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Knowledge · Natural Compounds

Alpha-Lipoic Acid

Database-based evaluation · 765 studies in our database, 193 of them controlled human trials · As of · How we work

Alpha-lipoic acid is a naturally occurring sulfur-containing substance; human studies show mixed to favorable results in metabolic disorders and diabetic nerve damage.

We evaluated 329 human studies on Alpha-Lipoic Acid, including 135 randomised controlled trials and 70 meta-analyses or systematic reviews; the controlled studies include 11,719 participants in total. As of 15 October 2026.

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1. What Is Alpha-Lipoic Acid? Occurrence, Origin and Forms

Alpha-lipoic acid is a sulfur-containing compound that the human body produces in small amounts and that takes part in the energy metabolism of cells. It occurs in small amounts in foods such as spinach, broccoli, potatoes and yeast. It is offered as a dietary supplement, and in some countries approved medicinal preparations exist as well.

It occurs in leafy vegetables, potatoes, yeast and in liver and kidney. Inside the cell it sits in the mitochondria, where it takes part in turning sugar into usable energy.

For dietary supplements and study preparations, alpha-lipoic acid is produced chemically. It is usually present as a mixture of both mirror-image forms; the form found in the body is the R enantiomer. Studies examine mainly oral preparations, and in some cases administration into a vein.

Forms and Preparations Studied

  • Racemic mixture of the R and S forms in equal parts
  • R enantiomer (R-alpha-lipoic acid)
  • S enantiomer
  • Oral preparation as a tablet or capsule
  • Preparation for administration into a vein

Not covered on this page:

  • Combination products in which alpha-lipoic acid is mixed with other substances such as B vitamins or carnitine; these are assessed as a mixture.
  • Other thiol antioxidants such as N-acetylcysteine or glutathione.
  • Alpha-linolenic acid, a fatty acid from plant oils that is also abbreviated as “ALA”.

2. What Does Alpha-Lipoic Acid Do? Results by Area

AreaResult in controlled studiesStrength of evidenceStudiesParticipants
Oxidative stress (laboratory markers)mixedhigh14 meta-analyses · 44 controlled · 19 other2,543
Glucose and fat metabolismmixedhigh20 meta-analyses · 28 controlled · 26 other1,616
Nerve damage, especially in diabetesmixedhigh14 meta-analyses · 12 controlled · 39 other1,048
Weight and body compositionmixedhigh7 meta-analyses · 11 controlled · 7 other945
Livermostly no differencemoderate2 meta-analyses · 4 controlled · 5 other242
Eye and retinamostly no differenceunclear0 meta-analyses · 1 controlled · 2 other31
Other investigationsmostly improvedhigh23 meta-analyses · 61 controlled · 62 other3,716

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

Alpha-Lipoic Acid and Oxidative Stress (Laboratory Markers): Human Studies

In two meta-analyses, CRP, interleukin-6 and TNF-α decreased compared with the control 1154, and in another, CRP decreased 47. In chronic kidney disease, only CRP decreased, not interleukin-6 35. Antioxidative capacity also improved compared with the control in several controlled studies 110122154162, while others found no difference here 2437105112140157. Malondialdehyde decreased compared with placebo in several randomized studies 105122162, while in others there was no difference 37112140146. All results are laboratory values and not clinical effects; the heterogeneity of the studies and the sometimes small groups limit the informative value.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
10 Jibril et al. 2022systematic review · 1,035 participantsOral alpha-lipoic acid supplementation; per 500 mg/day, dose-response analysis; vs. Placebo or control (16 randomized trials)C-reactive protein: improved
11 Vajdi et al. 2023meta-analysis · 947 participantsAlpha-lipoic acid supplementation; vs. Placebo or controlC-reactive protein (CRP): improved (WMD: -0.69 mg/L, 95% CI: -1.13, -0.26, P=0.002); Interleukin-6 (IL-6): improved (WMD: -1.83 pg/ml, 95% CI: -2.90, -0.76, P=0.001); Tumor necrosis factor-α (TNF-α): improved (WMD: -0.45 pg/ml, 95% CI: -0.85, -0.04, P=0.032)
12 Yong et al. 2026systematic review · 926 participantsBuyang Huanwu Decoction combined with alpha-lipoic acid; vs. Control group (placebo or other treatment)SOD, MDA, T-AOC: improved
18 Ebada et al. 2019meta-analysis · 553 participantsAlpha-lipoic acid (racemate); vs. PlaceboGlutathione peroxidase (GPx): improved (SMD = 0.43, 95% CI [0.07,0.8]; p = 0.02)
24 Pires et al. 2025meta-analysis · 250 participantsAlpha lipoic acid as supplement; mean follow-up 3 months; vs. placebototal antioxidant capacity: no difference (MD 0.43; 95% CI -0.02 to 0.87; p=0.06)
31 Saeed et al. 2026systematic reviewAlpha-lipoic acid (ALA)oxidative stress (mechanisms): unclear
33 Salinas et al. 2026meta-analysisAlpha-lipoic acid (ALA) supplementation; 600 mg/day (particularly effective); vs. Placebo or other treatmentsnitric oxide levels: no difference
35 Rezaei et al. 2025meta-analysisAlpha-lipoic acid supplementation; 600 mg/day; vs. Control group (placebo or other)High-sensitivity C-reactive protein: improved (WMD = -2.91 mg/L, 95% CI: -4.65, -1.17); Interleukin-6: no difference; Malondialdehyde: no difference

