Protocol · Hepatic/Autoimmune
Primary Biliary Cholangitis Supportive Care Protocol
Vitamin D and Calcium are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Primary Biliary Cholangitis Supportive Care.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · none graded yet
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Vitamin D | Amount listed: 2,000–4,000 IU daily (higher if deficient; may need prescription doses) | Commonly deficient due to fat malabsorption; critical for bone health (osteoporosis risk high in PBC) | Not graded yet | ||
| Calcium | Amount listed: 1,000–1,200 mg daily with meals | Important for bone health; may be poorly absorbed; osteoporosis prevention | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Vitamin A | Amount listed: 10,000–25,000 IU daily (monitor levels; avoid excess) | Fat-soluble vitamin often deficient in PBC; supports vision and immune function | Not graded yet | ||
| Vitamin E | Amount listed: 400–800 IU daily (water-soluble form if malabsorption severe) | Fat-soluble vitamin deficiency common; antioxidant; may help with neuropathy | Not graded yet | ||
| Vitamin K | Amount listed: 2.5–10 mg daily or based on INR | Often deficient; essential for coagulation; may need monitoring | Not graded yet | ||
| Omega-3 Fatty Acids | Amount listed: 2–3 g EPA+DHA daily | Anti-inflammatory; may help with hypertriglyceridemia common in PBC | Not graded yet | ||
| SAMe (S-Adenosyl-L-Methionine) | Amount listed: 800–1,600 mg daily | Supports liver methylation and glutathione; some evidence in cholestatic liver disease | Not graded yet | ||
| Milk Thistle (Silymarin) | Amount listed: 420–600 mg silymarin daily in divided doses | Traditional hepatoprotective herb; antioxidant; limited evidence in PBC specifically | Not graded yet | ||
Shop this protocol
Support alongside medical care. These supplements are not a treatment for Primary Biliary Cholangitis. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
Each opens third-party tested products, matched to the dose above where we can.
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How this protocol works
In plain language
Primary Biliary Cholangitis (PBC), formerly called Primary Biliary Cirrhosis, is an autoimmune disease where the body's immune system attacks the small bile ducts in the liver. This leads to bile buildup, which damages the liver over time.
KEY FEATURES:
- Primarily affects women (90%)
- Usually diagnosed ages 40-60
- Positive anti-mitochondrial antibodies (AMA) in 95%
- Slowly progressive
- Can lead to cirrhosis if untreated
COMMON SYMPTOMS:
- Fatigue (most common, often debilitating)
- Itching (pruritus) - can be severe
- Dry eyes and mouth (Sicca syndrome)
- Right upper abdominal discomfort
- Jaundice (later stage)
- Bone pain (osteoporosis)
CRITICAL: PBC requires medical treatment with ursodeoxycholic acid (UDCA) - this is the cornerstone therapy. This protocol is SUPPORTIVE ONLY.
STANDARD TREATMENT:
- UDCA: First-line treatment; slows progression
- Obeticholic acid: For inadequate response to UDCA
- Fibrates: May help some patients (bezafibrate, fenofibrate)
- Symptom management: Cholestyramine for itching
- Liver transplant: For advanced disease
ASSOCIATED CONDITIONS:
- Osteoporosis (common and serious)
- Fat-soluble vitamin deficiencies (A, D, E, K)
- Thyroid disease
- Sjogren's syndrome
- Celiac disease
Vitamin D and Calcium* are critical for bone health.
Fat-soluble vitamins* (A, D, E, K) often need supplementation.
Monitor bone density* regularly and treat osteoporosis if present.
Expected timeline: PBC is a chronic disease. UDCA can significantly slow progression. Life expectancy normal or near-normal with early treatment and good response.