Alpha lipoic acid (ALA/Thiotic Acid) is a very powerful endogenously secreted antioxidant that is presumed to be very effective in the treatment of diabetic neuropathy, diabetes mellitus, and dementia that is as a result of the human immunodeficiency virus and Alzheimer’s disease. It can also be used to treat Amanita mushroom poisoning, glaucoma, and alcoholic liver disease.
In the body, endogenous alpha lipoic acid is available as both R-enantiomer, which is the biologically active component and the S-enantiomer which is the inactive component. Nevertheless, clinical procedures always utilize a mixture of these two components and they should be administered either orally or through an intraperitoneal administration. After its administration, ALA is rapidly absorbed into the body and distributed to various body parts and tissues which include the liver, the heart, and the skeletal muscles. ALA is then reduced to dihydrolipoic acid / DHLA when in these tissues and after that, it undergoes extensive metabolism and very little of it is excreted unchanged through various channels. DHLA and ALA are both fat and water soluble and they are classified under some of the most powerful antioxidants which can scavenge for reactive oxygen particles and chelate metals. They also have the ability to regenerate oxidized vitamin E, C, and Glutathione. Additionally, ALA is a natural cofactor in the mitochondrial dehydrogenase complex.
• The use of ALA for the treatment of Diabetes type II. A number of short-term preliminary studies revealed that ALA has the ability to improve a patient’s sensitivity to insulin in a case of diabetes mellitus type II. The administration of ALA to patients suffering from this condition can help to improve the glucose disposal and glucose intake levels in the skeletal muscles of these patients which alternatively improves the utilization of glucose and the patient’s sensitivity to insulin.
• The use of ALA for the treatment of Diabetic Neuropathy. Evidence from various clinical studies has suggested that lipid peroxidation and oxidative stress are the main causes of neuropathic pains and dysfunctions that are associated with diabetes. Because ALA exhibits very powerful antioxidant properties can be used to relieve the symptoms of neuropathy in these patients. Some of the symptoms of diabetic neuropathy include burning, pain, numbness, and neuropathic impairment scores.
Current evidence from various studies supports that Alpha Lipoic Acid can play a major role in improving a patient’s sensitivity to insulin. This works exceptionally in patients with type II diabetes. It can also be used to relieve the symptoms of diabetic neuropathy. Additional information concerning the use of this medication for other indications is either lacking or still inconclusive.
In a case of Diabetes Mellitus, Alpha Lipoic Acid may lead to a decrease in blood sugar concentration. So any patient who is suffering from this condition should administer this medication with caution and their blood sugar levels should be constantly monitored to assure safe levels. These patients should also be instructed on how to check their sugar levels and made aware of the signs and symptoms of hypoglycemia in case they come across any accidents.
There is still insufficient evidence to support the use of ALA during a pregnancy and during lactation but women who are going through either of these processes are advised to avoid this medication completely. It is better to stay on the safe side until its safety and efficacy are ascertained.
ALA should never be used together with drugs that contain anti-diabetic agents because it can increase the utilization of glucose in the body and decrease the body’s resistance to insulin. Patients receiving this combination may be exposed to a higher risk of developing hypoglycemia so in a case where a combination therapy is inevitable, dosage adjustments should be considered and they might be necessary. Additionally, patients who are taking anti-diabetic agents together with ALA should be carefully instructed on how to monitor their blood sugar concentrations.
ALA should never be taken together with drugs that decrease the effects of antidiuretic agents. ALA has proved to increase the utilization of glucose and it decreases the body’s resistance to insulin so patients who are receiving drugs that can decrease the concentration of glucose and sugar in the blood and decrease the body’s resistance to insulin should not be combined with ALA. This may enhance the effects of ALA to abnormal levels which might result in hypoglycemia. These drugs include; androgens, ACE inhibitors, Chromium, Disopyramide, fabric acid derivatives, green tea, orlistat, octreotide and horse chestnut.
ALA should never be administered together with drugs that can mask the signs and symptoms of hypoglycemia. Some effects from ALA can result in hypoglycemia so, drugs like beta-blockers, reserpine, clonidine, and guanethidine which can mask these symptoms are strictly contraindicated.
For a majority of patients, ALA appears to showcase very minimum side effects. Generally, it is well tolerated. In a controlled clinical study with a number of diabetic patients, only some mild symptoms were realized and they were associated with mild hypoglycemia. In other cases, some effects of nausea, vomiting and skin conditions were reported.
The dosage amount of ALA required for an adult patient should be about 250-500 ml of normal saline which should be administered through an intravenous injection.
The dosage form of Alpha Lipoic Acid available at Absolute Pharmacy is an injection solution. All our solutions are compounded under the stringent 795 USP guidelines which ensure that they are quality and safe for use. For more information on this medication and its administration, feel free to contact us.