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Your gut bacteria do more than digest food. They chemically rework the bile acids your liver makes, and the byproducts they leave behind can quietly track changes in your liver, kidneys, and bowel long before symptoms appear. 7-KDCA (7-ketodeoxycholic acid) is one of those byproducts, and emerging research has found that fecal levels shift alongside fatty liver disease progression, diabetic kidney disease, irritable bowel syndrome, and colorectal cancer.
This is an exploratory marker. There are no clinical guidelines for it yet, and the evidence comes from research cohorts rather than large outcome trials. For someone interested in tracking how gut microbes are reshaping bile acid chemistry as part of a broader metabolic picture, this measurement offers a window into a process that standard lab panels do not capture.
Your liver makes primary bile acids like cholic acid to help you absorb fat. Once those bile acids reach the intestine, gut bacteria modify them through a process called oxidation. 7-KDCA is one of the products of that microbial reworking, formed when bacteria carrying specific enzymes alter bile acids in the gut.
Because 7-KDCA only exists when both halves of the system are working, your liver pumping out bile acids and your gut bacteria transforming them, its level reflects the combined state of liver bile acid production and microbial activity. When something disrupts that balance, the level changes. That is why researchers are increasingly interested in this byproduct as a window into the gut, liver, and kidney working together.
Fecal 7-KDCA rises as fatty liver disease (called NAFLD, or non-alcoholic fatty liver disease) progresses to its more aggressive inflammatory form (called NASH, or non-alcoholic steatohepatitis) and toward fibrosis, the scarring that signals serious liver damage. The increase tracks with both disease activity and the degree of scarring, and it appears tied to changes in the gut bacteria that reshape bile acids.
What this means for you: if you already know you have fatty liver, or you have metabolic risk factors that put you at risk, an elevated fecal 7-KDCA reading alongside other liver markers may signal that the bile acid axis is being disrupted as the liver disease evolves. It is not a stand-alone diagnostic, but it can complement standard liver tests and imaging.
In people with type 2 diabetes, fecal 7-KDCA increases in step with kidney decline. Higher levels correlate with worse kidney filtration (measured by eGFR, your estimated kidney filtration rate) and with more protein leaking into the urine, two of the most established markers of diabetic kidney damage. The change is described as step-wise, meaning it tracks the progression of disease rather than appearing all at once.
What this means for you: if you have diabetes and you are already monitoring kidney markers like creatinine and urine albumin, this byproduct may add a microbiome-related dimension to that picture. It points to a potential pathway, microbial bile acid chemistry, that conventional kidney tests do not measure.
Fecal 7-KDCA is elevated in people with diarrhea-predominant irritable bowel syndrome (IBS-D), particularly in those with the most severe bowel symptoms. The pattern fits a broader phenomenon called bile acid overexcretion, where excess bile acids reach the colon and contribute to looser stools. Fecal bile acid profiles, including microbially generated species, have also been associated with colorectal cancer risk in human studies.
What this means for you: chronic loose stools that do not respond to typical interventions can have many causes, but bile acid disruption is one that is often missed. Elevated fecal 7-KDCA in this setting suggests a worth-investigating pathway that goes beyond food triggers and standard inflammation markers.
Research using a different specimen, plasma rather than stool, has found that 7-KDCA is lower in people with parathyroid carcinoma compared to those with benign parathyroid adenoma. In a study of 115 patients, plasma 7-KDCA helped distinguish carcinoma from adenoma with moderate accuracy. This evidence comes from blood, not stool, so it is not directly transferable to a fecal test, but it shows that 7-KDCA chemistry shifts in unexpected disease settings beyond the gut.
Studies have also reported differences in fecal bile acid profiles between people with osteopenia and those with osteoporosis, suggesting bile acid chemistry may be linked to bone density patterns. The mechanism here is still being worked out, and these findings are early.
There are no standardized clinical reference ranges for fecal 7-KDCA. This is a research-stage marker, and published values vary widely depending on the population studied, the assay method (typically a lab technique called LC-MS/MS that uses liquid chromatography paired with mass spectrometry to identify and quantify specific molecules), and the units used. The studies that report 7-KDCA generally compare disease groups to healthy controls within the same cohort rather than referencing universal cutpoints.
This means a single number is hard to interpret in isolation. The most useful approach is to compare your result to the range your specific lab reports for healthy individuals, and to track your own value over time within the same lab so that day-to-day assay differences do not muddle the trend.
For a marker without clinical cutpoints, your own trajectory matters more than any single reading. Bile acid chemistry shifts with diet, gut bacteria, and bile flow, and a single sample captures one moment in a biology that fluctuates. Establishing a baseline and watching the direction of change gives you a far more meaningful signal than chasing a one-time number.
A reasonable cadence: get a baseline reading, retest in three to six months if you are making targeted changes (gut, liver, or kidney directed), and then at least annually as part of broader monitoring. If you are working on a specific condition that links to bile acid disruption, more frequent testing during active intervention can help you see whether the pathway is shifting.
Because this is an exploratory marker, an abnormal reading is best treated as one piece of a pattern rather than a diagnosis on its own. The most useful next step is to look at what else is happening in your bile acid and gut profile. If you ordered 7-KDCA as part of a broader stool bile acid panel, examine the full picture, including total bile acids, primary versus secondary bile acid balance, and short chain fatty acids.
From there, the right specialist depends on which clinical context the abnormal result lines up with. A persistently elevated fecal level alongside abnormal liver enzymes warrants a hepatologist (a liver specialist). The same elevation alongside declining kidney filtration in someone with diabetes warrants a nephrologist (a kidney specialist). Elevated levels with chronic diarrhea or unexplained gut symptoms warrant a gastroenterologist with experience in bile acid disorders. The marker is not a substitute for those specialty workups, but it can sharpen the question they investigate.
Several factors can shift a single fecal 7-KDCA reading without indicating a real change in your underlying biology:
7-Ketodeoxycholic Acid is best interpreted alongside these tests.