Alpha-lipoic acid (ALA) is a molecule that acts as a cofactor for some enzymatic reactions related to blood sugar metabolism and cellular energy. It is found in the mitochondria of cells and has been shown to help support antioxidative status, a normal inflammatory response, and healthy metabolism. 

In preclinical studies, ALA has been shown to help promote the body’s healthy insulin signaling pathways. It may help support the activity of signaling molecules in the insulin/insulin-like growth factor-1 pathway and certain proteins, such as insulin receptor substrate 1, phosphatidylinositide 3 kinase, and protein kinase B. ALA has been shown to modulate the activity of certain pro-inflammatory cytokines, such as nuclear factor kappa-B. ALA may help scavenge reactive oxygen species, and it can exhibit chelating activity for certain metals. ALA may also support cognitive function, a healthy response to neuroinflammation, and brain health.

A recently published review article by Amponsah-Offeh and colleagues explored the relationship between hypertension and nutraceuticals that may help support antioxidative status. The authors postulate that ALA may help support certain aspects of cardiovascular health. ALA may help support healthy levels of glutathione and nuclear factor erythroid 2–related factor 2 activity. It also plays an important role in redox reactions related to glutathione and vitamins C and E, and it helps to modulate endothelial nitric oxide synthase (eNOS) expression, which is primarily expressed in the cardiovascular system. The activity of eNOS is believed to play a role in vascular homeostasis, vasodilation, and the production of nitric oxide. Several animal studies involving hypertensive murine models have reported that ALA helped support normal blood pressure. 

Clinical studies have indicated that ALA may help support the body’s response to certain neuropathy and pain. Improvements in symptoms related to diabetic neuropathy have been reported in several clinical trials. A randomized, prospective clinical trial reported improvements in chronic lumbosacral radicular pain in the presence of supplementation with ALA. Another recent trial explored the potentially supportive role of ALA as an adjunct in the presence of symptoms related to fibromyalgia. 

More research is needed, particularly in the clinical setting, as evidence suggests that ALA may help support blood sugar homeostasis, antioxidative status, a healthy response to inflammation, and metabolic health. Research indicates that the R-enantiomer from dietary sources and certain supplements has higher bioavailability than other forms of ALA. In addition, ALA can be obtained from fruits and vegetables, such as spinach, broccoli, brussels sprouts, and tomatoes. 

By Dr. C Ambrose, ND, MAT