Evidence supporting the use of: Alpha lipoic acid
For the health condition: Peripheral Neuropathy

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Alpha lipoic acid (ALA) is supported by scientific evidence for use in treating peripheral neuropathy, particularly diabetic neuropathy. ALA is a potent antioxidant, and oxidative stress is implicated in the pathogenesis of nerve damage in diabetes and other conditions that cause neuropathy. Several randomized controlled trials (RCTs), mostly from Europe, have investigated the efficacy of ALA—especially in intravenous form—showing statistically significant improvements in neuropathic symptoms such as pain, burning, and paresthesia compared to placebo. The most substantial clinical evidence comes from the "ALADIN" (Alpha-Lipoic Acid in Diabetic Neuropathy) series of studies and the SYDNEY trials, which demonstrated that ALA (generally 600 mg/day IV for 3 weeks) can reduce symptoms of diabetic polyneuropathy. Oral ALA also appears to be beneficial, though the results are less robust than with IV administration; some meta-analyses and systematic reviews have found moderate improvements in symptoms, but methodological limitations and heterogeneity among studies exist. ALA is generally well-tolerated, with mild gastrointestinal side effects being the most common. Overall, while more high-quality, long-term studies are needed, current evidence supports the use of ALA, particularly as an adjunctive therapy, for peripheral neuropathy. Its use is included in some European guidelines, but not universally recommended in the United States. ALA is not a cure but may offer symptomatic relief for certain patients.

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