Antioxidant ALA Eases Pain From Diabetic Neuropathy

In a new study published in the November issue of the journal Diabetes Care, the antioxidant alpha-lipoic acid (or ALA), taken in pill form, lessened pain in people with diabetic neuropathy, or nerve damage resulting from diabetes. Previous research has shown that intravenous ALA therapy can help to reduce pain and numbness due to diabetic neuropathy, but treatment with ALA in pill form has not been widely studied.


In this study, 166 people with Type 1 or Type 2 diabetes were divided into four groups. Three of the groups received different doses of ALA, while the fourth group received a placebo (or inactive pill). After five weeks of once-daily treatment, all three groups that had been taking ALA experienced reductions in total neuropathy symptoms, stabbing pain, and burning pain compared to the placebo group. (There were, however, no significant differences between the treatment and placebo groups in numbness.)

Because all three doses of ALA were similarly effective and the side effects of treatment—nausea, vomiting, and dizziness—increased with the dose, the researchers concluded that the lowest studied dose of 600 milligrams once daily appeared to be the most effective.

ALA is a sulfur-containing compound that is made in small amounts in the body but is not found in food. Other studies have shown that its action as an antioxidant may not only help protect against neuropathy pain, but may also enhance insulin action, improve blood circulation, and decrease oxidative stress in people with diabetes.

If you are interested in trying ALA therapy, it’s important to discuss taking it with your health-care provider before you start. There is some chance that ALA could increase the risk of hypoglycemia (low blood glucose) in people who use insulin or certain oral diabetes drugs. It may also interfere with absorption of the vitamin biotin. Finally, keep in mind that ALA supplements, like all supplements, are not regulated by the U.S. Food and Drug Administration (FDA) for quality or effectiveness.

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  • Mary

    My daughter brought me a bottle of ALA last weekand suggested I ask my physician about it. My neuropathy symptoms have just begun this month and been diagnosed.The Dr. approved its’ use, but I am still waiting for a dosage schedule. I am eager to try this as we decided to try to go the nonprescription route first.

  • David Buitt

    You know this is good to hear, I know it would help me and others when I feel pain in my legs.

    I hope it can be approved for this pain

    It is good to know.


  • Tara Dairman, Web Editor

    Hi David,
    ALA is a supplement that is already on the market, rather than a prescription drug awaiting approval. If you are interested in trying it, talk to your diabetes care provider, who may be able to recommend a trustworthy brand or source.

  • David Buitt

    Thanks for letting me know it is already on the market. It is nice to hear that.

    I will have to talk to my Dr. about getting this. It is nice that a real person answered my comments.

    Thanks again


  • Ephrenia

    I don’t need a new study to know this is great stuff. I started using it several months ago and currently have NO neuropathy symptoms anymore.

    I take Rexall brand (purchased at WalMart for about $8 for a bottle of 75 capsules) 200mg three times a day. Even though this study only dosed once a day, it has been used in Europe for years and they (according to several websites) recommend 3 times a day due to the speed of metabolization.

    I do get one side effect. I get indigestion if I take it without eating after taking it.

    I’m glad to see America finally getting into looking at more natural remedies. I do wish they were better regulated because I did try another brand but had symptoms return while using it.

    One thing they didn’t mention, no neuropathy treatment is going to work if you continue creating new damage by not controlling your blood sugar levels!

  • Joyce

    I’ve been taking ALA for about 8 years. It completely
    got rid of the numbness in my toes and relieved
    pain in my thighs. I also recommend acetyl-l-carnitine.
    Puritans Pride Vitamins sells a combo of the two on their

  • Robert

    My wife and I have been using 600 mg/day ALA for several years. We have noted significant reduction, not only in neuropathy of the feet and legs for me (I am a type 2 diabetic of 15 years) but also joint pain from trigger finger surgery for my wife. I have recommended it to my friends for years. We take our dosage in the morning with breakfast and have not seen any side affects. Many studies recommend two doses/day but due to convenience and positive results we have stayed with one.

  • Diana

    My endocrinologist recommended “Alpha-betic” multivitamins years ago when I was first diagnosed with T2DM because it contained ALA. I have no idea of the amount of ALA contained in the vitamin. I do know my neuropathic pain is gone as long as I take it and when I am off for about a week, the pain starts to creep back. I gave it to my Dad who does not have diabetes, but has neuropathy for other reasons. He has had good results also.

