Alpha-Lipoic Acid

Also known as: ALA, DHLA, Thioctic Acid

Safety Rating: 

(For explanations of what these safety ratings mean, click here)

Potential Side Effects 

Applied to the skin:

• Burning
• Itching
• Rash
• Stinging

Swallowed:

• Bitter taste
• Burning sensation from throat to stomach
• Headache
• Nausea/vomiting
• Stomach upset
• Urine color change
  
  

Overview

What is it? An antioxidant made in the human body, found in foods like spinach, broccoli, yams, carrots, organ meat, red meat, and yeast.

Why is it used? While there is a long list of claims about ALA, it is usually found in products claiming to “help control blood sugar” and  “reduce nerve pain”.

What’s the harm?

• There have been 2 recorded cases of children with ALA poisoning, leading to seizures, vomiting, and unconsciousness.
• Combining ALA with other blood sugar lowering products may drastically lower blood sugar and cause hypoglycemia (blood glucose <70mg/dL). If the blood sugar drops too quickly, it can cause loss of consciousness, seizures, and heart problems that can lead to death.
  
  

Intractions with health conditions

Alcoholism: Alcoholism can cause Thiamine (Vitamin B-1) deficiency. Based on animal studies, people with low levels of Thiamine may be at a higher risk of ALA poisoning.

Cancer: Not much is known about the safety of combining antioxidants with chemotherapy. Patients should speak to their oncologist (cancer specialist) before adding any supplements, especially if they are on chemotherapy drugs.

Diabetes: May increase the risk of hypoglycemia (extremely low blood sugar) when combined with medications meant to control blood sugar.

Surgery: ALA may impact blood sugar levels during and after surgery, which may complicate the procedures. Because the effect is unpredictable, it is recommended that ALA be stopped 2 weeks before surgery.

Thyroid: may impact some thyroid medications

Drug Interactions

Antidiabetic/blood sugar control: could increase the risk of low blood sugar when taken with medications meant to control blood sugar. Examples:

• Metformin
• Glipizide (Glucotrol)
• Glimepiride (Amaryl)
• Insulin
• Pioglitazone (Actos)
• Liraglutide (Victoza)
• Canagliflozin (Invokana)
• Sitagliptin (Januvia)

Cancer: Not much is known about the safety of combining antioxidants with chemotherapy. Patients should speak to their oncologist (cancer doctor) before adding any supplements, especially if they are on chemotherapy drugs. 

Thyroid: may decrease efficacy of medications to treat low thyroid hormone levels. Examples:

• Levothyroxine (Synthroid)
• Armour Thyroid
  
  

Interactions with herbs/supplements

Blood sugar-lowering products: Combining with products that may lower blood sugar increases the risk of hypoglycemia (extremely low blood sugar). Examples include:

• Bitter melon
• Bitter Orange
• Black Pepper
• Chromium
• Ginseng
• Milk Thistle
• Turmeric
• White Mulberry
  
  

Interactions with foods: Taking with food will reduce how much ALA gets absorbed into the body

Interactions with lab tests: None known

References:

1. *Natural Medicines. (2019, March 11). Alpha-Lipoic Acid [Monograph]. Natural Standard Professional Monograph. Retrieved from: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=767
   
2. Mayo Clinic (2018). "Hypoglycemia". Retrieved 03/2019: https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685 
3. **Medscape (2012). "Why is Hypoglycemia So Dangerous? Tight glucose control raises concerns about complications".  Retrieved 03/2019: https://www.medscape.com/viewarticle/773188 
   
   

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