Alpha-Lipoic Acid

Effects and Benefits

Core Identification

Common Names:
- Alpha-Lipoic Acid
- ALA
- Lipoic Acid
- Thioctic Acid
- R-Lipoic Acid (specific form)

Latin Name: N/A (synthetic/endogenous compound)

Category: Other Supplement

Uses

Traditional Uses

• Liver disease treatment - European medical tradition, used since 1970s for hepatitis and cirrhosis
• Mushroom poisoning antidote - German medical practice, intravenous administration
• Metabolic support - Traditional inclusion in B-vitamin complexes for energy production

Modern Uses

• Diabetic Peripheral Neuropathy - Reduces symptoms of tingling, numbness, and nerve pain in hands and feet | Research quality: Strong
• Key findings: The NATHAN trial (36 centers in Canada, Europe, and US) found 600mg daily moderately improved small nerve fiber and muscular function; used as prescription medication in Europe for decades

• Source citations: Moyad - The Supplement Handbook; Colbert - Reversing Diabetes

• Blood Sugar Support - Improves insulin sensitivity and glucose uptake in type 2 diabetes | Research quality: Strong

• Key findings: Acts as an "insulino-mimetic" by recruiting GLUT-4 glucose transporters to muscle cells; improves insulin resistance in overweight adults; works like a less potent version of metformin by activating AMPK pathway

• Source citations: Ferriss - The 4-Hour Body; Brewer - TDT Encyclopedia of Vitamins

• Antioxidant Support - Regenerates vitamins C, E, glutathione, and CoQ10 | Research quality: Strong

• Key findings: Works in both water-soluble and fat-soluble compartments; restores intracellular glutathione levels; increases excretion of toxic heavy metals like mercury

• Source citations: Colbert - Reversing Diabetes; Ferriss - The 4-Hour Body

• Weight Loss Support - May promote modest weight loss when combined with calorie restriction | Research quality: Moderate

• Key findings: Korean clinical trial showed 1,800mg/day (600mg before each meal) resulted in 4.5-5 pounds greater weight loss than placebo over 5 months; 23% of ALA group lost 5%+ body weight vs 10% of placebo

• Source citations: Moyad - The Supplement Handbook

• Liver Support - Supports liver function in hepatitis, cirrhosis, and toxic damage | Research quality: Moderate

• Key findings: Intravenous interventions in 1970s trials reversed liver disease in 75 of 79 subjects; used to treat toxic liver damage including mushroom poisoning

• Source citations: Brewer - TDT Encyclopedia of Vitamins; Ferriss - The 4-Hour Body

• Hearing Protection - May protect against age-related and chemotherapy-induced hearing loss | Research quality: Preliminary

• Key findings: Animal models show protection against hearing loss; preliminary human study showed 600mg daily for 10 days protected inner ear from trauma and improved both subjective and objective hearing measures

• Source citations: Moyad - The Supplement Handbook

• Carpal Tunnel Syndrome - Being researched as neuroprotectant before/after surgery | Research quality: Preliminary

• Key findings: Due to history of reducing nerve injury, ALA is getting preliminary research for CTS neuroprotection
• Source citations: Moyad - The Supplement Handbook

Active Compounds

Primary Active Ingredients:
- Alpha-Lipoic Acid (the compound itself) - Acts as co-enzyme with B vitamins for energy production; potent antioxidant in both water and fat environments
- R-Lipoic Acid - The naturally occurring, more bioavailable form; more readily absorbed but more expensive
- R/S-Lipoic Acid - Synthetic racemic mixture; less expensive and used in most clinical trials

Dosage Information

Standard Dosage:
- Form: Capsule
- Amount: 50-100 mg per day
- Frequency: Once daily
- Purpose: General antioxidant support and energy

Therapeutic Dosage:
- Form: Capsule
- Amount: 300-600 mg per day
- Purpose: Diabetic neuropathy, blood sugar support, liver health
- Duration: Ongoing with medical supervision
- Note: Dr. Colbert starts diabetic patients on 300mg twice daily, may increase to 600mg two to three times daily

Weight Loss Dosage:
- Form: Capsule
- Amount: 1,800 mg per day (600 mg three times daily)
- Timing: Approximately 30 minutes before each meal
- Duration: 5+ months based on clinical trials

Maximum Safe Dosage:
- Daily maximum: Studies have used up to 1,800 mg safely
- NOAEL (No Observable Adverse Effect Level): 60 mg per kilogram of body weight (approximately 4,091 mg for a 150-pound person)
- Warning threshold: Higher doses may increase GI side effects; doses above 100mg may cause acid reflux in some individuals

