One of the most painful complications of diabetes is peripheral neuropathy. Peripheral neuropathy is a type of nerve damage that generally affects the feet and legs, but may also affect the hands and arms. Up to half of people with diabetes have peripheral neuropathy.
Symptoms of peripheral neuropathy include:
- Tingling (like pins and needles)
Peripheral neuropathy can lead to serious foot problems, such as blisters and sores that don’t heal and become infected. Sores and infections can greatly increase the risk of losing a toe, foot, or part of the leg.
Medications are typically prescribed to treat peripheral neuropathy; these may include antidepressants, anti-seizure medicines, and over-the-counter creams, patches, and sprays. Alternative and complementary treatments may be used, too, including alpha lipoic acid.
What is alpha lipoic acid?
Alpha lipoic acid (ALA) is a naturally occurring substance found within the cells of the body. This substance converts glucose into energy. It also functions as an antioxidant; antioxidants are molecules that fight free radicals in the body, protecting against damage and possibly diseases, such as heart disease, type 2 diabetes, and cancer.
Unlike other antioxidants, such as vitamin C and vitamin E, ALA is both fat and water soluble, making it easier to deliver energy and fight off free radicals.
What are sources of alpha lipoic acid?
The body makes small amounts of ALA, but it’s also found in certain foods including:
- Brussels sprouts
- Brewer’s yeast
- Rice bran
ALA is also available as a supplement.
What are the health benefits of alpha lipoic acid?
ALA is used for a number of conditions, including:
- Weight loss
- Heart disease
- High blood pressure
- Alzheimer’s disease
- Rheumatoid arthritis
- Alcohol-related liver problems
- Altitude sickness
- Bipolar disorder
However, good evidence for ALA helping these conditions is lacking. On the other hand, ALA may be beneficial for these conditions:
- High cholesterol (by increasing the amount of HDL, or “good,” cholesterol and lowering the amount of LDL, or “bad,” cholesterol)
- Diabetes (by helping to improve insulin sensitivity, thereby controlling blood sugar levels)
- Skin damage from the sun or smoking (by decreasing inflammation and slowing down aging)
Does alpha lipoic acid help with peripheral neuropathy?
ALA has been used in Germany for a long time to treat peripheral neuropathy, although most of the studies have used ALA in an IV form rather than an oral supplement. A 2012 study published in the International Journal of Endocrinology looked at intravenous administration of 600 milligrams (mg) of ALA daily over a period of three weeks, leading to a “significant and clinically relevant reduction in neuropathic pain.”
The ALADIN (Alpha-Lipoic Acid in Diabetic Neuropathy) Study used IV ALA in people with type 2 diabetes for three weeks in doses of either 600 mg or 1200 mg daily, also with significant benefit and no significant adverse effects.
The downsides of IV therapy are the cost, inconvenience, and the clinical oversight needed for administration. IV administration of ALA is not widely used in the U.S. The use of oral ALA has also been studied: the ALADIN-III Study involved giving 600 mg of ALA orally three times daily for six months to 509 patients. There was no significant improvement in neuropathy symptoms, although nerve function improved.
Yet, in the SYDNEY 2 trial, oral doses of either 600 mg, 1200 mg, or 1800 mg of ALA once daily for five weeks were given to 181 patients with type 2 diabetes. Neuropathy symptoms improved in all three groups, and the authors concluded that the 600 mg dose once daily provided the “optimum risk-to-benefit ratio,” as the higher doses of ALA showed an increase in nausea, vomiting and vertigo.
Are there side effects to taking alpha lipoic acid?
ALA is considered to be a safe supplement when taken orally. But, there isn’t a lot of research on the long-term use of ALA. The most common side effects are:
- Skin rash
Because ALA could possibly lower blood sugar levels, you might also have symptoms of hypoglycemia (weakness, lightheadedness, headache, sweating, confusion, irritability, fast heart rate) if you take ALA and also take insulin or diabetes pills that can cause low blood sugar.
ALA may interact with other dietary supplements, such as psyllium, fenugreek, guar gum, horse chestnut, and ginseng.
Should you take alpha lipoic acid?
If you have peripheral neuropathy and are interested in taking ALA, talk with your healthcare provider first, especially if you take insulin or a sulfonylurea, have liver disease, a thyroid condition, or drink a large amount of alcohol. You should also not take ALA if you are pregnant or nursing.
Remember that there is no guarantee that ALA will work. If you and your healthcare provider decide that taking alpha lipoic acid could be helpful, decide together on a daily dose (e.g., 200 to 400 mg taken three times daily). Stop taking it if you have side effects or if your neuropathy symptoms worsen. Also, decide how long you will take it; if you are not noticing any improvement in symptoms, it’s a good idea to discontinue ALA.