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Alpha Lipoic Acid |
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Nutritional Insider considers Alpha Lipoic Acid one of the most important supplements an individual may take. Alpha Lipoic Acid is a superior anti-oxidant - penetrating all portions of your cells. ALA exerts a wide variety of anti-inflammatory actions at the cellular level, which can lead to benefits ranging from anti-aging effects and weight loss.
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What is Alpha Lipoic Acid: |
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Alpha Lipoic Acid is often referred to as “The Universal Antioxidant” due to the fact that it is soluble in both water and fat, and can easily pass through the blood-brain barrier. These aspects allow Alpha Lipoic Acid to be easily and quickly absorbed by cells throughout the body. Alpha Lipoic Acid is a fat-soluble and water-soluble, sulfur-containing acid found naturally inside every cell of the body.
Alpha Lipoic Acid is an essential part of several important mitochondrial (cellular) functions. These can include:
helping the body produce energy for normal activity (by converting blood glucose into energy and aiding in metabolism);
helping the body produce glutathione (essential to the body’s ability to detoxify itself). Is a powerful antioxidant neutralizing the free radicals that cause cell damage in systems such as the heart, lungs, and brain.
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History of Alpha Lipoic Acid: |
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In the 1930s, scientists noticed that a certain factor was necessary for the growth of bacteria. Dr. Lester Reed of the Department of Chemistry at the University of Texas would later isolate this factor (later called alpha lipoic acid). Alpha Lipoic Acid was found to be an important element of growth for several different types of bacteria.
From the 1950s through the 1980s, research on Alpha Lipoic Acid focused only on its effects on glucose and energy production. Alpha Lipoic Acid’s powerful antioxidant properties would later be recognized when studies began to surface illustrating successful Alpha Lipoic Acid treatments for chronic liver disease, as well as case histories involving the survival of a B-cell lymphoma patient, and the survival of another with metastatic pancreatic cancer. Research for Alpha Lipoic Acid treatment of human diseases is still in its early stage, and continues to show promise.
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Benefits of Alpha Lipoic Acid: |
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Alpha Lipoic Acid supplementation increases liver production of glutathione (which aids in detoxification); supports and boosts effects of vitamin E and vitamin C supplementation; and can easily be absorbed from food or the intake of capsule supplements.
Alpha Lipoic Acid’s ability to speed the removal of glucose from the blood is currently being studied in the treatment of Diabetes. Latest studies suggest that Alpha Lipoic Acid treatment for Diabetes reduces pain, numbness, and nerve damage, as well as reducing instances of glaucoma and degeneration of the retina. Animal studies show that Alpha Lipoic Acid treatment may also prevent Diabetes-related kidney damage.
In addition to its function as a powerful antioxidant/anti-inflammatory, alpha lipoic acid increases the body’s ability to take glucose into the cells. This increased sensitivity to insulin results in decreased blood sugar levels and accelerated weight loss. Alpha Lipoic Acid can be a key supplement for effective weight and fat loss.
Due to Alpha Lipoic Acid’s ability to easily pass into the brain, it is being studied for its effects on diseases involving the brain and nerves. Preliminary research looks promising for the efficacy of Alpha Lipoic Acid treatment of Alzheimer’s, Parkinson’s, Cancer, strokes related to brain damage, cataracts, glaucoma, heart failure, and age-related Frailty (a decline in muscle size and strength, brain function, immunity, and energy).
Alpha Lipoic Acid is also being studied in the treatment of HIV and Multiple Sclerosis. The detoxification ability of Alpha Lipoic Acid is frequently examined, and has proven useful for the treatment of chronic liver diseases. Alpha lipoic acid supplementation relieves stress on the liver and helps the body rid itself of toxins. Alpha Lipoic Acid’s detoxification abilities include chelation (metal-binding) – making it a useful treatment in Amanita (a poisonous mushroom) and mercury poisoning.
Alpha Lipoic Acid supplementation can also be benficial in supporting weight loss as it is essential for the efficent conversion of glucose into energy, excess glucose with in the body is converted and stored within the body as fat.
