High dose ALA in diabetes

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High dose ALA in diabetes

Postby ikulo » Fri Nov 26, 2010 1:05 am

For those of you taking ALA, this study administered 1800mg daily to diabetics and found what seems like only minor side effects.

[Efficacy and safety of high-dose α-lipoic acid in the treatment of diabetic polyneuropathy.]

[Article in Chinese]

Gu XM, Zhang SS, Wu JC, Tang ZY, Lu ZQ, Li H, Liu C, Chen L, Ning G.

Ruijin Hospital, Jiaotong University School of Medicine, Yuanyang Subdivision, Shanghai 200025, China.
Abstract

OBJECTIVE: To evaluate the efficacy and safety of high-dose α-lipoic acid in the treatment of diabetic polyneuropthy with regards to sensory symptoms and nerve conduction velocity.

METHODS: A total of 236 diabetics with symptomatic polyneuropathy were enrolled into this 5-center, randomized, double-blind and placebo-controlled study of α-lipoic acid 1800 mg daily (n = 117) or matching placebo (n = 119) for 12 weeks. The primary outcome was total symptom score (TSS). Secondary end points included nerve conduction velocity, individual symptom score, HbA1c and safety parameters. The above parameters were reviewed and recorded at zero point and after treatment for 2, 4, 8, 12 weeks separately.

RESULTS: 73.27% patients with symptomatic polyneuropathy improved after treatment with α-lipoic acid for 12 weeks versus 18.27% with placebo. TSS declined by 2.6 ± 2.3 with α-lipoic acid. And it was more than 0.7 ± 1.4 versus placebo (P < 0.05). TSS decreased quickly after treatment with α-lipoic acid for 2 weeks (P < 0.05). And it was better than placebo. Individual symptom scores of pain, extremity numbness, burning sensation or resting abnormal sensations were significantly diminished as compared to those before treatment and placebo group (all P < 0.05). Nerve conduction velocity had no change. HbA1c further decreased at the end of trial after α-lipoic acid treatment (P < 0.05). The incidence rates of adverse effects were 25.4% vs 11.8% in the treatment and control groups. The major manifestation was burning sensation from throat to stomach (12.7%).

CONCLUSION: Oral treatment with high-dose α-lipoic acid for 12 weeks may improve symptoms in patients with diabetic polyneuropathy. Dose of 600 mg thrice daily for 2 weeks has marked effects with a reasonable safety.


http://www.ncbi.nlm.nih.gov/pubmed/21092474
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Re: High dose ALA in diabetes

Postby NHE » Fri Nov 26, 2010 3:46 am

Hi Ikulo,

ikulo wrote:For those of you taking ALA, this study administered 1800mg daily to diabetics and found what seems like only minor side effects.


Do you know which isomer of lipoic acid this study used? In effect, either the R enantiomer or the R/S racemic mixture? The R form is the natural form while the S enantiomer is a synthetic by-product. The S form appears to have some physiological cost associated with it while the R form is stated to be about 12x more times effective.

I put together this post a while back which discusses the differences in more detail. http://www.thisisms.com/ftopict-4347.html

In addition, many folks recommend taking either sodium or potassium r-lipoate as it is a more stable form as it doesn't auto-polymerize which would reduce its effectiveness.

Thanks, NHE
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Postby ikulo » Fri Nov 26, 2010 3:29 pm

Hmmm, not sure as I don't have access to the full paper. It says alpha lipoic acid, and I always just assumed that ALA was the mixture of R and S. Is that not correct?
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Re: High dose ALA in diabetes

Postby NHE » Fri Nov 26, 2010 4:53 pm

ikulo wrote:Hmmm, not sure as I don't have access to the full paper. It says alpha lipoic acid, and I always just assumed that ALA was the mixture of R and S. Is that not correct?


That's been my assumption as well especially when dealing with lipoic acid supplements. In effect, R-lipoic acid typically costs more so manufacturers are going to put R vs. S information on the label to justify the increased cost. I've always assumed that if a product is simply labeled as "alpha lipoic acid", then it's a 50/50 mix of the R and S enantiomers. What authors of journal papers do could be different. One would have to read the materials and methods section to be certain.

NHE
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Postby ikulo » Sun Nov 28, 2010 10:42 pm

Speaking of ALA, do you happen to know whether it's best to take ALA with food or without? I've read some contradictory statements. For one, some have noted that ALA is water and fat soluble, so I would assume that ALA should be taken with food since its fat soluble. However, I've also read that ALA is better absorbed on an empty stomach. Do you have any ideas?
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Re: High dose ALA in diabetes

Postby NHE » Mon Nov 29, 2010 2:53 am

Hi Ikulo,

ikulo wrote:Speaking of ALA, do you happen to know whether it's best to take ALA with food or without? I've read some contradictory statements. For one, some have noted that ALA is water and fat soluble, so I would assume that ALA should be taken with food since its fat soluble. However, I've also read that ALA is better absorbed on an empty stomach. Do you have any ideas?


I've run into the same discrepancy and have yet to find a definitive answer. I remember reading in a journal paper (search PubMed for papers by the author Packer) that lipoic acid was better absorbed on an empty stomach. Moreover, one supplement from Source Naturals that I took had this direction on the label. The manufacturer then changed it to read that it should be taken with a meal. I'm still not sure which is best.

NHE
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