Alpha Lipoic Acid is promoted as a powerful anti-oxidant that regenerates vitamin C and indirectly vitamin E, increases intracellular glutathione and CoQ10. Its benefits are often exaggerated with one author stating lipoic acid has the potential to prevent diabetes, improve glucose control, decrease the neuronal damage in diabetes, prevent cataracts, treat glaucoma, prevent oxidative damage, and treat amanita mushroom poisoning. Altern Med Rev 8/98;3:308. ALA has been heavily researched in animal studies and some double-blind human studies are now being reported finding clear benefit for diabetic peripheral neuropathy and burning mouth syndrome. It also helped photoageing on facial skin. An open study claims it was helpful for loss of smell after a viral upper respiratory illness (Laryngoscope. 2002 Nov;112(11):2076-80). Unfortunately, open trials are serious prone to exaggerate or imagine benefit where none exists.

Burning Mouth Syndrome: Alpha Lipoic Acid Helps in DB: Naples, Italy university study of 60 patients in DB PC of oral treatment I think. Exact figures improving were not reported in the abstract but were a majority of patients. Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy. Femiano F, Scully C. J Oral Pathol Med. 2002 May;31(5):267-9

Diabetic Neuropathy: Alpha Lipoic Acid Orally Helps: DB PC 24 patients. Half given 600 mg tid for three weeks. Total symptoms decreased 47% vs. 24% with placebo. Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy. Ruhnau KJ, Meissner HP, Finn JR, Reljanovic M, Lobisch M, Schutte K, Nehrdich D, Tritschler HJ, Mehnert H, Ziegler D. Diabet Med. 1999 Dec;16(12):1040-3

Diabetic Peripheral Neuropathy & Heart: Alpha Lipoic IV Helps: DB PC studies: 1) 1200mg/d, 600mg/d, 100mg/d or placebo IV 3 weeks found decrease peripheral burning, pain numb feet in 328 diabetics for 1200 and 600mg groups. 2) 73 pt with diabetic cardiac autonomic neuropathy manifest by decrease heart rate variability. DB PC Rx with 800mg/d beneficial increase in heart rate variability. Ziegler, Germany, Diabetes ’97;46 Suppl 2:S62-6

Diabetc Neuropathy: Alpha Lipoic Acid IV Helps: Russian study, apparently funded by a manufacturer, had 120 diabetic patients in DB PC receiving ALA 600 mg/d intravenously for 14 treatments. They report 5.7 points decrease in pain symptoms vs. 1.8 with placebo including decreases in burning pain, numbness, and prickling. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Ametov AS, Barinov A, Dyck PJ, Hermann R, Kozlova N, Litchy WJ, Low PA, Nehrdich D, Novosadova M, O'Brien PC, Reljanovic M, Samigullin R, Schuette K, Strokov I, Tritschler HJ, Wessel K, Yakhno N, Ziegler D; SYDNEY Trial Study Group. Diabetes Care. 2003 Mar;26(3):770-6

Facial Skin: Alpha-Lipoic Acid Improved Photoageing: In a DB PC study of 33 women mean age 54 who put LA cream on half of their faces for 12 weeks and an identical cream without LA on the other half, laser profilometry, the most objective method used, showed an average decrease in skin roughness of 51% on the LA-treated side, compared with 41% on the placebo-treated half of the face (P < 0.001). Randomized, placebo-controlled, double blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoageing of facial skin. Beitner H. Stockholm, Sweden. Br J Dermatol. 2003 Oct;149(4):841-9

Liver Disease: Alpha Lipoic Acid Orally No Help: 6 month DB PC Rx 300mg/d found disease improved if stopped drinking but not if continued drinking and that LA had no effect on either group. Marshall, Gut ’82;2:1088

Aging: Juvenon: Acetyl-L-Carnitine + Alpha Lipoic Helped Only "Biomarkers" in Elderly Sedentary Men: A very small DB PC crossover 17-week study of 18 "healthy" but sedentary men 60-71 years of age with a four week washout between the acetyl-l-carnitine 500 mg with alpha lipoic acid 200 mg b.i.d. vs. placebo found no clear benefit to the supplement for fitness. After a 45 minute exercise test, 8 of 9 biomarkers for "cellular health and oxidative stress" favored the supplement: ammonia, beta-carotene, glutamine, glutathione, malondialdehyde, total antioxidant status (TAS), vitamin C, and vitamin E-gamma tocopherol. biomarkers for cellular health and oxidative stress: ammonia, beta-carotene, glutamine, glutathione, malondialdehyde, total antioxidant status (TAS), vitamin C, vitamin E-alpha tocopherol. Vitamin E-gamma tocopherol did not. Fitness, strength, and weight were not helped by the supplement. The total scores for the majority on the Psychological General Well-Being Index were said to be significantly better. Although the study was done by the Dept of Kinesiology of San Francisco State University in 2001, it has still not been published in a refereed scientific journal as of Dec. 2003.  The study was apparently financed by the manufacturer, Bruce Ames of Juvenon. The combination was promoted in a puff piece in Reader's Digest, Nov. 2003 entitled, "The New Pill That Can End Aging." and a similar puff piece in Discover Magazine, Oct. 2003, in which Ames is called "controversial." The Juvenon website is full of anecdotal testimonies. www.juvenon.com.

   Ed: The research looks very poor for Juvenon. Alpha lipoic has been found to work for peripheral neuropathy but at higher doses than recommended by Juvenon. While claims of other benefits for alpha lipoic are made, the research is not there. Acetyl-L-Carnitine looks like a loser in far larger studies than the one done for Juvenon. 60 tablets costs $40.  It looks like a real waste of money, even for sedentary elderly men.  A little daily exercise would be certain to be much better for fitness and strength and probably mood. As for biomarkers, who cares. We want evidence of real health benefits.

No Studies on Dementia: A Cochane Review article did an intensive search of the medical literature and was unable to find a single scientific study on whether Alpha Lipoic helps prevent or treat dementia. 3/2004. This is despite an intense promotion by some in the "alternative medicine" area of this product.

Animal Research: Some Hopes: Alpha-lipoic acid helped in a mouse model for asthma. J Allergy Clin Immunol. 2004 Aug;114(2):429-35. Lipoic acid pretreatment attenuates ferric chloride-induced seizures in rats. Brain Res. 2004 Aug 6;1016(2):139-44. alpha-Lipoic acid ameliorates altered colonic contractility and intestinal transit in STZ-diabetic rats. Indian J Exp Biol. 2004 Mar;42(3):279-82. Protective effect of alpha-lipoic acid against chloroquine-induced hepatotoxicity in rats. Better than silymarin. J Appl Toxicol. 2004 Jan-Feb;24(1):21-6. Salt-induced hypertension in WKY rats: prevention by alpha-lipoic acid supplementation. Mol Cell Biochem. 2003 Dec;254(1-2):319-26. Lipoic acid supplementation prevents angiotensin II-induced renal injury in rats. Kidney Int. 2003 Aug;64(2):501-8. Lipoic acid prevents hypertension, hyperglycemia, and the increase in heart mitochondrial superoxide production in rats. Am J Hypertens. 2003 Mar;16(3):173-9. Alpha-lipoic acid and CoQ10 had no impact on longevity or tumor patterns compared with control mice fed the same number of calories, whereas caloric restriction increased maximum life span by 13% (p <.0001) and reduced tumor incidence. Free Radic Biol Med. 2004 Apr 15;36(8):1043-57

Thomas E. Radecki, M.D., J.D.

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