This ratio represents the relationship between more cytotoxic bile acids (e.g., lithocholic and deoxycholic acid) and protective bile acids such as ursodeoxycholic acid (UDCA). An elevated ratio may suggest increased oxidative or inflammatory stress in the liver or gut environment. A lower ratio, with higher levels of neuroprotective bile acids, indicates better bile acid homeostasis and reduced cellular stress. Balanced values support optimal liver detoxification and metabolic resilience.
This ratio reflects the balance between potentially harmful (cytotoxic) bile acids—such as lithocholic and deoxycholic acid—and protective bile acids like ursodeoxycholic acid (UDCA). It provides insight into oxidative, inflammatory, and metabolic stress impacting the liver–gut axis.
A higher ratio may indicate increased oxidative or inflammatory stress, impaired bile acid detoxification, or reduced conversion of toxic bile acids into protective forms. It can also reflect microbial imbalance or excessive bile acid production.
A lower ratio typically indicates better hepatobiliary protection, efficient bile acid recycling, and decreased cellular stress. This may occur when UDCA levels are adequate to counteract cytotoxic bile acids.
Supporting liver detoxification, maintaining gut microbial balance, and ensuring adequate antioxidant intake can help regulate this ratio. Nutrients such as taurine, glycine, and phosphatidylcholine, along with a balanced diet and proper hydration, promote bile acid homeostasis and metabolic resilience.