From the Guidelines
Alpha-lipoic acid (ALA) has been shown to be effective in treating painful diabetic neuropathy (DPN) and may be considered for this purpose, as stated in the 2024 standards of care in diabetes 1.
Benefits of Alpha-Lipoic Acid
The benefits of alpha-lipoic acid include:
- Reducing symptoms of diabetic neuropathy (nerve pain) when taken at 600 mg daily for at least 3 months
- Improving insulin sensitivity and helping manage blood sugar levels in people with diabetes, typically at doses of 600-1200 mg daily
- Supporting heart health by improving endothelial function and reducing several cardiovascular risk factors
- Potential weight management benefits by increasing metabolism and reducing appetite
- Protecting brain function and slowing cognitive decline due to its antioxidant properties and ability to cross the blood-brain barrier
Important Considerations
- For most adults, a typical supplemental dose ranges from 300-600 mg daily, though higher doses may be used for specific conditions under medical supervision
- ALA is generally well-tolerated, but potential side effects include stomach upset, skin rash, or low blood sugar in diabetics
- It is advisable to consult with a healthcare provider before starting supplementation, especially if you have existing health conditions or take medications
Evidence Quality and Limitations
The evidence for ALA's benefits is based on various studies, including the 2024 standards of care in diabetes 1, which provides the most recent and highest quality guidance on the use of ALA for treating painful DPN. Other studies, such as those published in 2021 1 and 2020 1, provide additional insights into the potential benefits and limitations of ALA supplementation. However, the 2024 standards of care in diabetes 1 take precedence due to its recency and focus on clinical practice guidelines.
From the Research
Benefits of Alpha-Lipoic Acid
- Alpha-lipoic acid (LA) has been shown to have diverse pharmacologic and antioxidant properties, making it a potential therapeutic agent for various chronic diseases 2, 3, 4.
- LA improves glycemic control and polyneuropathies associated with diabetes mellitus, and effectively mitigates toxicities associated with heavy metal poisoning 2.
- As an antioxidant, LA directly terminates free radicals, chelates transition metal ions, increases cytosolic glutathione and vitamin C levels, and prevents toxicities associated with their loss 2, 3.
- The major benefit of LA supplementation is in patients with diabetic neuropathy, with studies showing significant improvements in symptoms and quality of life 2, 3, 5.
- LA has also been shown to increase insulin sensitivity in patients with type 2 diabetes, making it a potential adjunctive antidiabetic agent 6.
Specific Benefits for Diabetic Patients
- LA supplementation has been shown to reduce the incidence of peripheral neuropathy in patients with type 2 diabetes, with a significant decrease in symptoms after 4 and 8 months of treatment 5.
- LA has also been shown to reduce the incidence of depressive disorder in patients with type 2 diabetes, with a significant decrease in depression scores after 4 and 8 months of treatment 5.
- LA may have a role in managing other diabetic complications, such as retinopathy, nephropathy, and cardiovascular autonomic neuropathy, although more research is needed to confirm its efficacy in these areas 4.