Alpha Lipoic Acid: Benefits, side effects, research and dosage

Alpha-lipoic acid (ALA) is naturally found in your body and is important in converting food into energy.

It is a fatty acid that converts glucose or blood sugar into energy through the aid of oxygen. When oxygen is used, the process of converting sugar into energy is called aerobic metabolism.

A review from the Journal of Parenteral and Enteral Nutrition  [1] defines fatty acids as “energy sources and membrane constituents.

They have biological activities that act to influence cell and tissue metabolism, function, and responsiveness to hormonal and other signals.” 

Join us to uncover the benefits, potential side effects, recommended dosages, and much more about this exceptional compound.

Whether you are a wellness enthusiast or seeking solutions to specific health concerns, the information aims to equip you with the knowledge you need to make informed decisions about integrating ALA into your regimen.

What is alpha-lipoic acid ALA used for?

ALA is a naturally occurring compound found in the human body. It plays a pivotal role in various biological processes, particularly as a co-factor in the production of energy within our cells.

This remarkable molecule is often referred to as the “universal antioxidant” due to its unique ability to work in both water-soluble and fat-soluble environments, allowing it to protect a wide range of cells and tissues from oxidative damage.

What is alpha-lipoic acid ALA used for?
Photograph: YuriArcursPeopleimages/Envato

Key attributes of ALA

  • Antioxidant properties: ALA is a potent antioxidant that helps neutralize harmful free radicals. By doing so, it helps protect cells from oxidative stress, a process linked to aging and numerous chronic health conditions.
  • Energy production: ALA plays a crucial role in mitochondrial function, where it helps convert glucose into energy. This energy production is essential for the proper functioning of our organs and tissues.
  • Natural sources: While ALA is synthesized in small amounts in the human body, it can also be obtained through dietary sources. Foods like spinach, broccoli, and organ meats (such as liver and kidney) contain ALA, albeit in relatively modest quantities.
  • Supplement form: ALA is available in supplement form, making it easier for individuals to incorporate into their daily routines. These supplements typically contain synthetic ALA, and some products feature the R-lipoic acid (R-LA) form, considered the more biologically active version.

What are the benefits of taking ALA?

Therapeutic uses of ALA have been investigated in several uses. Here are some potential benefits of ALA:

Potential treatment of diabetes 

Diabetes mellitus is a metabolic disorder that affects more than 400 million people worldwide [2].

It is a chronic condition that affects the body’s ability to appropriately metabolize lipids, carbohydrates, and protein.

ALA has been shown to have the potential to treat diabetes mellitus. Findings from previous studies have shown that diabetes mellitus is due to excessive production of reactive oxygen species (ROS), which are free radicals in the cells.

The natural antioxidants in the body could not cope with neutralizing ROS. In turn, diabetes mellitus develops.

Animal model studies [3], [4] have shown the potential of ALA in increasing glucose uptake from the bloodstream in both insulin-resistant and insulin-sensitive muscle tissues. 

Human studies on the effects of ALA on glucose metabolism have also been conducted. A systematic review [5] published in the Metabolism: Clinical and Experimental journal reported that in individuals with metabolic disorders, intake of ALA supplementation significantly reduced blood glucose levels.

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Potential in treating nerve pain 

A clinical trial [6] published in the BioMed Pharmacotherapy journal recruited 210 individuals suffering from idiopathic pain.

All participants had normal glucose levels and were randomized to receive 800 mg/day of ALA while the second group was randomized to receive 400 mg/day of ALA and the third group received a placebo.

The findings of this study showed that those who received 800 mg/day of ALA reported the greatest reduction of pain scores followed by those in the 400 mg/day group. Those in the placebo group did not report improvements in their pain scores. 

Meanwhile, a systematic review [7] published in the International Journal of Endocrinology pooled results of several clinical trials and found out that intravenous infusion of 600 mg of ALA per day for 21 days helped relieve neuropathic pain.

A lower dose of 300 mg of intravenous ALA would also yield positive effects in reducing neuropathic pain.

As shown in another clinical trial [8], intravenous infusion of 300 mg/day to 600 mg/day of ALA for four weeks significantly reduced neuropathic pain in patients with diabetic peripheral neuropathy.

These findings are important since these revealed that even lower doses of intravenous ALA could relieve diabetic peripheral neuropathy pain. However, it is unclear if the same dosages, when taken orally would also yield similar benefits. 

The findings of these studies help add evidence that ALA could be an effective alternative in reducing neuropathic pain in patients with diabetic peripheral neuropathy and those with long-term conditions that can damage the nerves. 