  • nlruiz

    hello to everyone, My name is Nate and I have had diabetes for about 18 years now and just recently was diagnosed with diabetic neuropathy (legs,feet and arms). I have tried the drugs (vicadin and neurotin)for the pain but get very nauceous, so I am now trying a special formula the wellnes support network, extracts from vitamins B1 and B12, it seems to help alittle and I’ve contacted their customer support and they suggested I increase my dosage, 2 or 3 steps per week, although I have read that ALA (alpha lipoic acid, 300-600mg),GLA (from Borage, Evening Primrose or Black Currant Oil, 450mg), carnitine (acetyl and L about 1K mg)and magnesium 300mg will also help with neuropathy, has anyone tried any of these in combo form and if so has it helped ? the burning pain was really intense initially but has subsided somewhat but not entirely, it still keeps me awake at night and the bottom of my feet still burn, also are there any problems taking any of these together, it seems to me that the more the merrier in helping to relieve and restructure my nerve endings. I would appreciate any feed back, thanks.

  • Tara Fifer

    Another thing to note if you are a diabetic on statin drugs (cholesterol lowering drugs), you are at rist of neuropathy due to the statins lowering your Co-Q10 levels. It is probably a great idea to supplement with about 200mg of Co-Q10 to replace what is being lost.

  • remi

    I have had diabetics for 6 years and not till this week has it been a real wake up call. I have deep burning, itching, and reddness in my hads. I went to the dr. about it and was told it was probobley nearopthy. the dr. said there is nothing he could do for me. I’m the type of person that hates pain and did not like to stick myself. but in light of the pain in my hands from the burning and itching I’m going to start checking myself more offten. and start the ala today and see if it helps.

  • Keren Sleigh

    My Step Father suffers extremely badly from Diabetes and Diabetic Neuropathy here in the uk. In fact the doctors here have said that his is the worse case of Diabetic Neuropathy they have seen. As we speak, my Step Father is yet again in hospital in another Diabetic coma (the 3rd in as many months)from which the doctors are finding it difficult to bring him round. They cannot find any help for him from the numerous tablets he has to take each day (including many morphine based drugs. It seems as though the doctors just change him from one set of pills to another constantly in the hope that one combination will work. Do you think that ALA would help in this extreme case and is it available here in the UK? My Step Father is only 45 and the family have been told to prepare for the worst before hea reaches 50. He has a young family and an absolutely divoting wife who is at the end of her tether and needs help.
    Thank you in advance
    Any advice that can be given for my Step Father would be enormously appreciated as both the family and the doctors seem to have reached a dead end in their efforts to help him and in the meantime, my Step Father continues to suffer in such agony and distress.

  • Kat

    Keren, Suggest you get “Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal
    Blood Sugars.” It has all the information on ALA, plus there’s a blog for it. I can’t say whether it’s working or not, only started taking it two days ago. I’m only taking 200 mg a day with 500 mg of Primrose Oil as suggested by Dr. Bernstein. Good Luck!

  • M Ross

    Nice article except it is not true that supplements are not regulated by the FDA for quality. Supplements are required to be manufactured by Good Manufacturing Practices in plants inspected by the FDA to see that these GMP protocols are followed.

  • Morris

    Nice to see yet another study on the effectiveness of ALA. Eight years ago when I was diagnosed with neuropathy I Googled and read many European studies that soon had me taking ALA at 200mg 3X/day, since the studies seemed to show that results did not improve beyond that, and that spread out was the way to go. It helped me- in 6 months 95% of my neuropathy symptoms wer gone, and they have not come back since, even though I stopped taking it long ago. So this study, far from being truly new, corroborates what many of the European studies said a while back.

    Since then I have recommended ALA to probably hundreds of people on the ADA message boards, and many of them have reported that it helped them as well. I do recognize the names Kat and Ephrenia amongst the commenters above. Some have reported that when they stop taking it the neuropathy starts returning. These seem to be people whos e blood sugar control has stabilized a bit above normal.

    My theory is that high blood sugar often causes neuropathy, and to reverse it, normal blood sugar creates an optimum environment for nerves to heal themselves. ALA seems to quicken that process, and works best in conjunction with normalized blood glucose. Nobody knows for sure exactly how ALA works, but one theory is that, as the only anti-oxidant that is simultaneously both fat and water soluble, it gets to places where other meds and supplements cannot, like into the nerve sheathes where nerve damage occurs.

