Traditionally used for
- Eye health
- Nose & throat
- Colds & fever
- Digestion
- Urinary & fluids
- Nerves & recovery
- Skin
- Liver & jaundice
☯ TCM Properties
Clears Heat from the Heart and Liver and alleviates spasms (Liver Wind); Clears Heat and resolves Fire toxicity; Clears and drains Liver Heat and benefits the eyes; Clears Heat and eliminates childhood nutritional impairment
Traditional Chinese Uses
Xiong Dan (bear bile) is classically placed among the heat-clearing substances: bitter and cold, entering the Liver, Gallbladder, Heart, Spleen and Stomach channels. Traditional texts value it to clear Heat and cool the Heart and Liver, extinguish Liver Wind and relieve spasms in high fever with convulsions, resolve Fire toxicity in sores, jaundice and sore throat, drain Liver Heat to brighten the eyes (red, painful eyes and superficial visual obstruction), and reduce childhood nutritional impairment (gan) with worms.
Serious ethical and legal caveat: bear bile is taken from Ursus thibetanus and related bears, which are CITES Appendix I / threatened species, and its trade is banned or heavily restricted in most jurisdictions. It should not be sourced. Ursodeoxycholic acid (UDCA) and other plant or synthetic bile substitutes are now used in its place.
Relationships
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Botanical Description
Xiong Dan is the dried gallbladder and bile of bears, historically derived from the Asiatic black bear Ursus thibetanus and the brown bear Ursus arctos. The fresh organ is sac-shaped, dark green-brown, and on drying yields a brittle, glassy, dark amber to black mass with a characteristic bitter taste, owing chiefly to ursodeoxycholic acid (UDCA) and other bile salts. Used in classical TCM to clear heat, calm convulsions, brighten the eyes, and resolve toxin, bear bile is one of the most strictly regulated substances in international wildlife trade: Ursus thibetanus and most Ursus species are listed in CITES Appendix I, prohibiting all commercial international trade in wild-caught material. Modern practice strongly favors synthetic UDCA (a licensed pharmaceutical for cholestatic liver disease) or plant-derived substitutes such as Coptis or Phellodendron to avoid contributing to the cruelty of bear farming and the depletion of wild populations.
Active Constituents
Tauroursodeoxycholic acid (TUDCA)
Conjugated bile acid (taurine conjugate of ursodeoxycholic acid)Concentration: the dominant bile acid of bear gall bladder bile; a forensic HPLC survey of bear specimens found a mean of about 3087 micrograms per mL, and TUDCA is the marker used to establish the identity of bear bile powder
A hydrophilic, cytoprotective bile acid. It is the single constituent that chemically distinguishes bear bile from pig, cattle and goat bile, which is why it is the analytical marker. It is also available as an isolated compound and as the closely related licensed drug ursodiol, so nothing about its pharmacology requires an animal source.
Ursodeoxycholic acid (UDCA)
Secondary bile acid (7-beta-hydroxy epimer of chenodeoxycholic acid)Concentration: reported at roughly 1-39 percent of total bile acids in Ursidae bile, against under 0.5 percent in most other mammals
This is the same molecule as the licensed pharmaceutical ursodiol. It displaces hydrophobic, cytotoxic bile acids from the bile acid pool, lowers biliary cholesterol saturation and is cytoprotective to hepatocytes and cholangiocytes. Every documented pharmacological property of bear bile that has been reproduced in controlled work is a property of this molecule.
Taurochenodeoxycholic acid (TCDCA)
Conjugated bile acidConcentration: a mean of about 1968 micrograms per mL in the same forensic HPLC survey of bear bile
A hydrophobic, detergent-like and comparatively cytotoxic bile acid. It contributes nothing therapeutic over UDCA and is part of why crude bile is a less controlled preparation than the isolated drug.
Taurocholic acid
Conjugated bile acidConcentration: a mean of about 212.6 micrograms per mL in Asiatic bear bile, with higher levels reported in North American and polar bear bile
Cholic acid conjugate. Relevant mainly as an adulteration marker: cattle bile is cholic-acid rich, and in mice cattle bile, but not bear or pig bile, produced lipid profile changes and fatty liver injury attributed to cholic acid.
