Also indexed as: ALA, Lipoic Acid, Thioctic Acid

What is it?
Alpha lipoic acid (ALA) is a vitamin-like
antioxidant, sometimes referred to as the “universal antioxidant” because it
is soluble in both fat and water.1 ALA is manufactured in the body and is found in
some foods, particularly liver and yeast.
ALA is capable of regenerating several other antioxidants back to their active states,
including vitamin C,2 vitamin E,3 glutathione,4 and coenzyme Q10.5
ALA has several potential benefits for people with diabetes. It enhances glucose uptake in
type 2 (adult onset or non-insulin-dependent)
diabetes, inhibits glycosylation (the abnormal attachment of sugar to protein), and has
been used to improve diabetic nerve damage and reduce pain associated with that nerve
damage.6 Most studies have used intravenous alpha lipoic acid, but oral
supplementation has nonetheless proved partially helpful in treating at least one form of
diabetic neuropathy, using 800 mg per day.7
Preliminary evidence indicates that 150 mg of alpha lipoic acid, taken daily for one month,
improves visual function in people with
glaucoma.8
ALA has been shown to inhibit the replication of the HIV virus in the test tube; however, it is not known
whether supplementing with ALA would benefit HIV-infected people.9
Intravenous administration of ALA has significantly increased the survival rate of people
who have eaten poisonous mushrooms.10 Such a treatment should be prescribed by a
doctor and should not be attempted on one’s own.
Where is it found?
The body makes small amounts of alpha lipoic acid. There is only limited knowledge about
the food sources of this nutrient. However, foods that contain mitochondria (a specialized
component of cells), such as red meats, are believed to provide the most alpha lipoic acid.
Supplements are also available.
Alpha lipoic acid has been
used in connection with the following conditions (refer to the
individual health concern for complete information):
Who is likely to be deficient?
Although alpha lipoic acid was thought to be a vitamin when it was first discovered,
subsequent research determined that it is created in the human body—and thus is not an
essential nutrient. For this reason, deficiencies of alpha lipoic acid are not known to occur
in humans.
How much is usually taken?
The amount of alpha lipoic acid used in research to improve diabetic neuropathies is 800 mg
per day and 150 mg per day for glaucoma.
However, much lower amounts, such as 20–50 mg per day, are recommended by some doctors
for general antioxidant protection, although
there is no clear evidence that such general use has any benefit.
Are there any side effects or interactions?
Side effects with alpha lipoic acid are rare but can include skin rash and the potential of
hypoglycaemia in diabetic patients. People who
may be deficient in vitamin B1 (such as
alcoholics) should take vitamin B1 along with alpha lipoic acid supplements. Chronic
administration of alpha lipoic acid in animals has interfered with the actions of the vitamin,
biotin. Whether this has significance for
humans remains unknown.11
At the time of writing, there were no well-known drug interactions
with alpha lipoic acid.
References
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1. Kagan V, Khan S, Swanson C, et al. Antioxidant action of thioctic acid
and dihydrolipoic acid. Free Radic Biol Med 1990;9S:15.
2. Lykkesfeldt J, Hagen TM, Vinarsky V, Ames BN. Age-associated decline
in ascorbic acid concentration, recycling, and biosynthesis in rat hepatocytes—reversal
with (R)-alpha-lipoic acid supplementation. FASEB J 1998;12:1183-9.
3. Scholich H, Murphy ME, Sies H. Antioxidant activity of dihydrolipoate
against microsomal lipid peroxidation and its dependence on alpha-tocopherol. Biochem
Biophys Acta 1989;1001:256-61.
4. Busse E, Zimmer G, Schorpohl B, et al. Influence of alpha-lipoic acid
on intracellular glutathione in vitro and in vivo.
Arzneimittelforschung1992;42:829-31.
5. Kagan V, Serbinova E, Packer L. Antioxidant effects of ubiquinones in
microsomes and mitochondria are mediated by tocopherol recycling. Biochem Biophys Res
Commun 1990;169:851-7.
6. Packer L, Witt EH, Tritschler HJ. Alpha-lipoic acid as a biological
antioxidant. Free Radic Biol Med 1995;19:227-50 [review].
7. Ziegler D, Ulrich H, Schatz H, et al. Effects of treatment with the
antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. Diabetes
Care 1997;20:369-73.
8. Filina AA, Davydova NG, Endrikhovskii SN, et al. Lipoic acid as a
means of metabolic therapy of open-angle glaucoma. Vestn Oftalmol 1995;111:6-8.
9. Baur A, Harrer T, Peukert M, et al. Alpha-lipoic acid is an effective
inhibitor of human immuno-deficiency virus (HIV-1) replication. Klin Wochenschr
1991;69:722-4.
10. Nichols TW Jr. Alpha-lipoic acid: biological effects and clinical
implications. Altern Med Rev 1997;2:177-83 [review].
11. Zempleni J, Trusty TA, Mock DM. Lipoic acid reduces the activities of
biotin-dependent carboxylases in rat liver. J Nutr 1997;127:1776–81.
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The information presented in Healthnotes is for informational purposes
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making any changes in prescribed medications. Information expires March 2007.