Taurine

Category

Herbs & Supplements

Synonyms

Acomprosate, glycochenodeoxycholic acid, glycocholic acid, taltrimide, taurochenodeoxycholic acid, taurocholic acid, tauro-UDCA, tauroursodeoxycholic acid, TUDCA, ursodeoxycholic acid.

Background

Taurine, or 2-aminoethanesulfonic acid, was originally discovered in ox (Bos taurus) bile and was named after taurus, or bull. A nonessential amino acid-like compound, taurine is found in high abundance in the tissues of many animals, especially sea animals, and in much lower concentrations in plants, fungi, and some bacteria. As an amine, taurine is important in several metabolic processes of the body, including stabilizing cell membranes in electrically active tissues, such as the brain and heart. It also has functions in the gallbladder, eyes, and blood vessels, and may have some antioxidant and detoxifying properties.

Taurine is a constituent of some energy drinks, including Red Bull®. Numerous clinical trials suggest Red Bull® and similar energy drinks may be effective in reducing fatigue, and improving mood and endurance. However, these drinks contain other ingredients, which may also offer benefit in these areas, including caffeine and glucuronolactone. The effect of taurine alone in energy drinks has not been studied. Thus, the effectiveness of taurine in energy drinks is unclear and further research is still required.

Several taurine derivatives are being investigated for medical use, such as taltrimide as an antiepileptic drug. Other taurine derivatives in various stages of development include acamprosate (antialcoholic), tauromustine (anticancer), and tauroursodeoxycholic acid (liver disorders).

The efficacy of taurine has been investigated for diabetes, hypertension (high blood pressure), cystic fibrosis, liver disorders, cardiovascular disorders, and nutritional support. Although promising in many fields, additional study is needed before a firm recommendation can be made for these indications. Taurine is added to many infant formulas based on the decreased ability to form taurine from cysteine in this population.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Nutritional supplement (infant formula): Early evidence suggests that taurine supplementation may aid in auditory maturation, fatty acid absorption, and increased serum taurine levels. However, additional study is needed in this area.
Grade: B

Congestive heart failure (CHF): Preliminary study suggests that taurine may be beneficial as an adjunct to traditional medications for symptoms of congestive heart failure. Taurine may be superior to coenzyme Q10, although further study is warranted to confirm these findings.
Grade: C

Cystic fibrosis: The interest in taurine for individuals with cystic fibrosis is based on its potential to increase effects of ursodeoxycholic acid (UDCA), as well as its potential to increase nutritional status. However, results are mixed. More study is needed to drawn a firm recommendation in this area.
Grade: C

Diabetes mellitus (type 2): It has been proposed that diabetes patients have decreased taurine levels. Currently, there is limited available evidence to recommend for or against the use of taurine in the treatment of diabetes.
Grade: C

Energy: Energy drinks containing taurine, along with other ingredients such as caffeine and glucuronolactone, have been available for about a decade. Overall these drinks have been suggested to decrease sleepiness associated with driving, increase concentration, mood, and memory, and positively affect well-being and vitality. Further study is required to examine the effect of taurine alone.
Grade: C

Epilepsy (seizure): Preliminary evidence suggests that taurine may be beneficial in epileptic patients. However, additional study is needed in this area.
Grade: C

Hypercholesterolemia (high cholesterol): Taurine may offer benefit to individuals fed a high fat and high cholesterol diet. More study is needed to make a firm recommendation.
Grade: C

Hypertension (high blood pressure): Preliminary results suggest that taurine may be beneficial in lowering blood pressure in individuals with borderline hypertension. Additional study is needed before a firm recommendation can be made.
Grade: C

Iron deficiency anemia: Preliminary study suggests that taurine aids in the ability of iron supplements to increase hemoglobin, red blood cell count, and serum ferritin. Additional study is needed before a firm recommendation can be made.
Grade: C

Liver disease: Currently, the evidence in support of taurine in liver disease is minimal and additional study with positive results is needed before a firm recommendation can be made.
Grade: C

