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Alpha-lipoic acid
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=== Clinical Trials === ==== Diabetic Neuropathy ==== Meta-analyses of randomized controlled trials suggest that infusion of 300 to 600 mg/day of lipoic acid for 2 to 4 weeks significantly reduced symptoms of diabetic neuropathy.<ref>{{Cite journal | last = Han | first = Tingting | last2 = Bai | first2 = Jiefei | last3 = Liu | first3 = Wei | last4 = Hu | first4 = Yaomin | date = Oct 2012 | title = A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy | url = https://www.ncbi.nlm.nih.gov/pubmed/22837391 | journal = European Journal of Endocrinology | volume = 167 | issue = 4 | pages = 465–471|doi=10.1530/EJE-12-0555|issn=1479-683X|pmid=22837391|pmc=|quote=|access-date=|via=}}</ref> A randomized, double-blind, placebo-controlled trial in 181 patients with diabetic neuropathy found that oral supplementation with either 600 mg/day, 1,200 mg/day, or 1,800 mg/day of lipoic acid for 5 weeks significantly improved neuropathic symptoms. There was no difference between the low, moderate or high dose groups.<ref>{{Cite journal | last = Ziegler | first = Dan | last2 = Ametov | first2 = Alexander | last3 = Barinov | first3 = Alexey | last4 = Dyck | first4 = Peter J. | last5 = Gurieva | first5 = Irina | last6 = Low | first6 = Phillip A. | last7 = Munzel | first7 = Ullrich | last8 = Yakhno | first8 = Nikolai | last9 = Raz | first9 = Itamar | date = Nov 2006 | title = Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial | url = https://www.ncbi.nlm.nih.gov/pubmed/17065669 | journal = Diabetes Care | volume = 29 | issue = 11 | pages = 2365–2370|doi=10.2337/dc06-1216|issn=0149-5992|pmid=17065669|pmc=|quote=|access-date=|via=}}</ref> Improvements in neuropathy from these trials are not always corroborated with electrodiagnostic testing. It is thought, that the beneficial effects of ALA on neuropathy may be due to effects on the small nerve fibers, making it a candidate treatment for [[Small fiber peripheral neuropathy|small fiber neuropathy]].<ref>{{Cite journal | last = Swiecka | first = Marta | author-link = | last2 = Maslinska | first2 = Maria | author-link2 = | last3 = Kwiatkowska | first3 = Brygida | author-link3 = | date = 2018 | title = Small fiber neuropathy as a part of fibromyalgia or a separate diagnosis? | url = https://www.openaccessjournals.com/articles/small-fiber-neuropathy-as-a-part-of-fibromyalgia-or-a-separate-diagnosis.pdf | journal=International Journal of Clinical Rheumatology | volume = 13 | issue = 6 | pages = 353-359|doi=|pmc=|pmid= | access-date = 2019-10-29|quote=|via=}}</ref> ==== Multiple Sclerosis ==== A small pilot study designed to evaluate the safety of lipoic acid in 30 people with relapsing or progressive multiple sclerosis found that treatment with 1,200 to 2,400 mg/day of oral lipoic acid for 2 weeks was safe. Those with the higher serum concentrations of lipoic acid had the lowest serum concentrations of MMP-9 — a marker of inflammation.<ref>{{Cite journal | last = Yadav | first = V. | last2 = Marracci | first2 = G. | last3 = Lovera | first3 = J. | last4 = Woodward | first4 = W. | last5 = Bogardus | first5 = K. | last6 = Marquardt | first6 = W. | last7 = Shinto | first7 = L. | last8 = Morris | first8 = C. | last9 = Bourdette | first9 = D. | date = Apr 2005 | title = Lipoic acid in multiple sclerosis: a pilot study | url = https://www.ncbi.nlm.nih.gov/pubmed/15794388 | journal = Multiple Sclerosis (Houndmills, Basingstoke, England) | volume = 11 | issue = 2 | pages = 159–165|doi=10.1191/1352458505ms1143oa|issn=1352-4585|pmid=15794388|pmc=|quote=|access-date=|via=}}</ref> A 2-year trial of 1,200 mg/day LA in secondary progressive MS demonstrated a significant reduction of whole-brain atrophy and trend toward improvement in walking speed.<ref name=":1" />
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