Further studies in this area: 36 37 38 47 53 54 57 61 76 92 94 97 99 101 102 104 105 110 111 112 117 119 121 122 123 125 127 128 131 132 133 136 137 138 139 140 144 146 147 149 153 154 157 159 161 162 164 165 166 167 168 172 174 175 196 197 214 230 231 232 235 239 242 244 246 249 251 263 264

Alpha-Lipoic Acid, Glucose and Fat Metabolism: Human Studies

In several meta-analyses, alpha-lipoic acid lowered fasting blood glucose compared with the control 295362 and HbA1c 2953. Two other meta-analyses found no difference in HbA1c 1833. Insulin resistance also improved in several studies 2962135173, and triglycerides in one meta-analysis 29. In the lipid profile, several studies found improvements in total and LDL cholesterol 193555, while others saw no difference here 141821. A meta-analysis in obese adults without diabetes found no change in glucose and lipid levels 14. In addition to metformin or tanshinone IIA sodium sulfonate, alpha-lipoic acid lowered fasting blood glucose more than the accompanying agent alone 139175. The robustness is high, but the heterogeneity of populations, doses, and comparison groups as well as predominantly short study durations limit transferability.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
10 Jibril et al. 2022systematic review · 1,035 participantsOral alpha-lipoic acid supplementation; per 500 mg/day, dose-response analysis; vs. Placebo or control (16 randomized trials)HbA1c: improved (MD: -0.32%, 95% CI: -0.45, -0.18); Fasting plasma glucose: improved; Triglycerides: improved
12 Yong et al. 2026systematic review · 926 participantsBuyang Huanwu Decoction combined with alpha-lipoic acid; vs. Control group (placebo or other treatment)HbA1c: no difference
14 Luo et al. 2025meta-analysis · 704 participantsAlpha-lipoic acid (racemic, oral supplementation); vs. Placebo or control (RCTs)Triglycerides: no difference (SMD: -0.08, 95% CI: -0.24 to 0.09, p=0.36); Total cholesterol: no difference (SMD: 0.08, 95% CI: -0.55 to 0.71, p=0.80); HDL cholesterol: no difference (SMD: -0.05, 95% CI: -0.22 to 0.11, p=0.52)
18 Ebada et al. 2019meta-analysis · 553 participantsAlpha-lipoic acid (racemate); vs. PlaceboHbA1c: no difference (SMD = 0.01, 95% CI [-0.32,0.35]; p = 0.94); Fasting blood glucose (FBG): no difference (SMD = -0.06, 95% CI [-0.44,0.33]; p = 0.78); Postprandial blood glucose (PPBG): no difference (SMD = 0.04, 95% CI [-0.27,0.34]; p = 0.82)
19 Mahmoudinezhad et al. 2023meta-analysis · 548 participantsAlpha-lipoic acid supplement; 300-1200 mg/day; 2-16 weeks; vs. PlaceboTotal cholesterol: improved (WMD: -10.78 mg/dl, 95% CI: -20.81, -0.74, P=0.002); LDL cholesterol: improved (WMD: -10.88 mg/dl, 95% CI: -19.52, -2.24, P=0.014); Triglycerides: improved (WMD: -31.02 mg/dl, 95% CI: -49.63, -12.42, P<0.001)
21 Li et al. 2026meta-analysis · 414 participantsAlpha-lipoic acid (ALA) supplementation; vs. PlaceboLipid profiles: no difference; Glycemic indices: no difference
25 Tabrizi et al. 2019meta-analysis · 140 participantsAlpha-lipoic acid (ALA) supplementation; vs. Placebo or control (not specified)Fasting glucose: improved (WMD -36.93 mg/dL; 95% CI, -65.58, -8.28; P = 0.01); Triglycerides: no difference (WMD -7.45 mg/dL; 95% CI, -51.35, 36.45; P = 0.739); Total cholesterol: no difference (WMD -23.23 mg/dL; 95% CI, -48.07, 1.62; P = 0.067)
29 Mohammadi et al. 2026meta-analysisAlpha-lipoic acid supplementation; vs. Control group (placebo or other)HOMA-IR: improved (WMD: -0.74, 95 % CI: -1.17, -0.31; P = 0.001); Fasting blood glucose: improved (WMD: -5.28 mg/dL, 95 % CI: -7.21, -3.35; P < 0.001); Total cholesterol: improved (WMD: -3.91 mg/dL, 95 % CI: -7.35, -0.46; P = 0.026)

