Description
Alpha-lipoic acid (ALA) is a potent antioxidant that helps combat oxidative stress by neutralizing free radicals. It regenerates other antioxidants like vitamin C and E, enhancing overall antioxidant defense. ALA plays a crucial role in reducing cellular damage caused by conditions like diabetes, neuropathy, and aging. Its ability to function in both water- and fat-soluble environments makes it versatile in protecting various tissues. Regular supplementation of ALA may improve mitochondrial function and reduce inflammation associated with oxidative stress.
Résumé
- Alpha-lipoic acid (ALA), or thioctic acid, is a naturally occurring organophosphorus compound vital for enzymatic function within mitochondria. It exists in two optical isomers, R and S, with the R form being naturally present and the S form chemically prepared. ALA is amphiphilic, enabling its action both within cell membranes and cytoplasm. Food sources of ALA include spinach, kidney, heart, liver, and broccoli.
- ALA serves as a universal antioxidant by scavenging free radicals, reducing oxidized forms of other antioxidants, chelating metal ions, and acting as a co-actor for mitochondrial enzymes. It plays a critical role in restoring glutathione levels, reducing lipid peroxidation, increasing antioxidant enzyme activity, and enhancing blood flow to nerves. Furthermore, ALA improves glucose metabolism, nerve conduction, and corrects neuropeptide deficits.
- Pharmacokinetically, ALA has a bioavailability of 30% due to a significant first-pass effect, though absorption is rapid, reaching maximum concentration within 30 minutes of oral ingestion. Absorption occurs primarily in the small intestine. Taking ALA on an empty stomach, around 30 minutes before a meal, is advisable to avoid reduced absorption caused by food interaction.
- Clinical studies, including ALADIN, SYDNEY, and NATHAN trials, have extensively explored ALA's efficacy in treating diabetic neuropathy. The 600 mg daily dose has shown optimum benefit-risk ratio. Studies suggest that ALA can prevent the progression of neuropathic impairment, and in some studies it demonstrates pain reduction.
- Meta-analyses confirm that ALA treatment decreases total symptom scores (TSS) and neuropathy impairment scores (NIS) in patients with diabetic neuropathy. ALA also has potential applications in other medical conditions like fibromyalgia, chemotherapy-induced neuropathy, and Alzheimer's disease. Long-term treatment can be safely combined with other therapies like pregabalin and gabapentin, and switching from ALA to Gabapentin could cause neuropathy symptoms.
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À propos des intervenants
Dr Hasan Husein Hasan Moshtohry
Médecin consultant en médecine interne, hôpital Mediclinic Al Noor, Abu Dhabi, Émirats arabes unis
Divulgation financière
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