Prevention of cataracts 

Antioxidants reduce free radical damage to the eyes. An animal model study [9] evaluated the anti-cataract effects of ALA on goat lenses with induced cataractogenesis.

The findings of this study revealed that treatment of eye lenses with 60 micrograms/ml of ALA significantly prevented the formation of cataracts on these eye lenses.

Meanwhile, another model study [10] revealed that ALA and fisetin significantly prevented cataract development in experimental cataract models. These animal model studies provide additional evidence of the potential of ALA in treating cataracts due to oxidative stress or advanced diabetes. 

Promotion of weight loss 

Although clinical trials did show that ALA supplementation can reduce weight, the reduction in weight is not large.

For example, a systematic review funded by Yale and was published in the Obesity Reviews journal [11] demonstrated that supplementation with ALA resulted in an average weight loss of only 1.27 kg.

Similarly, another systematic [12] reflected the same results where ALA supplementation resulted in reduction of weight. However, the average weight loss was also small at only 1.5 pounds.

Due to the heterogeneity of the studies, such as differences in the duration of treatment with ALA and the dose of this supplement, it would be difficult to determine if the findings would be applicable to the general population.

However, supplementation with ALA could be an important step in your weight loss journey. These findings confirm that supplementation alone might not be sufficient in losing weight.

Instead, there is a need to change diet, lifestyle and increase physical activities to have significant reductions in weight.

Potential treatment of Alzheimer’s Disease 

It has been shown that genetic, environmental, and social factors cause Alzheimer’s disease. As an antioxidant, ALA has been studied to determine its protective effects against Alzheimer’s disease.

Animal model studies [12] have shown that ALA has neuroprotective effects through neutralizing hydrogen peroxide and other radicals involved in killing cortical neurons.

Importantly, animal model studies also showed that ALA tends to increase production of acetylcholine, an important neurotransmitter of the brain that is reduced when an individual has Alzheimer’s disease. 

Alzheimer’s disease is also caused by inflammation. Individuals with this disease do not only have elevated levels of free radicals but also increased levels of pro-inflammatory cytokines (compounds responsible for recruiting and activating inflammatory cells into the brain).

ALA was shown to prevent inflammation of the brain through scavenging reactive oxygen species (free radicals), transition metal ions that destroy cells, and increasing the levels of reduced glutathione, another antioxidant shown to increase longevity of cells. Further, ALA was also seen to reduce the levels of inflammatory cells. 

Although studies supporting the benefits of ALA on Alzheimer’s disease are all animal model studies, the results are promising since these showed that ALA has the potential to treat this disease or prevent it.

Potential treatment of Alzheimer’s Disease 
Photograph: pondsaksit/Envato

Potential treatment for cancer 

An increasing number of studies have been conducted to investigate the role of ALA in cancer therapy.

Cancer cells rely on glucose for energy. However, these cells convert glucose to lactate to generate ATPs or adenosine triphosphate, the energy currency of the cells.

The persistent conversion of glucose to lactate to harvest ATPs can lead to inability of the cells to suppress tumors and activation of oncogenes. As a result, cancer progresses rapidly.

Hence, to arrest this cycle, it is necessary to inhibit this type of glucose conversion. An enzyme called pyruvate dehydrogenase catalyzes the conversion of pyruvate to acetyl CoA, preventing the production of lactate.

An animal model study [13] revealed that daily administration of ALA in tumor cells delayed its growth. It was hypothesized that ALA prevented the conversion of pyruvate to lactate, which prevented the proliferation of the tumor cells.

The tumor cells used in the study were neuroblastoma and breast cancer cells. Apart from breast cancer and neuroblastoma cells, ALA was also shown to delay tumor growth in lung cancer cells, thyroid cancer cells, lung cancer, and colon cancer cells through different mechanisms.

All these mechanisms eventually result in cell death, thereby reducing the spread of cancer.

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Effects of ALA

On patients suffering from schizophrenia 

In recent years, clinical trials have been conducted to examine the effects of ALA in reducing side effects of antipsychotic drugs.

A systematic review [14] that summarized the findings of clinical trials on ALA and schizophrenia reported that patients who take antipsychotic drugs and ALA supplements experienced fewer to no side effects of the antipsychotic drugs. 

In summary, these studies reported a reduction in BMI and body weight; reduced visceral fat areas; no severe side effects; minor side effects such as dermatological and gastrointestinal symptoms; significant improvement of neurocognitive parameters; decrease in fasting glucose levels. 

The study durations varied from 12 weeks to four months with dosages ranging from 600-1800 mg/day; 100 mg/day; and 500 mg/day of ALA taken orally.