⚠ Drug Interactions
Legal and conservation restriction: Ursus thibetanus is listed on CITES Appendix I
The Asiatic black bear is on CITES Appendix I, so commercial international trade in the animal or its derivatives, bile included, is prohibited. The IUCN assesses the species as threatened with a declining population. Essentially all commercial bear bile now comes from farming rather than from wild bears: roughly 17,000 bears are held for bile extraction across Asia, with bile drawn from the gall bladder through transabdominal fistulas, indwelling catheters or repeated needle aspiration. Farming remains legal in China; it is prohibited in Vietnam, and the Republic of Korea banned the breeding, keeping and bile extraction of bears with effect from 1 January 2026, with criminal penalties after a six-month grace period. Two controlled veterinary studies of bears removed from these farms document the consequences. In 2019, bile-extracted bears showed markedly abnormal alanine transaminase, gamma-glutamyltransferase, total bilirubin, alkaline phosphatase, urea nitrogen, creatinine and white cell counts against farm, zoo and free-range comparison groups, with 7.3-fold odds of raised bilirubin consistent with hepatobiliary disease and reduced long-term survival even after removal from the farm. In 2025, in 180 formerly bile-extracted bears, 76.1 percent had at least one validated lesion of systemic hypertension and 62.8 percent had two or more, correlating with renal disease. This is a finding about the production method, not an opinion about it.
Clinical note: Do not source, stock, dispense or advise a patient how to obtain this substance. Where a UDCA effect is wanted, prescribe or refer for licensed ursodiol, which is the same active molecule with a defined dose and no animal source.
Ursodiol (licensed ursodeoxycholic acid) and tauroursodeoxycholic acid supplements
Bear bile and ursodiol are not analogues, they are the same active chemistry: UDCA and its taurine conjugate TUDCA are the bile acids that define bear bile, and ursodiol is pharmaceutical-grade UDCA. Ursodiol has a real, quantified evidence base, including a 146-patient double-blind randomised trial in primary biliary cirrhosis and a Cochrane review of 16 trials in 1447 patients, and it is a licensed medicine with a known dose, a known impurity profile and no animal source. Bear bile has no comparable controlled human evidence. Taking both is simply duplicated dosing of the same bile acid.
Clinical note: Treat this as the practical answer rather than a caveat: the licensed drug replaces the animal product entirely. Check for concurrent ursodiol or TUDCA supplements before any bile-acid preparation is added, and do not stack them.
Bile acid sequestrants (colestyramine, colestipol, colesevelam)
Anion-exchange resins bind bile acids in the gut lumen and prevent their absorption. In man, colestyramine given during ursodeoxycholic acid administration measurably altered the biliary bile acid pattern and bile acid synthesis, confirming that the resin intercepts the administered bile acid. The same binding applies to TUDCA and UDCA from any source.
Clinical note: If a sequestrant cannot be avoided, separate administration by at least four to five hours and give the bile acid at the wider interval. Expect reduced effect regardless.
Pig, cattle and goat bile sold as bear bile (documented adulteration and substitution)
This is the form in which practitioners actually meet the drug. Forensic HPLC of 217 seized gall bladder items found 67.74 percent were domestic pig, only 19.36 percent were Asiatic bear, 6.45 percent were goat and 6.45 percent contained no animal bile at all. Mass spectrometric methods now exist specifically to separate bear bile powder from other bile sources, which tells you how routine the substitution is. The substitution is not chemically neutral: in mice, cattle bile, but not bear bile or pig bile, produced lipid profile changes and fatty liver injury, mediated by its cholic acid content. So a patient given an unverified Xiong Dan product is most likely receiving pig bile, and in the worst case is receiving a preparation with demonstrated hepatotoxicity in animals.
Clinical note: Assume any Xiong Dan product of unknown provenance is misidentified. This is a further reason to use ursodiol, where identity and dose are guaranteed, rather than attempting to authenticate an illegal product.
Evidence Tier
Strong evidence · 5 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
1
0 verified · 1 unverified
Show the study
Randomized controlled trial
1
0 verified · 1 unverified
Other clinical trial
0
Observational / case report
2
0 verified · 2 unverified
In vitro / animal
1
0 verified · 1 unverified
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
A Multicenter, Controlled Trial of Ursodiol for the Treatment of Primary Biliary Cirrhosis
Cited here as the substitution evidence, not as evidence for bear bile. A two-year multicentre double-blind trial randomised 146 patients with biopsy-proved primary biliary cirrhosis to ursodiol 13-15 mg/kg/day or placebo. Treatment failed in 6 ursodiol patients against 13 on placebo (P < 0.01), the proportion with clinically overt disease fell only in the ursodiol arm, and bilirubin, alkaline phosphatase, transaminases, gamma-glutamyltransferase, cholesterol, IgM, antimitochondrial antibody titre and Mayo risk score all improved significantly. Ursodiol is pharmaceutical UDCA, the same molecule that defines bear bile, obtained without an animal.