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Sources and Forms of Alpha Lipoic Acid: |
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Alpha lipoic acid is made by the body in small amounts. It can also be found in foods such as spinach, broccoli, peas, Brewer’s yeast, Brussels sprouts, rice bran, potatoes, and organ meats (especially kidney, liver, heart, and skeletal muscle). Alpha Lipoic Acid capsules supplements are also widely available in drugstores, vitamin websites, and in health food stores. On rare occasions, Alpha Lipoic Acid is given by injection under medical supervision.
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Recommended Dosage of Alpha Lipoic Acid: |
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The amount of Alpha Lipoic Acid synthesized in our bodies varies directly with our type of diet. Greater Alpha Lipoic Acid content is found in diets containing more uncooked vegetables (Alpha Lipoic Acid is partially destroyed by cooking).
In order to reap the benefits of Alpha Lipoic Acid as an antioxidant additional supplementation is required. As a nutritional supplement, the FDA does not oversee, regulate, or recommend a specific dosage for Alpha Lipoic Acid supplementation.
Different health institutions give different recommendations regarding the optimal dosage for daily alpha lipoic acid supplementation – anywhere from 50 mg/day to 600 mg/day. The Linus Pauling Institute at Oregon State University, specializing in micronutrient research, recommends a daily dose of 200-400 mg for generally healthy people. Dr. Perricone recommends anywhere from 200 to 400 mgs of Alpha Lipoic Acid per day to patients with specific health problems, or who are trying to lose body fat.
Studies show that a daily dosage of 600 mg in patients with diabetic neuropathy significantly improved symptoms – reducing sensory, motor, and neurological damage to the peripheral nerves in the lower extremities. Research into alpha lipoic acid is still in its early stages and appears to be well-tolerated by most people. The long-term effects of Alpha Lipoic Acid supplementation are still unknown. For maximum absorption, Alpha Lipoic Acid supplements should be taken on an empty stomach.
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Safety and Side Effects of Alpha Lipoic Acid: |
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Reported side effects of Alpha Lipoic Acid supplementation have been minor and include headaches, tingling (a “pins and needles” sensation), skin rash, muscle cramps, nausea, upset stomach, and low blood sugar. Allergic reactions include itching or hives, swelling in the hands or face, swelling or tingling in the mouth or throat, chest tightness, chest distress, trouble breathing, or rash.
Very rarely, a condition called insulin autoimmune syndrome occurs in people using Alpha Lipoic Acid. In this autoimmune response, antibodies are directed against the body’s own insulin, and can lead to hypoglycemia (very low blood sugar). Safety of Alpha Lipoic Acid treatments is unknown for: children, nursing/pregnant women, long-term high-dose usage, and those with kidney disease.
Alpha Lipoic Acid may improve blood sugar control, so people with diabetes should only take Alpha Lipoic Acid under the supervision of a medical professional. Animal studies have indicated that thyroid hormone levels may be affected, though this has not yet been seen in humans. Careful and constant monitoring by a health care provider is necessary if you have diabetes and are taking medications such as: metformin (Glucophage), glyburide (DiaBeta, Glynase), glipizide (Glucotrol), pioglitazone (Actos); supervision is also necessary for those taking thyroid medications (levothyroxine, Synthroid, Eutirox). Contraindications to Alpha Lipoic Acid include: Amikacin and Gentamicin (Alpha Lipoic Acid reduces the efficacy of these antibiotics), Cisplatin (Platinol), and Cyclophosphamide.
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Frequently Asked Questions on Alpha Lipoic Acid: |
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Can Alpha Lipoic Acid be used to treat Diabetes?
Numerous studies show that a daily Alpha Lipoic Acid regimen is beneficial in the treatment of diabetes, as well as in the management of the painful symptoms of peripheral neuropathy (extensive nerve damage) and other diabetes-related complications. A group of DPN (diabetic peripheral neuropathy) patients were given a 600 mg daily intravenous dosage of Alpha Lipoic Acid. Significant overall reduction in painful symptoms were reported in 100% of the patients after five weeks. DPN Symptoms measured included: numbness, stinging sensations, and burning sensations.
Analysis of clinical trials also showed researchers that Alpha Lipoic Acid(intravenous) treatment was tolerated very well by their patients (with the exception of a single patient developing minor chest distress), and determined that an Alpha Lipoic Acid regimen was safe for most people. Alpha Lipoic Acid was also shown to have an advantageous effect on endothelial function (function of cells lining the heart, blood vessels, lymphatics, and serous cavities), along with lowering glucose levels in the blood.