    And of course unlike the meds commonly prescribed for neuorpathy, ALA helps with the cause, rather than as a painkiller, numbing the symptoms. That does not mean it will help everyone, for some could well be past a point of no return, where the nerve damage is irreversible. But if my experience is any indication, you would have to really ignore extreme pain, or not be aware of this possibility, to get to where it is irreversible. Mine was truly excruciating, totally denigrating the quaality of my life, so if I could reverse it, many others might be able to do the same…

  • RandallB

    ALA has worked great for me. I had ten wooden piggies and completely numb ball of foot. My doctor is great but was just measuring the progression of the Diabetic Neuropathy on my checkups.

    After 8 months of using 200 mg ALA at breakfast and 400 mg ALA(with 800mg A-L-Caritine)at lunch I have most of the feeling back in all ten. Bottoms are still a bit numb but I can feel the fish line poke test that Doc gives on all but the tips of them. Night pain is 80% gone. She was amazed and asked what I was doing. She said that she would tell a couple other of her patients that are going thru the same stuff. I use the Walmart brand of ALA.

  • Charlie

    I’ve had non diabetic neuropathy for 4 years. As many of the other posters have stated, my Doctors basically said, you’ll have to live with it. My Dr. prescribed Neurontin and that did (does) help.
    I discovered ALA online and began taking one 600 mg in the morning and another at night. Also am still on 300mg of Neurontin 3 times a day. After 6 weeks my pain has decreased probably 80%. I’m 72 and in really good health except PN but I felt that in a year or two I was going to be immobilized.
    I believe ALA has made a new person out of me, I can now walk, use the fitness center, etc.
    My only question is, why is ALA not promoted by Doctors, PN websites and others?

    • James T. O’Brien

      My neuroligist just prescribed ALA this past week. His patients have had good results with less neuropathy pain by recommending ALA. I am really confused by all of the products claiming to be ALA. What are some good places to get this supplement?

  • Charlie

    Just getting started with the PN. Newrontin seemed to depress me and not help a lot.I have ALA on the way from Puritians Pride. Gool Luck to all.

  • Jen

    I suffer from terrible neuropathy due to several back surgeries & I also have hypothyroidism. I just started taking ALA about 5 days ago & can already see a difference. I actually found a combo form at my local walmart w/Acetyl L-Carnitine 800mg & Alpha Lipoic Acid 400mg for around $8.00 I’m taking it twice a day, with breakfast & dinner. Like I said it really seems to be helping & I’m gonna continue to take it.

  • Anne

    I have been using ala for about a week now for really bad neuropathy in my feet .I already can feel a change esp .at night I am a more comfortable .before i could not sleep for the pain ,burning etc its a little better when walking but not a lot yet ,but its early days .it deffo does work hoping for great things in a few months time 600mgs once a day on empty stomach good luck everyone !

  • Beth

    i am not diabetic but I suffer with ideopathic peripheral neuropathy progressing since around 2002. About two years ago I decided to try Gabapentine and by week 2 not only was I terribly nauseous but my mind could not focus. I stopped cold turkey and have been trying to deal with the pain that starts to erupt everyday about 3 PM. I started ALA last week and I think it’s starting to work. The discomfort is less and I’m praying that it continues to improve. The posts here are so supportive. TY

    • User2014

      I am NOT diabetic. Gabapentine worsened my shortness of breath (COPD), difficulty with urination, and lower back ache. Three weeks ago, I started R-ALA 200 mg on empty stomach in the morning, and than again at bed time. It has really helped me. One other thing that I tried and works for me is eating baby clams. Baby clams contain the highest amount of B12.

  • Lee

    I am not able to use Acetyl L-Carnitine due to side effects experienced such as swelling hands, a sense of tightness in the face and chest so cannot speak to how effective it is. However do take 200mg of R-ALA three times per day, along with Evening Primrose each time. Although several doctor’s are on record as mentioning a concern for biotin depletion, digging further I found the study behind the recommendation not to be viable. Please as always research and decide for oneself but looking further I became more concerned that taking additional biotin with the R-ALA form would diminish it’s effectiveness. R-ALA along with keeping my glucose within the 100-130 range has helped make significant progress over the past month. The neuropathy has existed for about eight months, and was initially thought to be an ulnar nerve problem where transposition surgery was recommended. Fortunately, I had an orthopaedic specialist that sent me back to the PCP for a diabetes test. I’ve only been managing the diabetes for six weeks and have had sufficient improvement where I canceled the surgery and will give it a year, understanding these things take time.