R-ALA, formally α-lipoic acid, is (through well-understood physiology) a cofactor for some enzymes, notably the pyruvate dehydrogenase complex, the 2-oxoglutarate dehydrogenase complex, branched-chain oxoacid dehydrogenase complex and the acetoin dehydrogenase complex.

The link above asserts, with no evidence, that some OTC forms of R-ALA, taken by mouth, are helpful for neuropathy but others are not. For example, one commercially available form of R-ALA is rejected on the grounds that "it is not 100% sodium stabilized". This sounds very scientific but is meaningless.

If people with neuropathy choose to self-medicate with R-ALA taken by mouth that is their call. However, they should do so in the knowledge that there is no good evidence that it will help.

These issues are discussed in more detail here Lipoic Acid | Linus Pauling Institute | Oregon State University.

ALA was the one nutrient my husband took that had the greatest impact on his PN. R-ALA was not available back then. We decided to tried the ALA based on how they were using it Germany for diabetic PN. I think they dosed at 900 mg/day.

If memory serves me correctly, John's pain level dropped from an 8 to about the 3-5 range within weeks of starting ALA.

It's certainly worth trying. The only concern I had was with higher dose and how it may impact mercury detoxification. It could mobilize more mercury than your body can handle. But John did fine with it.

Interesting thought about the mercury Marlene. Does R-ALA keep mercury from being excreted from your body?

The ALA doesn't prevent from being excreted, it can attach to the heavy metal so it can be detoxed. It's more about your body's ability to excrete it through the normal detox process. If your body, mostly the liver, is inefficient at detoxing or if your body is already overloaded with "toxins" then adding more to your detox burden would not be desired. So it's better to go slow if adding in r-ALA to see how you do. Lower dosage and hold at that level for a week or so before upping the dosage.

If my memory serves me correctly, (and this is my simple way of understanding it), if you can't excrete it, the body will want to do something with it and deposit it again in the tissues. Adding fiber, and things like green drinks help guide the toxin/heavy metal out. I'll have to see if I can find info on it. It's been a long time since I looked into it and may not have kept the info. I was hoping it would be a good chelator for iron because at the time, John had iron overload and ALA is a know heavy metal chelator but not efficient enough to remove iron.

There's some who suggest not using ALA at all if you have amalgam fillings. We ignored that piece of info and John did fine on ALA.

Thanks for the info Marlene. How have to check to see how quickly they suggest one increases the R-ALA.

I am laid up in bed with a frozen left knee so this will be
brief.

I see some issues with this "protocol".
The use of this term bothers me.

The massive dose of NaRALA without documentation of saftey
is problematic. I found side effects of A-fib on line for ALA
and also racing heart and insomnia.

ALA shares a transporter with biotn and iodide. This creates
potential issues too.

So do your homework before considering trying this.

Anyone who can get me info on who this is, please PM it
to me.
















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