Alpha Lipoic Acid supplement benefit, side effects, use for blood sugar, diabetes and diabetic neuropathy, 50 mg capsule dosage, influence on eyes and vision by Ray Sahelian, M.D.
Over the counter dosages include capsules and tablets that are 25 mg, 50 mg, 100, 200, 300 and even 600 mg per pill
July 4, 2014

Alpha lipoic acid is a powerful, natural antioxidant becoming recognized as having some unique properties in the therapy and prevention of a broad range of diseases. In addition to being a powerful antioxidant, this supplement helps the body use glucose, hence it's potential role in improving blood sugar control. ALA reduces complications from a high sugar diet. it is readily absorbed from the diet or as a supplement. This nutrient has a variety of benefits, particularly for diabetics.

The two types available over the counter
If you're taking a conventional lipoic acid supplement, you're likely only getting half or less of the benefit of natural lipoic acid. The reason for this is that most alpha lipoic acid products on the market have both forms: the S form, and the R form.
R-lipoic acid is much more potent (2 times or more) than commonly sold alpha lipoic acid which contains both the R and S forms. The S form is chemically the mirror image of the R form and cannot be used by the body, hence it is useless. Thus, 50 mg of R- alpha lipoic acid is equivalent to about 100 mg of the regular version. However, since many of the products over the counter have high dosages, getting less is not in issue.

buy R Alpha Lipoic Acid product 50 mg capsule per dose

 

 

 



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Suggested use, dosage: For long term use, 10 to 50 mg of R- alpha lipoic acid capsule a few times a week is quite adequate. For smaller amounts, you may open a capsule and put it in water or juice. The capsule is best taken in the morning with breakfast. If you plan to take higher amounts, please do so under medical supervision.
   Use of this nutrient can often lead to a mild feeling of well-being. Interestingly, there’s also a slight visual enhancement that occurs. However, this visual enhancement is not as dramatic as that of Eyesight Rx.

Q. Is the R-Lipoic Acid 50 mg a bioenhanced and/or stabilized formulation?
   A. I actually do not know what these terms mean in relation to this supplement, these terms appear to be a marketing ploy by some companies. A search on Medline for "alpha lipoic acid bioenhanced stabilized" did not reveal any findings.

Dosage, how much to take
As we found out about vitamin E, high doses of antioxidant supplements may not lead to more benefits. In fact, there comes a point where a supplement, no matter how benign, can become unhealthy if the doses are too high. For this reason I do not recommend more than 10 to 50 mg of alpha lipoic a day for long term use as a way to improve health. Those who have a medical condition may need higher amounts. There are products out there that have 300 mg per capsule. I am not convinced they are healthy to take, except perhaps to treat an existing medical condition for a specific period of time.
    
   Animal research has shown that R ALA can increase or maintain levels of other antioxidants including COQ 10, vitamin C, vitamin E and glutathione, which often declines with age.

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Testimonial received by email
I wanted to extend my thanks for your supplements! I am a 51-year -old physician assistant who works in a busy family practice. I recently tried your alpha lipoic acid and acetyl-l carnitine supplements. I felt better the first day, so my husband tried them and he did too! I must admit that this changes my perspective on nutraceuticals - from here on out, I will not hesitate to recommend that my patients visit your site! 

Conditions where it may benefit
This nutrient may benefit those with diabetes, heart disease, hypertension, high cholesterol, Alzheimer's disease, Parkinson's disease, and Huntington's disease.
It improves blood sugar control, neuropathy associated with diabetes mellitus, and toxicity associated with heavy metal poisoning.

The ideal antioxidant?
Fruits, herbs and vegetables contain countless antioxidants. They are all important, and taking alpha lipoic acid is certainly not a substitute for eating a diet loaded with refined sugars, desserts, and high-fat junk. However, it offers some benefits you won’t find in other antioxidants. In a review article published in the journal Free Radical Biology and Medicine, one of the leading scientists in the area of antioxidant chemistry, Lester Packer, Ph.D., from the University of California at Berkeley, comes close to calling it the "ideal" antioxidant, for the following reasons:

Alpha lipoic acid is readily absorbed from the diet or as a supplement.
It can regenerate vitamin C from its oxidized form, dehydroascorbic acid, and regenerate other antioxidants.
Chelates transition metal ions (e.g. iron and copper),
It can enhance the synthesis of glutathione, the main antioxidant within our cells. Glutathione effectively mops up all types of toxins and free radicals. However, we cannot take supplements of this antioxidant since it is unable to cross cell membranes.
It can even pitch in and help when the body is lacking vitamin E. When laboratory animals were depleted of their vitamin E stores because their diet lacked this nutrient, they displayed obvious symptoms of vitamin E deficiency. However, when their diet was supplemented with ALA, the animals were completely protected.