Animal studies show that biomarkers for oxidative stress are fully reversed in diabetic rats, and that a daily regimen of Alpha Lipoic Acid can have protective effects against cataracts (a common complication of diabetes) in diabetic rats.
Haak E, Usadel KH, Kusterer K, et al. Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy. Exp Clin Endocrinol Diabetes. 2000;108(3):168-74.
Kojima M, Sun L, Hata I, et al. Efficacy of alpha-lipoic acid against diabetic cataract in rat. Jpn J Ophthalmol. 2007 Jan-Feb;51(1):10-3.
Liu F, Zhang Y, Yang M, et al. Curative effect of alpha-lipoic acid on peripheral neuropathy in type 2 diabetes: a clinical study. Zhonghua Yi Xue Za Zhi. 2007 Oct 16;87(38):2706-9.
Sena CM, Nunes E, Louro T, et al. Effects of alpha-lipoic acid on endothelial function in aged diabetic and high-fat fed rats. Br J Pharmacol. 2008 Mar;153(5):894-906.
Can Alpha Lipoic Acid be used as a potential treatment for Alzheimer’s?
With Alpha Lipoic Acid’s ability to cross the blood-brain barrier to pass easily into the brain, plus its known antioxidant effects, some researchers have focused on the possibility that an Alpha Lipoic Acid regimen may one day treat or prevent Alzheimer’s disease. In one study, ten-month old Tg2576 cerebral amyloidosis-transgenic mice (mice genetically engineered to develop brain plaque associated with the development of Alzheimer’s) were fed an Alpha Lipoic Acid containing diet for 6 months. The subsequent assessment showed that the Alpha Lipoic Acid treated mice exhibited notably improved learning and memory retention in the Morris water maze task.
Another study on the cellular level showed a protective effect on cortical neurons against toxicity induced by beta-amyloid (Abeta) peptides (the brain plaque associated with the development of Alzheimer’s). Research into Alzheimer’s shows the Abeta peptides induces an inflammatory reaction in surrounding brain cells, and many believe that the reverse mechanism is also true – inflammation in brain cells encourages accumulation of Abeta peptides.
Researchers are currently testing an Abeta peptide vaccine – a vaccine that may prevent Alzheimer’s. One major complication associated with these vaccinations are vaccine-triggered inflammation and resulting tissue damage. Investigations continue to be made as to whether a powerful antioxidant such as Alpha Lipoic Acid can help mediate vaccination-triggered inflammation.
Jesudason EP, Masilamoni JG, Kirubagaran R, Davis GD, Jayakumar R. The protective role of DL-alpha-lipoic acid in biogenic amines catabolism triggered by Abeta mayloid vaccination in mice. Brain Res Bull. 2005 Apr 30;65(4):361-7.
Quinn JF, Bussiere JR, Hammond RS, et al. Chronic dietary alpha-lipoic acid reduces deficits in hippocampal memory of aged Tg2576 mice. Neurobiol Aging. 2007 Feb;28(2):213-25.
Sopher BL, Fukuchi K, Kavanagh TJ, Furlong CE, Martin GM. Neurodegenerative machanisms in Alzheimer disease: A role for oxidative damage in amyloid beta protein precursor-mediated cell death. Mol Chem Neuropathol. 1996 Oct-Dec;29(2-3):153-68.
Can Alpha Lipoic Acid be used to treat or prevent Cancer?
Numerous studies have shown that Alpha Lipoic Acid is effective at inhibiting tumor/cancer growth at the cellular level. When cells containing Tetrachlorohydroquinone (TCHQ) (a known carcinogen encouraging the growth of skin tumors) were given a dihydrolipoic acid (reduced form of Alpha Lipoic Acid) treatment, the results showed a significant inhibition of tumor cell growth. The therapy also slowed down the rate of cell death in the TCHQ-containing cells.
Another benefit of Alpha Lipoic Acid supplementation is its protective effects on normal cells during chemo-therapy on cancer patients. During cancer radiation treatment, gamma-radiation interacts with the water molecules in both normal cells and cancerous cells. Negative effects of radiation therapy were found to be dose-dependent – with an increase in radiation leading to an increase in the depletion of essential antioxidants such as Alpha Lipoic Acid and glutathione. Alpha Lipoic Acid treatment in these patients resulted in: fully restored antioxidant levels, decreased amount of cell injury, and increased cell protection against irradiation-induced cytotoxicity.
