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Alpha-Lipoic Acid

Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain alpha-lipoic acid (ALA). Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with a pharmacist or health care professional before starting.



Scientists have studied ALA for the following health problems:

Diabetes
Many studies have shown that ALA may improve blood sugar levels when injected. Diabetes is a serious illness that should be treated by a qualified doctor.
Nerve pain or damage
ALA has been studied as a treatment for nerve pain or damage (neuropathy) linked to diabetes or cancer treatment. Although this research is promising, it is too early to make recommendations.
Glaucoma
Although ALA has been studied in humans as a possible treatment for glaucoma, there is not enough scientific evidence to make a recommendation at this time.
HIV cognitive impairment
ALA has been studied as a treatment for nerve damage linked to HIV. At this time, there is not enough scientific evidence to recommend ALA for this condition.
Radiation exposure
Early evidence suggests that ALA may be beneficial for people who are exposed to high levels of radiation. More studies are needed before ALA can be recommended for this use.
Alcoholic liver damage
ALA has been studied as a treatment for alcohol-related liver disease. However, no benefits have been found. There is not enough scientific evidence to recommend ALA for this use.
Burning mouth syndrome
ALA shows some promise as a treatment for burning mouth syndrome among those who have not taken calming medications, called tranquilizers. Additional research is needed before any recommendations can be made.
Skin aging
Early research shows that a skin cream containing ALA may help improve signs of skin aging. More research is needed before any recommendations can be made.
Wound healing (patients undergoing hyperbaric oxygen therapy)
When the body turns oxygen into energy (a process called oxidation) toxins called free radicals are produced. ALA may reduce tissue damage that is often caused by long-term exposure to high levels of oxygen. Additional research is needed to fully understand how this might work.
Pancreatic cancer
There is currently not enough evidence to determine if ALA can help treat pancreatic cancer.
Preventing ischemic reperfusion injury after liver surgery
When blood supply to an organ is blocked, it is called ischemia. When blood flow is restored (called reperfusion), it may cause swelling and stress that can lead to organ damage. Treatment with ALA before surgically removing part of the liver may help prevent this type of organ damage. More research is needed.
Kidney disease
There is not enough evidence to recommend for or against ALA in kidney disease patients.


ALA has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care professional before taking ALA for any unproven use.

Aging (memory enhancement)
Alzheimer's disease
Amanita poisoning
Antioxidant
Atherosclerosis (clogged arteries)
Atopic dermatitis
Bile flow
Bone loss
Cancer
Cerebrovascular disease
Chemotherapy side effects
Cognitive impairment
Constipation
Contact dermatitis
Degenerative brain disorders
Depression
Diminished appetite (in cancer patients)
Down syndrome
Endothelial dysfunction
Hearing damage (from certain drugs)
Heart muscle injury (adriamycin-induced)
Hepatitis C
High blood pressure
High cholesterol
HIV
Immune system stimulant
Inflammation
Inflammatory vascular diseases
Lead poisoning
Liver disease (biliary cirrhosis)
Mercury poisoning
Metabolic disorders
Metabolic syndrome
Mitochondrial myopathies
Mountain sickness
Multiple sclerosis
Muscular dystrophy (facioscapulohumeral dystrophy)
Mushroom poisoning
Nerve problems (from kidney disease)
Neural tube defects
Neurodegenerative diseases
Nutritional supplement
Obesity
Pain after surgery
Parkinson's disease
Problems with blood sugar metabolism
Psoriasis
Retinal leukostasis
Retinal ischemia/reperfusion
Retinopathy
Sepsis (prevention and treatment)
Sickle cell anemia
Smell disorders
Stomach irritation
Toxic kidney damage (oxaliplatin-induced)
Vascular dementia
Wilson's disease (a hereditary disorder)


Allergies

People with allergies to ALA should avoid using it. Allergic skin reactions (called contact dermatitis) have occurred after an alpha-lipoic acid anti-wrinkle cream was used. In one study, pain and redness occurred where ALA was injected.

Side Effects

Few side effects of ALA have been reported. The most common complaints include nausea, vomiting, and dizziness, which generally occurred in studies at doses of 1,200 to 1,800 milligrams.

Some natural medicine experts discourage the use of ALA in people with underactive thyroids (hypothyroidism). Based on deaths seen in animal research, ALA should be avoided in patients with thiamine deficiency, a condition commonly linked to alcoholism. However, there are no specific studies in humans, so the risks of ALA use in people with these conditions are not clear.

Use cautiously if you have type 2 diabetes due to the possible risks of increased insulin sensitivity and trace element deficiencies. One case of insulin autoimmune syndrome, a rare disease that causes the immune system to mistakenly attack insulin, leading to low blood sugar levels, was reported after ALA use.

Pregnancy And Breast-Feeding

There is not enough scientific evidence available to recommend using ALA during pregnancy or breast-feeding.


Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with a health care professional or pharmacist before using herbs or dietary supplements.

Interactions With Drugs

It appears that ALA lowers blood sugar levels. Caution is advised if you are taking prescription drugs that may lower blood sugar levels. Patients taking oral drugs for diabetes or insulin should be monitored closely by their doctors while using ALA. Dosing adjustments may be necessary.

In theory, ALA may affect thyroid levels. Caution is advised if you have been diagnosed with thyroid disease. Patients using drugs for thyroid disease should be monitored closely by their doctors while using ALA. Dosing adjustments may be necessary.

ALA, when given with the anticancer drug doxorubicin, helps protect against heart damage. Using ALA may allow doctors to prescribe higher doses of doxorubicin. ALA seems to have similar protective effects when given with another anticancer drug called adriamycin, although more research is needed.

ALA may affect drugs that are broken down by the liver. Use cautiously if you are taking antibiotics.