It should be noted that the clinical trials included in the systematic review had small sample sizes ranging from 10 patients with stable schizophrenia to 22 patients.

Due to the small sizes, it is difficult to generalize findings to other patients with schizophrenia.

However, initial results showed that there is a trend towards use of ALA and reduction of side-effects of antipsychotic drugs.

Supplementing antipsychotic drugs with ALA at 800-1200 mg/day could help optimize the health of these patients and reduce the side effects associated with antipsychotics.

Notably, obesity and the development of metabolic disorders are serious side effects of antipsychotics since these increase the risk of type 2 diabetes mellitus and cardiovascular diseases.

Hence, preventing these side effects would reduce the development of comorbid diseases often linked with antipsychotics. 

On patients with multiple sclerosis 

It has been shown that ALA has the potential to treat or manage symptoms of multiple sclerosis through its anti-inflammatory effects.

Multiple sclerosis is due to multicentric inflammation and loss of myelin sheaths of the nerves in the body and brain.

A clinical trial [15] published in the Neuroimmunomodulation journal revealed that the administration of 1200 mg of ALA for 12 weeks significantly reduced inflammatory cells.

The anti-inflammatory effects of ALA reduced symptoms of multiple sclerosis among patients taking the ALA supplements.

Initial results showed that walking performance and gait improved with the supplementation.

However, the study had a small sample population. This requires conducting larger trials in the future to confirm results of this small clinical trial.

Despite the lack of findings from larger trials on the effects of ALA on symptoms of multiple sclerosis, these initial results showed that ALA could be a promising treatment for symptoms of multiple sclerosis.

On stroke and brain function 

ALA has been shown to easily pass into the brain. Due to this property, it is hypothesized that it may help protect nerve and brain tissues. Hence, it could be a potential treatment for stroke.

There are conflicting results on the effects of ALA on brain functioning following a stroke. For instance, one study [16] found no evidence that ALA could improve antioxidant capacity indices, serum levels of inflammatory cells and albumin in stroke patients.

However, another study [17] found that administration of ALA improved functional outcomes of stroke patients.

Although both studies could not be comparable due to differences in the health outcomes investigated, the findings showed that at the molecular level, the effects of ALA may not be seen immediately.

Prolonged therapy with ALA might be needed to observe improvements in the functional outcomes of stroke patients.

on stroke and brain function
Photograph: svitlanah/Envato

Other research studies on ALA 

  • Administration of a cream with 5% ALA might reduce fine lines due to sun damage. 
  • Preliminary studies showed that alpha-lipoic acid can bind with toxic chemicals such as iron, arsenic and mercury and other metals that could act as free radicals in tissues. 
  • Preliminary studies suggested that ALA might play a role in managing erectile dysfunction. 
  • Some studies suggested it might address complications due to middle ear infections (otitis media). 

Is it safe to take alpha-lipoic acid daily?

While ALA offers numerous health benefits, it’s important to be aware of potential side effects and take necessary precautions before incorporating it into your wellness routine. Here are some considerations:

Gastrointestinal upset

Some individuals may experience mild gastrointestinal discomfort such as nausea, vomiting, or stomach cramps when taking ALA supplements. To minimize these effects, consider taking ALA with food.

Skin rash

Although rare, an allergic reaction to ALA can manifest as a skin rash. If you notice any skin changes after starting ALA supplementation, discontinue use and consult a healthcare professional.

Hypoglycemia

ALA has the potential to lower blood sugar levels. If you are diabetic or on medications to regulate blood sugar, monitor your levels closely when using ALA and consult your healthcare provider for possible adjustments in your medication.

Insulin and medication interactions

ALA may interact with insulin and certain medications, affecting their efficacy. It’s crucial to inform your healthcare provider about any supplements you’re taking to avoid adverse interactions.

Thiamine deficiency

Long-term use of ALA can potentially lead to thiamine (vitamin B1) deficiency. To mitigate this risk, consider taking a B-complex supplement that includes thiamine when using ALA for extended periods.

Incorporating ALA into your health and wellness routine can be beneficial, but it’s essential to be cautious and well-informed about potential side effects and interactions.

Your healthcare provider can help you make informed decisions regarding the use of ALA to ensure it aligns with your individual health goals and needs.

What are the dietary sources of ALA? 

Although a healthy individual naturally produces ALA sufficient for the body’s needs, there are some individuals who may be deficient in ALA.

Supplementation with ALA is necessary in those who are malnourished or deficient of ALA. Dietary sources of ALA include organ meats such as liver, red meat, and yeast. 