In one frequently-reviewed case study, a patient with pancreatic cancer survived far past the expected survival time period of 18 to 20 months. Pancreatic cancer is considered terminal, with patients having a 20% chance of survival past one year, and a 4% chance of survival past five years. In October 2002, the patient was diagnosed with terminal pancreatic cancer. He underwent a program that included daily intravenous Alpha Lipoic Acid and low-dose naltrexone (an opioid receptor antagonist used in the treatment of alcohol dependence), along with following daily lifestyle changes including: a strict dietary regimen, stress-reduction practices, and physical exercise. In January of 2006, the patient returned to full-time work, symptom-free, and without further signs of cancer progression. The intravenous dosage was well tolerated by this patient, and other patients undergoing this same treatment protocol are currently being carefully monitored and surveyed.
Berkson BM, Rubin D, Berkson AJ. Long term survival of a 46-year-old man with pancreatic cancer and liver metastases and treated with intravenous Alpha Lipoic Acid and low dose naltrexone. Integrative Cancer Therapies. March 2006;5(1):83-89.
Davis GD, Masilamoni JG, Arul V, et al. Radioprotective effect of DL:-alpha-lipoic acid on mice skin fibroblasts. Cell Biol Toxicol. 2008 June 13.
Wang YJ, Yang MC, Pan MH. Dihydrolipoic acid inhibits tetrachlorohydroquinone-induced tumor promotion through prevention of oxidative damage. Food Chem Toxicol. 2008 Dec;46(12):3739-48.
Can Alpha Lipoic Acid be used to treat Hepatitis and other chronic liver diseases?
The number of adults seeking liver transplantation due to chronic Hepatits C infections increase every year. There is currently no effective cure for Hepatitis C. Therapies such as interferon and antivirals work only 30% of the time. When the liver has become damaged due to constant inflammation, fatty liver accumulation (steatosis), and necrosis (death) of liver cells – a liver transplant is sought. This is still not an ideal solution, however, as residual Hepatitis C viremia will infect the new liver; and transplants are costly and dangerous procedures requiring life-long management.
Treatment with Alpha Lipoic Acid is currently being studied as a possible conservative alternative to liver transplantation. Three patients with chronic Hepatitis C Virus infection were placed on a program of treatment with three antioxidants including Alpha Lipoic Acid, silymarin, and selenium. All three patients recovered full functional health, returned to full-time work, avoided liver transplantation, and had remarkably improved laboratory values.
In another study, 125 patients with chronic liver disease due to either viral infection or long-term alcohol use, were placed on a similar program, with results showing an increase in liver detoxifying function. Another trial focusing on 50 chronic Hepatitis C patients measured specific markers of liver health and function before, during, and after, a 20-week oral antioxidant treatment including Alpha Lipoic Acid, plus a twice-weekly intravenous treatment. Normalization of liver enzyme levels occurred in 44% of the patients (with pre-treatment elevated levels). Levels remained normal in 73% of these patients 20 weeks after treatment had ended. A decrease in viral load was seen in 25% of patients, histologic (tissue) improvement obtained by liver biopsy occurred in 36% of patients.
While evidence exists illustrating alpha lipoic supplementation can improve function in a diseased liver, evidence also exists showing that Alpha Lipoic Acid may have a protective effect against agents toxic to the liver. Though not approved by the FDA, Alpha Lipoic Acid has been used as a treatment in Amanita mushroom (a liver-damaging) poison. In an animal study, healthy rats treated orally with Alpha Lipoic Acid in varying amounts for 7 days showed a dose-dependent, protective effect against chloroquine (a liver-damaging toxin) injections. Administration of Alpha Lipoic Acid also improved levels of glutathione, vitamin C, and vitamin E in plasma levels.
Berkson BM. A Conservative Triple Antioxidant Approach to the Treatment of Hepatitis C. Combination of Alpha-Lipoic Acid (Thioctic Acid), Silymarin and Selenium. Three Case Histories. Medizinische Klinik. 1999;94(3):84-89.
Loginov AS, Nilova TV, Bendikov EA, Petrakov AV. Pharmacokinetics of preparations of lipoic acid and their effect on ATP synthesis, processes of microsomal and cytosol oxidation in hepatocytes in liver damage in man. Farmakil Toksikol. 1989 Jul-Aug;52(4):78-82.
