Alpha-lipoic acid (ALA) is a fatty acid and antioxidant. Recommended for liver protection.

Alpha-lipoic acid is very important in several ways. It easily crosses cell membranes and works as an antioxidant in both lipid (fatty) and aqueous (watery) parts of the body. It can counter many different forms of oxidative stress and prevent the cellular damage they might cause.

Alpha-lipoic acid both directly reduces oxidative stress in the body and indirectly spares, recycles or regenerates the other major antioxidants.

It is an important component of protocols aimed at preventing mitochondrial dysfunction and all the problems it can cause, including neuropathy, myopathy, bone marrow suppression (and resulting decreases in red and white blood cells and platelets), pancreatitis, fatty liver, lactic acidosis, and fat loss (lipoatrophy).

One of alpha-lipoic acid’s other very important uses is as a liver protective agent. It is very important to the liver cell metabolic pathways (the pathways used when the liver performs its important functions, including the breakdown and processing of toxins) and can be rapidly depleted when the liver is under stress. Since both HIV and hepatitis C induce glutathione deficiency, and that deficiency can allow the liver to become damaged by oxidative stress, alpha-lipoic acid’s effectiveness in raising cellular glutathione levels is probably very important for liver protection and repair. Its ability to help protect the liver’s mitochondria may be very important to help prevent the development of a fatty liver.

Alpha-lipoic acid has been shown to increase insulin sensitivity and help reduce blood sugar in non-people with HIV with Type 2 diabetes and, thus, might also be considered as a possibly useful agent for those with blood sugar problems.

Alpha-lipoic acid may also be useful for cognitive dysfunction in HIV disease. Tissues of the central nervous system are known to be particularly vulnerable to oxidative stress because of their high rate of oxygen consumption and high mitochondrial density. The mitochondria produce lots of free radicals during normal oxidative metabolism and, especially without sufficient antioxidant protection, the mitochondrial tissue may be damaged. It is believed that this sort of oxidative stress damage may be partially responsible for neurodegenerative diseases. In animal studies, alpha-lipoic acid has been shown to improve memory, apparently by reversing the damage that had been induced by oxidative stress in the brain.

Some PWHIV take 300 – 600 mg per day if attempting to correct high liver enzyme levels. Others take 300 – 400 per day if using high-dose garlic and are liver-impaired. PWHIV also take 200 – 300 per day if not liver impaired, but protecting from the ill effects of high-dose prophylactic drugs. Finally, many PWHIV take 300 – 400 per day for a high-dose multifactorial antioxidant protection which helps to recycle other antioxidants (e.g. vitamin C/vitamin E) which many are using. Many also use the supplement to prevent or manage neuropathy.

Alpha-lipoic acid may reduce the amount of minerals in the body through a process called chelation; therefore it is best taken with a good multivitamin.

PWHIV should let their doctor know that they are taking this supplement. Some may be able to tolerate higher doses of liver-toxic drugs than would normally be the case. Never stop suddenly while continuing to take pharmaceutical agents without closely monitoring your liver enzyme levels.