Alpha Lipoic Acid Question
January 4, 2013 Written by JP
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Today’s column is a response to the first health related question that was posed to me in 2013. During a recent consultation, a client inquired about the relative merits of an antioxidant compound commonly known as alpha lipoic acid. She noted that it’s frequently cited as one of the more potent antioxidants because it supposedly works in concert with other free radical scavengers such as glutathione and vitamins C and E. A recent review in Frontiers in Ethnopharmacology, a prestigious medical journal, supports this claim and details various others functions of a-lipoic acid including its ability to: a) chelate heavy metals; b) lower systemic inflammation; c) regulate gene expression; d) repair damaged proteins in the body.
By far, the most prevalent application of a-lipoic acid is in the field of integrative diabetic care. In recent months, several new studies and a systematic review report that alpha lipoic acid is an effective means of managing diabetes and related complications. For instance, the October 2012 issue of the European Journal of Endocrinology analyzed the results of fifteen randomized controlled trials on the effects of intravenous a-lipoic acid in patients with diabetic peripheral neuropathy – a common form of nerve damage that can cause numbness and pain. The findings of the meta-analysis determined that alpha lipoic acid, “is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms”. Other recent studies report that the use of a-lipoic acid also imparts potent antioxidant activity in both type 1 and type 2 diabetics, and may have an additional application for diabetics and non-diabetics at risk for cardiovascular disease. One interesting finding buried deep in the medical literature is that a combination of aerobic exercise and a-lipoic acid may yield greater health benefits than either practice alone.
In closing, I want to point out a few important details about a-lipoic acid and its potential as a dietary supplement. First, while many foods including broccoli, liver and spinach contain alpha lipoic acid, they don’t possess enough of it to serve in a therapeutic capacity. Second, two studies from 2012 suggest that a-lipoic acid may be a valuable adjunct for select eye conditions such as age-related macular degeneration and dry eye syndrome. In the case of dry eye syndrome, a nutraceutical consisting of a-lipoic acid, EPA (a fatty acid found in fish oil) and phytoestrogens “significantly improved signs and symptoms of dry eye syndrome” in a group of postmenopausal women. Last, but not least, is the issue of dosage and form. The two most common forms of a-lipoic acid are the natural version (R-alpha lipoic acid) and a mixture of the natural and a synthetic form of a-lipoic acid (R,S alpha lipoic acid). The natural R- form is more expensive and less studied, but appears to be more effective in certain individuals. The most common dosage utilized in current and previous clinical studies is approximately 600 mg/day of either intravenous or oral a-alpha lipoic acid. Ideally, oral versions of alpha lipoic acid should be split up due to its brief “half life” or length of activity after ingestion.
To learn more about the studies referenced in today’s column, please click on the following links:
Study 1 – A Systematic Review and Meta-Analysis of A-Lipoic Acid … (link)
Study 2 - Comparative Study of Alpha-Lipoic Acid and Mexidol Effects … (link)
Study 3 - Effect of A-Lipoic Acid on Platelet Reactivity in Type 1 Diabetic … (link)
Study 4 - Alpha-Lipoic Acid Ameliorates Oxidative Stress by Increasing Aldehyde … (link)
Study 5 - Glycemic and Oxidative Status of Patients w/ Type 2 Diabetes … (link)
Study 6 - Effect of A-Lipoic Acid and Exercise Training on Cardiovascular Disease … (link)
Study 7 - Effect of (R)-α-Lipoic Acid Supplementation on Serum Lipids … (link)
Study 8 - Effects of Phytoestrogen Supplementation in Postmenopausal Women … (link)
Study 9 - Age and Gender Dependent Bioavailability of R- and R,S-α-Lipoic Acid … (link)
Study 10 - Single Dose Bioavailability and Pharmacokinetic Study of a Innovative … (link)
Health Benefits Associated with Alpha Lipoic Acid
Source: Front. Pharmacol., 17 November 2011 (link)
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Tags: Alpha Lipoic Acid, Eyes, Inflammation
Posted in Diabetes, Heart Health, Nutritional Supplements
January 4th, 2013 at 11:41 pm
Dr Berkson, formerly with the NIH, is a big believer in alpha lipoic acid.
http://www.anticancer.org.uk/2011/10/q-with-dr-burt-berkson-low-dose.html
January 5th, 2013 at 1:30 pm
Thanks for sharing that Iggy. Interesting! I should write a column about naltrexone in the near future as well.
Be well and happy new year!
JP
January 5th, 2013 at 5:24 pm
Whilst ALA has shown many health benefits some research has shown that whilst it is sometimes quoted as being a heavy metal chelator for cadmium and mercury it can end up not removing the metal, but moving it around the body and depositing it in the brain.
Thorne did a comprehensive study on Glutathione and ALC on their respective chelating effects of mercury and found in their conclusions that:
“The evidence that ALA may mobilize
heavy metals to other tissues from tissues where
the metals are most concentrated, specifically the
brain, is troublesome.”
http://www.thorne.com/altmedrev/.fulltext/7/6/456.pdf
Dr Andrew Cutler will only use very small doses of 25mg of ALA for helping to remove mercury from his autistic patients for this reason.
