Alpha-lipoic acid is a nutrient I've pretty much ignored. It always seemed like one of those, "nice but not necessary" items for any Lyme supplement checklist. Recently, however, I have started to consider that it may be a more vital component to any Lyme disease protocol than I initially thought. In fact, J. Burrascano, M.D., in his 2008 revised treatment guidelines for Lyme disease, puts alpha-lipoic acid in the "required" supplement category.
So what's so great about alpha-lipoic acid?
Whenever you kill Lyme critters, you create a fireworks display of free radicals in the body. These free radicals damage cells and create inflammation, which in turn affects immune function. Alpha-lipoic acid is a potent catcher and destroyer of free radicals. And while so many nutrients have anti-oxidant properties, alpha-lipoic acid is at the forefront of anti-radical power. Other anti-oxidants, such as vitamin E, serve only to quench free-radicals in the fatty membrane of cells, while others, such as vitamin C, get 'em in the watery part only. Alpha-lipoic acid has the unique ability to quench free radicals in both the watery and fatty part of cells, which means that it can eliminate radicals generated from all kinds of metabolic processes. As if that weren't enough, it makes other anti-oxidants more effective, because anti-oxidants are thought to function synergistically; that is, they work together, and alpha-lipoic acid happens to play a central role in this anti-oxidant network.
What this all amounts to is less cellular damage and inflammation as a result of Lyme and the fouled-up metabolic processes it creates.
Another benefit of alpha-lipoic acid is that it lowers glucose and insulin levels as it improves insulin sensitivity (function). It does this by increasing the burning of glucose by speeding up the Krebs cycle(sometimes by up to one-third!), and by improving the efficiency of insulin, which moves glucose into cells. In fact, high doses of alpha-lipoic acid have shown to improve insulin's effectiveness by an average of twenty-seven percent in diabetic patients. Due to the HPA dysfunction that is found in Lyme disease, many Lyme patients suffer from some degree of insulin resistance. Alpha-lipoic acid may be one effective way to combat this.
Finally, alpha-lipoic acid reverses nerve damage in several ways. First, by restoring normal glucose levels and getting rid of the cell-damaging free radicals (and in this regard it also can reverse other kinds of damage in the body), but also by increasing nerve conduction. Studies have found that it can stabilize variable and erratic heart rates. I don't know whether the results of such studies apply to Lyme patients, too, but it would seem to also be beneficial for those of us with skippy hearts.
So what dosage should Lyme disease patients take? I don't know, but I have heard that doses higher than 600 mg per day can mobilize heavy metals in the body, and unless you are taking a strong metal binder in conjunction with it, such as DMSA, you might end up shifting metals around in your body. Whether this is true or not, I don't know, but to be on the safe side, I would recommend not going above this dose. If you're hitting the bugs hard or wish to reverse insulin resistance, however, a higher dose, such as 500-600 mg might be necessary. Taking alpha-lipoic in lower doses, say 200-300 mg, is beneficial for maintenance of good health.