5-ALA (5-aminolevulinic acid)

Tier 2 — promising · Mitochondrial · Blood sugar · Iron metabolism · Cytochrome synthesis

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 —…

Dose: 50–150 mg/day 5-ALA, typically as 5-ALA + sodium ferrous citrate (SFC) combination; taken with meals