Talk:Lipoic acid

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Things to do[edit]

-Please check out the recommendations for the peer review above (click on "archived"). They suggest using Nicotinamide adenine dinucleotide as an example of what the article should look like.

-The article is too long and has too many references. Try to stick to recent reviews and not get bogged down in the details of every research article. The lengthy historical list is unnecessary. I propose we list only uses for lipoic acid that are in clinical trials or are approved for use instead of listing every case study.

-I suggest we don't have a section on the basic research on the function of administered lipoic acid and just stick to the established medical knowledge. What a "function" for an administered compound would be is not clear. Qchristensen (talk) 09:23, 10 April 2014 (UTC)

The list of possible benefits should be an actual list, not a run-on sentence.

Lipoic acid has been the subject of numerous research studies and clinical trials. Lipoic acid was shown:

The tag soup makes it nearly impossible to edit, though.


  1. ^ Ritschell W. Curative liver protection by thioctic acid.Pharm Acta Helv. (1959) 34:189-94
  2. ^ Murabayashi, A; Yamada, M (June 1964). "EFFECTS OF THE ORAL ADMINISTRATION OF HEPATOPROTECTIVE DRUGS ON THE PREVENTION OF HEPATIC DISORDERS AFTER LUNG SURGERY". Kyobu geka. the Japanese journal of thoracic surgery 17: 372–4. PMID 14171363. 
  3. ^ Issekutz, L (April 1967). "Evaluation of the therapeutic effect of live protective substances". Arzneimittel-Forschung 17 (4): 419–24. PMID 4879441. 
  4. ^ Gómez Ponsa, JM (November 1970). "1st experiences with the use of a new liver protector in liver diseases". Revista espanola de las enfermedades del aparato digestivo 32 (5): 593–600. PMID 4924709. 
  5. ^ Kummer, P; Ott, A (December 1959). "Studies on liver circulation under the influence of thioctic acid and other medications". Munchener medizinische Wochenschrift (1950) 101: 2399–2402. PMID 14412705. 
  6. ^ Möller, E; Brinkmann, W; Weber, O; Wildhirt, E (March 1967). "Treatment of chronic liver diseases with thioctic acid". Medizinische Klinik 62 (10): 380–4. PMID 4874626. 
  7. ^ Horáková, O; Horák, J; Horák, F (March 1967). "The hepatotropic effect of alpha-lipoic acid". Ceskoslovenska farmacie 16 (3): 129–33. PMID 4859914. 
  8. ^ Iasinovskiĭ, MA; Terletskaia, TM; Bondarchuk, AF (May 1969). "Use of lipoic acid in complex therapy of patients with liver diseases". Vrachebnoe delo 5: 9–12. PMID 4904841. 
  9. ^ Ivkov, VG (October 1969). "Lipoic (thioctic) acid and its significance in hepatology". Sovetskaia meditsina 32 (10): 122–8. PMID 4910429. 
  10. ^ Romanov, VS (1971). "Use of lipoic acid and its amide in chronic liver diseases". Sovetskaia meditsina 34 (12): 43–5. PMID 4948129. 
  11. ^ Dabski, H; Brzeski, Z (June 1970). "Treatment of chronic diseases of the liver parenchyma with thioctic acid". Polski tygodnik lekarski (Warsaw, Poland : 1960) 25 (24): 899–901. PMID 4913117. 
  12. ^ Brinkmann, W; Klein, B; Möller, E (December 1971). "Is the rebound effect in liver diseases following glucocorticoid therapy avoidable by using alpha-lipoic acid?". Therapie der Gegenwart 110 (12): 1774–5 passim. PMID 4945968. 
  13. ^ Pace, O (February 1956). "Trial therapy of various liver diseases with intravenous administration of liver extracts with vitamins and lipotropic substances". Minerva medica 47 (14): 458–60. PMID 13309035. 
  14. ^ Hecht, Y; Barbier, P; Caroli, J (1967). "Coenzyme treatment of severe jaundice due to hepatitis (Thölen's method)". Rein et foie, maladies de la nutrition; actualites 10: 95–118. PMID 4295322. 