Myotonic dystrophy: Preliminary study indicates that taurine supplementation may result in improvements in myotonic complaints. Although promising, additional study is needed to confirm these findings.
Grade: C

Nutritional support (TPN): The use of taurine has been examined in total parenteral nutrition in various patient groups (trauma, cancer, and long term patients). Preliminary study is promising, but more study is needed in this area.
Grade: C

Obesity: Currently, there is insufficient available evidence to recommend for or against the use of taurine in the treatment of obesity.
Grade: C

Surgery (coronary bypass): Taurine may act as an antioxidant. The results from preliminary study are encouraging; however, more trials are needed in this field before a firm recommendation can be made.
Grade: C

Vaccine adjunct: Currently, there is insufficient available evidence to recommend for or against the use of taurine as a vaccine adjunct.
Grade: C

Vision problems (fatigue): Taurine supplementation may reduce visual fatigue due to visual display terminals. Until further information is available, no firm recommendation can be made.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Aerobic fitness, alcohol dependence, alertness, Alzheimer's disease, antioxidant, Attention Deficit and Hyperactivity Disorder (ADHD), autism, bile secretion problems (biliary atresia), bipolar disorder, breast cancer, cardiac abnormalities (cardiac contractility), cardiomyopathy (dilated, hypertrophic), cardiovascular health (myocardial revascularization), cholestasis (stoppage of bile flow), cirrhosis (liver disease), concentration enhancement, depression, diabetes (prevention), digestive aid (fat absorption), Down's syndrome, exercise performance enhancement, fatigue, fatty liver, Huntington's chorea/disease, hypertriglyceridemia (elevated level of fatty acid compounds in the blood), ischemic heart disease, macular degeneration, malnutrition, memory enhancement, mental performance, mood stabilization, muscle atrophy (myotonia), myocarditis/endocarditis (acute viral), nervous system function (neurobehavioral development), nutritional supplement (amino acid supplementation), platelet aggregation inhibition, quality of life, retinitis pigmentosa (eye disease), steatorrhea (excess fat in the stool), thalassemia (inherited blood disorder), tinnitus (ringing in the ears), trauma, weight loss.

Dosing

Adults (over 18 years old)

Taurine is likely safe when taken by mouth by adults in doses up to 3 grams daily for up to one year.

Up to 9 grams per day has been studied, but there is currently no proven effective dose for any indication. Nonetheless, for congestive heart failure, 3-6 grams of taurine has been taken by mouth daily for up to one year. The same dose has been studied for up to two months for high blood pressure. For diabetes mellitus type 2, 1,000-1,500 milligrams daily in divided doses for 30-90 days has been used. For hypercholesterolemia, 6 grams of taurine powder daily for three weeks has been used. For iron-deficiency anemia, 1,000 milligrams of taurine per day has been used for 20 weeks, and for liver disease, 4 grams has been used three times daily for six weeks. For visual fatigue, 3 grams per day for twelve days has been used. As a vaccine adjuvant, 9 grams taurine on the same day and one day prior to influenza vaccine administration has been used. For obesity, 3 grams daily for seven weeks has been used.

Injections of taurine have been used in the treatment of epilepsy, and as a nutritional supplement or coronary bypass surgery. Injections should only be given under the supervision of a qualified healthcare professional.

Children (under 18 years old)

Taurine is possibly safe in children when taken by mouth at 30 milligrams per kilogram body weight daily for up to four months.

Other doses have been studied, but are not necessarily safe or effective. For cystic fibrosis, 30-40 milligrams per kilogram body weight daily for seven days to six months has been used. As a fortified infant formula, 470 micromoles per liter of taurine has been taken by mouth for six days in pre-term and full term infants; 45 micromoles per liter taurine added to Similac Special Care® formula in low weight infants has also been taken by mouth until release from hospital or infant attained weight of 2,500 grams. As parenteral nutrition, 10.8 milligrams per kilogram per day during the first ten days of life has been used.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Taurine is an amino acid and it is unlikely that there are allergies related to this constituent. However, allergies may occur from multi-ingredient products that contain taurine.