Further studies in this area: 31 33 35 36 37 38 39 40 46 48 51 53 55 62 65 90 92 98 104 109 111 114 115 116 123 124 125 128 130 132 133 134 135 139 146 155 161 164 165 168 169 171 173 175 184 189 190 192 193 200 203 204 205 210 212 215 218 222 223 230 239 245 246 251 255 259

Alpha-Lipoic Acid and Nerve Damage, Especially in Diabetes: Human Studies

In diabetic nerve damage, orally or intravenously administered alpha-lipoic acid improved symptom scores compared with control in several meta-analyses 72733404570. Neuropathy scores also improved in several studies 7274075. Several studies also found a reduction in pain intensity 5675 as well as in neuropathic pain 3345. In contrast, two review articles with placebo comparison found no confirmed difference in the overall symptom score 1344. Against gamma-linolenic acid, both agents acted similarly 95. Combinations with prostaglandin E1, epalrestat or Buyang-Huanwu decoction were tested only as a combination against individual agents and cannot be attributed to alpha-lipoic acid alone 458912. In carpal tunnel syndrome, after surgery more nerve values improved under alpha-lipoic acid than under placebo; a statistical group comparison is not reported 151. Another study found no difference from placebo in nerve conduction velocity 118. In chemotherapy-induced neuropathy, a placebo-controlled study found no difference 74, as did a small study in multiple sclerosis 147. The optimal form, dose and route of administration as well as the benefit in non-diabetic nerve damage remain open.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
4 Jiang et al. 2016systematic review · 2,676 participantsLipoic acid plus prostaglandin E1; vs. Prostaglandin E1 or lipoic acid monotherapyClinical efficacy: improved (p<0.00001, RR=1.32, 95% CI 1.26 to 1.38); Median motor nerve conduction velocity: improved (p<0.00001, MD=4.69, 95% CI 3.16 to 6.23); Median sensory nerve conduction velocity: improved (p<0.00001, MD=5.46, 95% CI 4.04 to 6.88)
5 Zhao et al. 2018meta-analysis · 1,894 participantsAlpha-lipoic acid plus epalrestat; at least 2 weeks; vs. Epalrestat monotherapy or alpha-lipoic acid monotherapyTherapeutic efficacy: improved (RR = 1.29, 95% CI: 1.21-1.38; RR = 1.43, 95% CI: 1.34-1.54); Median motor nerve conduction velocity: improved (WMD = 5.41, 95% CI: 2.07-8.75); Median sensory nerve conduction velocity: improved (WMD = 5.87, 95% CI: 1.52-10.22)
6 Abubaker et al. 2022systematic review · 1,500 participantsAlpha-lipoic acid; vs. Placebo or other treatmentImprovement of neuropathic symptoms: unclear (three trials (37.5%) observing significant improvements in symptoms and five trials (62.5%) not observing any notable results)
7 Hsieh et al. 2023meta-analysis · 1,242 participantsOrally administered alpha-lipoic acid; 600, 1200, or 1800 mg/day (subgroup analysis); vs. PlaceboTotal symptoms' score (TSS): improved; Neurological disability score (NDS): improved; Global satisfaction score: improved
8 Ran et al. 2024meta-analysis · 1,153 participantsAlpha-lipoic acid, epalrestat, and mecobalamin as triple combination; vs. Monotherapy or dual therapy with the same drugsOverall therapeutic outcome: improved (odds ratio: 3.74; 95 % confidence interval: 2.57-5.45; p < 0.00001); Median motor nerve conduction velocity (MNCV): improved; Sensory nerve conduction velocity (SNCV): improved
12 Yong et al. 2026systematic review · 926 participantsBuyang Huanwu Decoction combined with alpha-lipoic acid; vs. Control group (placebo or other treatment)Overall response rate: improved (RR = 1.24, 95%CI 1.17-1.32; I²=0%); TCM syndrome scores: improved (SMD=-0.76, 95%CI -0.98 to -0.54); Nerve conduction velocity (peroneal motor): improved (SMD = 1.01, 95%CI 0.48-1.54; I²=92%)
13 Baicus et al. 2024systematic review · 816 participantsAlpha-lipoic acid (thioctic acid); 6 to 48 months; vs. PlaceboTotal Symptom Score at 6 months: no difference (MD -0.16 points, 95% CI -0.83 to 0.51); Neuropathy Impairment Score-Lower Limbs at 6 months: no difference (MD -1.02 points, 95% CI -2.93 to 0.89)
27 Shen et al. 2026meta-analysisAlpha-lipoic acid (racemate), oral, intravenous, or sequential; 600–1,800 mg/day; 3 to 208 weeks; vs. Placebo or another ALA administration routeTotal Symptom Score (TSS): improved; Neuropathy Impairment Score (NIS): improved; Neuropathy Impairment Score in the Lower Limbs (NIS-LL): improved (I2 = 0%, SUCRA: 97.4%)

