kathi

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. Decisions to use herbs or supplements should be
carefully considered. Individuals using prescription drugs should
discuss taking herbs or supplements with their pharmacist or health care
provider before starting.

Evidence

Scientists have studied alpha-lipoic acid for the following health
problems:

Diabetes Multiple studies have shown that alpha-lipoic acid may improve
blood sugar levels when taken intravenously, and there is some evidence
that alpha-lipoic acid taken by mouth may work better than placebo for
improving blood sugar levels in patients with type 2
(non-insulin-dependent) diabetes. These studies, however, have been
small and, overall, of low quality. Better studies are needed to provide
more definitive answers in the future. Diabetes is a serious illness and
should be treated under the supervision of a qualified health care
provider. Nerve pain or damage Alpha-lipoic acid has been studied as a
treatment for nerve pain or damage
(neuropathy) associated with diabetes. These studies, however, have been
small, low quality and not fully convincing. At this time, there is not
enough scientific evidence to recommend alpha-lipoic acid for this
condition. Glaucoma There are some studies in humans of alpha-lipoic
acid as a treatment for glaucoma, but there is not enough scientific
evidence to make a recommendation at this time. HIV cognitive impairment
Alpha-lipoic acid has been studied as a treatment for neurodegeneration
associated with HIV. At this time, there is not enough scientific
evidence to recommend alpha-lipoic acid for treating this condition.
Radiation exposure Early evidence suggests that alpha-lipoic acid may be
beneficial to individuals exposed to high levels of radiation, but there
are flaws in the design of existing research. More studies are needed
before alpha-lipoic acid can be recommended for this use. Alcoholic
liver damage Alpha-lipoic acid has been studied as a treatment for
alcohol-related liver disease. However, no benefits have been observed.
There is not enough scientific evidence to recommend alpha-lipoic acid
for this use.

Unproven Uses

Alpha-lipoic acid 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 provider before taking alpha-lipoic
acid for any unproven use.

Alzheimer's dementia Cancer Cerebrovascular disease Chemotherapy
toxicity Constipation Depression Hepatitis C High cholesterol HIV Immune
system stimulant Krabbe's disease (a metabolic disorder) Lead poisoning
Leigh's disease (a disease of the brain and spinal cord in infants)
Liver disease Mountain sickness Mushroom poisoning Nerve problems from
kidney disease Neural tube defects Nutritional supplement Ototoxicity
(hearing damage from certain drugs) Parkinson's disease Porphyria (a
metabolic disorder) Pain after surgery Sickle cell anemia Stomach
irritation Wilson's disease (a hereditary disorder)

Potential Dangers

Allergies

People with allergies or hypersensitivities to alpha-lipoic acid should
avoid its use. In one study, pain and redness occurred around a needle
site when alpha-lipoic acid was injected thorough a vein.

Side Effects

Few side effects have been reported from alpha-lipoic acid. The most
common complaints include nausea and vomiting.

Some natural medicine experts discourage the use of alpha-lipoic acid in
people with diseases of the thyroid (hypothyroidism). Based on deaths
seen in animal research, alpha-lipoic acid should be avoided in patients
with thiamine deficiency, a condition commonly associated with
alcoholism. However, there are no specific studies in humans, so the
risks of alpha-lipoic acid use in people with these conditions are not
clear.

Pregnancy And Breast-Feeding

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

Interactions

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 your health care provider or pharmacist before using herbs or
dietary supplements.

Interactions With Drugs

It appears that alpha-lipoic acid lowers blood sugar levels. Caution is
advised if you are also taking prescription drugs that may lower blood
sugar levels. Patients taking oral drugs for diabetes or using insulin
should be monitored closely by their health care provider while using
alpha-lipoic acid. Dosing adjustments may be necessary.

In theory, alpha-lipoic acid may alter 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 health
care provider while using alpha-lipoic acid. Dosing adjustments may be
necessary.

Interactions With Herbs And Dietary Supplements

Alpha-lipoic acid 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 health care
provider while using alpha-lipoic acid. Dosing adjustments may be
necessary.

Products that may raise blood sugar levels, such as devil's claw, may
reduce the effectiveness of alpha-lipoic acid when used for a blood
sugar-lowering effect.

Dosing

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 provider 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 alpha-lipoic acid at
recommended dosages for up to two years.

For Diabetes

Adults (Aged 18 Or Older)

Capsules: A common dose for lowering blood sugar levels and treating
diabetic nerve pain or damage (neuropathy) is 800 to 1,800 milligrams
per day, in divided doses, by mouth. Diabetes is a serious illness and
should be treated under the supervision of a qualified health care
provider.

Children (Younger Than 18)

The dosing and safety of alpha-lipoic acid have not been studied in
children, and therefore alpha-lipoic acid cannot be recommended.

Summary

Although alpha-lipoic acid has been suggested for many conditions, it
has been most studied for lowering 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 and should be treated under the
supervision of a qualified health care provider. Alpha-lipoic acid 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 deficiency and in children. Alpha-lipoic acid
appears to be safe when used in recommended doses for up to two years.
Consult your health care provider 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.

Resources

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

Natural Standard reviewed more than 200 articles to prepare the
professional monograph from which this version was created.

Some of the more recent English-language studies are listed below:

1.Jacob S, Ruus P, Hermann R, et al. Oral administration of
RAC-alpha-lipoic acid modulates insulin sensitivity in patients with
type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Radic
Biol Med 1999;27(3-4):309-314.
2.Reljanovic M, Reichel G, Rett K, et al. Treatment of diabetic
polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a
two year multicenter randomized double-blind placebo-controlled trial
(ALADIN II). Alpha Lipoic Acid in Diabetic Neuropathy. Free Radic Res
1999;31(3):171-179.
3.Ruhnau KJ, Meissner HP, Finn JR, et al. Effects of 3-week oral
treatment with the antioxidant thioctic acid (alpha-lipoic acid) in
symptomatic diabetic polyneuropathy. Diabet Med
1999;16(12):1040-1043.
4.Ziegler D, Schatz H, Conrad F, et al. Effects of treatment with the
antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM
patients: a 4-month randomized controlled multicenter trial (DEKAN
Study). Deutsche Kardiale Autonome Neuropathie. Diabetes Care
1997;20(3):369-373.
5.Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic
diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a
7-month multicenter randomized controlled trial
(ALADIN III Study). ALADIN III Study Group. Alpha-Lipoic Acid in
Diabetic Neuropathy. Diabetes Care 1999;22(8):1296-1301.

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