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Alpha-Lipoic Acid & IV Nutritional Therapy

There are a number of IV Lounges which offer a handful of compounding recipes ranging from weight loss to immune boost, to even enhancing your #libido. These aren't inherently wrong, but I find this similar to taking supplements without really understanding your deficiency or first having a full evaluation of your history combined with your physical and diagnostic study review. When IV Nutritional Therapy is provided by a practitioner who is trained and licensed to create their own formulas, we can specify your treatment to your individual needs. We know that a number of chronic diseases are improved with various supplements, but if we utilize baseline testing, such as the #NutraEval from Genova, we can identify exactly where your deficiencies are and combine all this information to create a formula specific to you.



Alpha-Lipoic Acid


One way we can individualize your treatment, is when we give alpha-lipoic acid (ALA) to our type 2 diabetic clients, or those with burning mouth syndrome, fibromyalgia, chronic fatigue syndrome, various neuropathies, or even #atherosclerosis or #cancer. Type 2 diabetes for example, is associated with high levels of oxidative stress. In nerdy terms, diabetes impairs endothelial nitric oxide synthase activity and increases the production of reactive oxygen species, thus resulting in diminished nitric oxide bioavailability and increased oxidative stress. We know that alpha-lipoic acid has been shown to improve insulin sensitivity in type 2 diabetic individuals.


Alpha-lipoic acid is a disulfide compound, which is produced in small quantities within our cells and serves as an antioxidant at pharmacological doses. Good stuff! In addition to these antioxidant properties, though, alpha-lipoic acid is specifically beneficial for diabetic clients because of its anti-inflammatory and hypoglycemic properties (Akbari, Ostadmohammadi, Tabrizi, et al, 2018; Konrad, Vicini, Kusterer, Hoflich, Assadkhani, Bohles, Sewell, Tristschler, Cobelli, & Usadel, 1999).


The 1999 study mentioned above, by researchers Konrad et al., evaluated both lean and obese individuals with type 2 diabetes by offering them 600 mg of ALA by mouth, twice per day for four weeks. Researchers found both groups realized increased glucose effectiveness compared to their control groups. Lean diabetic clients were also found to have a higher degree of insulin sensitivity and lower fasting glucose levels. Furthermore, after ALA treatment, lactate and pyruvate before and after glucose loading were approximately 45 percent lower in both obese and lean diabetics, leading researchers to conclude that treatment with ALA prevents hyperglycemia-induced increments of serum lactate and pyruvate levels and increases glucose sensitivity. Another study found that oral treatment with ALA at 800 mg/day for four months improves cardiac autonomic dysfunction in those with type 2 diabetes (Ziegler & Gries, 1997).


Intravenous Administration of ALA for Diabetics


There is evidence here as well, that the intravenous infusion of ALA is beneficial for diabetics. In a small, randomized, controlled trial, 13 individuals received either 1000 mg ALA or normal saline. Both groups were comparable in body mass index, age, and duration of diabetes and had similar degrees of insulin resistance. After administration of the ALA, they experienced a significant increase of insulin-stimulated glucose disposal. The metabolic clearance rate for glucose rose by 50 percent in the treatment group, while the control group had no significant change (Jacob, Henricksen, Schiemann, Simon, Clancy, Tritschler, Jung, Augustin, & Dietze, 1995). Another study found similar results with a 30 percent increase in insulin-stimulated glucose disposal with 500 mg ALA intravenously per day for ten days (Jacob, Henriksen, Tritschler, Augustin, & Dietze, 1996). A third study, found while both oral and intravenous ALA were offered and improvements in insulin sensitivity were found, the improvements associated with oral administration were minimal (about 20 percent) compared to the improvements seen with intravenous administration. The oral group even increased doses up to 1,800 mg and longer treatment times, 30 days oral verses 10 days IV, and the intravenous group remained superior in outcomes (Jacob, Ruus, Hermann, Tritschler, Maerker, Renn, Augustin, Dietze, & Rett, 1999; Evans & Goldfine, 2000).


Burning Mouth Syndrome and ALA


As the name implies, burning mouth syndrome (BMS) is a chronic condition characterized by burning in the oral cavity, often associated with hyposalivation, xerostomia, and taste disturbances. Why this happens is a bit of a mystery, but it is associated with anxiety, depression, and cancer phobia, as well as menopause, nutrient deficiencies, #hypothyroidism, diabetes, and blood pressure medications.


There is some theory that this may also have a neurological component, or be a sort of neuropathy (Femiano & Scully, 2002). ALA has been used in the treatment of neuropathy associated with diabetes so researchers began to hypothesize its potential for treatment in burning mouth syndrome (BMS). This has been evaluated in a few studies with conflicting results. While two studies in particular did not demonstrate a significant improvement, several others have found ALA effective in the treatment of BMS with dosages at 600 mg day. Researchers found that duration of the syndrome, intensity of symptoms, and previous treatment with psychotropic medications were factors which influenced the likelihood of benefit of ALA in the management of BMS.