Interactions With Herbs And Dietary Supplements

ALA may lower blood sugar levels. People using herbs or other supplements that lower blood sugar levels, such as bitter melon (Momordica charantia), should be closely monitored by their doctors while using ALA. Dosing adjustments may be necessary.

Products that may raise blood sugar levels, such as devil's claw, may reduce ALA's blood sugar-lowering effects.

Use cautiously if you have a thyroid disorder because ALA may affect thyroid hormone levels.

Herbs and supplements broken down by the liver may be affected. Vitamin C levels may be increased.


The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care professional before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

In general, experts believe it is safe to use ALA at recommended dosages for up to two years. Currently, there is no general recommendation on dosage, dose frequency, form of administration and/or preferred form of ALA.

For Diabetes/Diabetic Neuropathy

Adults (Aged 18 Or Older)

Oral Capsules: For lowering blood sugar levels and treating diabetic nerve pain or damage (neuropathy), a dose of 600 to 1,800 milligrams has been taken by mouth in daily divided doses. Sustained release formulations are available. Diabetes is a serious illness and should be treated under the supervision of a qualified health care professional.

Children (Younger Than 18)

The dosing and safety of ALA have not been studied in children, and therefore, ALA cannot be recommended.

For Drug-Induced Cardiotoxicity

Adults (Aged 18 Or Older)

ALA in doses of 100 milligrams per kilogram was reported to reduce heart damage caused by the anticancer drug doxorubicin. However, the study was a poorly described study.

For Nerve Pain or Damage

Adults (Aged 18 Or Older)

A dose of 600 milligrams of ALA has been injected for 10 days and then taken by mouth.

Children (Younger Than 18)

Because the dosing and safety of intravenous ALA has not been well studied in children, ALA cannot be recommended.


Although alpha-lipoic acid (ALA) has been suggested for many conditions, most studies have focused on its ability to lower blood sugar levels. The best evidence supports its use intravenously, but some evidence also suggests that benefits may be seen when taken by mouth. It is important to remember that diabetes is a serious illness that should be treated by a qualified health care professional. ALA has not been proven for any other health conditions and has not been shown to have benefits when used as a nutritional supplement in healthy people. It should be avoided in pregnant or breast-feeding women, in people with thiamine deficiencies, and in children. ALA appears to be safe when used in recommended doses for up to two years. Consult a health care professional immediately if you experience side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.


  1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
  2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Alpha-Lipoic Acid

Some of the more recent studies are listed below:

  1. Al-Majed AA, Gdo AM, Al-Shabanah OA, Mansour MA. Alpha-lipoic acid ameliorates myocardial toxicity induced by doxorubicin. Pharmacol Res 2002;Dec, 46(6):499-503.
  2. Alleva R, Nasole E, Di Donato F, et al. Alpha-lipoic acid supplementation inhibits oxidative damage, accelerating chronic wound healing in patients undergoing hyperbaric oxygen therapy. Biochem Biophys Res Commun 2005;Jul 29, 333(2):404-410.
  3. Ametov AS, Barinov A, Dyck PJ, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Diabetes Care 2003;Mar, 26(3):770-776.
  4. Balachandar AV, Malarkodi KP, Varalakshmi P. Protective role of DL alpha-lipoic acid against adriamycin-induced cardiac lipid peroxidation. Hum Exp Toxicol 2003;May, 22(5):249-254.
  5. Bondy SC, Yang YE, Walsh TJ, et al. Dietary modulation of age-related changes in cerebral pro-oxidant status. Neurochem Int 2002;Feb, 40(2):123-130.
  6. Bruckner I, Bustan C, Adamescu E, et al. Diabetic neuropathy: choices of treatment. Rom J Intern Med 2002;40(1-4):53-60.
  7. Chang JW, Lee EK, Kim TH, et al. Effects of alpha-lipoic acid on the plasma levels of asymmetric dimethylarginine in diabetic end-stage renal disease patients on hemodialysis: a pilot study. Am J Nephrol 2007;27(1):70-74. Epub 2007;Jan 26.
  8. Chidlow G, Schmidt KG, Wood JP, et al. Alpha-lipoic acid protects the retina against ischemia-reperfusion. Neuropharmacology 2002;Nov, 43(6):1015-1025.
  9. Dunschede F, Erbes K, Kircher A, et al. Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by alpha-lipoic acid in humans. World J Gastroenterol 2006;Nov 14, 12(42):6812-6817.
  10. Femiano F, Gombos F, Scully C. Burning mouth syndrome: the efficacy of lipoic acid on subgroups. J Eur Acad Dermatol Venereol 2004;Nov, 18(6):676-678.
  11. Kamenova P. Improvement of insulin sensitivity in patients with type 2 diabetes mellitus after oral administration of alpha-lipoic acid. Hormones (Athens) 2006;Oct-Dec, 5(4):251-258.
  12. AYAYTang J, Wingerchuk DM, Crum BA, et al. Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy. Neurologist 2007;May, 13(3):164-167.
  13. Tankova T, Cherninkova S, Koev D. Treatment for diabetic mononeuropathy with alpha-lipoic acid. Int J Clin Pract 2005;Jun, 59(6):645-650.
  14. Tankova T, Koev D, Dakovska L. Alpha-lipoic acid in the treatment of autonomic diabetic neuropathy (controlled, randomized, open-label study). Rom J Intern Med 2004;42(2):457-464.
  15. Thom E. A randomized, double-blind, placebo-controlled study on the clinical efficacy of oral treatment with DermaVite on ageing symptoms of the skin. J Int Med Res 2005;May-Jun, 33(3):267-272.
  16. Ziegler D, Ametov A, Barinov A, et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care 2006;Nov, 29(11):2365-2370.



Last updated May 08, 2008


   
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