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Explored as a possible aid for recovery and lean-mass preservation in frail or catabolic populations, though a Merck-sponsored Phase 2b trial in elderly hip-fracture patients (Adunsky et al., 2011, Archives of Gerontology and Geriatrics, PMID 21067829) was halted early over a cardiac safety signal rather than demonstrating a clear functional benefit
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Mechanistically, TGR5 regulates cardiomyocyte fatty acid uptake by modulating CD36 activity ( Bacteroides, Rikenella , and Prevotella genera ( CD36 overactivation disrupts cardiac lipid homeostasis by uncoupling fatty acid uptake from oxidation, resulting in lipid accumulation, lipotoxicity, and consequent cellular dysfunction
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higher users report up to 1 mg in stacks