Anti-aging, can it help you live longer?
Glucose (sugar) has been implicated in the aging process because of its ability to react with some proteins, such as collagen, to produce glycation. That is, a glucose molecule attaches to some amino acids of a protein and makes the protein less functional, leading to malfunction. As we age, the amount of glycation of the proteins in our bodies tends to increase. The glycation of the collagen in our tendons and arteries increases with age in proportion to the increase in blood glucose that occurs with aging. However, restricting calories can help prevent this age-related increase in glycation. In other words, avoiding excess sugar and excess calorie consumption could theoretically, over the years and decades, help our proteins stay healthier. Alpha lipoic acid could help lower the rate of glycation. Practical ways to use this information include:
Eat small, frequent meals throughout the day instead of one or two excessively large ones. Eating these small meals, or snacks, will help maintain your blood sugar at a relatively steady state, instead of wide fluctuations.
Make sure to get some protein with each meal. Avoid a purely carbohydrate meal, except when you want to induce sleep at night. Carbohydrates, eaten an hour or two before bed, will help you feel sleepy.
Even relatively "healthy" drinks, such as fruit juices, can increase blood sugar significantly when consumed in large amounts, such as six ounces or more. Many people quickly gulp down eight ounces of orange juice in the morning, in addition to a cup of coffee laced with a teaspoon or two of sugar.

Alzheimer's disease
Alpha-lipoic acid as a new treatment option for Alzheimer's disease -- a 48 months follow-up analysis. J Neural Transm Suppl.
In a previous study, 600mg ALA was given daily to nine patients with Alzheimer's disease (receiving a standard treatment with choline-esterase inhibitors) in an open-label study over an observation period of 12 months. The treatment led to a stabilization of cognitive functions in the study group.

Asthma
Alpha-Lipoic acid inhibits airway inflammation and hyperresponsiveness in a mouse model of asthma.
J Allergy Clin Immunology. 2004.
We evaluated the therapeutic effect  in a mouse model of asthma. Compared with untreated asthmatic mice, treated mice had significantly reduced airway hyperresponsiveness, a lower proportion of eosinophils among BAL cells, and significantly improved pathologic lesion scores of the lungs.

Blood sugar
This nutrient could lower blood sugar levels.

Burning mouth syndrome treatment
BMS has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. An older study shows benefit from ALA use while a newer study does not show any benefit over placebo. The problem with the newer study is that it was only 20 days long while the older study was for 2 months. Also, in the newer study, both placebo and ALA patients improved.

Alpha lipoic acid in burning mouth syndrome - a randomized double-blind placebo-controlled trial.
J Oral Pathol Med. 2009.
Patients were randomized into two cycles of treatment: one with alpha lipoic acid and one with placebo both administered in identical capsules. The study failed to demonstrate the effectiveness of ALA over placebo.

This was a double blind, controlled study conducted for two months on 60 patients with constant burning mouth syndrome. Following treatment there was a symptomatic improvement with the majority showing at least some improvement after 2 months. This improvement was maintained in over 70% of patients at the 1 year follow-up. Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy. J Oral Pathol Med 2002. Stomatology Clinic II, University of Medicine and Surgery, Napoli, Italy.

Benefit for diabetes
Lipoic acid is helpful in diabetes, particularly for those with diabetic neuropathy and diabetic nephropathy. Oxidative stress plays a central role in the cause and progression of late microangiopathic (small vessel) complications in diabetes mellitus. Treatment of diabetic patients reduces oxidative stress and urinary albumin excretion, and slows the progression of endothelial cell damage. ALA may also may tissues more sensitive to insulin.
  
In a study completed at the University of Heidelberg in Germany, the effect of ALA on the progression of kidney cell damage and the course of diabetic nephropathy was evaluated in 84 patients with diabetes over 18 months. Thirty-five patients were treated with 600 mg alpha-lipoic acid per day. After 18 months of follow up, those on ALA had a slower progression of the disease than the control group as shown by a decrease in the amount of protein lost in urine.

Improvement of insulin sensitivity in patients with type 2 diabetes mellitus after oral administration of alpha-lipoic acid.
Hormones 2006.
Twelve patients were treated with oral alpha-lipoic acid, 600 mg twice daily over a period of 4 weeks. At the end of the treatment period, insulin sensitivity of diabetic patients was significantly increased.

