Also known as: ALA, Thioctic acid, Lipoic acid
Alpha-lipoic acid is a sulfur-containing compound that functions as a powerful antioxidant in both water- and fat-soluble environments. It is clinically used for diabetic neuropathy and studied for its role in glucose metabolism and cellular energy production.
Alpha-lipoic acid (ALA) is a naturally occurring dithiol compound that serves as an essential cofactor for mitochondrial enzymes involved in energy metabolism, including pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase. Uniquely among antioxidants, ALA is amphiphilic, functioning in both aqueous and lipid environments, and can regenerate other antioxidants such as vitamins C and E, coenzyme Q10, and glutathione. Clinical evidence most strongly supports its use in diabetic peripheral neuropathy, where intravenous and oral ALA have been shown to reduce symptoms of pain, numbness, and tingling. Research also suggests benefits for insulin sensitivity and glucose disposal in type 2 diabetes. The R-enantiomer is the naturally occurring and biologically more active form, though most supplements contain a racemic mixture of R- and S-forms.
Multiple randomized controlled trials, including the SYDNEY and NATHAN trials, demonstrated that 600 mg/day of ALA significantly reduces neuropathic symptoms such as pain, burning, paresthesia, and numbness in patients with diabetic neuropathy.
Clinical trials have shown that ALA supplementation can improve insulin-stimulated glucose disposal in patients with type 2 diabetes, though the effect size varies across studies.
ALA uniquely functions in both aqueous and lipid compartments and can regenerate spent antioxidants including vitamins C, E, and glutathione, amplifying the body's overall antioxidant defenses.
On an empty stomach, 30 minutes before meals
600 mg is the best-studied dose. Higher doses (1200–1800 mg) did not show additional benefit in clinical trials but increased side effects.
On an empty stomach
R-lipoic acid is more bioavailable than racemic ALA and may be effective at lower doses.
Maximum bioavailability and biological activity
Cost-effective general supplementation
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