5-ALA (5-aminolevulinic acid)
What it is
A rate-limiting precursor in heme and cytochrome biosynthesis that directly stimulates mitochondrial electron transport chain components including cytochrome c oxidase. Serum 5-ALA declines significantly with age. Six Japanese RCTs (N=50–500 each) consistently find 50–150 mg/day 5-ALA combined with sodium ferrous citrate significantly lowers postprandial blood glucose and HbA1c in pre-diabetes and type 2 diabetes. Also investigated for COVID-19 (blocks ACE2 receptor binding in vitro) and sarcopenia (increases mitochondrial activity in muscle). Photosensitivity risk at doses above 150 mg — clinically used at high doses (60 mg/kg) for photodynamic cancer therapy.
Dose
50–150 mg/day 5-ALA, typically as 5-ALA + sodium ferrous citrate (SFC) combination; taken with meals
Time of day & tips
Best taken with meals. Morning dosing aligns with metabolic diurnal patterns. Avoid excessive unprotected sun exposure, especially at doses approaching 150 mg (photosensitivity risk increases). Ensure pharmaceutical-grade product — some agricultural-grade 5-ALA contains contaminants. Blood glucose monitoring recommended if diabetic.
Cycling
Safety data from Japanese trials extends to 24 weeks. Long-term safety beyond 1 year not fully established. Monitor HbA1c and fasting glucose to assess metabolic response.
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