INDEX

Alpha Lipoic Acid

Background

  • Alpha-lipoic acid (ALA) is made naturally in the body and may protect against cell damage in a variety of conditions. Food sources rich in alpha-lipoic acid include spinach, broccoli, and yeast.

  • ALA, known as the “universal oxidant,” has been used for decades in Europe to treat nerve conditions, including nerve damage resulting from poorly controlled diabetes.

  • There is strong evidence that ALA may help treat type 2 diabetes and neuropathy. According to a survey of 685 herbalists, ALA was one of the 10 most frequently recommended dietary supplements due to its efficacy in reducing high blood sugar levels.

  • ALA appears to be generally well tolerated, with minimal adverse effects.

  • There are not enough data to support the use of ALA in Amanita poisoning (a poisonous mushroom that causes liver damage), which has reportedly been a common practice for many years.

  • The therapeutic use of alpha-lipoic acid is not approved by the U.S. Food and Drug Administration (FDA) or corresponding regulatory agencies in other countries.

Scientific Evidence

Uses

Grade*

Neuropathy (nerve pain or damage)

Several studies have shown that alpha-lipoic acid (ALA) is an effective treatment for neuropathy (nerve pain or damage) associated with diabetes.

A

Type 2 diabetes

Several studies have shown that ALA may help control and improve blood sugar levels. Additional studies on this topic are needed. Diabetes is a serious illness and should be treated under the supervision of a qualified healthcare provider.

A

Altitude sickness

Antioxidants that included ALA had mixed effects on altitude sickness. Additional research is needed on ALA alone.

C

Alzheimer’s disease

Early research shows mixed results regarding ALA for brain protection. Additional research on this topic is needed.

C

Antioxidant

ALA may increase the production of glutathione and help repair cell damage. Most studies support the antioxidant effects of ALA. Additional research is needed in this area.

C

Bone density

Overall evidence of ALA for improving bone mineral density is lacking, although ALA has increased density in a specific hip bone. Further research is needed.

C

Cachexia (weight loss/wasting from some diseases)

Early research suggests that alpha-lipoic acid with other antioxidants may improve weight loss from cancer. Studies evaluating ALA alone are needed.

C

Cancer

Overall evidence of ALA for preventing cancer progression is currently lacking. Additional research is needed in this area.

C

Carpal tunnel syndrome

Early research suggests that ALA and gamma-linolenic acid may benefit symptoms of carpal tunnel syndrome, particularly in the early stages of the disease. Additional research evaluating ALA alone is needed.

C

Cognitive function (associated with HIV)

ALA has been studied as a treatment for cognitive impairment (problems with mental function) caused by nerve damage in HIV patients. More high-quality studies are needed.

C

Glaucoma (increased eye pressure)

ALA may protect the eye from excess pressure, but more research is needed to evaluate ALA’s long-term effect.

C

Heart disease prevention

In early research, ALA and other antioxidants had mixed effects on blood pressure. The effects of ALA alone are unclear, and further research is needed.

C

Heart failure

Antioxidants that included ALA improved some measurements of blood flow. Further research is needed on ALA alone.

C

Heart muscle protection during heart surgery

Early research shows that antioxidants, including ALA, may benefit people undergoing cardiac surgery. Further research is needed on ALA alone.

C

High blood pressure

The effect of ALA on blood pressure in unclear. Additional research on this topic is needed.

C

High blood sugar/glucose intolerance

In people with impaired glucose tolerance, ALA had mixed results in improving insulin levels and the insulin response. Further research is needed on this topic.

C

HIV patients on antiretroviral therapy

In HIV patients on antiretroviral therapy, ALA improved white blood cell function. Additional research on this topic is needed.

C

Improving blood flow (endothelial dysfunction)

ALA has shown mixed results for improving blood flow. Additional research on this topic is needed.

C

Inflammation

The effects of ALA on inflammation markers are unclear. Further research is needed on this topic.

C

Ischemia-reperfusion injury protection (prevention of tissue damage after restored blood flow)

ALA may prevent tissue damage after restored blood flow in the liver. Additional research on this topic is needed.

