Alpha Lipoic Acid

In 1999 we looked at a relatively new antioxidant supplement called alpha-lipoic acid (ALA) and concluded that it might one day prove to be very important, but that it was too early to recommend it. Since then more studies on it have been done. Is the evidence today strong enough to support its use?

Scientists first discovered the importance of ALA in the 1950s, and recognized it as an antioxidant in 1988. It has been the subject of a tremendous amount of basic research around the world, some being done at the University of California, Berkeley by Dr. Lester Packer, a leading expert on antioxidants.

The body needs ALA to produce energy. It plays a crucial role in the mitochondria, the energy-producing structures in cells. The body actually makes enough ALA for these basic metabolic functions. This compound acts as an antioxidant, however, only when there is an excess of it and it is in the "free" state in the cells. But there is little free ALA circulating in your body, unless you consume supplements or get it injected. Foods contain only tiny amounts of it. What makes ALA special as an antioxidant is its helps deactivate an unusually wide array of cell-damaging free radicals in many bodily systems.

In particular, ALA helps protect the mitochondria and the genetic material, DNA. As we age, mitochondrial function is impaired, and it.s theorized that this may be an important contributor to some of the adverse effects of aging. ALA also works closely with vitamin C and E and some other antioxidants, "recycling" them and thus making them much more effective.

ALA is being studied in animals and in humans as a preventive and/or treatment for many age-related diseases. These range from heart disease and stroke to diabetes and Parkinson.s and Alzheimer.s disease, as well as declines in energy, muscle strength, brain function, and immunity. It is also being studied for HIV disease and multiple sclerosis. In Germany, in particular, it is already prescribed to treat long-term complications of diabetes, such as nerve damage, thought to result in part from free-radical damage; there is also evidence that it can help decrease insulin resistance and thus help control blood sugar. Many studies have yielded promising results; others are still underway.

Add some carnitine

One of the best-known proponents of ALA is Dr. Bruce Ames, professor of molecular and cell biology at the University of California, Berkeley. He has helped develop and study an ALA supplement called Juvenon, which has been patented by UC Berkeley. Juvenon, in addition, contains another promising compound, acetyl-L-carnitine, which is also involved in energy production in the mitochondria. Ames and his colleagues have found that high doses of these compounds, in combination, enable elderly rats to function like younger ones. Of course, the same results may not occur in humans. Human studies are just getting started.

Why it is still too soon to act

Though evidence has been accumulating, it is clear that the research on ALA is still in its early stages. Large, long-term, well-controlled studies on human are needed. No one knows what dose should be used for what ailment. Most studies have used 100 to 600 milligrams a day, but higher doses have also been studied.

Though ALA so far appears to be safe, the long-term effects of large supplemental doses are unknown. If ALA is as powerful as it seems, there may be a danger in too much of a good thing. In addition, while in Germany it is sold only by prescription and (like other supplements) is monitored by the government, in the U.S. you have no way of knowing what.s in the bottles.

Bottom line: We still advise waiting until more research has been done. If you have diabetes, heart disease, Parkinson.s, or Alzheimer.s, you may be unwilling to wait. In that case, talk to your doctor before taking ALA. The supplement may, for instance, affect the dosage of your diabetes medication.

UC Berkeley Wellness Letter, August 2003