Alpha Lipoic Acid (ALA is a disulfide molecule that contains two thiol groups (sulfur and hydrogen) and supplement companies claim it has an antioxidant property and increasing insulin sensitivity and also that it will give an increase in muscle cell volume.

When doing a serach on PubMed, there is a lot of science being done on rats. These studies show the following effects: Radical scavenger, enhancing glucose uptake in muscle cells, stimulating the enzyme pyruvate-dehydrogenase and thereby reducing serum levels of lactate and pyruvate (ref 4).

In diabetic studies, both human and on rats, several promising results can be found. In the development of type 2 diabetes, there is some evidence that hyperglycemia results in the generation of reactive oxygene species (ROS). These reactive oxygene species work as radicals and with time the compensatory endogenous antioxidant enzymes are overwhelmed and the result is activation of stress-sensitive signaling pathways. This process has several concequences: Insulin resistance, beta cell dysfunction and late complications. Where does the antioxidant ALA fit in. As an antioxidant it reduces ROS. ALA (also vitamine C and E) is also involved in the regeneration of the antioxidant glutathione. Taken together these effects of ALA will probably reduce beta cell dysfuncion and late complications in type 2 diabetics. In fact, ALA has been used in Germany for many years to treat the late diabetic complication of neuropathy. And, there are several studies that show improved insulin sensitivity by ALA (ref 2, 3).

Human studies on non-diabetics and human preformance are more sparse.
The most interesting is made by Burke, Tarnopolsky et al (ref 1) in which supplementing with carbohydrate, creatine and ALA was studied. One group consumed daily creatine monohydrate only (20 gram), another group consumed creatine monohydrate (20 gram) and sucrose (100 gram) and one group consumed creatine monohydrate (20 gram), sucrose (100 gram) and ALA (1000 mg). Muscle biopsy was preformed before the study and after the study. The biopsies were analyzed and phoshpocreatine, creatine and adenosine triphosphate were measured. The subject refrained from exercise and consumed the same balanced diet for 7 days. Body weight increased 2.1% following the intervention and with no difference between the groups. There was a significant increase (p<.05) increase in total creatine concentration following creatine supplementation, with the group ingesting ALA showing a greater increase (phosphocreatine 87.6 vs 106.2; total creatine 137.8 vs 156.8 mmol per kg dry mass. Although this study was small (16 subjects), of short term and factors that were not controlled (diet and exercise), this study indicate that ALA (in a fairly high dose 1000 mg, most other studies use 600 mg) increase creatine content as compared to the ingestion of creatine and sucrose or creatine alone.

Conclusion
Putting all the facts together, should ALA be used by the bodybuilder as a supplement? The science for diabetics, although small studies, show promise in that ALA probably leads to lesser complications and a better insulin sensitivity (in type 2 diabetes). If I had type 2 diabetes, I would supplement with ALA (600-1000 mg daily). No studies show clearly that ALA would improve glucose metabolism in healthy subjects. It could be like that but it has not been shown. The biopsy study by Burke, although some critisism can be made, show increased creatine levels in muscles when supplementing with ALA in healthy subjects. And that is good news for the bodybuilder. For the healthy bodybuilder ALA might have some positive effects. My recommendation is to give it a try and see if it works for you. I you decide to give ALA (600 mg) a try, why not combine it with carbs (about 50 gram), glutamine (10 gram) and creatine (10 gram) in a post training cocktail.

References

1. Burke DG et al. Effect of alpha-lipoic acid combined with creatine monohydrate on human skeletal muscle creatine and phosphagen concentration. Int J Sport Nutr Exerc Metab sep 13(3): 294-302, 2003.

2. Evans JL et al. Oxidative stress and stress-activated signaling pathways: A unifying hypothesis of type 2 diabetes. Endocrine reviews 23(5):599-622, 2002.

3. Evans JL et al. Pharmacokinetics, tolerability, and fructosamine-lowering effect of a novel, controlled-release formulation of alpha-lipoic acid. Am Ass of Clinical Endocrinologists 8(1), jan-feb, 2002.

4. Konrad T et al. Alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Diabetes Care 22(2): 280-287, 1999.

About the writer: Carl-Marcus Lokrantz, MD and nutritionist, studied medicine at the prestigous Karolinska Institute, Stockholm, Sweden and also studied Nutrition at Stockholm University. Carl-Marcus Lokrantz works in internal medicine and also has a buisiness where he helps bodybuilders with training, nutrition and managing. His company LOKRANTZ CONSULTING offers the complete support for the serious athlete. For more information, check out www.lokrantzconsulting.com.

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