Risks and Benefits of Alpha-Lipoic Acid Supplements

Alpha-lipoic acid is an antioxidant our body manufactures internally. Is there any advantage to taking extra in supplement form? Double-blind, randomized, placebo-controlled trials show no benefit for fibromyalgia, but they do show about five pounds (~2.27 kg) of weight loss over an average of 14 weeks. The mechanism isn’t clear, though in rodents it does appear to reduce appetite. Waist circumference wasn’t significantly affected, though, suggesting it failed to reduce much visceral (deep abdominal) fat.

Though the cholesterol benefits aren’t entirely consistent, overall, alpha-lipoic acid may lower LDL cholesterol by 9 points within an average of 10 weeks at doses mostly around 600 mg a day. Combined with a drop in inflammatory markers with a similar dose, six out of seven trials found an improvement in artery function after both acute and chronic dosing, representing probably the most valuable benefit. Okay, what are the downsides?

Alpha-lipoic acid advocates stress that it’s “readily available from dietary sources,” but at doses nowhere near what’s sold in supplements. Although organ meats are listed as common sources, ginger root actually appears to have the highest concentration, with the most per serving in apples, bananas, and cauliflower. Most supplements are in the 600 mg range, though, and there’s only about one milligram in an apple, banana, or cup (100 g) of cauliflower. Though I’d rather eat 600 bananas than 5,000 chicken livers; the doses in supplements far exceed what we would ever be exposed to naturally.

There have been dozens of short-term clinical studies that failed to note adverse treatment-related effects even up to 1800 mg a day. But there was a case report published of a healthy 16-year-old girl who took just that amount—600 mg every half-hour three times to self-treat her headache, and she ended up hospitalized in the ICU in metabolic acidosis with full-body seizures and an inability to clot her blood properly. The authors concluded that there is “no safe dose for children” for supplements like alpha-lipoic acid, but she wasn’t exactly a toddler at 16 years old and 130 pounds (60 kg). A prior fatal suicide involved a 14-year-old who was said to have swallowed ten capsules. I would exercise caution until we have a better idea of its safety window.