Thioctic acid—what is it really?

Alpha-Lipoic Acid, also known as thioctic acid, is a natural anti-oxidant which has been used for years in Europe because of its ability to maintain or restore liver health. Its strong anti-oxidant capabilities have been used for radiation sickness and diabetes-related neuropathy. It has also been investigated as a possible HIV inhibitor.

The theory behind taking alpha-lipoic acid

Alpha-Lipoic Acid has been successfully used to maintain liver health and to treat several toxin-related illnesses. It has been used extensively in Europe for years as a non-toxic nutrient to treat various chemical overdoses such as mushroom poisoning, radiation poisoning and alcoholic hepatitis. It has also been used to treat diabetic neuropathy and elevated liver enzymes. Elevated liver enzymes, which can indicate liver damage, can be a serious problem for people with life-threatening diseases. For people who take oral medications such as antibiotics and/or anti-virals, balanced liver enzymes are essential for these drugs to be properly metabolized. Unfortunately, these same drugs can cause increased liver enzymes. Alpha-Lipoic acid may help protect the liver so that you can take certain drugs. A second possible benefit of Alpha-Lipoic Acid would be its ability to raise glutathione (GSH) levels and to decrease concentrations of reactive oxidants. Low levels of glutathione may cause oxidative stress, and cause inflammation and damage organs. It may also damage nerve cells, leading to peripheral neuropathy. Oxidative stress may also speed up the replication of HIV.

Alpha-lipoic acid for neuropathy

There have been several clinical trials of Alpha-Lipoic Acid, these trials may help us understand what Alpha-Lipoic Acid does, and how it may be of benefit to us. A 1993 placebo-controlled trial concluded that Alpha-Lipoic Acid was effective in reducing oxidative stress in people with diabetes. Eighty people were randomized to either placebo or one of three antioxidants. These included: Alpha-Lipoic Acid (600 mg), selenium (100 mcg), or vitamin E (1200 IE). Everyone on the antioxidants reported a reduction in oxidative stress, including reduced neuropathy and organ inflammation. There was no reported statistical difference between the antioxidants.

Studies in PWAs

There has been one clinical trial of Alpha-Lipoic Acid in PWAs. In a German pilot study, 10 people took 300 mg/day of Alpha-Lipoic Acid for 8 weeks. After 8 weeks, glutathione was increased substantially in 7 PWAs, and CD4/CD8 cells were increased in 6 PWAs. There is currently a second trial open in Germany, attempting to enroll 30 PWAs to study the possible use of Alpha-Lipoic Acid in treating PWAs with peripheral neurophy.

Side effects and toxicity

Side effects are minimal when taken at the doses used in clinical trials. In studies involving volunteers, decreased blood platelets (thrombocytopenia) and nausea were reported by those taking higher doses of Alpha-Lipoic Acid (900 mg). However, the data singling out Alpha-Lipoic Acid as the cause of these effects are unsubstantiated. Like most antioxidants, Alpha-Lipoic Acid is chelating agent, and can purge minerals from your body. In one study of Alpha-Lipoic Acid the amount of iron in their blood was shown to decrease significantly. This depletion can often lead to anemia. You and your doctor should monitor iron levels with regular blood tests.

Dosing

The optimum dose of ALA is not known; neither is it known whether different doses should be used for liver enzymes as compared with neuropathy. We know from trials and anecdotal reports that people are taking 200–600 mg/day. Only a large trial of Alpha-Lipoic Acid that measures the efficacy and side effects with different dosages will clarify what is best.