The Health Benefits of Alpha-Lipoic Acid

This antioxidant may be helpful for weight loss, diabetes, and nerve pain

Alpha-lipoic acid is a compound found naturally inside every cell of the human body. Its primary role is to convert blood sugar (glucose) into energy using oxygen, a process referred to as aerobic metabolism. Alpha-lipoic acid is also considered an antioxidant, meaning that it can neutralize harmful compounds called free radicals that damage cells at the genetic level.

What makes alpha-lipoic acid so unique is that it is soluble in both water and fat. That means that it can deliver energy immediately or warehouse it for future use.

Alpha-lipoic acid can also recycle "used" antioxidants, including vitamin C, vitamin E, and a potent amino acid compound known as glutathione. Whenever these antioxidants neutralize a free radical, they destabilize and become free radicals themselves. Alpha-lipoic acid helps restore them by absorbing excess electrons and converting them to the back to their stable form.

Alpha-lipoic acid is sometimes taken as a supplement under the presumption it can improve certain metabolic functions, including fat burning, collagen production, and blood glucose control. There is growing evidence of at least some of these claims.

In addition to supplements, alpha-lipoic acid is synthesized in the body and found in many of the foods we eat, especially Brussels sprouts, spinach, broccoli, peas, brewer's yeast, potato, yams, carrots, rice bran, and organ meats.

Health Benefits

Much of the research involving alpha-lipoic acid has been centered on the prevention of diabetes and the management of diabetic nerve pain.

In addition, many alternative practitioners contend that alpha-lipoic acid can prevent or treat a multitude of health conditions, including alcoholic liver disease, HIV, Alzheimer's disease, bipolar disorder, cardiac arrhythmia, high blood pressure, rheumatoid arthritis, premature labor, schizophrenia, and erectile dysfunction, among others. To date, there is little evidence to support these claims.

Here are some of the more promising findings related to alpha-lipoic acid use:

Diabetes

It has long been presumed that alpha-lipoic acid can aid in the control of glucose by increasing the speed in which the blood sugar is metabolized. This could potentially aid in the treatment of diabetes, a disease characterized by abnormally high blood glucose levels.

An early study examining the effect of alpha-lipoic acid in rats found that supplementation enhanced the activity of signaling proteins that trigger the production of insulin (the hormone responsible for blood glucose control). Despite the promising findings, the same result has not been seen in most human studies.

A 2006 study in the journal Hormones reported that adults with type 2 diabetes who were given a daily 600-milligram (mg) dose of alpha-lipoic acid for four weeks experienced a short-term improvement in insulin sensitivity, but no changes in blood glucose levels.

Some scientists believe that oral supplements will not provide the therapeutic effect needed to prevent or treat diabetes and have begun investigating whether an intravenous (IV) infusion might help.

A 2011 study from China provided a compelling proof-of-concept of the hypothesis: 12 obese adults with prediabetes experienced improvements in insulin resistance after two weeks of daily 600-mg alpha-lipoic acid infusions.

While this approach would be impractical in clinical practice, it does hint at the potential benefit of alpha-lipoic acid in preventing the onset of type 2 diabetes. By contrast, there is no evidence that the supplement can prevent or treat type 1 diabetes, the form the disease typically associated with an immune system malfunction.

Nerve Pain

Neuropathy is the medical term used to describe the pain, numbness, and abnormal sensations caused by nerve damage. Oftentimes, the damage is caused by the oxidative stress placed on the nerves by chronic diseases such as diabetes, Lyme disease, shingles, thyroid disease, kidney failure, and HIV.

It is believed by some that alpha-lipoic acid, given in large enough doses, can counter this stress by exerting potent antioxidant activity. There has been evidence of this effect in people with diabetic neuropathy, a potentially debilitating condition experienced in people with advanced diabetes.

A 2012 review of studies from the Netherlands concluded that a daily 600-mg intravenous dose of alpha-lipoic acid given over three weeks provided "significant and clinically relevant reduction in neuropathic pain."

As with the previous diabetes studies, oral alpha-lipoic acid supplements were generally less effective or had no effect at all.

Other studies have explored the effect alpha-lipoic acid might have in treating other forms of neuropathy. To date, there have been no suggestions of a benefit, either in dealing with infectious causes of neuropathy or neuropathy induces by medications (such as chemotherapy).

Currently, only Germany has approved the use of intravenous alpha-lipoic acid for the treatment of diabetic neuropathy.

Weight Loss

Alpha-lipoic acid's ability to enhance calorie burning and promote weight loss has been exaggerated by many diet gurus and supplements manufacturers. With that being said, there is growing evidence that alpha-lipoic acid can influence weight, albeit modestly.

A 2018 review of studies from the Yale University found that alpha-lipoic acid supplements, ranging in dose from 300 to 1,800 mg daily, helped prompt an average weight loss of 2.8 pounds compared to a placebo.

