The November, 2006 issue of the journal Diabetes Care published a report concerning the finding that alpha-lipoic acid given to diabetic patients improved symptomatic diabetic polyneuropathy, a painful condition of the nerves that affects the quality of life of many diabetics. Alpha-lipoic acid is an antioxidant that has been previously shown to help improve the symptoms of diabetic neuropathy when administered intravenously for three weeks.
In a multicenter, randomized, double-blind trial known as SYDNEY 2, 181 diabetics in Russia and Israel with symptoms of distal symmetric polyneuropathy received a placebo for one week followed by a daily oral supplement of 600 milligrams, 1,200 milligrams, or 1,800 milligrams alpha-lipoic acid, or a placebo for five weeks. Participants scored their symptoms during screening, before beginning treatment, and after each week of treatment.
One hundred sixty-six subjects completed the trial. There was a significant reduction in mean total symptom scores (TSS) and individual scores for stabbing pain and burning pain compared to the placebo group. Total symptom scores at the end of the trial for those who received alpha-lipoic acid were not significantly different, with 62 percent of the subjects who received 600 milligrams alpha-lipoic acid experiencing a 50 percent or greater reduction in total symptom scores after five weeks, compared to 50 percent of those who received 1,200 milligrams and 56 percent of those who received 1,800 milligrams. None of the patients who received the 600 milligram dose dropped out of the study, whereas 11 of those who received the higher doses discontinued the study due to nausea, making the 600 milligram dose appear to be the best choice.
Alpha-lipoic acid’s ability to improve neuropathy symptoms may be due to an improvement in blood flow caused by alpha-lipoic acid’s antioxidant action. The authors conclude that the benefit of orally administered alpha-lipoic acid in the current trial is comparable to that found for the compound when administered intravenously, and note that significant improvement is demonstrable within one to two weeks of treatment.
As a powerful antioxidant, lipoic acid positively affects important aspects of diabetes, including prevention, blood sugar control, and the development of long-term complications such as disease of the heart, kidneys, and small blood vessels (Dincer Y et al 2002; Jacob S et al 1995, 1999; Kawabata T et al 1994; Melhem MF et al 2002; Nagamatsu M et al 1995; Song KH et al 2005a; Suzuki YJ et al 1992). It has also been shown to reduce the pain associated with diabetic neuropathy (Halat KM et al 2003). Studies include:
Clinical trials of people with diabetes who had symptoms caused by nerve damage affecting the heart showed significant improvement taking 800 mg oral alpha-lipoic acid daily without significant side effects (Ziegler D et al 1997a,b).
In another study, 23 diabetic patients were treated with 600 mg alpha-lipoic acid, delivered intravenously daily for 10 days, followed by 600 mg oral alpha-lipoic acid for 60 days. At the end of the study, all participants showed significant improvements in cranial neuropathy, as well as improvements in both peripheral and autonomic neuropathy, which affects internal organs (Tankova T et al 2005).
In another study, 26 patients with type 2 diabetes were given 600 mg alpha-lipoic acid daily for 3 months. At the end of the study, 20 patients experienced a significant regression of neuropathic symptoms, while 5 patients experienced a complete cessation of all symptoms. Alpha-lipoic acid was especially beneficial in women and in thinner and younger patients (Negrisanu G et al 1999).
When alpha lipoic acid is ingested, it is first converted to its reduced form, R-dihydro-lipoic acid, where the main action of lipoic acid is initiated. R-dihydro-lipoic acid is the reduced (or active) form of R-lipoic acid. R-dihydro-lipoic acid produces the majority of the results attributed to R-lipoic acid and alpha lipoic acid. By consuming R-dihydro-lipoic acid, you are obtaining the form of R-lipoic acid that is immediately available to cells. R-dihydro-lipoic acid is only available in liquid capsules because it is itself a liquid and must be kept sealed from air.
Methylcobalamin is the form of vitamin B12 active in the central nervous system. It is an active coenzyme of the vitamin B12 analogs, that is essential for cell growth and replication. The liver may not convert cyanocobalamin, the common supplemental form of vitamin B12, into adequate amounts of methylcobalamin the body may need for proper neuronal functioning. Methylcobalamin may exert its neuroprotective effects through enhanced methylation, acceleration of nerve cell growth, or its ability to promote healthy homocysteine levels.
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