Further studies in this area: 28 33 36 40 41 44 45 56 64 65 69 70 74 75 79 95 107 117 118 129 131 147 151 174 175 183 184 185 186 187 192 195 196 197 198 200 202 207 209 211 217 222 224 229 235 237 245 248 249 250 251 253 258 259 261 262 263

Alpha-Lipoic Acid, Weight and Body Composition: Human Studies

Oral alpha-lipoic acid slightly lowered body weight compared with placebo in several meta-analyses and one randomized controlled trial 295890. BMI also improved in several controlled studies 2958128. Waist circumference decreased in several controlled studies 2990116128. A meta-analysis also reports a decrease in fat mass 29. In obese adults and obese children and adolescents, randomized controlled trials found greater weight loss than under placebo 73104. A non-randomized study found it also in addition to metformin 171. In contrast, there are results with no difference: in chronic kidney disease and in polycystic ovary syndrome, BMI remained unaffected 3537, and after stroke only waist circumference improved, not weight and BMI 116. The findings come from studies with oral intake. The evidence is strong, but dose, duration and the transferability to the R-enantiomer remain open.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
10 Jibril et al. 2022systematic review · 1,035 participantsOral alpha-lipoic acid supplementation; per 500 mg/day, dose-response analysis; vs. Placebo or control (16 randomized trials)Body weight: improved (MD600 mg/day: -0.30 kg, 95% CI: -0.04, -0.57)
21 Li et al. 2026meta-analysis · 414 participantsAlpha-lipoic acid (ALA) supplementation; vs. PlaceboAdipocytokines: no difference; Obesity measures: no difference
29 Mohammadi et al. 2026meta-analysisAlpha-lipoic acid supplementation; vs. Control group (placebo or other)Waist circumference: improved (WMD: -1.10 cm, 95 % CI: -1.66, -0.54; P < 0.001); Body mass index: improved (WMD: -0.27 kg/m2, 95 % CI: -0.44, -0.10; P = 0.002); Fat mass: improved (WMD: -1.42 kg, 95 % CI: -2.53, -0.31; P = 0.012)
35 Rezaei et al. 2025meta-analysisAlpha-lipoic acid supplementation; 600 mg/day; vs. Control group (placebo or other)Weight loss: no difference; Body mass index: no difference
37 Abu-Zaid et al. 2024meta-analysisAlpha-lipoic acid (ALA) supplementation; vs. Control group (placebo or other treatment, not specified)Body mass index (BMI): no difference
58 Namazi et al. 2018meta-analysisAlpha-lipoic acid supplement; up to 1200 mg/day; vs. PlaceboBody weight: improved (WMD: -0.69 kg; 95% CI: -1.27, -0.10; I2 = 0%); BMI: improved (WMD: -0.38 kg/m2; 95% CI: -0.53, -0.24; I2 = 0%); Waist circumference: no difference (WMD: -0.30 cm; 95% CI: -1.18, 0.58; I2 = 17.8%)
67 Kucukgoncu et al. 2017meta-analysisAlpha-lipoic acid as a supplement; not reported; Study duration significantly affected BMI change; vs. PlaceboMean weight loss: improved (1.27 kg (confidence interval = 0.25 to 2.29)); Mean BMI change: improved (-0.43 kg/m2 (confidence interval = -0.82 to -0.03))
73 Koh et al. 2011randomised controlled · 360 participantsOral alpha-lipoic acid; 1200 or 1800 mg/d; 20 weeks; vs. Placebo, randomized double-blindWeight loss versus placebo: improved (2.1%; 95% confidence interval, 1.4-2.8; P<.05)