There was no association between the alpha-lipoic supplement dose and the amount of weight loss. Moreover, the duration of treatment appears to influence a person's body mass index (BMI), but not the person's actual weight.

What this means is that, while it appears you can only lose so much weight with alpha-lipoic acid, your body composition may improve as fat is gradually replaced by lean muscle.

High Cholesterol

Alpha-lipoic acid has long been believed to influence weight and health by altering the lipid (fat) composition in the blood. This includes increasing "good" high-density lipoprotein (HDL) cholesterol while lowering "bad" low-density lipoprotein (LDL) cholesterol and triglycerides. Recent research suggests this may not be so.

A 2013 study from New York reported that obese rats fed a diet fortified with alpha-lipoic acid not only lost weight but experienced an 11 percent drop in total cholesterol and 46 percent drop in LDL compared to rats fed an unfortified diet.

On the other hand, the triglyceride levels actually increased in the rats provided alpha-lipoic acid, while the HDL levels remain unchanged.

Similar results were seen in a 2011 study from Korea in which 180 adults provided 1,200 to 1,800 mg of alpha-lipoic acid lost 21 percent more weight than the placebo group after 20 weeks but experienced no improvements in total cholesterol, LDL, HDL, or triglycerides.

In fact, higher doses of alpha-lipoic acid conferred to increases in total cholesterol and LDL in the study participants.

Sun-Damaged Skin

Cosmetics manufacturers often like to boast that their products benefit from the "anti-aging" properties of alpha-lipoic acid. Research suggests that there may some credence to these claims.

An early study published in the Aesthetic Surgery Journal concluded that a topical 5% alpha-lipoic cream was able to reduce facial lines, especially around the eyes and upper lip, by as much as 50 percent in women ages 41 to 63 with moderate sun damage. The pore sizes of the participants were also seen to decrease. The topical cream was well tolerated with no apparent side effects.

Possible Side Effects

Alpha-lipoic acid is generally considered safe when taken as an oral supplement or used as a topical ointment. However, there is little research exploring the long-term safety of alpha-lipoic acid, including at what point the supplement may become toxic. There have, in fact, been several reports of seizures and vomiting in children who have taken doses of 2,400 mg or greater.

Common side effects of alpha-lipoic acid may include a headache, skin rash, muscle cramp, or a tingling "pins and needles" sensation. The side effects tend to be mild and will typically resolve once treatment is stopped.

Alpha-lipoic acid can decrease blood sugar levels. If you are taking diabetes medications, inform your doctor so that the drug dose can be adjusted if needed.

Animal studies strongly suggest that alpha lipoic acid can alter thyroid hormone levels. As such, people taking thyroid medications such as levothyroxine should be monitored by their doctor if alpha lipoic acid is being used.

Due to the lack of safety research, alpha-lipoic acid should not be used in children, pregnant women, or nursing mothers.

Dosage and Preparation

While considered safe, there are no guidelines directing the appropriate use of alpha-lipoic acid. Most oral supplements are sold in formulations ranging from 100 to 600 mg. Based on the bulk of the current evidence, a maximum daily dose of up to 1,800 mg is presumed to be safe in adults.

With that being said, everything from body weight and age to liver function and kidney function can impact what is safe for you as an individual. As a general rule of thumb, err on the side of caution and always opt for a lower dose.

Alpha lipoic acid supplements can be found online and in many health food stores and drugstores. For maximum absorption, the supplements should be taken on an empty stomach.

What to Look For

As a dietary supplement, alpha-lipoic acid is not subject to strict regulation by the U.S. Food and Drug Administration (FDA). To ensure you are getting a quality supplement, opt for brands that have undergone voluntary testing by an independent certifying body like the U.S. Pharmacopeia (USP), ConsumerLab, and NSF International. By doing so, you can be better assured that the supplements contain the listed ingredients and are manufactured to the highest quality standards.

Other Questions

Can I get all of the alpha-lipoic acid I need from food?

Although almost all food contains some alpha-lipoic acid, the level tends to be small. The only exceptions are organ meats and certain leafy and root vegetables. As such, alpha-lipoic acid is not considered an essential nutrient because you don't need it to obtain it from food.

Alpha-lipoic acid is instead synthesized endogenously (in the body) through a series of biochemical processes involving fatty acids, proteins, and an enzyme known as lipoic acid synthase. If you eat a nutritious diet, your body will have all the raw materials it needs to make alpha-lipoic acid.

How do I know if I have an alpha-lipoic acid deficiency?

An alpha-lipoic acid deficiency is practically unheard of. Rare genetic mutations have been described in medical literature in which the body is unable to produce lipoic acid synthase. It is estimated that fewer than one of every 1,000,000 people are affected.

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