  15. ^ Caroli, J; Thölen, H; Hecht, Y; Rautureau, M; Bognel, JC; Lauga, J (February 1966). "Acute atrophy of the liver due to viral hepatitis treated by coenzyme A, alpha-lipoic acid, D.P.N and cocarboxylase". Revue medico-chirurgicale des maladies du foie 41 (1): 7–18. PMID 5327295. 
  16. ^ Colombi, A; Thölen, H; Huber, F (April 1969). "Influence of coenzyme A, nicotinamide adenine dinucleotide (NAD), alpha-lipoic acid and cocarboxylase on acute hepatitis (double blind experiment)". Internationale Zeitschrift fur klinische Pharmakologie, Therapie, und Toxikologie. International journal of clinical pharmacology, therapy, and toxicology 2 (2): 133–8. PMID 4308212. 
  17. ^ Pagliaro, L (June 1959). "On a case of siderosis with liver cirrhosis treated with thioctic acid". Sicilia sanitaria 12: 150–2. PMID 14429786. 
  18. ^ De Pasquale, C; Nardi, E; Ronchi, F (December 1959). "Considerations on the use of thioctic acid in the treatment of hepatic cirrhosis". La Clinica terapeutica 17: 580–93. PMID 13814973. 
  19. ^ Rausch, F (January 1955). "Clinical observations on thioctic acid (lipoic acid); preliminary report". Arzneimittel-Forschung 5 (1): 32–4. PMID 14351072. 
  20. ^ Roth, H; Cruchaud, A (July 1957). "Thioctic acid, hepatotropic biocatalyzer; its role in the treatment of hepatic coma". Revue medicale de la Suisse romande 77 (7): 574–86. PMID 13454274. 
  21. ^ Thoelen, H; Bigler, F; Heusler, A; Staub, H (November 1962). "Therapy of hepatic coma with coenzyme A, alpha-lipoic acid and diphosphopyridine nucleotide". Deutsche medizinische Wochenschrift (1946) 87: 2488–95. PMID 13981021. 
  22. ^ Thölen, H; Colombi, A; Duckert, F; Huber, F; Möller, HR; Bigler, F (August 1967). "Effects of a treatment with coenzyme A, alpha-lipoic acid, diphosphopyridine nucleotide and cocarboxylase on endogenous hepatic coma". Helvetica medica acta 33 (6): 492–504. PMID 4295373. 
  23. ^ Ziegler, K (April 1970). "Current views on the therapy of hepatic coma". Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete 25 (8): 341–3. PMID 4331690. 
  24. ^ Mach, B; Mossor-Ostrowska, J; Wilkoń, B (July 1973). "Treatment of hepatic coma in the course of viral hepatitis". Wiadomosci lekarskie (Warsaw, Poland : 1960) 26 (13): 1255–8. PMID 4580740. 
  25. ^ Flinn, LB; D'alonzo, CA (July 1961). "A screening investigation of the use of lipoic acid as an anti-diabetic agent". Delaware medical journal 33: 193–6. PMID 13700294. 
  26. ^ Sauer, H; Böninger, C (December 1970). "What is reliable in the therapy of diabetes mellitus?". Der Internist 11 (12): 430–6. PMID 4924814. 
  27. ^ Lesnichiĭ, AV (February 1972). "Use of lipoic acid in diabetes mellitus". Vrachebnoe delo 2: 36–7. PMID 4563634. 
  28. ^ Klein, W (April 1969). "Diabetic neuropathy". Deutsches medizinisches Journal 20 (8): 268–70. PMID 4920138. 
  29. ^ Bock, E; Schneeweiss, J (October 1959). "A contribution to the therapy of neuropathia diabetica". Munchener medizinische Wochenschrift (1950) 101: 1911–2. PMID 13801880. 
  30. ^ Pagliaro, L (1956). "Influence of thioctic acid on carbohydrate metabolism. I. Modifications of basal glycemia, glycemic curve after oral administration of glucose and of curve after insulin". Bollettino della Societa italiana di biologia sperimentale 32 (1-2): 49–52. PMID 13374014. 
  31. ^ Pagliaro, L (1956). "Influence of thioctic acid on carbohydrate metabolism. II. First results of the mechanism of hypoglycemic action of thioctic acid". Bollettino della Societa italiana di biologia sperimentale 32 (1-2): 52–3. PMID 13374015. 