Side Effects and Warnings

Taurine is an amino acid and oral (by mouth) supplementation that has been well tolerated for up to one year.

Taurine supplementation may reduce blood pressure in individuals with high blood pressure. Use cautiously in individuals with a history of low blood pressure due to the potential for increased hypotensive (blood pressure lowering) effects.

In human infants, taurine-supplemented formula increased absorption of fat, particularly saturated fat. The same was observed in cystic fibrosis patients supplemented with taurine.

Taurine was found to reduce platelet aggregation and may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in patients with epilepsy, as taurine derivaties, specifically taltrimide, may increase seizure frequency. Taurine may also cause drowsiness and ataxia.

An energy drink containing taurine, caffeine, glucuronolactone, B vitamins, and other ingredients (Red Bull Energy Drink®) caused mania in a stable bipolar man. It is not known if this effect is related to taurine itself. Deaths following Red Bull Energy Drink® have also been reported, and are likely a result of dehydration, due to the combined effects of caffeine and alcohol and/or exercise.

Use cautiously in patients with high VLDL cholesterol due to potential for further increases. Also use cautiously in individuals on hypolipidemic (cholesterol lowering) medications due to potential for antagonistic effects. Patients with hypertriglyceridemia should also use with caution due to potential for increased levels of triglycerides.

Pregnancy & Breastfeeding

Taurine supplementation is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence, although taurine is a natural component of breast milk.

Interactions

Interactions with Drugs

Caution is advised in patients taking anesthetics, because injections of taurine may decrease in plasma malondialdehyde (MDA) and glutathione peroxidase in erythrocyte lysate and plasma.

Taurine may reduce platelet aggregation and may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Based on studies in cystic fibrosis patients, preterm infants, and biliary surgical patients, taurine may increase the absorption of fat and decrease fatty acid excretion. Patients taking antihyperlipidemic agents should use taurine with caution due to possible additive effects.

Taurine may suppress the sympathetic nervous system and may decrease blood pressure. Caution is advised in patients taking antihypertensive (blood pressure lowering) agents.

A mixture of taurine, diltiazem, and vitamin E may have a beneficial effect on the progression of visual field loss in retinitis pigmentosa patients.

Taurine may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Taltrimide is a taurine derivative with potent anticonvulsant activity. The combination of taurine and taltrimide may result in increased seizure frequency. Taltrimide may also increase phenytoin concentrations and decrease serum carbamazepine concentrations. Furthermore, a potential exists for taurine or its metabolites to antagonize the effects of anticonvulsive therapy.

Tamoxifen is often used as an adjuvant in patients with advanced breast cancer. Taking taurine with tamoxifen may reduce the tamoxifen-induced hepatotoxicity (liver toxicity). Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.

Interactions with Herbs & Dietary Supplements

Taurine may reduce platelet aggregation and may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Based on studies in cystic fibrosis patients, preterm infants, and biliary surgical patients, taurine may increase the absorption of fat and decrease fatty acid excretion. Patients taking antihyperlipidemic herbs, such as red yeast, should use taurine with caution due to possible additive effects.

Taurine may suppress the sympathetic nervous system and may decrease blood pressure. Caution is advised in patients taking antihypertensive (blood pressure lowering) herbs or supplements.

An energy drink containing taurine, caffeine, glucuronolactone, glucose, sucrose, and B vitamin complex may reduce sleepiness and lane drifting while driving following sleep restriction or increase readiness potential after exhaustive exercise. In theory, these energy drinks may have antagonistic effects when used with herbs with sedative effects. When these energy drinks are taken with other supplements included in the drinks, such as B vitamin complex, additive effects may occur.

Taurine may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Taurine may also increase the absorption of iron or reduce tyrosine levels. Ingestion of glutamine may increase plasma taurine levels.

