The Analyst - Internet Health Report: Treatment: Alpha Lipoic Acid

Alpha Lipoic Acid Last updated: Sep 22, 2008

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	Alpha Lipoic Acid


	Discovered in 1951, lipoic acid (also called alpha-lipoic acid or ALA) has long been recognized as a coenzyme that helps break down sugar for energy production during the Krebs cycle. Only recently has its therapeutic potential been realized. Lipoic acid is medically approved in Germany for treating adult-onset type II diabetes and its complications. Ironically, the research that demonstrated its increased blood sugar utilization was done in the United States. Lipoic acid is not a controlling factor in such instances, but research shows that a high intake (300 to 600mg per day) tends to normalize blood sugar levels in diabetics. [Haugaard, N., et al. "Stimulation of glucose utilization by thioctic acid," Biophys Acta 222: 583-86, 1970] Lipoic acid also fights free radical damage in both fatty and watery regions of cells and helps to recycle other antioxidants in what is described as "antioxidant synergism". A recent study showed that when lipoic acid was missing, other antioxidants did not interact well, thereby reducing their ability to protect cells. [Packer, L., et al. "Alpha-lipoic acid as a biological antioxidant," Free Radical Biol & Med. 19(2): 227-50, 1995] It can be found in potatoes, carrots, broccoli, yeast, beets, yams and kohlrabi, and is also abundant in red meat. It is a vitamin-like antioxidant that is also produced naturally in the body; it is the only antioxidant that is fat- and water-soluble; it is easily absorbed and transported across cell membranes. Whereas many antioxidants only provide protection outside of cells, ALA is broken down inside cells to dihydrolipoic acid - an even more potent antioxidant. It also regenerates other antioxidants like vitamin C, vitamin E and glutathione. It protects the liver from alcohol damage, the lungs from smoke damage, and enhances glucose disposal in type II diabetes and reduces associated neuropathy and cataracts. Individuals with capillary fragility (bruise easily) can benefit. While some human studies involve doses as high as 1,000mg daily, 100mg is sufficient to obtain the antioxidant effects in most cases. Clinical applications for this nutrient include the following conditions: diabetic polyneuropathy, cataracts, glaucoma, ischemia-reperfusion injury, radiation injury, metal toxicity, Amanita mushroom poisoning and CCl4 poisoning. Because of its unique characteristics ALA is likely to have therapeutic application in a wide range of additional clinical conditions. No RDA has been established. Humans are usually not deficient in alpha-lipoic acid, but supplementation can help in some conditions.

Alpha Lipoic Acid can help with the following:

Alcohol-related Problems

Alpha-lipoic acid should not be given in high doses to patients suspected of having a thiamine deficiency unless the thiamine deficiency is also corrected. Individuals who may be deficient in vitamin B1 (such as alcoholics) should supplement vitamin B1 along with alpha-lipoic acid.

Aging

Premature/Signs of Aging

Parkinson's Disease / Risk

Cataracts / Risk

It has been reported that lipoic acid has been shown to be helpful for cataracts. Some doctors caution that with a high body level for mercury, you risk moving mercury INTO the lens and brain rather than out, so lipoic acid should only be used if mercury levels are known to be low.

Diabetes Type I

There is considerable evidence that alpha lipoic acid can be used to prevent and treat diabetes, both type I (juvenile diabetes) and type II (mature onset diabetes) and the complications of diabetes.

Multiple Sclerosis / Risk

Circulation

Atherosclerosis

Recycles vitamins E and C when they've been used. Dosage: 50mg bid.

Bruising Susceptibility

Increased Risk of Stroke

Environment / Toxicity

Mercury Toxicity / Amalgam Illness

Sources of sulfur such as alpha lipoic acid, MSM and garlic are helpful for protection against heavy metals in general and specifically useful in mercury toxicity. Alpha lipoic acid should not be used alone, as it only mobilizes mercury with a weak bond. Without additional chelators present, such as DMPS or DMSA, the mercury may just redistribute elsewhere in the body instead of being removed.

Heavy Metal Toxicity

Sources of sulfur such as alpha lipoic acid (ALA), MSM and garlic are helpful for protection against heavy metals in general and specifically useful in mercury toxicity. Alpha lipoic acid should not be used alone, as it only mobilizes mercury with a weak bond. Without additional chelators present, such as DMPS or DMSA, the mercury may just redistribute elsewhere in the body instead of being removed.

In animal studies, ALA has been found to protect from arsenic poisoning. [Arch Biochem Biophys 1960;86: pp.190-194 ]

Cigarette Smoke Damage

Low T-Helper Cell Level

Metabolic Syndrome (Syndrome X)

Numerous additional studies have indicated that alpha lipoic acid (ALA) is useful for the treatment of diabetes mellitus which follows syndrome X. ALA stimulates increased glucose utilization in muscle cells and significantly reduces human insulin resistance. This process may occur via an insulin signaling pathway.

