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Name: Alpha lipoic acid, Thiotic acid, ALA
Goes well with: Vitamin B12, Acetyl-L-Carnitine
Number of scientific references: 30
Level of Evidence: Level I What is this?
Note: Alpha Lipoic acid can help in Parkinson’s disease by boosting antioxidant defences, reducing mitochondrial dysfunction and protecting dopaminergic cells. It can help protect memory and cognition.
Pre-clinical evidence suggests that ALA can be utilized as an add-on to conventional anti-Parkinson’s drugs; further research in the form of clinical trials is required to confirm this.
Alpha lipoic acid (ALA) is an antioxidant that is naturally synthesized in the body. It imparts various therapeutic benefits that are not known to many of us.
The benefits include its ability to fight oxidation and inflammation, ameliorate heart health diseases and metabolic diseases, protect liver function and improve memory and cognition.
ALA is a very popular and effective natural supplement for peripheral neuropathy relief.
It can be obtained in trace amounts from vegetables and fruits. It is also widely available as a dietary supplement.
Pre-clinical studies indicate that Alpha Lipoic Acid helps in Parkinson’s disease by protecting dopaminergic neurons, reducing alpha-synuclein accumulation and improving antioxidant defences. It can help protect memory and overall brain health.
ALA can be a potential natural supplement (add-on therapy) for Parkinson’s disease; clinical trials are required to confirm its therapeutic efficacy.
Suggested Alpha Lipoic Acid Supplements For Parkinson’s Disease
Please consult a health practitioner before taking any health supplements.
ALA is available as racemic mixture supplements or as stabilised R-ALA supplements.
Here is a short summary on ALA and R-ALA supplements:
- ALA racemic mixture (contains both R- and S- form) has been successfully used in clinical studies.
- R-ALA standalone is said to be more potent than S-ALA and may deliver effects equivalent to the racemic or conventional ALA at a lower dose.
- R-alpha lipoic acid is more bioavailable than S-Alpha Lipoic Acid but it is unstable.
- Presence of S-Alpha Lipoic Acid in the racemic mixture improves the stability of the R-enatiomer.
- Stabilised R-Alpha Lipoic Acid is prepared in the form of sodium salt or cyclodextrin complex.
- Stabilised R-ALA supplements are more expensive than the racemic mixture.
Most studies, assesing the benefits of ALA, conducted to date have used the racemic form. I have listed both the supplement forms below.
Alpha Lipoic Acid (Racemic mixture) supplements
These contain both R- and S- form of alpha lipoic acid. Start with small doses and increase gradually.
|Doctor’s Best Alpha Lipoic Acid
Image Credit: Doctor’s Best, Inc.
It contains 600mg racemic mixture ALA. They are soy and gluten free, vegetarian capsules.
Dosage: 600mg per day
Stabilised R-ALA supplements
The stabilised form of R-Alpha Lipoic Acid available in the market today is Bio-Enhanced® R-Lipoic Acid developed by Geronova Research, Inc.(Buy from Amazon).
It is a sodium salt of Alpha Lipoic Acid.
Here are a few dietary supplements that contain Bio-Enhanced® R-Lipoic Acid.
Some may contain additional vitamins, so please read the complete ingredient list of the supplement before purchasing.
|Thorne Research R-Lipoic Acid||Doctor’s Best Stabilized R-Lipoic Acid|
Image Credit:Thorne Research, Inc.
Image Credit: Doctor’s Best
|It contains 300mg R-Lipoic Acid packed in vegetarian capsules.||It contains 100mg R-Lipoic Acid packed in vegetarian capsules.|
4 Proven Benefits of Alpha Lipoic Acid For Parkinson’s Disease
Here are a few research studies that indicate the possible pharmacological properties of Alpha Lipoic Acid that can help in Parkinson’s disease treatment and prevention.