Dosage and how to take ALA

ALA is available in different forms, including capsules, tablets, and powders. The R-lipoic acid (R-LA) form is considered the natural, more bioavailable form and is preferred by some individuals.

Studies have shown that oral intake of 600-1800 mg of ALA daily for up to six months did not lead to any adverse effects or side effects. Intravenous infusion of ALA at 300-600 mg/day also did not lead to any adverse effects.

  • Diabetes management: Individuals with diabetes or insulin resistance may benefit from higher doses, typically ranging from 300 to 600 milligrams per day. However, it’s essential to work with a healthcare provider to determine the appropriate dosage based on individual needs and blood sugar levels.
  • Specific health goals: Dosage may vary based on specific health goals. For example, some studies on neuropathy or cognitive health have used doses of up to 1,200 milligrams daily, but this should be done under medical supervision.

It is still best to consult with your doctor when planning to take ALA supplementation to improve your health. Your safety is of primary importance when taking these supplements. 

Currently, there are still no studies on the safety of ALA supplementation on pregnant and breastfeeding women.

There are also no studies examining the recommended dosage for this group along with the older adults and children. 

Precautions and considerations

  • If you are new to ALA or using it for specific health concerns, it’s advisable to start with a lower dosage and gradually increase it while monitoring your body’s response.
  • If you are taking ALA to manage diabetes, closely monitor your blood sugar levels and work with your healthcare provider to adjust your medication regimen if necessary.
  • Consult with a healthcare professional, especially if you are pregnant, nursing, have underlying health conditions, or are taking other medications, to determine the safest and most effective ALA dosage for your individual needs.
  • Be consistent with your ALA supplementation routine to maximize its potential benefits. Skipping doses or irregular use may impact its effectiveness.

ALA can offer a range of health benefits when used correctly and at the appropriate dosage.

Always consult with a healthcare professional to determine the best approach for your specific needs, and follow recommended guidelines for dosage and usage to optimize the positive effects of ALA while minimizing potential side effects.

Take home message 

To date, there are several studies pointing to the potential benefit of ALA in managing symptoms of type 2 diabetes, Alzheimer’s disease, multiple sclerosis, cancer and other diseases.

The anti-inflammatory and antioxidant properties of this compound may be key in preventing the progression of diabetic neuropathy, treatment of neuropathic pain and prevention of cataracts. 

ALA supplements are available in the market. However, always consult your doctor when you plan to take this supplement. 

By blending the power of science with personalized care, you can unlock the promising benefits of ALA while making well-informed choices that align with your unique health goals.

FAQs

What is alpha-lipoic acid useful for?

Alpha-lipoic acid (ALA) is useful for its antioxidant properties, which can help combat oxidative stress, manage blood sugar levels, and potentially support skin health and cognitive function.

Should I take alpha-lipoic acid everyday?

Whether you should take alpha-lipoic acid every day depends on your health goals and individual needs. Consult with a healthcare provider to determine the right dosage and frequency for your specific situation.

Does alpha-lipoic acid repair nerve damage?

Alpha-lipoic acid may have the potential to support nerve health and reduce symptoms of neuropathy, but it is not a guaranteed treatment for all forms of nerve damage. 

Is alpha-lipoic acid safe for kidneys?

ALA is generally considered safe for kidneys when used at appropriate dosages. However, individuals with kidney disease should consult with a healthcare provider before taking ALA.

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[1] https://pubmed.ncbi.nlm.nih.gov/26177664/
[2] https://www.who.int/health-topics/diabetes 
[3] https://pubmed.ncbi.nlm.nih.gov/19998523/ 
[4] https://pubmed.ncbi.nlm.nih.gov/11874439/ 
[5] https://www.metabolismjournal.com/article/S0026-0495(18)30153-7/fulltext 
[6] https://pubmed.ncbi.nlm.nih.gov/34649217/ 
[7] https://www.hindawi.com/journals/ije/2012/456279/ 
[8] https://pubmed.ncbi.nlm.nih.gov/22837391/ 
[9] https://www.ijrrjournal.com/IJRR_Vol.7_Issue.5_May2020/IJRR0051.pdf 
[10] https://pubmed.ncbi.nlm.nih.gov/25488016/ 
[11] https://onlinelibrary.wiley.com/doi/10.1111/obr.12528 
[12] https://pubmed.ncbi.nlm.nih.gov/16460684/ 
[13] https://pubmed.ncbi.nlm.nih.gov/22954700/ 
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723188 
[15] https://pubmed.ncbi.nlm.nih.gov/24821457/ 
[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191243/ 
[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038972/

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