Further studies in this area: 90 94 104 114 116 128 133 155 161 171 190 192 205 206 212 252 259

Alpha-Lipoic Acid and Liver: Human Studies

In fatty liver, a meta-analysis of placebo-controlled studies found no advantage for liver enzymes 21, and a randomized study likewise found no advantage for liver enzymes and degree of steatosis 133. After liver transplantation, post-reperfusion syndrome occurred less often with alpha-lipoic acid than with placebo, and plasma alarmins were lower 141. The studies are small and short; predominantly, there was no advantage over placebo or dietary advice. Compared with dietary advice alone, alpha-lipoic acid provided no advantage for ALT and AST 98. A systematic review describes modest improvements in humans but considers the data insufficient 31. Efficacy and safety with longer use and with higher doses remain open.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
21 Li et al. 2026meta-analysis · 414 participantsAlpha-lipoic acid (ALA) supplementation; vs. PlaceboLiver enzymes: no difference
31 Saeed et al. 2026systematic reviewAlpha-lipoic acid (ALA)liver enzymes: improved; steatosis-related outcomes: improved
98 Tutunchi et al. 2023randomised controlled · 92 participantsAlpha-lipoic acid (ALA) supplement; 8 weeks; vs. Control group (dietary recommendation) and myo-inositol and propolis groupsAST: no difference (p = 0.058)
124 Aslfalah et al. 2019randomised controlled · 60 participantsAlpha-lipoic acid; 100 mg/day; 8 weeks; vs. Placebo, randomized double-blindGamma-glutamyltransferase: unclear (P < 0.001); Alanine transaminase: unclear (P = 0.031); Urea, creatinine, uric acid, aspartate transaminase, alkaline phosphatase: unclear
133 Hosseinpour-Arjmand et al. 2019randomised controlled · 50 participants1200 mg alpha-lipoic acid (2 capsules/day) plus 400 mg vitamin E; 1200 mg ALA + 400 mg vitamin E daily; 12 weeks; vs. Placebo (starch) plus 400 mg vitamin Eliver steatosis grade: no difference; liver enzymes: no difference
141 Casciato et al. 2018randomised controlled · 40 participantsα-lipoic acid (racemate); 600 mg intravenous; before reperfusion, up to 2 days after reperfusion; vs. PlaceboPostreperfusion syndrome (PRS): improved (Nine of 40 patients developed postreperfusion syndrome (PRS), but seven of them belonged to the control group); PHD2 transcript levels: improved (decrease in PHD2); HIF-1α transcript levels: improved (increase in alpha subunit of hypoxia-inducible factor-1 (HIF-1α))
179 Dumitru et al. 2020study · 1,718 participantsOriginal formula of silymarin, organic selenium and alpha lipoic acid; Study started March 2018, end not statedProportion of grade I FLD patients with no sign of disease at end: improved (25%); Proportion of grade II FLD patients who recovered or improved: improved (74%); Proportion of grade III FLD patients who recovered or improved: improved (83%)
203 Genazzani et al. 2024case series · 32 participantsAlpha lipoic acid (ALA); 400 mg/day; 12 weeks; vs. Before-after comparison (no control group)ALT plasma levels: improved (decreased); AST plasma levels: improved (decreased); Hepatic Insulin Extraction (HIE) index: improved (greater HIE index decrease)