Table of Contents
- 1 Suggested Alpha Lipoic Acid Supplements For Parkinson’s Disease
- 2 4 Proven Benefits of Alpha Lipoic Acid For Parkinson’s Disease
- 3 Dosage of Alpha Lipoic Acid For Parkinson’s Disease
- 4 Precautions with Alpha Lipoic Acid Use
- 5 Conclusion
1.ALA ameliorates mitochondrial dysfunction and oxidative damage in Parkinson’s disease
Reduced antioxidant defences and increased prooxidant agents in the body occurs even as a consequence of ageing and may affect brain health adversely.
These reactive oxygen species cause DNA, cell or tissue damage.
Mitochondria, the powerhouse of the cell is affected by these reactive oxygen species. Mitochondrial dysfunction, in turn, leads to cell death.
Mitochondrial dysfunction is observed in brain cells in Parkinson’s disease. 
Researchers are looking forward to developing therapeutic agents that can target mitochondrial dysfunction and offer neuroprotection in Parkinson’s disease.
Alpha Lipoic Acid is one such natural agent that effectively curbs oxidative stress and mitigates mitochondrial dysfunction.
It has metal chelating activity and can regenerate our endogenous antioxidant agents such as Vitamin E, Vitamin C and glutathione. 
The combination of Alpha lipoic acid with Acetyl Carnitine (an amino acid) is found to be effective in protecting brain and nervous system health.
Pre-clinical studies show how pretreatment of cells with this combination helps improve energy production by the mitochondria and reduce production of reactive oxygen species thereby protecting the brain cells from oxidative stress and damage in Parkinson’s disease. 
Preserving mitochondrial function and antioxidant defences can help reduce the risk of neurodegenerative diseases.
According to a study conducted by Liu et al. including agents that support mitochondrial function and antioxidants in the diet can help protect the brain cells from age-related degeneration. They also improve memory and partially restore the function of the mitochondria.
Antioxidants restore key mitochondrial enzymes to help delay the decay of mitochondrial functioning. 
ALA offers similar protection from several neurological diseases.  (Pharmacology and Therapeutics, 2007)
It scavenges reactive oxygen species thereby preventing oxidative damage, influences the production of the neurotransmitter, acetylcholine to enhance signal transmission between neurons and increasing glucose (source of energy) uptake by the brain cells.
All these effects are attributed to the reduced form of Lipoic acid called dihydrolipoic acid.
Both forms, alpha lipoic acid and its reduced counterpart dihydrolipoic acid possess anti-oxidant potential. 
A study published in The International Journal of Neuroscience, 2011 highlighted that Alpha lipoic acid can help reduce the progression of neuronal degeneration in Parkinson’s disease. 
It’s unique biochemistry and utility as a universal antioxidant makes it a potential therapeutic agent for mitigating oxidative stress in Parkinson’s disease.
Quick Gist: Alpha lipoic acid prevents mitochondrial dysfunction thereby reversing inappropriate energy production by the cell.
It also fights oxidative stress effectively preventing damage and loss of healthy functional neurons in Parkinson’s disease.
2.Alpha Lipoic Acid protects dopaminergic neurons from damage
Environmental neurotoxins, mitochondrial dysfunction and oxidative stress are some of the factors that cause degeneration of neurons in Parkinson’s disease.
Dopamine is a neurotransmitter or chemical in our brain that is responsible for functions such as movement, motivation and cognition. Dopaminergic neurons are brain cells that produce dopamine.
These dopaminergic neurons are significantly affected and damaged in Parkinson’s disease. This possibly gives rise to motor symptoms such as tremors, rigidity, balancing issues, difficulty in moving etc.
Zaiton et al. have demonstrated the possible therapeutic benefits of ALA in an animal model of Parkinson’s disease.
Results showed that treatment with Alpha lipoic acid improved motor performance and significantly reduced the level of oxidative stress in the brain. 
Li and colleagues have observed that ALA enhances the expression of PCNA in dopaminergic cells undergoing pathological changes similar to that of Parkinson’s disease. 
PCNA is a protein that actively repairs dopaminergic neurons and thus protects neurons from toxicity.
Parkinson’s disease results in reduced levels of naturally produced antioxidant compounds like glutathione in the body.
Oxidative stress destroys the mitochondrial production and thereby its ability to produce energy to suffice survival of dopaminergic neurons.