Melham A, Stern M, Shibolet O, et al. Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase 1 clinical trial. J Clin Gastroenterol. 2005 Sep;39(8):737-42.
Pari L, Murugavel P. Protective effect of alpha-lipoic acid against chloroquine-induced hepatotoxicity in rats. J Appl Toxicol. 2004 Jan-Feb;24(1):21-6.
Additional research on Alpha Lipoic Acid detoxification benefits:
Berkson, BM. Thioctic Acid in the treatment of hepatotoxic mushroom poisoning (letter). New England Journal of Medicine. 1979;300:371.
Hruby K, Csomos G, Fuhrmann M, Thaler H. Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. Hum Exp Toxicol. 1983;2(2):183-195.
Rooney J. The role of thiols, dithiols, nutritional factors and interacting ligands in the toxicology of mercury. Toxicology. 2007;234:145-156.
What are the Anti-Aging Benefits of Alpha Lipoic Acid?
Research has shown that the antioxidant benefits of Alpha Lipoic Acid may help improve several symptoms of aging including – brain function, energy production, wrinkle reduction, and has even shown to extend the life span of rats.
One theory on aging asserts that aging is due to oxidative stress and overall physical wear-and-tear. If aging is due to oxidative stress (where free radicals outnumber antioxidants), then decreasing free radical quantity through Alpha Lipoic Acid supplementation may help reverse signs of aging. Older rats’ brain function and energy levels (with Alpha Lipoic Acid and carnitine supplementation) showed marked similarities to those of young animals.
Further animal studies show that Alpha Lipoic Acid supplementation increased rat life spans comparably to Dietary Restriction (another factor in increasing rat life span). Human studies show that in a 6-month time period - twice daily oral treatment with DermaVite (a preparation including Alpha Lipoic Acid) - helped reduce damaged collagen (thereby reducing wrinkles and facial scars); helped improve skin thickness and elasticity; and improved patients’ subjective assessments of: fine wrinkles, coarse wrinkles, tactile roughness, appearance of dilated blood vessels on skin, and overall skin quality.
Hagen, TM, Liu J, Lykkesfeldt J, et al. Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Proc of Natl Acad of Sci. 2002;99:1870-1875.
Merry BJ, Kirk AJ, Goyns MH. Dietary lipoic acid supplementation can mimic or block the effect of dietary restriction on life span. Mech Ageing Dev. 2008 Jun;129(6):341-8.
Perricione N. The Wrinkle Cure. Australia: Warner Books, 2000:71-72.
Thom E. A randomized, double-blind, placebo-controlled study on the clinical efficacy of oral treatment with DermaVite on aging symptoms of the skin. J Int Med Res. 2005 May-Jun;33(3):267-72.
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Additional Research on Alpha Lipoic Acid: |
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History
O’Kane DJ, Gunsalus IC. Pyruvic Acid Metabolism: A Factor Required For Oxidation By Streptococcus faecalis. J. Bacteriol. 1948;56:499-506.
Reed LJ, DeBusk BG, Gunsalus IC, Hornberger CS Jr. Crystalline alpha-lipoic acid; a catalytic agent associated with pyruvate dehydrogenase. Science. 1951;114(2952):93-4.
Benefits and ALA
Haak E, Usadel KH, Kusterer K, et al. Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy. Exp Clin Endocrinol Diabetes. 2000;108(3):168-74.
Kojima M, Sun L, Hata I, et al. Efficacy of alpha-lipoic acid against diabetic cataract in rat. Jpn J Ophthalmol. 2007 Jan-Feb;51(1):10-3.
Melham A, Stern M, Shibolet O, et al. Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase 1 clinical trial. J Clin Gastroenterol. 2005 Sep;39(8):737-42.
Sopher BL, Fukuchi K, Kavanagh TJ, Furlong CE, Martin GM. Neurodegenerative machanisms in Alzheimer disease: A role for oxidative damage in amyloid beta protein precursor-mediated cell death. Mol Chem Neuropathol. 1996 Oct-Dec;29(2-3):153-68.
Wang YJ, Yang MC, Pan MH. Dihydrolipoic acid inhibits tetrachlorohydroquinone-induced tumor promotion through prevention of oxidative damage. Food Chem Toxicol. 2008 Dec;46(12):3739-48.
