Common Name: Alpha-lipoic Acid
Synonyms: thioctic acid, lipoic acid, pentanoic acid, lipoate, dihydrolipoic acid, ALA

Overview:

Once thought to be a vitamin, ALA or alpha-lipoic acid is a potent antioxidant. Alpha-lipoic acid is a cofactor in the enzymes that are vital to the energy producing reactions of the mitochondria (mitochondria are the cellular factories responsible for the energy production of every cell) and when mitochondria do not function at peak efficiency neither can the cells. As a potent antioxidant, this organic acid scavenges a wide range of cell damaging free radicals. ALA is both fat and water soluble in is the missing link between Vitamin E (a fat soluble vitamin) and vitamin C (a water soluble vitamin), Because of this is links these vitamins so they can work in tandem. It is also involved the recycling of these important antioxidants as well as ubiquinone and glutathione. It is also important for cell growth, preventing cell damage, and helping the body to get rid of harmful substances. Although the human body can manufacture its own alpha-lipoic acid, poor nutrition or poor absorption can lead to lower levels of its precursors and thus to insufficient levels of this vital nutrient.

Benefits

Europeans have used ALA supplements for over 3 decades. In fact the German E Commission, the commission that is responsible for approving the use of herbs and supplements in Germany, has approved ALA for the treatment of the peripheral nerve damage caused by diabetes, well as that caused by alcoholism and for the treatment of hepatitis and other liver diseases.

ALA is been found to be beneficial in:

1. Regulating blood sugar levels in diabetics.
2. Treating diabetic neuropathy, the damage to the peripheral nerves that accompanies uncontrolled blood sugar. This often leads to loss of feeling in the hands and feet. Ultimately this leads to injuries that refuse to heal and ultimately in amputation.

Diabetic foot ulcer

3. Preventing the kidney damage so prevalent in diabetics.
4. Preventing diabetic retinopathies. This damage to the retina is caused by poor glucose regulation that causes the tiny blood vessels in the retina to weaken, leak blood into the inner eye and eventually causing blindness.

1. Helping to prevent cataracts. Studies reported in Free Radical Biology and Medicine stated that supplementation with ALA showed a 60% reduction of cataract development.
2. Treatment of stroke and brain function. Animal studies show that ALA has promise in lessening the brain damage after a stroke. Animals that received ALA supplementation had a four times greater survival rate after a stroke than those that received no supplementation.
3. The treatment of chronic hepatitis. There have been case reports that have shown that the use of ALA in combination with milk thistle and selenium to be helpful in the treatment of hepatitis C (a viral hepatitis that is contracted from blood and body fluids that does not have an adequate treatment and is often fatal).
4. Use with milk thistle as an antidote to Amanita, an extremely poisonous mushroom, which causes liver damage and death.
5. Studies are ongoing in the benefits of ALA in treating heart failure, glaucoma and HIV.
   

Dietary Sources

	Spinach		Broccoli
	Lean beef		Organ meats such as liver and kidney and yeast (especially Brewer’s yeast)

All are excellent sources of alpha-lipoic acid. Alpha lipoic acid is also available as a supplement in capsule or tablet form.

Recommended Dosage:

Pediatric

As there have been no studies on the pediatric use of ALA it is recommended that ALA supplementation not be used in children.

Adult

ALA dosages are available ranging from 30ng to 100mg tablets and capsules. There are no established recommended doses for alp Treatment of stroke and brain function. Animal studies show that ALA has promise in lessening the brain damage after a stroke. Animals that received ALA supplementation had a four times greater survival rate after a stroke than those that received no supplementation. alpha-lipoic acid.

For general antioxidant support the recommended dose of ALA is 20 to 50 mg per day.

Manufactures of ALA suggest one or two 50mg capsules daily.

In nerve function studies, a daily intake of 600mg in divided doses successfully improved nerve function.

Precautions

1. Women who are pregnant or nursing should take ALA supplements only under the supervision of a knowledgeable health care practioner.
2. Dietary supplements have the potential of side affects and interactions with medications. Because of this dietary supplementation should be discussed with your health care practioner before starting a supplementation program.
3. As ALA has been associated with improved blood glucose control, diabetics should monitor their blood sugar levels carefully as your healthcare practioner may need to adjust the dosage of insulin or oral blood sugar lowering medication.
4. Rarely skin rashes have been observed with ALA supplementation.

Interactions

Before adding alpha-lipoic acid supplements to your diet, discuss it with your healthcare practioner if you are taking:

1. The antibiotics amikacin or gentamicin. Animal studies actually should that ALA supplements actually reduced the side effects, especially toxicity to the ear, in these antibiotics. Additional studies are needed to confirm these benefits.
2. Alpha lipoic acid protected against the toxic effects of Cisplatin and cyclophosphamide in animal studies.
3. ALA has been shown to alter thyroid function. Hormone levels should be closely monitored in people who are taking thyroid medication and supplementing with ALA.