Diabetic neuropathy research
High blood sugar levels for prolonged periods can be toxic to nerves in the body. Diabetics who don't control their blood sugar eventually start losing sensation in their feet. Other problems follow resulting from damage to various nerves that supply internal organs. Even impotence can result due to loss of nerve sensation in genital organs. However high blood sugar may not be the only culprit. Diabetics are usually under high oxidative stress and this probably contributes to their neurological problems.
   Several studies indicate that this nutrient has beneficial effects on diabetic neuropathy, party due to its actions as an antioxidant, and also by improving the circulation to tiny blood vessels supplying nerve tissue.

Effects of alpha lipoic acid on microcirculation in patients with peripheral diabetic neuropathy.
Haak E,. University Hospital, Frankfurt, Germany.
One group of patients received 1200 mg alpha-lipoic acid orally per day over 6 weeks resulting in improved microcirculation.

Erectile dysfunction
Whether alpha lipoic acid helps those with sexual dysfunction is not fully understood but this nutrient does not seem to have a rapid action for this purpose.


Eye health, retina studies, eyesight
R alpha lipoic acid protects retinal pigment epithelial cells from oxidative damage.
Invest Ophthalmol Vis Sci. 2005.
The present study suggests that R ALA could be effective against age-associated increase in oxidative stress and mitochondrial dysfunction in retinal pigment cells.

Personally I find an improvement in vision and clarity within the first day of taking a 50 mg capsule.

Glaucoma
I have taken over your recommended dose of ALA now for about two years 300 mg day. In my defense, I just came across your website today. My eye pressure was at 28, but no evidence of glaucoma yet. The opthalmologist suggested statins to prevent glaucoma; however, I asked him for a few months reprieve first. Anecdotal information I found on the internet suggested that ALA in higher doses had lowered eye pressure and I found it also might help my idiopathic neuropathy. Within two months, my eye pressure dropped to 24, and is now maintaining at around 22!

Hypoglycemia
Would it be as beneficial for hypoglycemia as it is for diabetes? Or, would it be contraindicated and lower the blood sugar even more?
   I think those with hypoglycemia may not benefit from high dosages.

Liver health and glutathione preservation
R-alpha-lipoic acid reverses the age-associated increase in susceptibility of hepatocytes to tert-butylhydroperoxide both in vitro and in vivo. Antioxid Redox Signal. 2000.

Loss of smell (Olfactory)
Alpha lipoic acid may help regenerate loss of smell after a cold.

Alpha Lipoic acid in the treatment of smell dysfunction following viral infection of the upper respiratory tract. Hummel T. Laryngoscope 2002. Department of Otorhinolaryngology, University of Dresden Medical School, Germany.

Loss of taste, dysgeusia
Researchers at the University of Medicine and Surgery, in Napoli, Italy, selected patients with idiopathic dysgeusia, an altered perception of taste, matched for age and sex, for an open trial of alpha lipoic acid compared with placebo for 2 months. The results showed significant symptomatic improvements compared with placebo, suggesting that idiopathic dysgeusia may be a neuropathy comparable to the burning mouth syndrome.

Macular degeneration
Ann Nutr Metab. 2012. Effect of (R)-α-lipoic acid supplementation on serum lipids and antioxidative ability in patients with age-related macular degeneration. The apparent increase in SOD activity caused by LA supplementation indicates that LA may have a possible preventive effect in the development of AMD through an antioxidant mechanism.

Memory
Feeding alpha lipoic acid and acetyl-l-carnitine to old rats improves performance on memory tasks by lowering oxidative damage and improving mitochondrial function.

Multiple sclerosis
Alpha Lipoic acid in multiple sclerosis: a pilot study.
Mult Scler. 2005.
Thirty-seven multiple sclerosis subjects were randomly assigned to one of four groups for 14 days: placebo, ALA 600 mg twice a day, 1200 mg once a day and 1200 mg twice a day. We found that subjects taking 1200 mg had substantially higher peak serum levels than those taking 600 mg and that peak levels varied considerably among subjects. We conclude that oral alpha lipoic acid is generally well tolerated and appears capable of reducing serum matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels. It may prove useful in treating multiple sclerosis by inhibiting MMP-9 activity and interfering with T-cell migration into the CNS.

Skin health, benefit of cream
Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5% alpha lipoic acid related to photoageing of facial skin.
Br J Dermatol. 2003.
Alpha lipoic acid or the reduced form dihydrolipoate (DHLA) is a potent scavenger with anti-inflammatory properties. Previous uncontrolled studies with topical treatment with 5% alpha-lipoic acid-containing creams indicate a beneficial effect on photoageing skin. Our results indicate twelve weeks of treatment with a cream containing 5% alpha lipoic acid improves clinical characteristics related to photoageing of facial skin.

