Alpha-Lipoic Acid (ALA)
Alpha-lipoic acid is a universal antioxidant active in both aqueous & lipid compartments that regenerates other antioxidants; it has strong evidence for reducing neuropathic symptoms in diabetic polyneuropathy & improving insulin sensitivity.
Evidence last reviewed: 04 Apr 2026
The evidence for alpha-lipoic acid is robust, particularly in reducing neuropathic symptoms in diabetic patients, supported by multiple high-quality trials. However, while the benefits for insulin sensitivity are promising, further research is needed to fully understand its long-term effects.
Neuropathic symptoms in diabetic sensorimotor polyneuropathyPatients with type 1 or type 2 diabetes and symptomatic polyneuropathy · RCTHigh
The SYDNEY 2 trial (n=181, 5 weeks) found all three oral ALA doses (600, 1200, 1800 mg/day) significantly reduced the Total Symptom Score versus placebo (~50% vs 32% reduction); 600 mg/day provided the optimal risk-to-benefit ratio with fewer side effects than higher doses.
Neuropathic symptoms & deficits (intravenous ALA trials)Diabetic patients with symptomatic polyneuropathy · meta-analysis of RCTsHigh
Meta-analysis of 4 RCTs (ALADIN I, ALADIN III, SYDNEY, NATHAN II; n=1,258) found IV ALA 600 mg/day for 3 weeks significantly improved Total Symptom Scores (24.1% relative difference vs placebo) & neuropathic deficits; responder rate 52.7% vs 36.9% for placebo.
Metabolic & Antioxidant Support
Alpha-lipoic acid & fisetin are combined to support metabolic health & provide antioxidant benefits. Alpha-lipoic acid improves insulin sensitivity & supports metabolic function, while fisetin offers anti-aging & antioxidant support.
Forms & usage▾
Take 600 to 1800 mg daily, preferably with meals.