Alpha-Lipoic acid

INTRODUCTION

Alpha-lipoic acid is a naturally producing organic compound in the human body. It helps by acting as an antioxidant, therefore preferred in Diabetes, weight loss, and other health conditions. Studies showed that this elevates the reduced Oxidative stress and also reinstitutes the level of other antioxidants. (Moini et al., 2002). It is well known to act as a cofactor in energy metabolism in the mitochondria of each cell. The redox action of this organic acid is largely reviewed in terms of aging and age-related neurodegenerative diseases. (Packer & Cadenas, 2011). As it is both water and fat-soluble, this allows it to metabolize in every cell. (Golbidi et al., 2011). It is more helpful in neutralizing those oxidant species that are destructive to DNA. It can be taken as a food supplement also(associated along with lysine), reducing peripheral-diabetic neuropathy and reduced inflammation (Tutelyan VA et al., 2019). In patients with diabetic neuropathy, it enhances vasodilation, so improving microcirculation in the patient’s body. (Golbidi et al., 2011)(Sharma et al., 2020)(Vallianou et al., n.d.)And in case of inflammation, it helps suppress prostaglandin E-2 secretion while taking unsaponified avocado/soybean, reducing inflammation((No Title), n.d.) Also, It plays a role in iron chelation properties, as it can bind to Zn, Pb, and Cu(McCarville et al., 2017)(Shay et al., 2009).

So, It is helpful for therapeutic use in diabetic neuropathy and oxidative stress conditions. Still, there is a lot more to uncover, like the role of ALA in HIV/AIDS and liver disease need to be studied precisely. Also, there is a need to evaluate its uses and other aspects. 

MECHANISM OF ACTION

Characteristically there is a presence of a dithiolane ring in Alpha-lipoic acid. There are two types of ALA, oxidized lipoic acid(L.A.) and reduced dihydrolipoic acid(DHLA). Both are capable of acting against ROS; L.A. takes part in the process, while DHLA acts as an antioxidant without involving itself. Along with this, it also actively regenerates other antioxidant factors like Vitamin C and E hence increasing the Glutathione synthesis (Shay et al., 2009)

In Inflammation pathogenesis, cytokines are modulated by NF-kB with the help of kappa-B kinase, So ALA inhibits kappa-B kinase, affecting inflammation in the body and reducing it.and (Li et al., 2015)

HOW TO TAKE LIPOIC ACID

The human body can produce only one form, alpha-lipoic acid, in a small amount, so there is a need to opt for other supplement resources. Animal resources like meat contain a higher content of this, but plant sources like broccoli, tomatoes, spinach, and Brussels sprouts also have it. It is a natural product, natural resources like red meats, organ meat like liver, heart, kidney, etc. Broccoli, Spinach, Tomatoes, Brussels sprouts, Potatoes, green peas, rice bran, can be the sources. (Gora̧ca et al., 2011) Another form of ALA can be food supplements, which are available in the market. Some of them may contain 1,000times more amount of ALA than natural food sources. (Gora̧ca et al., 2011)

Doses of ALA uptake are not specified, but 300-600mg of the amount is generally preferred, and there are almost negligible side effects observed. Although this can vary with the severity of the disease, as in chronic disease, patients are kept on a high dose of ALA, which can be administered through supplemented food items. Many studies evaluated that people with cognitive disorders and diabetic complications are preferred with high doses, so it’s better to refer a healthcare professional in such cases, adding ease to the treatment and speedy recovery. But it is recommended to consume Alpha-lipoic supplements with an empty stomach because there are chances of lowering the bioavailability of acids due to the presence of food(Kõiv et al., 2020)(Gleiter et al., 1996).

ADMINISTRATION

ALA is taken orrally or by intravenous  injection. It shows a high therapeutic value in the case of type-1 and type-2 Diabetes Mellitus and neuropathy. In oral supplementation, studies showed that a 300mg dose of ALA for three months improves vision in Diabetic patient (Ziegler et al., 2004). While in the case of intravenous supplementation, studies showed improved neuropathic symptoms and neuropathic deficits with 600mg of ALA. (Gora̧ca et al., 2011)(Gȩbka et al., 2014)

APPLICATIONS OD ALPHA_LIPOIC ACID

In weight gain

It helps to reduce weight loss. If the AMP-protein kinase(AMPK) is in higher amount in the body, it will increase hunger but decrease calorie.(Kim et al., 2004) The body will face weight gain; upon acting Alpha-lipoic acid, AMPK gets suppressed, reducing appetite and weight loss. Also, there will be an increment in the number of calories. (Wang et al., 2010)

Some researchers showed in their studies that a person talking alpha-lipoic acid could reduce 2.8 pounds of weight compared to those with placebo treatment in 23 weeks. (Kucukgoncu et al., 2017)

In Diabetes

Diabetes is an increased blood sugar level that can lead to other health-related problems like kidney failure, heart disease. So Alpha-lipoic acid work with lowering blood sugar level.

