This Is MS Multiple Sclerosis Knowledge & Support Community

Hi everyone,
Kira here. I’m going to share my experience on this and ask if anyone else has experienced the same?

I started taking 1200 mg. Lipoic Acid in December when my neurologist recommended it, after he mentioned promising research results for MS.

I looked at the Clinical Trial being done at OHSU w/the VA in Portland, OR, using LA for MS, and after looking at the Adverse Events sections of that trial, asked my naturopath to do a Comprehensive Metabolic Panel (CMP) to make sure my kidneys were okay before I started it. Kidney failure is a rare but serious AE with this dose of LA.

Anyway, long story short-ish, my liver enzyme ALT was normal before I started LA mid-December. Since I started, we’ve done a CMP (naturopath acting as stand-in neurologist since I only see him every 3-6 months) 4x, starting in Dec., and Jan., Mar. and April.

The ALT keeps going up!! Now that’s a liver enzyme, not a measure of kidney function, and my Creatinine is okay, but my endocrinologist said it’s very possible that my liver function is indeed being compromised by LA.

After NHE and others posted on here Sodium R-Lipoic vs. Alpha Lipoic, I made the switch, and yet I still think I’m being adversely affected. I’ve made no other major supplement or medication changes, so I’m speculating that this is the issue. The only thing I can think to do is to go down in dose a bit more.

Is anyone else experiencing this? I have no idea if I’m right, but I am concerned. Even though my ALT isn’t hugely high, it’s going up every month in a definite pattern, and has never done so on the dozens of other CMPs I’ve had in my life.

Any thoughts?
Best, Kira.

Hi Kira,
How much Na-R-LA are you taking?

Hi NHE,
I’m taking 2 of the following daily (total of 600 mg. Daily); I get it @ Vitacost.

Genceutic Naturals R-Lipoic Acid Plus:

Bio-Enhanced®, Stabilized Na-RALA (Sodium R-Lipoate providing 240 mg of R-Lipoic Acid)......300 mg


I know you posted that Sodium R is 2-12x more potent than ALA, but since I couldn’t find a lot of follow-up explanation, journal articles, or studies with absolute or concrete conversion formulas, I decided to take 2 daily rather than 1.

I did this since this is the only MS med or supplement I’m on (+ Naltrexone & HiBiotin) My neurologist decided, with my agreement, not to put me on any DMDs, so I was a little afraid that 300 Sodium R would be too low.

The only other thing I could thing of is that 300 mg. Biotin is affecting my liver, but I dismissed this concern because even though I know Biotin affects labs, I’ve been on it for a year, and it hasn’t affected my ALT, AST, etc. up to this point.

Any thoughts? Kira.

DaisySue wrote:I’m taking 2 of the following daily (total of 600 mg. Daily); I get it @ Vitacost.

Genceutic Naturals R-Lipoic Acid Plus:

Bio-Enhanced®, Stabilized Na-RALA (Sodium R-Lipoate providing 240 mg of R-Lipoic Acid)......300 mg


I know you posted that Sodium R is 2-12x more potent than ALA, but since I couldn’t find a lot of follow-up explanation, journal articles, or studies with absolute or concrete conversion formulas, I decided to take 2 daily rather than 1.

It was 6-12x, but 600 mg of Na-R-lipoate should be enough.

DaisySue wrote:I did this since this is the only MS med or supplement I’m on (+ Naltrexone & HiBiotin) My neurologist decided, with my agreement, not to put me on any DMDs, so I was a little afraid that 300 Sodium R would be too low.

The only other thing I could thing of is that 300 mg. Biotin is affecting my liver, but I dismissed this concern because even though I know Biotin affects labs, I’ve been on it for a year, and it hasn’t affected my ALT, AST, etc. up to this point.

Any thoughts? Kira.

Stop taking the lipoic acid for a month or so and then retest your liver enzymes.

What is your diet like? Too much sugar can adversely affect the liver. See Dr. Robert Lustig's lecture 'Sugar the Bitter Truth.'

https://www.uctv.tv/shows/Sugar-The-Bitter-Truth-16717

Hi Kira,
Just curious, what else are you taking?

Hi NHE,
I just composed a whole PM to you listing what I take and some other questions, and then Saved Draft so I could look something up, and draft is gone. Dang. Anyway, I’m pretty confident that sugar consumption isn’t my Liver issue, and my serial blood tests seem directly tied to LA, not to the other supplements that I’ve been on for years and years without an elevated ALT.
SO...........what I was trying to look up, and would love to know now is:
Can you direct me to the paper, reference, site, etc., where the conversion of ALA to Sodium R-LA is spelled out? I left my Draft to re-read one of your old posts, in which you copied and pasted the Packer paper, and I’ve read info on the GeroNova site re: LA, but I would love actual #s.
I started 600-1200 mg. ALA in mid-December, and my January labs were normal. When I switched from ALA to Sodium-R-LA in mid-February, both mid-March and mid-April labs showed slightly elevated ALP, with upward trend.
Therefore, I don’t know if I’m taking too much Sodium R-LA (600 mg.), or if ALP would have gone up on either LA form after some time.
Thoughts?
Kira.