Thyroid gland influence
Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein- and glucose levels.
Arzneimittelforschung. 1991.
Our results demonstrate that alpha lipoic acid interferes with the production of T3 from T4 when it is co-administered with T4. The elevated level of T3, after T4 administration, is reduced by treatment with ALA.

My comments: It is possible that individual with thyroid problems who are medicated with Synthroid or Levoxyl may get a speeding heart if they take a high dose of ALA. Perhaps the dosage in those on thyroid medications should be limited to 10 to 20 mg.

Weight loss and anti-obesity
It is possible that a very high dosage can cause a decrease in appetite and weight loss but this is not safe.

In a trial involving 360 obese individuals with hypertension, diabetes mellitus or hypercholesterolemia individuals were randomly given ALA1200 mg per day or 1800 mg per day or placebo for 20 weeks. The results were the group taking 1800 mg experienced significantly more weight loss than the placebo group. Common side effects were urticaria and an itching sensation but these were generally mild. Effects of alpha-lipoic Acid on body weight in obese subjects. Am J Med. 2011.

Alpha lipoic acid side effects, safety, danger, risk
There are no indications that low doses, such as 5 to 20 mg, have side effects. Higher doses could cause nausea or stomach upset, along with over-stimulation, fatigue, and insomnia. High doses could also potentially lower blood sugar. This is often beneficial to patients who have diabetes, but it requires close monitoring of blood sugar levels. Those with thyroid problems may consider taking half a capsule of a 50 mg R alpha lipoic acid dose.

Atrial fibrillation
I read that you recommend no more than 10-50 mg/day. At the advice of a consultant at a GNC store, I started taking 900 mg (3 300mg tabs/day). Two weeks later I I suffered atrial fibrillation/ flutter which required hospitalization to get my heart in normal sinus rhythm. I've got a trans-esophageal echogram and an ablation scheduled. I am post-menopausal, healthy, non-smoking, active, normal weight. I had open heart / bypass surgery years ago for a blocked LADA, but was discharged from cardiac follow-up.

I had been taking 800 mg of ALA for months to lower my blood sugar under the care of a practitioner. I stopped a few weeks ago when I read in your website that this high dosage could cause atrial fibrillation and arrhythmia. Consequently, my sugar has shot up even though I'm very conscientious about what I eat. I also have open angle glaucoma. I'm 56 years old. I'd like to understand the connection with atrial fibrillation and arrhythmia.
    I am not sure how this occurs, and it does not happen in everyone. Some people are able to tolerate high dosages without heart rhythm disturbances whereas others are very susceptible.

Gastrointestinal symptoms
I have found that taking r lipoic greatly reduces my paresthesia. However, it also creates painful stomach cramps / ulcers after just a few weeks use. I am only taking 50 mg every other day, although one every day has better results.

Heart palpitations
I recently while on vacation was consuming more sugary snacks than usual, so I was offsetting this by consuming 300 mg R Lipoic Acid and cinnamon supplements to try to keep blood sugars down. I had an episode where my heart rate was actually around 60 and my BP was up but I heart was beating erratically. I have had tachycardia before but not while taking R LA. Do you think the ALA is causing the heart palpitations.
   I do not know the cause of the heart rhythm problems you may be experiencing, but, in my experience, high dose ALA use is associated with palpitations and tachycardia in some users.

Hypercalcemia
I take 300 mg of ALA a day for the past year, I have developed osteoporosis (Dexa-scan 5 yrs ago was perfectly normal), and have been diagnosed with high calcium levels. Tests for myeloma, thyroid issues, parathyroid, etc. are all clear. The doctor is trending my condition for three months and has asked me to stop taking excess calcium for three months before another lab. Have you come across any research studies that indicate that ALA could cause or contribute to hypercalcemia?
    I have not seen any information on the role of ALA and its long term effects on bone health but I will keep this in mind when I review future studies on this topic.

Pruritis, itching
Since 2008 I've been taking alpha lipoic acid sustained release 400 mg twice a day and in April 2009 the back of my head began itching and slowly got more intense to the point I had scratched till sores were on my head. As that slowly went away I started to itch on my lower back. Then that slowly moved from one place to another, my elbows then the stomach my upper back, knees the back of my legs. I itch all over now. I stopped taking it August 2009, now it is October 2009 and still itch sometimes. It is slowly getting better but you should see my body I have sores all over from scratching. always getting blood on my clothes.