Web References

1. http://www.umm.edu/altmed/ConsSupplements/AlphaLipoicAcidcs.html
2. http://en.wikipedia.org/wiki/Alpha_lipoic_acid
3. http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/alp_0159.shtml

References

1. Androne L, Gavan NA, Veresiu IA, Orasan R. In vivo effect of lipoic acid on lipid peroxidation in patients with diabetic neuropathy. In Vivo. 2000;14(2):327-330
2. Barbiroli, B., et al. 'Lipoic (thioctic acid) increases brain energy available and skeletal muscle performance as shown in vivo 31:-MRS in a patient with mitochondrial cytopathy', J. Neurol., 1995;242:472-7.
3. Berkson BM. A conservative triple antioxidant approach to the treatment of hepatitis C. Combination of alpha lipoic acid (thioctic acid), silymarin, and selenium: three case histories. Med Klin. 1999;94 Suppl 3:84-89.
4. Berkson, B., The Alpha Lipoic Acid Breakthrough, Prima Publishing, Rocklin, CA, 1998.
5. Biewenga, G., Haenen G., Bast, A., 'The pharmacology of the antioxidant Lipoic acid', Gen. Pharmacol. 1997 Sept; 29(3): 315-31
6. Bustamante, J., et al 'Antioxidant inhibition of thymocyte apoptosis by Dihydrolipoic acid', Free Radical Biol. & Med, 1995; 19:339-47.
7. Clark WM, Rinker LG, Lessov NS, Lowery SL, Cipolla MJ. Efficacy of antioxidant therapies in transient focal ischemia in mice. Stroke. 2001;32(4):1000-1004.
8. Conlon BJ, Aran JM, Erre JP, et al. Attenuation of aminoglycoside-induced cochlear damage with the metabolic antioxidant alpha-lipoic acid. Hear Res. 1999;128:40-44.
9. Faust A, Burkart V, Ulrich H, et al. Effect of lipoic acid on cyclophosphamide-induced diabetes and insulitis in non-obese diabetic mice. Int J Immunopharmacol. 1994;16:61-66.
10. Head KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern Med Rev. 2001;6(2):141-166.
11. Greenamyre, J., et al. 'The endogenous cofactors, thioctic acid and Dihydrolipoic acid, are neuroprotective against NMDA and malonlc acid Lesions of striatum', Neuroscience Letters, 1994; 171:17-20
12. Hruby K, Csomos G, Fuhrmann M, Thaler H. Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. Hum Exp Toxicol. 1983;2(2):183-195.
13. Jacob, S., et al. 'Enhancement of glucose disposal in patients with type 2 diabetes by Alpha-Lipoic acid'. Arzn.-Forsch, 1995;45:872-4.
14. Konrad, T., et al 'Alpha Lipoic Acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes', Diabetes Care. 1999 Feb; 22(2): 280-7.
15. Lynch MA. Lipoic acid confers protection against oxidative injury in non-neuronal and neuronal tissue. Nutr Neurosci. 2001;4(6):419-438.
16. Maitra, I, et al 'Alpha-Lipoic acid prevents buthionine sulfoximine - Induced cataract formation in newborn Rats', Free Radical Biology & Medicine, 1995-18:823-829.
17. Meletis, C., 'Basic Nutrient Support for Proper Immune Function'. Alternative & Complementary Therapies, Feb. 1999, p.44.
18. Melhem MF, Craven PA, Derubertis FR. Effects of dietary supplementation of alpha-lipoic acid on early glomerular injury in diabetes mellitus. J Am Soc Nephrol. 2001;12:124-133.
19. Mitsui, Y, et al 'Alpha-Lipoic acid provides neuroprotection from ischemla-reperfusion injury of peripheral nerve', J. Neuro. Sci., Feb. 1; 163(1): 11-6.
    Monograph:Alpha-Lipoic Acid. Altern Med Rev. 1998;3(4):308-311.
20. Nagamatsu M, Nickander KK, Schmelzer JD,et al. Lipoic acid improves nerve blood flow, reduces oxidative stress, and improves distal nerve conduction in experimental diabetic neuropathy. Diabetes Care. 1995;18:1160-1167.
21. Packer L, Kraemer K, Rimbach G. Molecular aspects of lipoic acid in the prevention of diabetes complications. Nutrition. 2001;17(10):888-895.
22. Packer L, Tritschler HJ, Wessel K. Neuroprotection by the metabolic antioxidant alpha-linoic acis. Free Radic Biol Med. 1997;22:359–378.
23. Schonhit, K, et al. 'Effect of Alpha-Lipoic Acid and Dihydrolipoic acid on ischemia/reperfuslon injury of the heart and heart mitochondria', Biochimica et Biophysics Acta., 1995; 1271:335-42.
24. Stol S., et al. 'The potent free radical scavenger Alpha Lipoic Acid improves memory in aged mice: putative relationship to NMDA receptor deficits', Pharmacol, Biochem.& Behavior, 1993: 46:799.805.
25. Whiteman, M., et al. 'Protection against peroxynitrite-dependent tyrosine nitration and alanti-proteinase inactivation by oxidised and reduced lipoic acid', FEBS Letters, 1996; 379:74-6.
26. Wickramasinghe, S., Hasan, R, 'ln Vitro Effects of Vitamin 'C', Thioctic Acid and Dihydrolipoic Acid on the Cytotoxicity of Post-Ethanol Serum', Biochemical Pharmacology, 1992; 43(3): 407-11.
27. Ziegler D., Gries, F., 'Alpha-Lipoic Acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy', Diabetes, 1997 Sept46 Supp12562.6.