dose of taurine commonly used in animal testing is approximately
200 mg/kg of body weight, which is the dose that prevented acetaminophen toxicity in rats injected with 800 mg/kg
body weight of acetaminophen intraperitoneally − a level that would otherwise severely damage liver cells. The
above noted dose of taurine prevented liver damage in this study and the researchers conclude that taurine
supplementation possesses prophylactic and therapeutic ef ects in acetaminophen-induced hepatic injury.10 This is
an important finding, as chronic use of the pain killer acetaminophen is a frequent cause of severe liver and kidney
damage in humans.12
Dosage and Standardized Grade
1. Congestive Heart Failure – 1500 to 2000 mg per day in divided doses 7
2. Insulin-dependent Diabetes Mellitus - 1500 mg per day in divided doses 8
3. Cystic Fibrosis - 30 mg per kg body weight per day, in cases of steatorrhea 4
4. Liver Support and Protection - 500 to 5,000 mg per day, depending upon exposures to toxic compounds and
degree of previous liver damage 5 (see also N-acetyl cysteine in compendium)
Adverse Side Effects, Toxicity and Contraindications
Taurine has been shown to have a depressant effect on the central nervous system and may adversely af ect short-
term memory. It is the nerve-depressant aspect of taurine that has at racted interest in those who are examining its
potential as an agent to treat epilepsy, which involves a state of over excitation. Some preliminary studies indicate that
it may have application for epileptics, but further investigation is necessary to establish its efficacy in these
cases.5,13,14,15
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Drug-Nutrient Interactions
There are no known instances where taurine supplementation interferes with or potentiates the ef ects of any drugs,
although its biological action in reversing congestive heart failure may be similar to that of cardiac glycoside drugs,
such as digitalis and digoxin. Thus, the at ending physician should be made aware of the patient’s intent to use taurine
supplementation in cases where digitalis is being administered. 5,6,7
It has been established that various chemotherapy drugs, such as cyclophosphamide, cisplatin, docetaxel, fluorouracil,
methotrexate and paclitaxel, deplete body stores of taurine and, thus, supplementation with taurine may be advisable
when taking these drugs. 16
Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal
vitamin and mineral supplements. All other supplements or dose alterations may pose a threat to the
developing fetus and there is generally insuf icient evidence at this time to determine an absolute level of
safety for most dietary supplements other than a prenatal supplement. Any supplementation practices
beyond a prenatal supplement should involve the cooperation of the at ending physician (e.g., magnesium
and the treatment of preeclampsia.)
References: Pregnancy and Lactation
1. Encyclopedia of Nutritional Supplements. Murray M. Prima Publishing 1998.
2. Reavley NM. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. Evans and
Company Inc. 1998.
3. The Healing Power of Herbs (2nd edition). Murray M. Prima Publishing 1995.
4. Boon H and Smith M. Health Care Professional Training Program in Complementary Medicine.
Institute of Applied Complementary Medicine Inc. 1997.
1. Hendler S. The Doctor’s Vitamin and Mineral Encyclopedia. Simon and Schuster 1990;224-5
2. Gonzalez-Qevedo A, Obregon F, Santiesteban Freixas R, et al. Amino acids as biochemical markers in epidemic and endemic optic
neuropathies. Rev Cubana med Trop 1998;50(Suppl):241-4
3. Thompson GN. Excessive fecal taurine loss predisposes to taurine deficiencyin cystic fibrosis. J Pediatr Gastroenterol Nutr
Mar1988;7(2):214-9
4. Smith LJ, Lacaille F, Lepage G, et al. Taurine decreses fecal faty acid and sterol excretion in cystic fibrosis. A randomized double-blind
trial. Am j Dis Child Dec1991;145(12):1401-4
5. Dietary Suplement Information Bureau, USA: Taurine (Dietary Supplementation Education Alliance, copyright 2001)
6. Azuma J, et al. Therapeutic Effect of taurine in congestive heart failure: a double-blind crossover trial. Clin Cardiol May 1985;8(5):276-82
7. Azuma J, et al. Therapy of congestive heart failure with orally administered taurine. Clin Ther 1983;5(4):398-408
8. Franconi F et al. Plasma and platelet taurine are reduced in subjects iwith insulin-dependent diabetes mel itus: ef ects of taurine
supplementation. Am J Clin Nutr May1995;61(5):1115-9
9. Hwang DF, Wang LC. Effect of taurine on toxicity of cadmium in rats. Toxicology Oct2001;167(3):173-80
10. Waters E, Wang JH, Redmond HP, et al. Role of taurine in preventing acetaminophen-induced hepatic injury in the rat. Am J Physiol
Gastrointest Liver Physiol Jun2001;280(6):G1274-9
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11. Wu C, Kennedy DO, Yano Y, et al. Thiols and polyamines in the cytoprotective effect of taurine on carbon tetrachloride-induced
heptotoxicity. J Biochem Mol Toxicol 1999;13(2):71-6
12. Drugs.com
13. Barbeau A. Zinc, taurine and epilepsy. Archives of Neurology 1974:30-52
14. Barbeau A, et al. The neuropharmacology of taurine. Life Sciences 1975;17:669-78
15. Takahashi R, Nakane Y. Clinical trial of taurine in epilepsy. In:Barbeau A and Huxtable RJ (eds.), Taurine and Neurological Disorders,
New York. Raven Press 1978:p375
16. Desai TK, Maliakkal J, Kinzie JL, et al. Taurine deficiency after intensive chemotherapy and/or radiation. Am J Clin Nutr 1992;55:708-11
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Trimethylglycine ( Betaine)
General Features
Trimethylglycine functions in the body as a methyl donor (as do folic acid, vitamin B12, choline and S-adenosyl-
methionine).1,2 As a methyl donor Trimethylglycine is particularly involved in liver function, including detoxification
reactions. As well, it plays a role in carnitine synthesis, which also occurs in the liver.3
Trimethylglycine is closely related to choline (tetramethylglycine) in that as choline donates one of its four methyl
groups to another molecule, it becomes Trimethylglycine (Betaine). If Trimethylglycine donates one of its methyl
groups, then it becomes dimethylglycine.2
In animals Trimethylglycine has been shown to protect against chemical damage to the liver.4-7 In alcohol-induced
liver damage, the first stage is accumulation of fat in the liver (fat y liver degeneration). Trimethylglycine has been
shown to be of benefit in these cases due to its lipotropic properties (donating a methyl group to aid in the transport of
fat out of the liver) in both animal and human studies.8,9 Betaine as a treatment for alcohol-related liver damage is very
popular in Germany, Italy and France, as is the use of milk thistle and S-adenosylmethionine.8-16
Betaine should not be confused with Betaine hydrochloride, which is primarily a supplement to provide hydrochloric
acid to patients with low stomach acidity, aiding digestion.
Betaine or Trimethylglycine supplementation is usually in the form of betaine citrate or betaine aspartate.13,14
Clinical Application and Mechanism of Action