C

Kidney disease

ALA may improve the blood vessel lining function, possibly benefiting patients with end-stage kidney disease. More research is needed in this area.

C

Lipid lowering effects

ALA has shown mixed results in reducing cholesterol levels. Further research is needed.

C

Migraine

ALA may help prevent migraines. Further research is needed to confirm these results.

C

Mitochondrial diseases

Research investigating the effect of ALA for mitochondrial diseases (problems with cell energy) is limited. Further research is required.

C

Pain (burning mouth syndrome)

ALA has shown mixed results as a treatment for burning mouth syndrome, a condition that causes the mouth to feel hot or tingly. Additional research is needed.

C

Peripheral artery disease

ALA may reduce pain associated with exercise in people with peripheral artery disease. Additional studies are warranted.

C

Radiation injuries

Limited research suggests that ALA may be beneficial for people exposed to high levels of radiation. Well-designed studies are needed.

C

Rheumatoid arthritis

Early research suggests that ALA acid lacks effects on symptoms of rheumatoid arthritis and inflammatory mediators. Further research is needed.

C

Schizophrenia

Early research suggests that ALA may reduce some adverse effects of antipsychotic drugs. Additional high-quality studies are needed.

C

Sciatica (pain from compressed nerve)

The antioxidant effects of ALA may aid recovery of nerve function and pain reduction. More high-quality studies are needed.

C

Skin aging

Early research shows that a skin cream with ALA may help improve signs of skin aging. More research is needed in this area.

C

Skin pigmentation disorders

Antioxidants with ALA may improve the effectiveness of treatment for skin pigmentation. Additional research on this topic is needed.

C

Steatohepatitis (fatty liver)

ALA may reduce liver size and reduce other symptoms of a fatty liver. More well-designed studies are needed.

C

Weight loss

Research suggests ALA may reduce weight gain associated with use of antipsychotic drugs. Additional high-quality studies are needed.

C

Wound healing (in people undergoing hyperbaric oxygen therapy)

ALA may reduce tissue damage caused by long-term exposure to high levels of oxygen. More research is needed in this area.

C

Alcoholic liver disease

ALA has been studied as a treatment for alcohol-related liver disease. However, benefits have not been observed at this time. More research is needed in this area.

D

*Key to grades:

A: Strong scientific evidence for this use;

B: Good scientific evidence for this use;

C: Unclear scientific evidence for this use;

D: Fair scientific evidence against this use (it may not work);

F: Strong scientific evidence against this use (it likely does not work).

Tradition

  • Age-related macular degeneration (vision loss), antiviral, atherosclerosis (clogged arteries), bile flow improvement, blood clot prevention, blood disorders (porphyria), brain damage, central nervous system disorders, chronic hepatitis, constipation, contact dermatitis (skin irritation from allergy), dementia (vascular), depression, Down’s syndrome, hearing damage (from certain drugs), hearing loss, heart damage from doxorubicin (Adriamycin®, Doxil®), immune system stimulant, inflammatory skin conditions (eczema, psoriasis), kidney protection (from chemotherapy), lactic acidosis (lipoamide dehydrogenase deficiency), lead toxicity, liver damage, metabolic disorders (metabolic syndrome), multiple sclerosis, muscular dystrophies (facioscapulohumeral dystrophy), neural tube defects, neuroprotection (oxaliplatin-related toxicity), nutritional supplement, Parkinson’s disease, post-operative pain, postural stability (vibration disease), retinopathy, scurvy, sensory disturbances (problems with sense of smell), sepsis (bacterial infection of the blood), sickle cell anemia, skin conditions (trigeminal trophic syndrome), stomach problems, stroke, thyroid conditions, Tourette’s syndrome, toxicity (cyclophosphamide, mercury, Amanita phalloides mushroom), vascular damage, vitamin E deficiency, Wilson’s disease (a hereditary disorder), zinc deficiency.

Dosing

Adults (18 years and older)

  • Currently there is a lack of consensus on dosage, dose frequency, form of administration, and/or preferred form of alpha-lipoic acid (ALA).

