Alpha-Lipoic Acid (ALA)

Commonly used for
Metabolic HealthNerve Health
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Alpha-lipoic acid is a potent antioxidant involved in mitochondrial energy production. It has the strongest evidence for improving symptoms of diabetic peripheral neuropathy and may modestly improve insulin sensitivity.
Form: R-alpha-lipoic acid (R-ALA) preferred; standard ALA also effective
Typical dose studied: 300–600 mg/day
Timing: 30 minutes before meals or on empty stomach
R-ALA is more bioavailable but often more expensive. Take away from meals for better absorption.
~ Moderate evidence
Avoid with: Alcohol use disorder
Interacts with: Diabetes medications — monitor for hypoglycemia; Thyroid medications
Already taking it? Monitor blood glucose if combined with glucose-lowering therapy. Correct any existing thiamine deficiency first -- ALA can accelerate thiamine depletion.
Ziegler D et al. ALA and diabetic neuropathy. ADA adjunctive evidence on ALA. Cochrane Reviews on ALA for diabetic neuropathy.
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