Faust A, Burkart V, Ulrich H, et al. Effect of lipoic acid on cyclophosphamide-induced diabetes and insulitin in non-obese diabetic mice. Int J Immunopharmacol. 1994;16:61-66.
Henriksen EJ. Exercising training and the antioxidant alpha-lipoic acid in the treatment of insulin resistance and type 2 diabetes. Free Radic Biol Med. 2006;40(1):3-12.
Ziegler D, Reljanovic M, Mehnert H, Gries FA. Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. Exp Clin Endocrinol Diabetes. 1999;107:421-430.
Zhang L, Xing GQ, Barker JL, et al. Alpha-lipoic acid protects rat cortical neurons against cell death induced by amyloid and hydrogen peroxide through the Akt signaling pathway. Neurosci Lett. 2001 Oct 26;312(3):125-8.
Additional research on this topic (cellular-level):
Smith JR, Thiagaraj HV, Seaver B, Parker KK. Differential activity of lipoic acid enantiomers in cell culture. J Herb Pharmacother. 2005;5(3):43-54.
Vig-Varga E, Benson EA, Limbil TL, et al. Alpha-lipoic acid modulates ovarian surface epithelial cell growth. Gynecol Oncol. 2006 Oct;103(1):45-52.
Wenzel U, Nickel A, Daniel H. Alpha-lipoic acid induces apoptosis in human colon cancer cells by increasing mitochondrial respiration with a concomitant O2-generation. Apoptosis. 2005 Mar;10(2):359-68.
Additional research on this topic (Quality of Life studies):
Rock E, DeMichele A. Nutritional approaches to late toxicities of adjuvant chemotherapy in breast cancer survivors. J Nutr. 2003 Nov;133(11 Suppl 1):3785S-3793S.
Mantovani G, Madeddu C, Gramignano G, et al. Subcutaneous interleukin-2 combination with medroxyprogesterone acetate and antioxidants in advanced cancer responders to previous chemotherapy: phase II study evaluating clinical, quality of life, and laboratory parameters. J Exp Ther Oncol. 2003 Jul-Aug;3(4):205-19.
Bergqvist-Karlsson A, Thelin I, Bergendorff O. Contact dermatitis to alpha-lipoic acid in an anti-wrinkle cream. Contact Dermatitis. 2006 Jul;55(1):56-7.
Breitner H. Randomized, placebo-controlled, double-blind study on the clinical efficacy of a cream containing 5% alpha-lipoic acid related to photoageing of facial skin. Br J Dermatol. 2003 Oct;149(4):841-9.
Puizina-Ivic N. Skin Aging. Acta Dermatovenerol Alp Panonica Adriat. 2008 Jun;17(2):47-54.
Schleicher ED, Wagner E, Nerlich AG. Increased accumulation of the glycoxidation product N(epsilon)-(carboxymethyl)lysine in human tissues in diabetes and aging. J Clin Invest. 1997 Feb 1;99(3):457-68.
Dosage
Al-Zamil MKH, Brezheva EV. Implication of alpha-lipoic acid preparations in the treatment of diabetic neuropathy. Zh Nevrol Psikhiatr Im S S Korsakova. 2008;108(2):27-30.
Atkins, Robert C. Dr. Atkin’s Vita-Nutrient Solution: Nature’s Answer to Drugs. New York: Simon & Schuster, 1998.
Haak E, Usadel KH, Kusterer K, et al. Effects of alpha-lipoic acid on microcirculation in patients with peripheral diabetic neuropathy. Exp Clin Endocrinol Diabetes. 2000;108(3):168-74.
Safety and ALA
Conlon BJ, Aran JM, Erre JP, et al. Attentuation of aminoglycoside-induced cochlear damage with the metabolic antioxidant alpha-lipoic acid. Hear res. 1999;128:40-44.
Segermann J, Hotze A, Ulrich H, et al. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein-, and glucose levels. Arzneimittelforschung. 1991;41:1294-1298.
Takeuchi Y, Miyamoto T, Kakizawa T, Shigematsu S, Hashizume K. Insulin Autoimmune Syndrome possibly caused by Alpha Lipoic Acid. Intern Med. 2007;46(5):237-239.
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