Further studies in this area: 206 210 247

Alpha-Lipoic Acid, Eye and Retina: Human Studies

For the eye, only one randomized controlled study is available: after acute optic neuritis, the retinal nerve fiber layer decreased with alpha-lipoic acid as with placebo 143. The strength of evidence is therefore unclear, because this single study was small and short; reliable statements about retinal function cannot be derived from it. A case series reports an improvement in retinal and optic nerve function, but only for a mixture of thioctic acid with vincamine, lutein and cyanocobalamin, so the finding cannot be attributed to the single substance 178. A review reports improvements in tear film parameters and corneal defects but leaves the course of diabetic retinopathy and keratopathy open 244. Overall, the data on alpha-lipoic acid for the eye are thin; controlled findings are lacking for the R-enantiomer and for intravenous administration.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
143 Falardeau et al. 2019randomised controlled · 31 participantsOral lipoic acid (racemate) versus placebo; 1200 mg once daily; 6 weeks treatment, 24 weeks follow-up; vs. Placebo, double-blind, randomizedChange in affected eye retinal nerve fiber layer (RNFL) thickness: no difference (108.47 (SD 26.11) at baseline to 79.31 (SD 19.26) at 24 weeks); Change in unaffected eye RNFL thickness: no difference (did not significantly change in either group over 24 weeks)
178 Abdelkader et al. 2019case series · 2,000 participantscombination of thioctic acid, vincamine, lutein and cyanocobalamin; 3-12 months, follow-up 12 months; vs. no control, before-afterimprovement of retinal and optic nerve function (ERG/VEP): improved (840 eyes out of the 1000 improved)
244 Mateo et al. 2025reviewAlpha-lipoic acidtear film parameters: improved; corneal defects: improved; diabetic retinopathy and keratopathy: unclear

Alpha-Lipoic Acid: Further Outcomes in Studies

In this area, very different endpoints were examined, predominantly with oral intake. Several controlled studies and reviews found less pain, for example in migraine, burning mouth syndrome and hemorrhoids 455968899799. In men with fertility disorders, sperm motility improved 2426159162. Vascular function improved in several studies 23102173, blood pressure decreased in a meta-analysis and two randomized studies 16115128. Mood and depression scores improved in two randomized studies 105122. The strength of evidence is overall high, but the studies differ greatly in population, dose and administration.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
1 An et al. 2022meta-analysis · 883,627 participantsAlpha-lipoic acid as dietary supplement; vs. Placebo or other controlCardiovascular risk factors: improved (moderate- to high-quality evidence for reducing CVD risk factors)
2 Nguyen et al. 2024systematic review · 35,717 participantsAlpha-lipoic acid as a supplement; vs. PlaceboSOFA score: no difference; 30-day all-cause mortality: no difference
3 Fogacci et al. 2020meta-analysis · 4,749 participantsAlpha-lipoic acid supplementation; vs. PlaceboTreatment-emergent adverse events (all p > 0.05)
6 Abubaker et al. 2022systematic review · 1,500 participantsAlpha-lipoic acid; vs. Placebo or other treatmentAdverse events (no reported adverse effects)
13 Baicus et al. 2024systematic review · 816 participantsAlpha-lipoic acid (thioctic acid); 6 to 48 months; vs. PlaceboAdverse events leading to treatment cessation within 6 months (RR 1.48, 95% CI 0.50 to 4.35)
15 Gupta et al. 2021systematic review · 701 participantsAlpha-lipoic acid among other agents; vs. Placebo or other agentsHearing outcome at 4 kHz: unclear
16 Vajdi et al. 2023meta-analysis · 674 participantsAlpha lipoic acid supplementation; less than 800 mg/day; ≤12 weeks; vs. Placebo or controlSystolic blood pressure: improved (WMD = -5.46 mmHg; 95% CI: -9.27, -1.65; p < 0.001); Diastolic blood pressure: improved (WMD = -3.36 mmHg, 95% CI: -4.99, -1.74; p < 0.001)
17 Christy et al. 2022meta-analysis · 594 participantsAlpha-lipoic acid; vs. Placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène, laser therapyPain intensity (VAS): no difference (P = 0.616); Self-reported symptom improvement: improved (1.923 times more likely (P = 0.031)); Pain reduction (VAS) clonazepam vs. ALA: unclear (4.08 (P < 0.001))

Further studies in this area: 20 22 23 24 26 30 32 34 35 36 37 39 41 42 43 45 49 50 52 59 60 63 66 68 76 78 81 83 86 87 88 89 90 91 93 96 97 99 100 101 102 103 105 106 108 109 110 113 114 115 117 120 121 122 123 126 128 129 130 132 136 137 138 139 140 142 144 145 146 148 149 150 152 153 156 157 158 159 160 162 163 165 170 172 173 176 177 180 181 182 183 184 188 189 191 192 193 194 199 200 201 202 203 204 205 208 209 212 213 214 216 217 219 220 221 224 225 226 227 228 230 232 233 234 236 238 239 240 241 243 249 254 255 256 257 260 263 264

