Alpha Lipoic Acid (Montiff) Each bottle 60 capsules. Each capsule, 300 mg of high-grade alpha lipoic acid.
A potent antioxidant and liver protective agent, research in Germany suggests that it is even stronger as an antioxidant than NAC while having proven capabilities to protect many organs and tissues from free radicals. It has been long used to treat neuropathy in diabetics and may have value for both neuropathy and dementia. One small study using 600 mg showed a stabilization in cognitive function among people with Alzheimers.
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.
German clinical research shows alpha lipoic acid to be a potent regenerator of glutathione, vitamin C, and therefore spares vitamin E, helping to keep those levels normalized. This is very important information and the first human study which has documented increases in glutathione (a very difficult compound to increase in PWHIV). In laboratory conditions alpha lipoic acid has been shown to be a more potent inhibitor of the activation of latent HIV (still dormant within cells) than NAC. Based on these data, many PWHIV and activists believe lipoic acid to be one of the most important core compounds in a comprehensive treatment strategy.
An indispensable agent for anyone who uses long-term prophylactic drugs in order to protect against liver damage. Also a must for those with an impaired liver and/or those who want to take high dose garlic. Another broad-spectrum antioxidant which should be a part of the protocol of any PWHIV (or PWHCV) who is interested in the most extensive multifactorial mix of free radical protecting agents.
PWHIV should let their doctor know that they are taking this supplement. Some may be able to tolerate higher doses of liver-toxic drugs than would normally be the case. Never stop suddenly while continuing to take pharmaceutical agents without closely monitoring your liver enzyme levels.
Some PWHIV take 3 to 6 capsules per day (100 mg each) if attempting to correct high liver enzyme levels. Others take 3 to 4 per day if using high dose garlic and liver-impaired. PWHIV also take 2 to 3 per day if not liver impaired, but protecting from the ill effects of high dose prophylactic drugs. Finally, many PWHIV take 3 to 4 per day for a high dose multifactorial antioxidant protection which helps to recycle other antioxidants (e.g. vitamin C/vitamin E) which many are using. Many also use the supplement to prevent or manage neuropathy.
A recent review article--the abstract below--is available free online.
Singh U, Jialal I. Alpha-lipoic acid supplementation and diabetes. Nutr Rev. 2008 Nov;66(11):646-657.
Laboratory of Atherosclerosis and Metabolic Research, Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, California 95817, USA.
Diabetes is a common metabolic disorder that is usually accompanied by increased production of reactive oxygen species or by impaired antioxidant defenses. Importantly, oxidative stress is particularly relevant to the risk of cardiovascular disease. Alpha-lipoic acid (LA), a naturally occurring dithiol compound, has long been known as an essential cofactor for mitochondrial bioenergetic enzymes. LA is a very important micronutrient with diverse pharmacologic and antioxidant properties. Pharmacologically, LA improves glycemic control and polyneuropathies associated with diabetes mellitus; it also effectively mitigates toxicities associated with heavy metal poisoning. As an antioxidant, LA directly terminates free radicals, chelates transition metal ions, increases cytosolic glutathione and vitamin C levels, and prevents toxicities associated with their loss. These diverse actions suggest that LA acts by multiple mechanisms both physiologically and pharmacologically. Its biosynthesis decreases as people age and is reduced in people with compromised health, thus suggesting a possible therapeutic role for LA in such cases. Reviewed here is the known efficacy of LA with particular reference to types 1 and 2 diabetes. Particular attention is paid to the potential benefits of LA with respect to glycemic control, improved insulin sensitivity, oxidative stress, and neuropathy in diabetic patients. It appears that the major benefit of LA supplementation is in patients with diabetic neuropathy.
PMID: 19019027 [PubMed - indexed for MEDLINE]
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. email@example.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.