In Germany, thioctic acid, also known as alpha-lipoic acid, is an approved therapy for diabetic neuropathy. The sulphur-containing compound, found in mitochondria, is necessary for converting food into energy. It also regenerates oxidized vitamins E & C, allowing the body to use the antioxidants again. When given as a supplement, thioctic acid works as an antioxidant that is both fat- and water-soluble. Thioctic acid is also known to chelate heavy metals from the body.
In their review of botanicals and dietary supplements that have undergone randomized controlled trials for diabetic neuropathy (J AM Board Fam Pract 16(1): 47-57, 2003), Kathleen M. Halat and Cathi E. Dennehy, PharmD, state that "[t]reatment with alpha-lipoic acid improves nerve blood flow and distal nerve conduction and increases endoneurial glucose uptake and energy metabolism in animals." Four randomized, double-blind, placebo-controlled studies entitled ALADIN (Alpha Lipoic Acid in Diabetic Neuropathy), ALADINII, ALADINIII, & ORPIL (Oral Pilot) have indicated that supplementation with alpha-lipoic acid reduces neuropathic deficits and symptoms.
Short-term parenteral use (IV) appears to be more effective than long-term oral use, although some clinical trials have shown improvement in nerve conduction velocity using oral doses of 600 to 1,200 mg/day for 2 years.
Adverse side effects of thioctic acid include headache, skin rash, stomach upset (at doses >600 mg/day), and possible hypoglycemia. Because thioctic acid is a chelating agent, Halat and Dennehy warn that iron levels need to be monitored as mineral deficiencies may occur. It may also chelate some medications, such as antacids, so thioctic acid should be taken at least 2 hours away from these.
Halat, Kathleen M. & Dennehy, Cathi E., PharmD. Botanicals and Dietary Supplements in Diabetic Perpheral Neuropathy. J Am Board Fam Pract 16(1):47-57, 2003
Passwater, Richard A., PhD. Lipoic Acid Basics--Interview with Dr. Jim Clark. www.healthy.net/asp/templates/interview.asp?PageType=Interview&ID=160
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