Withdrawal symptoms
I started taking ALA a few month ago for confusion and a possible diagnosis of MS multiple sclerosis. I took the brand Natural Factors 200mg. At first I took only 200 per day but noticed good side effects of increase energy, less craving of carbs and better brain clarity, so I started taking an additional pill mid afternoon and at night. I have always struggled to get out of bed in the morning because I had an over whelming tired, groggy, heavy body feeling. With the ALA My energy was great it I woke up so much easier and it seemed to even help with some mild depression and my brain clarity was so much better. I had an overall feeling of well being. About three weeks ago I noticed that if I forgot to take ALA in the afternoon I had a sleepy, tired…let down feeling. So I would pop a pill and within minutes feel fine again. I did not feel tired in the evening…but I took an ALA capsule at bed time to insure I would not have to drag myself out of bed in the morning. It did not interfere with my sleeping. Now I have a different issue…I have to make the bottle of ALA last until my next payday, so I am rationing the capsules I have and am only taking 1 per day in the morning. I am noticing some mental confusion again and some negative, depressive thinking and I am tired and yawning in the afternoon, however I am still not at groggy in the morning as I use to be. I would say I am noticing more withdrawal side effects then I had when I stopped taking Wellbutrin.

Dr. Sahelian’s experience
Unlike most antioxidants such as vitamins C, E, and selenium, there is actually a noticeable effect from taking alpha lipoic acid. I’ve observed a sense of relaxed wellbeing and slightly enhanced visual acuity. Higher dosages, such as 50 mg or more, even when taken in the morning, cause me to have insomnia.

Summary and review
Until long-term studies are published on humans, I do not recommend that you take more than 10 to 50 mg a day unless you’re being treated for a particular condition under medical supervision. Since ALA helps restore antioxidants, you may need less vitamins C and E and other antioxidants when you take them together.
   Alpha lpoic acid is an exciting addition to the list of nutrients, herbs, and hormones that can treat disease in a safer and more natural way, and help you become healthier. This nutrient offers many benefits, but, as with any medicine, we should not think of it as a magic bullet that can cure all types of diseases. The human body is complicated, with countless chemical reactions going on at any one time.

Absorption and metabolism
Plasma kinetics, metabolism, and urinary excretion of alpha lipoic acid following oral administration in healthy volunteers.
J Clin Pharmacol. 2003.
Exogenous racemic alpha lipoic acid orally administered is readily and nearly completely absorbed. Urinary excretion does not play a significant role in its elimination. Therefore, biliary excretion, further electrochemically inactive degradation products, and complete utilization of alpha lipoic acid as a primary substrate in the endogenous metabolism should be considered.


Storage, refrigeration, stability
There are some claims by certain companies that their product does not require refrigeration because it is assured that it is stable at room temperature, but a search on Medline in 2011 did not reveal any studies regarding the ideal way to store this product and whether it is better to refrigerate or keep at room temperature. Any claims by companies that their product last longer should be verified and they need to provide actual studies. 

Alpha Lipoic cream and skin health
Alpha Lipoic acid 5% skin cream can reduce damage from sun exposure.

A brief history
In the fall of 1950 a team of scientists headed by Dr. Lester Reed, from the Department of Chemistry at the University of Texas in Austin, isolated a compound that affected the metabolism of glucose. They named this compound alpha-lipoic acid. The term refers to "lipid" or fat, since it was not soluble in water. Initially scientists focused on its role in sugar metabolism. However, in the 1980s, its powerful antioxidant capabilities were discovered. The research with this nutrient has accelerated over the past few years. Various patents have been taken, and researchers are testing it for its potential in fighting infections and inflammation, protecting nerve cells, treating cardiovascular diseases, tumors, allergies, shielding against stomach ulcers, and so on. Naturally, there’s no guarantee that alpha lipoic acid will turn out to be appropriate for all these conditions.
 
Emails
I noticed a Doctor's Best ad promoting a "stabilized" R-lipoic acid as much better absorbed.
   We don't know what them mean by "stabilized R lipoic acid." It is quite potent and effective as is, we don't see the need to make any changes. In fact, many people may be overdosing themselves using too high dosages, and hence better absorption, even if true (which we seriously doubt), does not seem to be such a good idea.

Combining with biotin
I am looking at taking Lipoic CR which has 800mg of alpha-lipoic acid and 200 mcg biotin in one tablet. I have diabetes and this product helps.
   I don't see the necessity of taking it with biotin.