ThiolNAC (NYBC) Each bottle, 90 tablets, sustained release formula. Each tablet contains 500 mg of NAC and 200 mg of alpha lipoic acid. This is an excellent formula for those suffering from liver inflammation. It is also extremely convenient for many PWHIVs who take both NAC and Lipoic Acid since this 2-in-1 combination eliminates some pills while providing the same, generally accepted dosages. Suggested use is 2-3 tablets daily with meal or as directed. Reduce dose if headaches occur.

See the blog entries on NAC at http://nybc.wordpress.com. Increasing amounts of data are showing the benefits of NAC in conditions ranging from pulmonary problems to possibly reducing the potential for cancer cells to metastasize.

Thyroid caution! Lark Lands notes the following: Although it is not clear what percentage of people this may affect, in some people it appears that alpha-lipoic acid may block the proper conversion of T4, the storage form of thyroid hormone, into T3, the active form. This was first noted in animal research with alpha-lipoic acid, and has since been reported by a number of people known to me. When this occurs, people will develop the symptoms of hypothyroidism (which may include fatigue, low body temperature, weight gain, hair loss, splitting fingernails, depression, memory problems, muscle weakness, elevated cholesterol, and/or skin that is dry, rough or scaly). For this reason, it is important to monitor the thyroid, first at baseline, before lipoic acid is taken, and then after the first month or two of taking lipoic acid, to see if there have been any adverse effects. If not, it probably means that the thyroid is unlikely to be affected. However, it will still be wise to check the TSH level (a blood test that is an indicator of thyroid function) at least once or twice yearly, or any time that symptoms that could be related to low thyroid appear, as some people have taken 600 mg daily doses for lengthy periods (even up to five years in one case known to me) before TSH levels became elevated outside of the normal healthy range.

It is clear that this problem does not develop in everyone who uses lipoic acid. Some people seem to tolerate doses of 600 mg or even more daily with no problems, while others have developed serious thyroid problems with doses ranging from 500 mg to 1000 mg daily. In the people known to me who have been affected in this way, discontinuing the lipoic acid allowed the thyroid problems to disappear quite quickly. I personally experienced this when taking lipoic acid. My TSH had become seriously elevated, remaining at an abnormally high level for more than a year, and I had developed symptoms of hypothyroidism, including serious fatigue. Within six weeks of discontinuing the lipoic acid, my symptoms vanished and my TSH returned to normal and stayed there. I had made no other changes of any kind so it is clear to me that the lipoic acid was the problem for me that caused hypothyroidism. Since then, I have so far discovered four other people who developed similar problems while taking it. However, since alpha-lipoic acid is otherwise an excellent supplement, for all the reasons listed above, this does not mean it should be completely written off. Just do monitor the thyroid if you choose to take it!

NYBC adds that if you are on thyroid medication, it may be best to avoid lipoic at high doses.

Store unopened container at room temperature. Do not store at extreme temperatures. Once opened, reseal container and store in a cool, dry place (not refrigerator).

Lipoic and diabetes update
Poh Z, Goh KP. A current update on the use of alpha lipoic Acid in the management of type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets. 2009 Dec;9(4):392-398.
Medical Officer, Department of General Medicine, Alexandra Hospital, Singapore. adrianpoh28@gmail.com.

Type 2 Diabetes Mellitus (T2DM) which is characterised by insulin resistance, is closely linked to the triad of glucolipotoxicity, inflammation and oxidative stress. Increased adiposity, leading to increased free fatty acids (FFAs), contributes to insulin resistance by disrupting the signal transduction pathway of insulin mediated glucose disposal, and causes impaired insulin secretion. Hyperglycaemia and dyslipidaemia driven oxidative stress resulting from enhanced free-radical formation and/or defects in antioxidant defence is implicated in the pathogenesis of diabetic neuropathy (DN). This and other inflammatory pathways account for a complex network of interacting metabolic factors responsible for causing diabetes and her complications. There is growing evidence that Alpha Lipoic Acid (ALA) has beneficial effects on the treatment of T2DM and some of its complications. It represents an attractive pharmacological target in the treatment of T2DM by modulating the signal transduction pathways in insulin resistance and antagonizing the oxidative and inflammatory stresses, which are major players in the pathogenesis of this disorder. A potent anti-oxidant and free radical scavenger, ALA also targets cellular signal transduction pathways which increases glucose uptake and utilization, thus providing specific targeted therapy in the treatment of insulin resistance and diabetic neuropathy. Apart from the rare risk of Insulin Autoimmune Syndrome (IAS), ALA has shown to be relatively safe, even in patients with renal and liver failure. This review focuses and summarises the molecular mechanisms of T2DM, and underlines the therapeutic value of ALA in this globally significant disease.