  • For alcoholic liver disease, 300 milligrams of ALA has been taken by mouth in three divided doses daily for up to 24 weeks.

  • As an antioxidant, 200-1,200 milligrams of ALA has been taken by mouth daily for four weeks to six months. Additionally, 600-1,200 milligrams of ALA has been taken by mouth in two or three divided doses for 3-90 days.

  • For bone density, 600 milligrams of ALA has been taken by mouth twice daily for 12 months.

  • For cognitive function associated with HIV, 600 milligrams of ALA has been taken by mouth twice daily for 10 weeks.

  • For glaucoma (damaged optic nerve),150 milligrams of ALA taken by mouth for one month showed improvement over 75 milligrams of ALA taken by mouth for two months.

  • For high blood pressure, 600 milligrams of ALA has been taken by mouth daily for eight weeks.

  • For HIV patients on antiretroviral therapy, 300 milligrams of ALA has been taken by mouth three times daily for six months.

  • For impaired glucose tolerance, 250 milliliters of saline solution containing 600 milligrams of ALA was injected once daily for up to three weeks. Additionally, 250 milliliters of saline containing 300 milligrams of ALA has been used as a single dose.

  • For improving blood flow, 600-1,800 milligrams of ALA has been taken by mouth. Additionally, 300-600 milligrams of ALA in 250 milliliters of saline has been injected for up to three weeks.

  • For inflammation, 300-600 milligrams of ALA has been taken by mouth for up to three months.

  • For kidney disease, 600 milligrams of ALA has been taken by mouth daily for 8-12 weeks.

  • For lipid lowering effects, 600 milligrams of ALA has been taken by mouth daily for up to16 weeks. A dosage of 400 milligrams was also taken by mouth daily for four weeks. A dosage of 600 milligrams of ALA in 200 milliliters of saline has been injected into a vein daily for 14 days.

  • For migraine, 600 milligrams of ALA has been taken by mouth daily for three months.

  • For neuropathy (nerve damage), 600-1,800 milligrams of ALA has been taken by mouth daily in divided doses from 19 days to four years. A dose of 100-1,200 milligrams of ALA has been injected into a vein for up to four weeks.

  • For pain (burning mouth syndrome), 200-800 milligrams of ALA has been taken by mouth daily for up to three months.

  • For peripheral artery disease, 600 milligrams of ALA has been taken by mouth daily in two divided doses for three months.

  • For prevention of tissue damage after restored blood flow, 600 milligrams of ALA in 50 milliliters of sodium chloride has been injected into a vein.

  • For rheumatoid arthritis, 300 milligrams of ALA has been taken by mouth three times daily for 12 weeks.

  • For sciatica (pain from compressed nerve), 600 milligrams of ALA has been taken by mouth daily for 60 days.

  • For steatohepatitis (fatty liver), 300 milligrams of ALA has been taken by mouth twice or thrice daily for 1-2 months.

  • For type 2 diabetes, 300-1,800 milligrams of ALA has been taken by mouth daily for up to two years. Doses of 500-1,000 milligrams of ALA in saline or sodium chloride have been injected into a vein for up to three weeks.

  • For weight loss, 400-600 mg of ALA has been taken by mouth three times daily for 20 weeks. Additionally, 1,000 milligrams of ALA has been taken daily by mouth for 12 weeks.

  • For wound healing in people undergoing hyperbaric oxygen therapy, 300 milligrams of ALA has been taken by mouth before exposure to oxygen and immediately after therapy. Then, patients took 300 milligrams by mouth twice daily for the next 30 treatments.

Children (younger than 18 years)

  • For children receiving radiation injuries, 400 milligrams of ALA has been used daily for four weeks.