Fibromyalgia & IV Nutritional Therapy with ALA


A truly disabling disorder for many, fibromyalgia is characterized by widespread pain and frequently is accompanied by sleep disturbance, fatigue, depression, and cognitive dysfunction. The commonly prescribed analgesics provide incomplete relief with their own side effects, some even aggravating the symptoms of the disease they are prescribed to treat. New treatment options are certainly necessary, and of course, I am always an advocate for digging into the underlying, root issue.


We currently understand that fibromyalgia is a disease of inflammation and oxidative stress. Alpha-lipoic acid, which at pharmacologic doses acts as a potent antioxidant, has also been demonstrated to have anti-inflammatory effects on the body. When administered orally, ALA is rarely present in tissues above micromolar levels and is therefore unlikely to function as a primary cellular antioxidant. Instead, its potent antioxidant properties appear to be attributable to the fact that ALA increases cellular glutathione levels by regulating #glutathione synthesis and ameliorating oxidative stress (Yoshida, Hirokawa, Tagami, Kawakami, Urata, & Kondo, 1995). There appear to be no randomized controlled trials to date on the efficacy of ALA in the treatment of fibromyalgia, but there is one currently underway and other studies to date suggest outcomes should be favorable.


Chronic Fatigue Syndrome & ALA


Chronic fatigue syndrome is yet another chronic disease associated with oxidative stress and inflammation, so much so that mitochondrial dysfunction is being suggested as the underlying root cause. This disease is debilitating and fraught with relapsing fatigue. Neuropsychiatric concerns are common, such as #depression, irritability, sleep disorders, autonomic symptoms and neurocognitive defects, and physiosomatic concerns such as malaise, hyperalgesia, irritable bowel, muscle pain and tension.


ALA has been studied as a treatment for CFS because of its antioxidant and antiinflammatory properties, as well as its role in mitochondrial function, and they have been supportive, although there are no random control trials to date. It's widespread use as a safe nutrient with the ability to reduce oxidative stress, decrease inflammation, and support mitochondrial function justifies its use as a modality for the treatment of CFS.


Neuropathy and IV Nutritional Therapy


Diabetic neuropathy, or peripheral nerve dysfunction in those with diabetes, appears to be slowed or even reversed with the use of ALA. Studies have demonstrated significant improvements in stabbing and burning pain, with an oral dose of 600 mg providing the most favorable cost-benefit ratio of all oral doses tested.


Intravenous infusions have also been evaluated at 600 mg per day over a period of three weeks, and this lead to clinically significant reduction in neuropathic pain. This same study were unable to determine if an oral dose of the same amount, offered for three to five weeks, offered clinically significant outcomes. One study found a reduced reporting of pain by about half, and a more recent systematic review (2018) found ALA at 600 mg day, intravenously, for at least three weeks had minimal side effects and significant reduction in symptoms for peripheral neuropathy.


Cancer & ALA


Most cancer cells utilize aerobic glycolysis and although grossly inefficient, it is the preferential conversion of glucose to lactate for ATP generation, even when oxygen is present. Cancer cells utilize large amounts of glucose to keep up with their energy demands, and because essentially all types of cancer utilizes this pathway, there is theory that shifting cancer cell metabolism toward complete oxidation of glucose and away from aerobic glycolysis, we might effectively reduce proliferation of cancer cells (Feuerecker, Pirsing, Seidl, et al., 2012).


Pre-clinical studies have found ALA effective in reducing neuroblastoma cell lines Kelly, SK-N-SH, Neuro-2a and the breast cancer cell line SkBr3. ALA is a cofactor of pyruvate dehydrogenase, a key consideration in nutrients which can steer energy production away from aerobic glycolysis and toward complete oxidation of glucose, ultimately resulting in a decrease in lactate production and inhibition of glycolysis. ALA has also been found to inhibit cancer cell proliferation and even apoptosis by other mechanisms and in other breast cancer cell lines, including highly invasive breast cancer cells, including metastatic breast cancer.


Additionally, ALA has been shown to have a similar response to colon #cancer cells and dramatically decrease non-small cell lung cancer cell proliferation by down-regulating growth factor receptor-bound protein 2. Studies specifically evaluating the efficacy of ALA in the inhibition and treatment of cancer are limited to experimental data; however, this research is super encouraging.


Atherosclerosis and ALA via IV Nutritional Therapy


Oxidative stress is considered the primary cause of many cardiovascular diseases, including atherosclerosis. This oxidative stress worsens as we age, which increases our risk for cardiovascular conditions. Antioxidants are known to help decrease the incidence of atherosclerosis, and ALA exerts potent antioxidant effects on the body and has been studied in experimental models for its ability to prevent and reverse atherosclerosis.


This research is truly fascinating. Body weight has decreased in study groups, with clear evidence of reduced atherosclerotic plaque in the abdominal aorta with further reduction in lipid and inflammatory cell content. ALA has also shown to improve vascular reactivity, inhibit NF-xB activation, and decrease oxidative stress and the expression of key adhesion molecules in the vasculature. Other studies have found LDL levels to be lower, significantly, in the ALA groups with less atherosclerotic plaques on their aortas and even a reduced decline typically seen in diabetic individuals, suggesting that ALA is a promising protective agent for reducing cardiovascular complications of diabetes.


We are more than happy to discuss if any of these IV Nutritional Therapies are right for you.

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