Alpha lipoamide is an amide derivative of lipoic acid that has a stronger protective effect on mitochondria compared to ALA.
Alpha lipoamide is found to restore ATP levels (known as the energy currency of the cell) in dopaminergic cells.  (Neurotoxicity Research, 2018)
It helps regulate the healthy functioning of the mitochondria and protect neurons in Parkinson’s.
Levodopa the most commonly prescribed drug in Parkinson’s; however, it is known to exhibit some side effects.
Administering Alpha lipoic acid along with Levodopa in the early stages of Parkinson’s can help suppress its side effects and enhance its protective action. 
Abdin and Sarhan observed that ALA offers neuroprotection in Parkinson’s disease by lowering oxidative stress and mitochondrial dysfunction and preventing cell death.
It also lowered side effects associated with levodopa such as catalepsy (a state of seizure-like activity and rigidity), normalized brain chemistry and preserved the structure of the brain that experiences maximum damage in Parkinson’s disease. However, these findings are limited to animal studies.
According to a study published in the Journal of Medicinal Chemistry, developing a drug that combines ALA and levodopa can prove to be more therapeutic than levodopa alone. 
Autooxidation of levodopa (breakdown of levodopa and its oxidization in the body) reduces its therapeutic efficacy and causes side effects.
ALA prevents levodopa from being auto-oxidised and improves the sustained release of levodopa.
Quick Gist: Alpha lipoic acid protects dopaminergic neurons from damage induced by toxic metals, reactive oxygen species and toxic chemicals. It promotes survival and viability of neurons in Parkinson’s disease.
Preliminary studies suggest that combined therapy with Alpha Lipoic Acid and Levodopa may offer better neuroprotection and reduce side effects associated with levodopa.
3.It is a cognition enhancer and can improve memory
Patients with Parkinson’s disease experience non-motor symptoms such as impaired memory, cognition, learning ability.
According to a study published in Expert Opinion on Investigational Drugs,2008 alpha lipoic acid in combination with acetylcarnitine can help improve cognition and memory by exerting antioxidant, anti-inflammatory and antidepressant action. 
Researchers have demonstrated that ALA can protect from age-related memory decline. (Read How ALA Benefits Memory)
Molz et al. have described how Lipoic acid improves memory in various ways.
One of these mechanisms is by reversing age-associated impairment of neurotransmitters function that regulates cognition and memory and thereby protecting the memory functions. 
Oxidative stress and inflammation in the neurons can affect them adversely. Loss of the healthy functional neurons deteriorates metal health and consequently impairs cognition and memory.
The anti-inflammatory property of ALA helps protect brain cells and subsequently memory and cognitive function.
Just like Parkinson’s disease, Alzheimer’s disease is a neurodegenerative condition. Degeneration of brain cells in Alzheimer’s significantly impacts memory and cognition.
Fava and colleagues have demonstrated the therapeutic potential of ALA supplements (600mg/day) in improving memory and cognition in Alzheimer’s disease patients with or without diabetes. 
Similar clinical trials should be conducted to understand whether Alpha lipoic acid can help protect cognition and memory in Parkinson’s disease and/or dementia.
A study conducted by Liu et al. helped gain insights on how alpha lipoic acid can possibly improve memory. 
They observed that the antioxidant property of ALA protects memory by preventing mitochondrial decay initiated by oxidative stress and damage.
ALA can be combined with other antioxidants such as N-acetyl cysteine, Vitamin E for better protection of cognition. 
Quick Gist: Alpha lipoic acid helps enhance memory and cognition in Parkinson’s disease by protecting against neuronal damage, improving antioxidant defences and preserving neurotransmitter functions.
ALA in combination with Acetyl-L-carnitine is effective in protecting brain health and improving cognition.
4.Alpha Lipoic Acid can reduce inflammation and offer neuroprotection
Researchers are investigating various molecular targets that can be manipulated by anti-inflammatory drugs such that it can help delay or prevent degeneration of dopaminergic neurons.
Experimental studies suggest that it helps prevent acute and chronic inflammation. 
