Alpha-Lipoic Acid and Diabetic Neuropathy

Diabetes and Alpha-Lipoic Acid and Neuropathy. One of alpha-lipoic acid’s primary uses is to treat nerve damage, including diabetic neuropathy, a dangerous long-term complication of diabetes that causes pain and loss of feeling in the limbs.

Alpha lipoic acid enhances glucose uptake in type 2 diabetes, inhibits glycosylation (the abnormal attachment of sugar to protein), and has been used to improve diabetic nerve damage and reduce pain associated with that nerve damage. (Free Radic Biol Med 1995;19:227-50).

Over the past 20 years, the number of adults diagnosed with diabetes has more than doubled, and children are being diagnosed with diabetes in alarming numbers. Diabetes has rapidly emerged as a leading culprit in the epidemic of heart disease that is sweeping the country, and it is a leading cause of amputation and blindness among adults.

As a powerful antioxidant, alpha lipoic acid positively affects important aspects of diabetes, including blood sugar control and the development of long-term complications such as disease of the heart, kidneys, and small blood vessels. (Arzneimittelforschung. 1995 Aug;45(8):872–4; Free Radic Biol Med. 1999 Aug;27(3-4):309–14; J Am Soc Nephrol. 2002 Jan;13(1):108–16; Diabetes Care. 1995 Aug;18(8):1160–7; Biochem Biophys Res Commun. 2005 Jan 7;326(1):197–202).

Lipoic acid plays a role in preventing diabetes by reducing fat accumulation. In animal studies, lipoic acid reduced body weight, protected pancreatic beta cells from destruction, and reduced triglyceride accumulation in skeletal muscle and pancreatic islets (Expert Opin Investig Drugs. 2004 Dec;13(12):1641–3; Biochem Biophys Res Commun. 2005 Jan 7;326(1):197–202).

It’s difficult, however, to obtain therapeutic amounts of this vitamin like substance through diet alone. Instead, many experts recommend using supplements to get the full benefits of alpha lipoic acid.

Alpha lipoic acid is an approved treatment for diabetic neuropathy in Germany. Many studies in both animals and humans have produced promising results with lipoic acid in preventing diabetic neuropathy. It has been used for years for this purpose in Europe.

German researchers, reporting in the Journal Free radical biology & medicine, conducted a placebo-controlled study of 72 patients with type-2 diabetes. Some participants were supplemented with alpha-lipoic acid in various doses while the others were given a placebo (sugar pill).

They concluded that the results suggest oral administration of alpha-lipoic acid can improve insulin sensitivity by 25% after 4 weeks of treatment in patients with type-2 diabetes. All benefited from lowered glucose levels. There were no significant differences among the three doses of Alpha lipoic acid, suggesting that 600 mg/day may be the maximum effective dose. (Free Radic Biol Med. 1999 Aug;27(3-4):309-14).

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Alpha lipoic acid speeds the removal of glucose from the bloodstream, partly by enhancing insulin function, and it reduces insulin resistance, a foundation of many cases of coronary heart disease and obesity.

In the treatment of diabetes, the recommended dose is 300 to 600 mg daily. Alpha lipoic acid supplementation is very safe. In over 30 years of extensive use and testing in European clinical trials in the treatment of diabetic neuropathy, there have been no reported side effects. (Quillin,1998, Murray, 1996).

Because alpha-lipoic acid has been associated with improved blood sugar control, people with diabetes should follow their blood sugar levels carefully when taking this supplement in order to avoid hypoglycemia (low blood sugar). Your doctor may decide that a reduction in dosage of insulin or oral blood sugar-lowering drugs is needed if you are taking this supplement.

It should also be noted that 600 mg/day doses were mainly used for diabetic neuropathy. Lower doses can be effective in diabetes blood sugar control, especially when included with other products such as gymnema, vanadium, bitter melon, fenugreek and chromium (which itself helps prevent and possibly reverse diabetic neuropathy).

Many healthcare practitioners suggest a limit of 100 milligrams per day unless specifically advised for a specific condition such as diabetes.

Alpha lipoic acid has a dual role in human health; it is a powerful antioxidant and is a key component for producing cellular energy. It is involved in the metabolic process of converting carbohydrates into energy. Carbohydrates, protein and fat are all broken down and formed into ATP, the universal energy source used by the body.

Alpha-lipoic acid assists the body’s energy production and acts as a powerful antioxidant, helping to treat diabetic neuropathy (nerve-damage caused by the disease), protecting the liver, preventing cataracts, boosting immune function, and possibly helping to slow the progression of Alzheimer’s disease. Because alpha-lipoic acid can pass easily into the brain, it has protective effects on brain and nerve tissue and shows promise as a treatment for stroke and other brain disorders involving free radical damage.