A mixture of taurine, diltiazem, and vitamin E may have a beneficial effect on the progression of visual field loss in retinitis pigmentosa patients.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Julie Conquer, PhD (RGB Consulting); Tracee Abrams, PharmD (University of Rhode Island); Nicole Giese, MS (Natural Standard Research Collaboration); Juliann Goodfriend, PharmD (Northeastern University); Toni Schaeffer, PhD, PharmD (Albany College of Pharmacy); Rebecca Strauss, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration); Mario M. Zeolla, PharmD, BCPS (Albany College of Pharmacy).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Azuma J, Sawamura A, Awata N, et al. Therapeutic effect of taurine in congestive heart failure: a double-blind crossover trial. Clin.Cardiol. 1985;8(5):276-282.

Balkan J, Oztezcan S, Hatipoglu A, et al. Effect of a taurine treatment on the regression of existing atherosclerotic lesions in rabbits fed on a high-cholesterol diet. Biosci Biotechnol Biochem 2004;68(5):1035-1039.

Colombo C, Battezzati PM, Podda M, et al. Ursodeoxycholic acid for liver disease associated with cystic fibrosis: a double-blind multicenter trial. The Italian Group for the Study of Ursodeoxycholic Acid in Cystic Fibrosis. Hepatology 1996;23(6):1484-1490.

Hagar HH, El Etter E, Arafa M. Taurine attenuates hypertension and renal dysfunction induced by cyclosporine A in rats. Clin Exp Pharmacol Physiol 2006;33(3):189-196.

Li Q, Guo JC, Jin HB, et al. Involvement of taurine in penicillin-induced epilepsy and anti-convulsion of acupuncture: a preliminary report. Acupunct Electrother Res 2005;30(1-2):1-14.

Mas MR, Isik AT, Yamanel L, et al. Antioxidant treatment with taurine ameliorates chronic pancreatitis in an experimental rat model. Pancreas 2006;33(1):77-81.

Merli M, Bertasi S, Servi R, et al. Effect of a medium dose of ursodeoxycholic acid with or without taurine supplementation on the nutritional status of patients with cystic fibrosis: a randomized, placebo-controlled, crossover trial. J.Pediatr.Gastroenterol.Nutr. 1994;19(2):198-203.

Oriyanhan W, Yamazaki K, Miwa S, et al. Taurine prevents myocardial ischemia/reperfusion-induced oxidative stress and apoptosis in prolonged hypothermic rat heart preservation. Heart Vessels 2005;20(6):278-285.

Rakotoambinina B, Marks L, Badran AM, et al. Taurine kinetics assessed using [1,2-13C2]taurine in healthy adult humans. Am.J.Physiol Endocrinol.Metab 2004;287(2):E255-E262.

Smith LJ, Lacaille F, Lepage G, et al. Taurine decreases fecal fatty acid and sterol excretion in cystic fibrosis. A randomized double-blind trial. Am.J.Dis.Child 1991;145(12):1401-1404.

Spencer AU, Yu S, Tracy TF, et al. Parenteral nutrition-associated cholestasis in neonates: multivariate analysis of the potential protective effect of taurine. JPEN J Parenter.Enteral Nutr 2005;29(5):337-343.

Spohr C, Brons C, Winther K, et al. No effect of taurine on platelet aggregation in men with a predisposition to type 2 diabetes mellitus. Platelets. 2005;16(5):301-305.

Tabassum H, Rehman H, Banerjee BD, et al. Attenuation of tamoxifen-induced hepatotoxicity by taurine in mice. Clin Chim.Acta 2006;370(1-2):129-136.

Tyson JE, Lasky R, Flood D, et al. Randomized trial of taurine supplementation for infants less than or equal to 1,300-gram birth weight: effect on auditory brainstem-evoked responses. Pediatrics 1989;83(3):406-415.

Zhang M, Bi LF, Fang JH, et al. Beneficial effects of taurine on serum lipids in overweight or obese non-diabetic subjects. Amino.Acids 2004;26(3):267-271.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.