Li and colleagues were the first to examine the anti-inflammatory effects of Alpha Lipoic Acid in Parkinson’s disease. 
They observed that lipoic acid inhibited the activity of nuclear factor kappa B (a protein complex that is involved in inflammatory processes) and other pro-inflammatory mediators in the brain.
This resulted in the prevention of dopaminergic neuronal loss, reduced motor dysfunction and lowered alpha-synuclein accumulation.
Alpha-synuclein is a protein whose abnormal accumulation in the brain is considered as a pathological feature of Parkinson’s disease.
They suggested that ALA can be a potential antioxidant, anti-inflammatory and neuroprotective agent for halting disease progression in Parkinson’s disease.
Alpha Lipoic Acid exists in two forms: R- and S- form. The R- form is said to be more bioavailable but it is less stable.
A recent study published in The International Journal of Biochemistry and Cell Biology, 2017 highlighted that R-lipoic acid can serve a potential neuroprotective agent for Parkinson’s disease. 
It increases the viability of brain cells, reduces cell death, reactive oxygen species and most importantly protects mitochondrial dysfunction against oxidative stress.
In the study, it reversed the decrease of dopamine, reduced alpha-synuclein accumulation and reduced the expression of genes associated with Parkinson’s disease.
Kulikova et al. have formulated a nano-micellar form comprising of alpha lipoic acid and carnosine to offer neuroprotection in the early stages of Parkinson’s disease. It helps restore the level of dopamine metabolites required for survival of dopaminergic neurons. 
Quick Gist: The anti-inflammatory properties of alpha lipoic acid can help reduce inflammation in the brain and reduce the progression of Parkinson’s disease.
It’s ability to protect dopaminergic neurons, reduce mitochondrial dysfunction and to strengthen antioxidant defences makes ALA a viable neuroprotective agent in Parkinson’s disease.
Dosage of Alpha Lipoic Acid For Parkinson’s Disease
There is no specific dose of ALA suggested for Parkinson’s disease and clinical trials on the same are awaited.
However other research studies conducted on neurodegenerative diseases have reported that a dose of 600mg ALA daily for 16 months in addition to anti-dementia treatment is safe and effective in improving cognition. 
Research studies investigating the use of ALA supplements in other disorders have found a dose of 300-600mg per day for 3-6 months to be effective.
Combining oral alpha lipoic acid with vitamin B12 (methylcobalamin) or ALCAR may have a synergistic therapeutic action.
ALA’s absorption may be hindered if combined with food. It should be taken 30 minutes before a meal or in a fasted state.
Consult a health practitioner before taking alpha lipoic acid supplements.
Precautions with Alpha Lipoic Acid Use
No upper limit of ALA intake has been recommended for humans. Some studies have used doses as high as 1800-2400mg and have not reported serious side effects.
But in some cases, gastric side effects have been noted at the high dose. These include nausea, vomiting, abdominal pain and dyspepsia.
A four-year study examining the benefits of alpha lipoic acid in neuropathy reported serious side effects that affected heart health and were also described as urinary in nature. 
There has been a case report describing the development of autoimmune insulin syndrome with ALA supplementation. 
It is important to note this adverse effect, and it is advisable to work with your health practitioner about the same.
A few cases of itching skin, skin ulceration and bronchitis have been reported at high dose ALA. 
ALA may have possible drug interactions with diabetes medicines, thyroid medications, chemotherapy and vitamin B1.
Please consult a health practitioner before taking alpha lipoic acid supplements.
The multiple medicinal benefits of Alpha lipoic acid suggest that it can be a potential therapeutic agent for Parkinson’s disease and may aid in its prevention.
It’s antioxidant action, ability to ameliorate mitochondrial dysfunction and anti-inflammatory property help protect and rescue dopaminergic cells.
ALA and ALCAR combination can help protect memory and cognition in Parkinson’s disease.
Alpha Lipoic Acid can be used as an add-on therapy for early-stage Parkinson’s disease.
Despite these promising research findings, there is a further need for human clinical trials that confirm these findings and identify an effective dose.
If you have used ALA for mitigating Parkinson’s disease symptoms, do share your experience in the comments section below.