4. How Is Alpha-Lipoic Acid Dosed? Preparation, Dose and Duration in Studies

The studies gave alpha-lipoic acid predominantly orally as a tablet, capsule, or dietary supplement; the summaries mostly do not state which form was used. Individual investigations gave alpha-lipoic acid intravenously, especially for diabetic nerve damage. The two mirror-image forms were not tested separately in the studies with a comparison group.

Preparation or formDoseDurationStudy
α-lipoic acid 600 mg once daily or placebo600 mg once daily4 years71
Fixed-dose combination pregabalin 80 mg plus thioctic acid 400 mg80 mg pregabalin plus 400 mg thioctic acid twice daily12 weeks72
Oral alpha-lipoic acid1200 or 1800 mg/d20 weeks73
Oral alpha-lipoic acid600 mg three times a day24 weeks74
Oral alpha-lipoic acid as add-on treatment600 mg twice daily6 months75
Alpha-lipoic acid (ALA) versus placebo—24 hours after surgery76
Combination of inositol and alpha lipoic acid—6 months77
Alpha-lipoic acid added to letrozole1800 mg/day ALA; letrozole 2.5-7.5 mgup to three treatment cycles or until pregnancy78
Alpha-lipoic acid 480 mg/day, pregabalin 150 mg/day, combinationALA 480 mg/day; pregabalin 150 mg/day12 weeks79
Lipicur: lipoic acid plus curcumin phytosome and piperinenot reported8 weeks80
Oral alpha-lipoic acid plus NB-UVB phototherapy300 mg daily6 months81
G-Series culture medium with three antioxidants (A3)—until day 5/6 of embryo culture82
Alpha-lipoic acid plus olfactory training—12 weeks83
Alpha lipoic acid 600 mg plus acetyl-L-carnitine, resveratrol, cholecalciferol600 mg alpha lipoic acid daily30 days treatment, follow-up to 60 days after84
Oral nutritional supplementation with alpha-lipoic acid, carnosine, zinc (LICA), B vitamins, and vitamin D3Daily oral, vitamin D3 800 IU6 months follow-up85

5. Is Alpha-Lipoic Acid Safe? Side Effects in Studies

The studies predominantly report no serious adverse events and no difference in treatment discontinuations due to side effects 34813. At higher doses, side effects occurred; at lower doses, administration was considered safe 40.

StudyReported side effects
3 Fogacci et al. 2020No increased risk of treatment-emergent adverse events
4 Jiang et al. 2016No serious adverse events associated with drug intervention
6 Abubaker et al. 2022No adverse effects reported
8 Ran et al. 2024No statistical difference in adverse effects
9 Jiang et al. 2018No serious adverse events reported
10 Jibril et al. 2022Safety assessed, no data in abstract
12 Yong et al. 2026Adverse events did not differ between groups
13 Baicus et al. 2024No difference in adverse events leading to treatment cessation (RR 1.48, 95% CI 0.50 to 4.35)
24 Pires et al. 2025no adverse events reported
27 Shen et al. 2026Intravenous route bypasses gastrointestinal risks
32 Ezzat et al. 2026Localized dermatitis to systemic reactions, patch-test-confirmed sensitization
33 Salinas et al. 2026ALA is safe

6. What Remains Open: Limits of the Evidence

  • The optimal form (racemate or R-enantiomer), dose, and route of administration are open for most endpoints.
  • Many studies are small and short; the heterogeneity of populations and comparison groups limits transferability.
  • For the eye and retina, only one small randomized controlled trial is available, which could not demonstrate a protective effect due to too few participants 143.
  • Combination preparations with other substances do not allow conclusions about the individual substance.
  • Long-term data on efficacy and safety with longer use and higher doses are lacking.

7. Bottom Line: What Is Established About Alpha-Lipoic Acid

Alpha-lipoic acid is a sulfur-containing substance that the body produces itself and that occurs in foods such as spinach, broccoli, potatoes, and yeast. Human studies mostly gave alpha-lipoic acid orally, and for nerve damage also intravenously. In oxidative stress, glucose and fat metabolism, diabetic nerve damage, and overweight, meta-analyses mostly found small improvements, but individual studies also found no difference; in fatty liver, there was predominantly no advantage. The evidence strength is predominantly high for these areas, but small groups, short duration, and inconsistent comparison groups limit the informative value. For the eye and retina, the data are sparse.

