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Ask Dr. Kaiser Question: Have there been any studies of alpha lipoic acid (thiotic acid) in the USA for peripheral neuropathy (HIV related or diabetic)? Dr. Kaiser replies: There a several research studies that have shown that the use of alpha lipoic acid as a sole intervention has beneficial results in the treatment of diabetic peripheral neuropathy. The first reference includes Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. by Ziegler D, Reljanovic M, Mehnert H, Gries FA in Exp Clin Endocrinol Diabetes. 1999; 107 (7) :421-30. This study showed that a 3-week pilot study of 1800 mg per day of alpha lipoic acid given orally possed a therapeutic effect, but this needs to be confirmed in a larger sample size. In addition, they found that oral treatment for 4-7 months tended to reduce neuropathic deficits and improves cardiac autonomic neuropathy.A second study reviewed the effects of alpha-lipoic acid (thioctic acid) in two multicenter, randomized, double-blind placebo-controlled trials. In the Alpha-Lipoic Acid in Diabetic Neuropathy Study, 328 patients with NIDDM and symptomatic peripheral neuropathy were randomly assigned to treatment with intravenous infusion of alpha-lipoic acid using three doses (ALA 1,200 mg; 600 mg; 100 mg) or placebo (PLAC) over 3 weeks. The total symptom score (TSS) (pain, burning, paresthesia, and numbness) in the feet decreased significantly from baseline to day 19 in ALA 1,200 and ALA 600 vs. PLAC. Each of the four individual symptom scores was significantly lower in ALA 600 than in PLAC after 19 days (all P < 0.05). The total scale of the Hamburg Pain Adjective List (HPAL) was significantly reduced in ALA 1,200 and ALA 600 compared with PLAC after 19 days (both P < 0.05). In the Deutsche Kardiale Autonome Neuropathie Studie, patients with NIDDM and cardiac autonomic neuropathy diagnosed by reduced heart rate variability were randomly assigned to treatment with a daily oral dose of 800 mg alpha-lipoic acid (ALA) (n = 39) or placebo (n = 34) for 4 months. Two out of four parameters of heart rate variability at rest were significantly improved in ALA compared with placebo. A trend toward a favorable effect of ALA was noted for the remaining two indexes. In both studies, no significant adverse events were observed. In conclusion, intravenous treatment with alpha-lipoic acid (600 mg/day) over 3 weeks is safe and effective in reducing symptoms of diabetic peripheral neuropathy, and oral treatment with 800 mg/day for 4 months may improve cardiac autonomic dysfunction in NIDDM. Integrative Health Consulting, a company that I am the director of is currently testing the effects of using a broad spectrum combination of micronutrients (including alpha lipoic acid) as a treatment for HIV peripheral neuropathy which occurs as a consequence of taking either D4T or DDI. You can review the protocol synopsis on my website at www.jonkaiser.com/research.html Check out our Message Board! |
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