Obviously not all people will have this problem as ALA has shown to help the aging brain among some seniors, it probably depends on how well your natural cellular glutathione levels cope with heavy metals. If you are not blessed with adequate detoxing genes as well asliver,gall bladder and kidney functions, then you may well end up with a lot of circulating metals which ALA may dump in the brain.
January 6th, 2013 at 2:18 am
Hi Liverock,
Thank you for contributing this intriguing information! After reading your comment, I dug around a little and found this provocative study:
http://archneur.jamanetwork.com/article.aspx?articleid=1151833
In essence, it reports that alpha lipoic acid + Vitamins C & E appear to reduce oxidative stress in the cerebrospinal fluid of patients with Alzheimer’s disease. However, taking a combination of these antioxidants *may* actually hasten cognitive decline! Not good – *if* this unexpected finding is supported by other research.
Based on your comment and the study described above, I’ll attempt to gather some additional data from a few a-lipoic acid experts that I’m familiar with. Please stay tuned!
PS – Until then, here is a relevant study in an animal model of mercury exposure:
http://www.ncbi.nlm.nih.gov/pubmed/12870874
Be well!
JP
January 6th, 2013 at 1:09 pm
It might have been better if the ALA had been combined with Selenium instead of Vitamins C&E.Selenium appears to be quite effective at binding Hg.
http://www.ncbi.nlm.nih.gov/pubmed/23033886
http://www.ncbi.nlm.nih.gov/pubmed/11265129
A study by the Catholic University of Rome showed the hearts of advanced CHF patients had mercury levels 22,000 times higher than other body tissues. As this appears to be a widespread problem, it might be advisable for those with CHF to discuss with a health provider before starting to take large doses of ALA.
http://naturalallopathiccardiology.com/cms/index.php?option=com_content&view=article&id=115&Itemid=151
January 7th, 2013 at 2:37 pm
Thank you, Liverock.
I agree that selenium can be useful re: reducing mercury accumulation. IMO, the role of mercury and cardiovascular disease is less certain. I’ll post some contradictory studies below. Naturally, I think it’s wise to limit mercury exposure and, when done judiciously and safely, lowering mercury-burden. I just don’t know if a-lipoic acid is likely to affect cardiovascular health in an adverse manner. Also, it’s important to consider whether the pros outweigh the cons.
I’ll add this concern to my list of questions for the alpha lipoic acid experts I plan to contact.
http://www.nejm.org/doi/full/10.1056/NEJMoa1006876#t=articleTop
http://www.ehjournal.net/content/10/1/99
http://www.sciencedirect.com/science/article/pii/S0013935111002131
Be well!
JP
January 24th, 2013 at 2:33 pm
hello.
i find your site by searching(crime and nutrition).
my Thesis is about nutrition and crime from the perspective of criminology.
may you please help me.in my country Researches about this subject is too fiddling.
thank you
January 26th, 2013 at 2:03 pm
Good day, r.n.
You can find more information by clicking on the citations (links) that I included in my column entitled, “Crime and Nutrition”.
http://www.healthyfellow.com/482/crime-and-nutrition/
You can also access additional research by visiting this medical journal database: http://www.ncbi.nlm.nih.gov/pubmed
Be well!
JP
February 12th, 2013 at 7:34 pm
Hi! I’m 53, looked healthy and had no health issues or symptoms but was diagnosed with Stage 3A colon cancer. I had surgery and subsequent 6 months of Chemo with Fluorouracil and Oxaliplatin. Now (four months post chemo) I have (terrible) Peripheral Neuropathy. I have a comment and a question. Upon reading many websites, I find yours is just wonderful and thank you for your Curcumin (Oxaliplatin) article at http://www.healthyfellow.com/1406/best-curcumin-supplement. As a comment on Alpha Lipoic Acid, it is an ingredient in “Neuropathy Support Formula” which has been helping me. I took it for a month and I had areas of my arms and feet which have returned to normal. I then stopped taking it for a month and I quit experiencing improvement. I wanted to know if it was helping. I started taking it again and now new areas have returned to normal. My question is, are the levels (150mg – 600mg) of R-Alpha Lipoic Acid per day something to be avoided at all costs or?
February 13th, 2013 at 7:19 pm
Hi Michael,
I’ve tried, thus far unsuccessfully, to find a genuine alpha lipoic acid to interview about potential side effects. So far, several experts have declined my request for an interview. However, I’ll keep trying to find a suitable candidate. In the meantime, here are several studies that offer a glimpse into the long and short term safety profile of this antioxidant:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3161301/
http://www.ncbi.nlm.nih.gov/pubmed/17065669
http://www.ncbi.nlm.nih.gov/pubmed/15532308
Are you taking the recommended dosage of 300 mg/day (along with the other components of the formula)? In other words, two capsules twice-daily?
Be well!
JP