Studies found that it reduces insulin resistance, lowers the fasting glucose level, and reduces HbA1c levels.

It removes fat in the muscle so that insulin can participate effectively in the body’s metabolism.

It reduces the chance of nerve damage and the risk of diabetic retinopathy is also reduced. (Akbari et al., 2018)(Foster, 2007)

Although it is very advantageous in the case of Diabetic treatment, it is not an effective treatment alone, so the person should take doctor preference before its consumption in such cases.

In ageing:

ALA can apply it to the skin in the form of a cream. When Alpha-lipoic acid is used, it protects the skin from the sun’s harmful U.V. radiations by its antioxidant property. (Podda et al., 1996)

Studies found that applying alpha-lipoic acid cream to the skin reduces wrinkles, lines, roughness, and there is no side effect. (Podda et al., 1996) Also, it increases the level of other antioxidants that protect the skin from U.V. damage (Matsugo et al., 2011)  

In memory loss

Oxidative stress is the primary reason for memory loss; being an antioxidant, Alpha-lipoic acid can be used to treat memory loss diseases like Alzheimer’s. (Maczurek et al., 2008)

of ALA was observed property in a study of Alzheimer’s, where ALA effectively lowers the symptoms and its further progression. But there are not many pieces of evidence in this case.

In reducing Heart disease risk factor

Oxidative stress is also linked to heart diseases so that an antioxidant could be much more effective in such cases, which is also observed ins several studies. (Skibska & Goraca, 2015)

Another thing is that it improves endothelial dysfunction, which can otherwise lead to heart failure, heart attack, and stroke. (Scaramuzza et al., 2015)

Another study showed that Alpha-lipoic acid could reduce LDL cholesterol and triglyceride level in adults. 

In promoting nerve function

Carpal tunnel syndrome, by the pinched nerve that results in tingling in the hands. Consumption of Alpha-lipoic acid before and after surgery improves the recovery rate. (Monroy Guízar et al., 2018) and also is helpful in diabetic neuropathy, as I have mentioned earlier. (Foster, 2007) which is characterized by nerve pain in diabetic patients. 

In reducing inflammation

Alpha-lipoic acid affects the inflammatory markers that can lead to inflammation along with Diabetes or other chronic infections.

Studies showed reducing C-reactive protein(CRP), an inflammatory marker,  by the action of alpha-lipoic acid (Saboori et al., 2018). It can also affect ICAM, VCAM, MMP-2 as observed in test-tube studies(Sola et al., 2005)

ADVERSE EFFECTS

Although it is considered safe without any side effects, some symptoms might be consequences like nausea, itching, and vomiting. And studies showed that a person could take an alpha-lipoic acid dose up to 2400mg with no side effect (Cremer et al., 2006), But higher doses are not preferred as there is no benefit as such. some studies showed extra alpha-lipoic acid consumption can lead to extra anti-oxidation that can result in a strain on the liver and breast tissue, also altering the livery enzymes. (Çakatay & Kayali, 2005)

So children and pregnant women must take it on the doctor’s recommendation only. Also, in the case of Diabetes, the patient should consult a health professional before consuming alpha-lipoic acid. Another study on a high dose of Alpha-lipoic acid reveals that extra ALA leads to hepatic necrosis; necrosis was observed in the thighs area with 90mg-100mg of ALA. So sometimes, small doses can be much more effective instead of high doses. 

If there is any alcohol consumption, thyroid disorders, or thiamine deficiency, the liver disease, then the person must concern a health professional before consumption.

TOXICITY

ALA with 200mg per day to 2400mg per day is considered safe without side effects. 

In the last 20 yrs, there are very few cases reported for ALA toxicity. One study showed that 121mg of ALA as per its body weight affected liver enzyme and liver functioning. (Cremer et al., 2006).  But there is a need to discover more about the potential side effects of Alpha-lipoic acid consumption and its related doses. 

MONITORING

There is a lot more need of consideration while recommending ALA for children who are diabetic or close to the diabetic. In such cases, higher ALA consumption leads to the effect in which children want to commit suicide. So these patients must be monitored carefully while going for an ALA dose. (Hadzik et al., 2014)Acute ALA poisoning can result in neurologic effects, metabolic acidosis, and T wave inversion. (Emir et al., 2018). High dose consumption causes confuse hypokinesis, etc., in animals, so they need to be monitored carefully (Shay et al., 2009).

CONCLUSION

Alpha-lipoic acid is generally safe to use and can be purchase from the counter as such. But due to lesser evidence of its toxicity and side effects, there is a lot more need to collect data and be discussed by healthcare professionals. In addition, there should be good communication among health care professionals to discuss the doses and the affecting sing and symptoms observed in the patient. 

ALA supplements are also very effective, but there is more to discover their doses and side-effects by the healthcare professionals.