Alpha-Lipoic Acid
IM / IV / SQ Therapy
In plain English
Alpha-lipoic acid is an antioxidant made naturally in the body and available as a supplement or IV. It is best supported for easing the burning, tingling nerve pain of diabetes. It is generally well tolerated; at higher doses some people get nausea or dizziness, and it can lower blood sugar.
The science
Alpha-lipoic acid (thioctic acid) is a mitochondrial cofactor and potent antioxidant that regenerates other antioxidants and improves microvascular/nerve function. In the randomized, double-blind, placebo-controlled SYDNEY 2 trial (Ziegler et al., Diabetes Care 2006; n=181), oral ALA (600-1,800 mg/day for 5 weeks) significantly improved symptomatic diabetic polyneuropathy versus placebo, with 600 mg/day giving the best risk-benefit balance (higher doses increased GI side effects); intravenous ALA has similar supportive trial data (ALADIN series). It can enhance insulin action (monitor for hypoglycemia). Its diabetic-neuropathy use is evidence-supported though not an FDA-labeled indication in the U.S.