Minor Note[edit]

The use of the word "vicinal" in the second sentence of the opening paragraph is incorrect. "Vicinal" only relates heteroatoms and functional groups to one another through their positions on the carbon framework not through their own heteroatomic connections. For the two sulfur atoms to be vicinal they would have to be bound to adjacent carbons, say C7 and C8 or C6 and C7 instead of C6 and C8. — Preceding unsigned comment added by (talk) 15:58, 8 June 2012 (UTC)

I agree, and have rephrased the sentence to avoid misuse of the word. Thanks for catching the problem and reporting it here. -- Ed (Edgar181) 16:39, 8 June 2012 (UTC)

Adverse effects[edit]

This may be a serious adverse effect when used in higher dosages.

Mechanisms of antioxidant and pro-oxidant effects of -lipoic acid in the diabetic and nondiabetic kidney.

This study demonstrates that dietary supplementation with 30 mg/kg -lipoic acid for 12 weeks in rats prevents the increase in albuminuria and development of glomerulosclerosis and tubulointerstitial fibrosis associated with diabetic nephropathy. Our studies indicate that one of the mechanisms by which -lipoic acid exerts this renoprotective effect in rats is via decreasing oxidative stress, specifically, by reducing NADPH-induced generation of O-2 and regulating the expression of NADPH oxidase subunits. Most interestingly, our study shows that the dietary supplementation with the same dose of -lipoic acid is associated with a decline in renal function and development of glomerulosclerosis and tubulointerstitial fibrosis in the nondiabetic kidney in rats. Thus, these findings indicate that, although -lipoic acid is renoprotective in diabetic nephropathy in rats, it has detrimental effects to the healthy kidney in rats. Ref Article — Preceding unsigned comment added by (talk) 16:04, 2 December 2012 (UTC)

Possible Bias[edit]

It is quite possible that the author has a bias. I do not have the technical background to confirm. In the Effects section, the article references Alpha lipoic Acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. The reference's abstract says: It is unclear if the significant improvements seen after 3–5 weeks of oral administration at a dosage of >600 mg/day are clinically relevant.. The author summarizes the article as: There is no corresponding clinical benefit taking it by mouth..

So the effects of oral administration are not clinically significant. I've clarified. Alexbrn talk|contribs|COI 06:10, 31 March 2014 (UTC)
What happened to stick to the source? Why is it inappropriate to simply state the original study authors uncertainty? Is this not having your cake and eating it too?Khimaris (talk) 21:39, 31 March 2014 (UTC)
What "uncertainty"? They found no clear clinical benefit. This is faithfully rendered for the general reader as: "there is no good evidence of meaningful benefit". For comparison see the DARE summary: "Oral administration resulted in statistically but not clinically significantly improvements". Alexbrn talk|contribs|COI 21:54, 31 March 2014 (UTC)
The study concludes with: "It is unclear if the significant improvements seen with the oral administration of alpha lipoic acid are clinically relevant." The Dare summary is not an actual part of the article as far as I can tell. It also doesn't state how it derived clinically significant when the original paper stated uncertainty. You should use a separate source if you want to use "there is no good evidence of meaningful benefit" that differs from what the actual paper has in it.Khimaris (talk) 22:28, 31 March 2014 (UTC)
DARE is part of Cochrane - expert peer-reviewed abstracts. It was just to show my wording is a faithful wording for the general reader. Alexbrn talk|contribs|COI 22:36, 31 March 2014 (UTC)
I don't care what DARE is part of. You've added information to the article without properly attributing it. The current source is the original article. Either remove the statement or add a second source for DARE's position on the study. I would do it myself but it would obviously be reverted.Khimaris (talk) 22:47, 31 March 2014 (UTC)
We summarize secondary sources here, we do not cobble together primary sources to try to undermine high quality secondary sources. If you have a high quality secondary source that contradicts the Cochrane review, please present it. Otherwise, trying to go around WP:MEDRS will not get us anywhere. Yobol (talk) 02:35, 1 April 2014 (UTC)
Yobol, who is this "we" you speak of and who gave "we" the authority to make such flippant statements? I've asked Alex this and I will ask you: Why is it unreasonable to say that Cochrane's review of the literature did not find a any trials?
My head explodes that I have to fight tooth and nail to add such a simple statement to an article. It makes no god damned sense. Khimaris (talk) 03:19, 1 April 2014 (UTC)
I have no problem expanding the fact there have been no RCTs discussing dementia; I do have a problem with people adding WP:OR saying there have been without appropriate WP:MEDRS compliant sourcing. "We" is a discussion of what all editors of medical content should be following, specifically WP:MEDRS. You can choose not to follow WP:MEDRS, but you will likely soon find your edits reversed as "we" should be following them. Yobol (talk) 03:27, 1 April 2014 (UTC)
I'm calling bullshit again. WP:MEDRS is a guideline. I disagree with some of the regulations but I've been following it. Yet somehow "we" get to pick and choose what gets added and how it is worded. There is nothing in WP:MEDRS nor WP:MEDMOS that requires articles to be specifically worded in the fashion you and Alexbrn have chosen. Hopefully "we" can get to the point of not shrieking "FOLLOW MEDRS" and actually address the issues at hand. — Preceding unsigned comment added by Khimaris (talkcontribs) 03:55, 1 April 2014 (UTC)
Calling "bullshit" carries no weight if you don't accept the underlying sourcing principles in use here at Wikipedia. MEDRS is the guideline that is the application of the WP:V policy to biomedical content, so saying "but it's just a guideline" isn't convincing. You need to provide a really compelling reason--one strong enough to sway consensus--that an exception to the general rule of the guideline should be made here. You haven't done that. Zad68 04:09, 1 April 2014 (UTC)
Guidelines and principles are not laws. Please be aware of this fact. Khimaris (talk) 04:27, 1 April 2014 (UTC)
Sure, Wikipedia isn't a legal system or a courtroom, see WP:NOT for all the things Wikipedia is not. Zad68 04:37, 1 April 2014 (UTC)
Wikipedia isn't a place to disseminate unwarranted condescension, but I think you know that by now...Khimaris (talk) 04:46, 1 April 2014 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── It looks like Khimaris has proposed language in an edit that might stick, to resolve this specific content dispute over LA in dementia. I would like to suggest that this section be closed and if there are remaining issues with this content, other bits, or the article in general, that they be re-opened under new sections. Starting out with accusations of bias is no way to productively work toward WP:CONSENSUS, which we all know is the foundation of WP. Jytdog (talk) 08:39, 1 April 2014 (UTC)