Bioavailability Notes:
- R-lipoic acid is better absorbed than R/S-lipoic acid
- R/S-lipoic acid has been used in most major clinical trials and remains effective
- Natural dietary sources (spinach, organ meats) contain only trace amounts insufficient for therapeutic benefit

How to Take It

Timing:
- For blood sugar support and weight loss: Take 30 minutes before meals
- For general antioxidant support: Can be taken with or without food
- For diabetic neuropathy: Consistent daily dosing, timing less critical

Synergies - What It Works Well With

Complementary Supplements:
1. Vitamin C - ALA regenerates vitamin C after it neutralizes free radicals | Enhanced antioxidant recycling
2. Vitamin E - ALA regenerates vitamin E | Extended antioxidant protection
3. Glutathione/NAC - ALA restores glutathione levels; NAC provides glutathione precursors | Combined antioxidant and liver support
4. CoQ10 - ALA regenerates CoQ10 | Enhanced cellular energy and antioxidant capacity
5. B Vitamins - ALA acts as co-enzyme with B vitamins | Improved energy metabolism
6. EGCG (Green Tea Extract) - Both recruit GLUT-4 transporters to muscle cells | Enhanced glucose uptake and metabolic support
7. Chromium - Both support insulin sensitivity | Complementary blood sugar support

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Other Blood Sugar-Lowering Supplements - Stacking with bitter melon, fenugreek, gymnema, ginseng, cinnamon may cause additive hypoglycemic effects | Monitor blood sugar carefully

Drug Interactions:
1. Diabetes Medications (Insulin, Metformin, Sulfonylureas) - ALA improves insulin sensitivity and can lower blood sugar | Risk of hypoglycemia; requires blood sugar monitoring and possible medication adjustment | Severity: Moderate
2. Thyroid Medications (Levothyroxine) - ALA may affect thyroid function; some patients develop decreased thyroid function | Monitor thyroid levels closely | Severity: Moderate
3. Chemotherapy Drugs - ALA is a potent antioxidant that could theoretically interfere with oxidative cancer treatments | Consult oncologist before use | Severity: Moderate

Food Interactions:
- No significant food interactions known
- Taking with food may reduce GI side effects but is not required for absorption

Safety Information

Contraindications:
- Uncontrolled diabetes without medical supervision (due to blood sugar effects)
- Thyroid disorders (may affect thyroid function)
- Heavy alcohol use (alcohol increases lactic acid production)
- Thiamine (B1) deficiency - ALA may worsen symptoms

Side Effects:
- Common: Mild GI upset, nausea, acid reflux (especially at doses above 100mg)
- Common: Malodorous urine (harmless, similar to asparagus effect)
- Less common: Skin rash, itching, allergic reactions
- Rare: Decreased thyroid function with prolonged use
- Rare: Hypoglycemia in diabetics (actually a therapeutic effect requiring medication adjustment)

Long-Term Use:
- Generally considered safe for long-term use at standard doses
- Diabetics and thyroid patients should have regular monitoring
- No established need for cycling at therapeutic doses
- The NATHAN trial demonstrated safety over extended treatment periods

Special Precautions:
- Surgery: Inform surgeon of use due to blood sugar effects; may need to discontinue 2 weeks before surgery
- Pregnancy: Insufficient safety data; avoid unless directed by healthcare provider
- Breastfeeding: Insufficient safety data; avoid unless directed by healthcare provider
- Children: Not enough research to establish pediatric dosing

Primary Uses At-a-Glance

Primary: Diabetic peripheral neuropathy, blood sugar support, antioxidant regeneration, metabolic syndrome support

Secondary: Weight loss support, liver health, hearing protection, heavy metal detoxification, chronic fatigue support, altitude adaptation

Sources

Local Library:
- Moyad, Mark - The Supplement Handbook
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Ferriss, Timothy - The 4-Hour Body
- Colbert, Don - Reversing Diabetes
- Moline, Peg - The Doctors Book of Natural Health Remedies
- WRCHM - Herb-Drug-Nutrient Interaction
- Lust, John - The Natural Remedy Bible
- Mars, Brigitte - The Home Reference to Holistic Health and Healing
- Curtis, Susan - Neal's Yard Remedies

General Knowledge:
- NATHAN Trial (Neurological Assessment of Thioctic Acid in Diabetic Neuropathy) - multi-center clinical trial
- Clinical research on AMPK pathway activation
- European medical use for diabetic neuropathy (prescription drug in Germany and other countries)