Synopsis

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

Lipoic acid (also called alpha-lipoic acid, ALA) is used to support or treat peripheral neuropathy, particularly diabetic neuropathy. There is a body of scientific evidence, primarily from randomized controlled trials and meta-analyses, that supports its efficacy, especially for neuropathic symptoms in diabetes. Mechanistically, lipoic acid acts as a potent antioxidant and may improve nerve blood flow, reduce oxidative stress, and enhance glucose utilization, all of which are relevant in the pathogenesis of diabetic neuropathy.

Clinical studies have shown that intravenous (IV) administration of alpha-lipoic acid (commonly 600 mg/day) over several weeks can significantly reduce symptoms such as pain, burning, and numbness compared to placebo. Some oral studies have also shown benefit, though the magnitude of effect is generally less robust than IV administration. For example, a 2012 meta-analysis (Ziegler et al., Diabetes Care) concluded that IV ALA for 2-4 weeks improves neuropathic symptoms, though the long-term benefits and efficacy of oral supplementation remain less clear.

Lipoic acid is generally well tolerated, though gastrointestinal side effects are possible. Its use in non-diabetic neuropathy is less well-studied. Overall, the evidence is moderate, with stronger support for short-term symptom relief in diabetic patients than for long-term prevention or reversal of neuropathy. Current guidelines in some countries (e.g., Germany) include ALA as a treatment option for diabetic neuropathy.

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