Ursodeoxycholic acid for primary biliary cirrhosis
The honest limit of the UDCA evidence. Sixteen randomised trials, 1447 patients with primary biliary cirrhosis. UDCA did not significantly reduce all-cause mortality (45/699 versus 46/692), mortality or liver transplantation (86/713 versus 89/706), pruritus or fatigue, but did improve liver biochemistry (bilirubin lower by 8.69 micromol/L, alkaline phosphatase by 257.09 U/L) and histological progression. The authors note that almost all included trials carried a high risk of bias. This is what the licensed drug can and cannot claim, and it is still far more than exists for the animal product.
A comparative study on the hepatoprotective action of bear bile and coptidis rhizoma aqueous extract on experimental liver fibrosis in rats
Directly addresses substitution within herbal practice. In rat liver fibrosis induced by carbon tetrachloride, alcohol and bile duct ligation, Coptidis Rhizoma aqueous extract and its major alkaloid berberine were compared with bear bile and its major compound tauroursodeoxycholic acid. All exerted anti-fibrotic effects; the extract and berberine raised superoxide dismutase activity, promoted bilirubin excretion and protected hepatocytes from cholestatic damage, and the authors concluded the effect was comparable to bear bile and that Coptidis Rhizoma and berberine can substitute for it. The authors state explicitly that they undertook the comparison because bears are endangered.
Metabolic derangements and reduced survival of bile-extracted Asiatic black bears (Ursus thibetanus)
Comparative serum biochemistry and haematology of bile-extracted bears against bears on farms without extraction, non-farm captive bears and free-ranging bears. Extracted bears had the highest values and greatest variation in alanine transaminase, gamma-glutamyltransferase, total bilirubin, alkaline phosphatase, urea nitrogen, creatinine and total white cell count; odds of raised total bilirubin were 7.3 times greater, consistent with hepatobiliary disease; and survival remained reduced after removal from the farms. This is the veterinary evidence behind the statement that the production method harms the animals.
High Prevalence of Lesions of Systemic Hypertension in Bile-Extracted Asiatic Black Bears (Ursus thibetanus) and Associated Renal Disease
Archived records, imaging and samples from 180 formerly bile-extracted Asiatic black bears. Using hypertensive retinopathy, left ventricular hypertrophy and aortic dilation as validated correlates of systemic hypertension, 76.1 percent had at least one lesion and 62.8 percent had two or more; lesions correlated with serum creatinine and renal histopathology. Aortic aneurysm rupture or dissection had previously been the third leading cause of death in a population of 600 formerly bile-extracted bears.
⚠ Safety & Contraindications
Safety Warnings
- Bear bile/gallbladder: sourced from endangered bears and largely illegal. Herbal substitutes (e.g. Huang Lian, Zhi Zi) are used clinically.
Regulatory Status
- CITES Appendix I; bear-bile trade heavily restricted/illegal in most jurisdictions.
Historical Texts
Xin Xiu Ben Cao (Newly Revised Materia Medica, also called the Tang Ben Cao)
Tang dynasty, 659 CEBen Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1596References
- Feng Y, Siu K, Wang N, Ng KM, Tsao SW, Nagamatsu T, Tong Y. Bear bile: dilemma of traditional medicinal use and animal protection . Journal of Ethnobiology and Ethnomedicine (2009) [DOI]
- Lin DL, Chang HC, Chen CY. Identification and quantitation of bile acids in bear bile by HPLC . Journal of Food and Drug Analysis (2000) [DOI]
- Zhang Y, Wei J, Li L, Liu Y, Sun S, Xu L, Liu S, Wang Z, Yang L. Rapid identification of bear bile powder from other bile sources using chip‐based nano‐electrospray ionization tandem mass spectrometry . Rapid Communications in Mass Spectrometry (2022) [DOI]
- Watanabe S, Tsuneyama K. Cattle bile but not bear bile or pig bile induces lipid profile changes and fatty liver injury in mice: mediation by cholic acid . The Journal of Toxicological Sciences (2012) [DOI]
- Hirschfield GM, Beuers U, Corpechot C, Invernizzi P, Jones D, Marzioni M, Schramm C. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis . Journal of Hepatology (2017) [DOI]
- Dutton AJ, Hepburn C, Macdonald DW. A Stated Preference Investigation into the Chinese Demand for Farmed vs. Wild Bear Bile . PLoS ONE (2011) [DOI]
- Rust, Sauter, Oswald, Büttner, Kullak‐Ublick, Paumgartner, Beuers. Effect of cholestyramine on bile acid pattern and synthesis during administration of ursodeoxycholic acid in man . European Journal of Clinical Investigation (2000) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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