References

  1. Ansar, H., Mazloom, Z., Kazemi, F., and Hejazi, N. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Saudi.Med J 2011;32(6):584-588. View Abstract
  2. de Oliveira, A. M., Rondo, P. H., Luzia, L. A., D’Abronzo, F. H., and Illison, V. K. The effects of lipoic acid and alpha-tocopherol supplementation on the lipid profile and insulin sensitivity of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Diabetes Res Clin Pract. 2011;92(2):253-260. View Abstract
  3. Galasko, D. R., Peskind, E., Clark, C. M., Quinn, J. F., Ringman, J. M., Jicha, G. A., Cotman, C., Cottrell, B., Montine, T. J., Thomas, R. G., and Aisen, P. Antioxidants for Alzheimer disease: a randomized clinical trial with cerebrospinal fluid biomarker measures. Arch.Neurol. 2012;69(7):836-841. View Abstract
  4. Han, T., Bai, J., Liu, W., and Hu, Y. A systematic review and meta-analysis of alpha-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol. 2012;167(4):465-471. View Abstract
  5. Haritoglou, C., Gerss, J., Hammes, H. P., Kampik, A., and Ulbig, M. W. Alpha-lipoic acid for the prevention of diabetic macular edema. Ophthalmologica 2011;226(3):127-137. View Abstract
  6. Koh, E. H., Lee, W. J., Lee, S. A., Kim, E. H., Cho, E. H., Jeong, E., Kim, D. W., Kim, M. S., Park, J. Y., Park, K. G., Lee, H. J., Lee, I. K., Lim, S., Jang, H. C., Lee, K. H., and Lee, K. U. Effects of alpha-lipoic Acid on body weight in obese subjects. Am J Med 2011;124(1):85-88. View Abstract
  7. Leong, J. Y., van der Merwe, J., Pepe, S., Bailey, M., Perkins, A., Lymbury, R., Esmore, D., Marasco, S., and Rosenfeldt, F. Perioperative metabolic therapy improves redox status and outcomes in cardiac surgery patients: a randomised trial. Heart Lung Circ. 2010;19(10):584-591. View Abstract
  8. Lopez-D’alessandro, E. and Escovich, L. Combination of alpha lipoic acid and gabapentin, its efficacy in the treatment of Burning Mouth Syndrome: a randomized, double-blind, placebo controlled trial. Med Oral Patol.Oral Cir.Bucal. 2011;16(5):e635-e640. View Abstract
  9. McNeilly, A. M., Davison, G. W., Murphy, M. H., Nadeem, N., Trinick, T., Duly, E., Novials, A., and McEneny, J. Effect of alpha-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance. Lipids Health Dis 2011;10:217. View Abstract
  10. Porasuphatana, S., Suddee, S., Nartnampong, A., Konsil, J., Harnwong, B., and Santaweesuk, A. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study. Asia Pac.J Clin Nutr 2012;21(1):12-21. View Abstract
  11. Rahman, S. T., Merchant, N., Haque, T., Wahi, J., Bhaheetharan, S., Ferdinand, K. C., and Khan, B. V. The impact of lipoic acid on endothelial function and proteinuria in quinapril-treated diabetic patients with stage I hypertension: results from the QUALITY study. J Cardiovasc.Pharmacol.Ther 2012;17(2):139-145. View Abstract
  12. Sun, Y. D., Dong, Y. D., Fan, R., Zhai, L. L., Bai, Y. L., and Jia, L. H. Effect of (R)-alpha-lipoic acid supplementation on serum lipids and antioxidative ability in patients with age-related macular degeneration. Ann Nutr Metab 2012;60(4):293-297. View Abstract
  13. Xiang, G., Pu, J., Yue, L., Hou, J., and Sun, H. alpha-lipoic acid can improve endothelial dysfunction in subjects with impaired fasting glucose. Metabolism 2011;60(4):480-485. View Abstract
  14. Xiao, C., Giacca, A., and Lewis, G. F. Short-term oral alpha-lipoic acid does not prevent lipid-induced dysregulation of glucose homeostasis in obese and overweight nondiabetic men. Am J Physiol Endocrinol.Metab 2011;301(4):E736-E741. View Abstract
  15. Ziegler, D., Low, P. A., Litchy, W. J., Boulton, A. J., Vinik, A. I., Freeman, R., Samigullin, R., Tritschler, H., Munzel, U., Maus, J., Schutte, K., and Dyck, P. J. Efficacy and safety of antioxidant treatment with alpha-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care 2011;34(9):2054-2060. View Abstract