Nervous System

Neuritis/Neuropathy

There was a marked synergy between GLA and alpha lipoic acid which produced compounds that had at least an order of magnitude increase in efficacy over either one alone in correcting motor nerve conduction velocity and endoneural blood flow defects. A 1.3:1 GLA:alpha lipoic acid ratio appears to be optimal against experimental diabetic neuropathy. [Diabetologia (1998), 41: pp.390-399 (rat study)]

Experimental work confirms that GLA-aLA (equimolar) conjugate is so effective that it completely reverses the effects of the broken neurotrophic mechanisms that correlate with diabetic neuropathy. [Diabetologia 1998 Jul; 41(7): pp.839-843]

Antioxidant Requirement / Oxidative Stress

Organ Health

Diabetes Type II / Risk

Numerous additional studies have indicated that ALA is useful for the treatment of diabetes mellitus. It stimulates increased glucose utilization in muscle cells and significantly reduces human insulin resistance.

600mg of alpha lipoic acid tid was found to improve polyneuropathy symptoms in patients with type II diabetes. A maintenance dose as low as 100mg tid may be sufficient to provide benefits. [Diabet Med 1999;16; pp.1040-1043]

Liver Detoxification / Support Requirement

Alpha-lipoic acid has been used very successfully as a therapeutic agent in a number of conditions relating to liver disease, including alcohol-induced damage, mushroom poisoning, metal intoxification and carbon tetrachloride poisoning.

Alpha lipoic acid is given in a dose of 300mg at least twice per day for hepatitis B or C. Alpha lipoic acid (ALA), silymarin, and selenium have been used in combination with success in reducing symptoms and elevated liver enzyme levels (though the viral load was not substantially reduced).

150mg per day improves visual function in people with both stage I and stage II glaucoma. [Vestn Oftalmol 1995;111: pp.6-8]

Risks

Increased Risk of Pancreatic Cancer

Please see the link between Increased Risk of Pancreatic Cancer and LDN. The dose of Alpha Lipoic Acid used with the patient to increase his survival time was 300 to 600 mg intravenously twice weekly and orally, ALA 300 mg twice daily.

Tumors, Malignant

Pancreatic Cancer

Please see the link between Pancreatic Cancer and LDN. The dose of Alpha Lipoic Acid used with the patient to increase his survival time was 300 to 600 mg intravenously twice weekly and orally, ALA 300 mg twice daily.

KEY

		May do some good
		Likely to help
		Highly recommended

GLOSSARY

Antioxidant: A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, beta carotene, the minerals selenium and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids.

Bruise: Injury producing a hematoma or diffuse extravasation of blood without breaking the skin.

Capillary: Any of the smallest blood vessels connecting arterioles with venules and forming networks throughout the body.

Cataract: A steadily worsening disease of the eye in which the lens becomes cloudy as a result of the precipitation of proteins. Most cataracts are caused by the functions of the body breaking down. Eye trauma, such as from a puncture wound, may also result in cataracts.

Coenzyme: A heat stable molecule that must be associated with another enzyme for the enzyme to perform its function in the body. It is necessary in the utilization of vitamins and minerals.

Diabetes Mellitus: A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Free Radical: A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.

Glaucoma: A disease of the eye characterized by vision loss due to an increase in the pressure of fluid within the eye. This rise in pressure results from a build-up of aqueous fluid and leads to progressive damage to the optic nerve that transmits visual signals to the brain. Over time, glaucoma can lead to a gradual loss in peripheral vision. There are usually no signs that you're developing glaucoma until vision loss occurs.

Glucose: A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.

Glutathione: A natural sulfur-bearing peptide formed from the linking of three amino acids: glutamic acid, cysteine and glycine. Glutathione acts as an antioxidant and detoxicant and is involved with the selenium-containing enzyme glutathione peroxidase. Glutathione is also involved in amino acid transport across cell membranes.

Lipoic acid: A sulfur-containing coenzyme used in the energy process and is also a powerful antioxidant. Has been used therapeutically in the treatment of AIDS and diabetes because of the synergy between alpha-lipoic acid and vitamin E and the interlocking cycles which lead to better optimization of antioxidant nutrients.

Milligram: (mg): 1/1,000 of a gram by weight.

Neuropathy: A group of symptoms caused by abnormalities in motor or sensory nerves. Symptoms include tingling or numbness in hands or feet followed by gradual, progressive muscular weakness.

RDA: Recommended Daily Allowance of vitamins or other nutrients as determined by the FDA. U.S. RDAs are more widely used than RDAs, and focus on 3 age groups: Infants of 0-12 months; Children of 1-4 years; Adults and children of more than 4 years.

Synergism: An interaction between two or more nutrients in which the action of the nutrients is greater when they are taken together than when taken individually.

Vitamin C: Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Vitamin E: An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.

Yeast: A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.