It has been suggested that alpha lipoic acid may slow aging of the brain and that it may be an anti-aging substance in general.

In the November 2006 edition of Diabetes Care, researchers from Russia and Israel reported on a 5 week randomized, double-blinded, placebo-controlled trial using alpha lipoic acid in 181 patients suffering with high blood sugar and damaged nerve endings.

Researchers measured various symptoms including stabbing and burning pain, tingling and numbness in the feet in these patients who suffered with malfunction of the peripheral nerves. The groups that received alpha lipoic acid 600 mg to 1,800 mg daily had an overall reduction in symptoms by about 50% compared to the placebo group. (Diabetes Care. 2006 29: 2365-2370).

Evidence indicates that 150 mg of alpha lipoic acid, taken daily for one month, improves visual function in people with glaucoma. (Vestn Oftalmol 1995;111:6-8).

Researchers have demonstrated, in a 16-week randomized trial, that lipoic acid, in oral doses of 600 milligrams daily for eight weeks, significantly inhibits the oxidation of LDL-cholesterol in healthy humans.

In addition, our supplies of several different antioxidants, including vitamins E and C, cannot be successfully maintained in the absence of lipoic acid. It appears to recycle available vitamin C and E.

Other antioxidants seem to benefit equally from the presence of lipoic acid. These antioxidants include coenzyme Q, glutathione, and NADH (a form of niacin). Because lipoic acid is used to help regulate blood sugar, individuals with diabetes may be at special risk of deficiency. (Worlds Healthiest Foods).

Conclusions from various studies – From 2004 – 1992:


Alpha-Lipoic acid supplementation represents an achievable adjunct therapy to help prevent vision loss in diabetic patients. (Diabetes. 2004 Dec; 53(12): 3233-8).

The blood pressure-lowering effect of lipoic acid in fructose rats may be related to improvement in insulin sensitivity. (J-Comp-Physiol-[B]. 2004 Nov; 174(8): 587-92).

The combined antioxidant and hypoglycemic (lowering the concentration of glucose in the blood) actions of lipoic acid both may contribute to its utility in preventing renal (kidney) injury and other complications of diabetes. (J-Am-Soc-Nephrol. 2002 Jan; 13(1): 108-16).

These data indicate that lipoic acid is effective in the prevention of early diabetic glomerular injury (capillary blood vessels in the kidneys) and suggest that this agent may have advantages over high doses of either vitamin E or vitamin C. (J-Am-Soc-Nephrol. 2001 Jan; 12(1): 124-33).

…recent trials have demonstrated that lipoic acid improves glucose disposal in patients with type II diabetes. In experimental and clinical studies, lipoic acid markedly reduced the symptoms of diabetic pathologies, including cataract formation, vascular damage, and polyneuropathy [Polyneuropathy is a neurological disorder that occurs when many peripheral nerves throughout the body malfunction simultaneously]. (Nutrition. 2001 Oct; 17(10): 888-95).

The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes. (Free-Radic-Biol-Med. 1999 Aug; 27(3-4): 309-14).

These data provide evidence that treatment with alpha-lipoic acid improves significantly the imbalance between increased oxidative stress and depleted antioxidant defence even in patients with poor glycemic control and albuminuria. (Free-Radic-Biol-Med. 1999 Jun; 26(11-12): 1495-500). Albuminuria is the presence of excessive protein (chiefly albumin but also globulin) in the urine; usually a symptom of kidney disorder.

In conclusion, intravenous treatment with alpha-lipoic acid (600 mg/day) over 3 weeks is safe and effective in reducing symptoms of diabetic peripheral neuropathy, and oral treatment with 800 mg/day for 4 months may improve cardiac autonomic dysfunction in NIDDM [non insulin dependant diabetes mellitus – type 2 diabetes]. (Diabetes. 1997 Sep; 46 Suppl 2S62-6).

This is the first clinical study to show that alpha-lipoic acid increases insulin stimulated glucose disposal in NIDDM [non insulin dependant diabetes mellitus – type 2 diabetes]. The mode of action of ALA and its potential use as an anti-hyperglycemic agent require further investigation. (Arzneimittelforschung. 1995 Aug; 45(8): 872-4).

These results suggest a potential for the therapeutic use of lipoic acid against diabetes-induced complications. (Free-Radic-Res-Commun. 1992; 17(3): 211-7).

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