Alpha-Lipoic Acid (ALA)

Tier 3 — weak evidence · Diabetic neuropathy · Antioxidant

Reduces nerve pain (numbness, tingling, burning) from diabetic neuropathy — confirmed by multiple reviews. Uniquely antioxidant in both water and fat. Lowers blood sugar — hypoglycemia risk with diabetes medications. NIH warns high doses (>1,200 mg/day) may reduce thyroid hormone levels. Use the R-ALA form; it is more potent than the racemic form.

Dose: 600 mg/day R-ALA (or 1,200 mg/day racemic ALA); take 30 min before meals; caution with diabetes medications