"It is unclear if the significant improvements ..are clinically relevant" does not equal "There is no corresponding clinical benefit" (talk) 05:02, 9 June 2015 (UTC)

Stepping back[edit]

just want to note that this article is a mess. way too technical in some aspects and not enough plain english. lots of content in the lead that is not in the body. am working on cleaning it up... Jytdog (talk) 07:03, 1 April 2014 (UTC)

ok, first pass is done. needs a lot more work. Jytdog (talk) 08:34, 1 April 2014 (UTC)

“Lipoic acid is cofactor for at least five enzyme systems. Two of these are in the citric acid cycle through which many organisms turn nutrients into energy.”

The mentioning that alpha lipoic acid is not one of the required nutrients seems to be written to specifically imply that it may not be of use or necessary for regular metabolic function but then the above quoted is completely the opposite.

Lipoic acid is made by the body, so is not a vitamin (required nutrient). It is still an important cofactor. Qchristensen (talk) 14:36, 25 June 2015 (UTC)

I agree this is ALA page is a mess and gets lost in too many side notes and not enough on the proven benefits. After reading it, you leave with more questions and a sense that this reference is inadequate and should not be given as a reference to those inquiring on the subject.

Part of the problem is that there are a lot of "benefits" that are unproven. This all started shortly after the structure of lipoic acid was solved, when a doctor administered low levels intravenously to 12 patients with various diseases. One patient in a coma woke up. Must be an amazing miracle drug, right? Qchristensen (talk) 14:36, 25 June 2015 (UTC)

Btw, does it cross the blood brain barrier? Does it detox heavy metals? These are not mentioned. This tells me this reference is just incomplete and written from dismissive or unintended but ignorant perspective rather that a full spectrum of a scientific educated knowledge. — Preceding unsigned comment added by (talk) 21:03, 18 February 2015 (UTC)

As I recall from my thesis work, lipoate can chelate metals to some extent. I don't recall ever finding conclusive evidence that it can do this when administered therapeutically, although it has been administered for this. Qchristensen (talk) 14:36, 25 June 2015 (UTC)

Problems with "Biological Function" and "Activity in Mitochondria"" section[edit]

There are major factual problems with this section. The section describes non-mitochonrial things. The mitochondria doesn't have an acetoin dehydrogenase, for example. I'll clean up this section a bit Qchristensen (talk) 07:26, 10 April 2014 (UTC)

Done Qchristensen (talk) 09:50, 10 April 2014 (UTC)

Decreasing lipoic acid levels[edit]

I took out the paragraph on the phenomenon of decreasing lipoic acid levels in sick patients. The references were not reputable (were very old and in obscure journals) and the research yielded no clear conclusions for this article. Qchristensen (talk) 10:07, 10 April 2014 (UTC)


Hello, I added PUBMED 9607614 - ALA in liver metabolism & disease. It seems there was some severe amputation of this article over years(?) and just about anything related to anything beneficial about this topic has been cut out. All the cites are right here ^^ some need to be returned x1987x(talk) 05:38, 26 January 2015 (UTC)

as Alexbrn mentioned in his edit, that was a very old source, and the use was experimental. Per WP:MEDMOS the "uses" section should reflect actual use, not research. Jytdog (talk) 14:48, 26 January 2015 (UTC)
"there was some severe amputation of this article over years(?) and just about anything related to anything beneficial about this topic has been cut out" as is the norm for anything related to nutrition.. (talk) 04:56, 9 June 2015 (UTC)

"should reflect actual use, not research" Why? There are Dozens of wiki articles of substances that are scientifically studied, researched and demonstrated in scientific literature. As is the case with Julone and cancer and there is a whole page for substances being “studied” on wiki for Favipiravir. Are only pharmaceuticals approved for posting the “research”

Sure, mentioning that people have studied it for use in liver metabolism and disease is valid. However, most of these ideas have very little support and so are only ideas. Qchristensen (talk) 14:29, 25 June 2015 (UTC)