Frequently Asked Questions

How well has Alpha-Lipoic Acid been studied in humans?

We evaluated 329 human studies on Alpha-Lipoic Acid, including 135 randomised controlled trials and 70 meta-analyses or systematic reviews; the controlled studies include 11,719 participants in total. As of 15 October 2026.

Does Alpha-Lipoic Acid help with oxidative stress (laboratory markers)? What the studies show

We evaluated 14 meta-analyses or systematic reviews, 44 controlled studies and 19 further studies; the controlled studies include 2,543 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 10111218

Does Alpha-Lipoic Acid help with glucose and fat metabolism? What the studies show

We evaluated 20 meta-analyses or systematic reviews, 28 controlled studies and 26 further studies; the controlled studies include 1,616 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 10121418

Does Alpha-Lipoic Acid help with nerve damage, especially in diabetes? What the studies show

We evaluated 14 meta-analyses or systematic reviews, 12 controlled studies and 39 further studies; the controlled studies include 1,048 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 4567

Does Alpha-Lipoic Acid help with weight and body composition? What the studies show

We evaluated 7 meta-analyses or systematic reviews, 11 controlled studies and 7 further studies; the controlled studies include 945 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 10212935

Does Alpha-Lipoic Acid help with liver? What the studies show

We evaluated 2 meta-analyses or systematic reviews, 4 controlled studies and 5 further studies; the controlled studies include 242 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: moderate. Sources: 213198124

Does Alpha-Lipoic Acid help with eye and retina? What the studies show

We evaluated one controlled study and 2 further studies; the controlled studies include 31 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: unclear. Sources: 143178244

What is alpha-lipoic acid and which forms were studied?

Alpha-lipoic acid is a sulfur-containing substance produced by the body that participates in energy production in cells. In human studies, alpha-lipoic acid was given as a tablet, capsule, or intravenously; the summaries mostly do not state the form. The two mirror-image forms were not tested separately in the studies with a comparison group.

Do human studies show an effect in diabetic nerve damage?

Several meta-analyses found better symptom scores with oral or intravenous administration compared with control 72733404570. For nerve conduction velocity, however, meta-analyses found no difference 73340. Two review articles with placebo comparison found no confirmed difference in the overall symptom score 1344; against gamma-linolenic acid, both agents acted similarly 95.

Is there evidence of an effect in overweight?

In obese adults and obese children and adolescents, randomized controlled trials found greater weight loss than with placebo 73104. A non-randomized study also found it in addition to metformin 171. In patients with polycystic ovary syndrome and in patients with chronic kidney disease, however, BMI remained unaffected 3537.

How well tolerated is alpha-lipoic acid in the studies?

At higher doses, side effects occurred; at lower doses, administration was considered safe 40. One meta-analysis names gastrointestinal complaints as the most common side effects 41; in case reports, an insulin autoimmune syndrome occurred after intake, which subsided after discontinuation 50.

What should be considered with combination preparations?

Combination preparations in which alpha-lipoic acid is combined with other substances such as B vitamins, carnitine, vitamin E, or plant extracts were examined separately. Their results cannot be attributed to the individual substance alpha-lipoic acid.

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    Effects of alpha-lipoic acid treatment on serum progranulin levels and inflammatory markers in diabetic neuropathy
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    Effects of Alpha-Lipoic Acid Supplementation on Plasma Adiponectin Levels and Some Metabolic Risk Factors in Patients with Schizophrenia
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    Silymarin-alpha lipoic acid and metabolic dysfunction-associated steatotic liver disease: Insights and methodological considerations
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    A Comprehensive Review of Safety, Efficacy, and Indications for the Use of Alpha-Lipoic Acid and Acetyl-L-Carnitine in Neuropathic Pain
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    Diabetes and the associated complications: The role of antioxidants in diabetes therapy and care
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    Diabetic Peripheral Neuropathy: Prevention and Treatment
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    Does Alpha-lipoic acid improve effects on polycystic ovary syndrome?
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    Dietary supplements for treatment of endometriosis: A review
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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.

International Health Research · https://ih-research.com/en/knowledge/alpha-lipoic-acid/ · Last updated: 2026-10-16