Alpha Lipoic Acid And Possible Thyroid Problems

Today's post comes from the New York Buyers Club blog (see link below) which is almost always a very reliable source of information about vitamins and supplements and Lark Lands, whose work has been used previously on this blog. It talks about potential problems with Alpha Lipoic Acid, one of the most recommended go-to supplements to help with neuropathic symptoms. Usually used in combination with Acetyl-L Carnitine and/or  N-Acetyl-Cysteine, they are co-enzymes which can have a beneficial effect on the nervous system. This article sounds a note of caution concerning higher doses of ALA and potential thyroid problems and advises getting the thyroid monitored (a simple blood test) if  you're taking ALA regularly. The problem here is that the symptoms of thyroid problems are very familiar to many HIV patients as it is (see below) but the blood test should clear up any doubts.

 Alpha lipoic acid: a caution about potential hypothyroidism from Lark Lands

November 20, 2011

NYBC has recently learned from our colleague Lark lands, long known for her expertise in supplementation stategies for people with diabetes and people with HIV, that for, some people, there may be a risk of hypothyroidism in taking alpha lipoic acid, especially at higher doses:

Alpha-lipoic acid (ALA) is a liver protective agent, and has been studied for peripheral neuropathy and lipodystrophy. It may slow HIV replication, and counter HIV-related dementia. ALA is very important in several ways. It easily crosses cell membranes and works as anantioxidant in both lipid (fatty) and aqueous (watery) parts of the body. It is a versatile and powerful antioxidant, both reducing oxidative stress in the body, and indirectly protecting, recycling, or regenerating other major antioxidants.

There is also good evidence that ALA has beneficial effects for those with type 2 diabetes and some of its complications. Its wide-ranging benefits for diabetes, according to recent research, include improved glycemic control, improved insulin sensitivity, as well as reduction of oxidative stress and neuropathy.

Caution

Our colleague Lark Lands, an expert on supplementation for people with diabetes and people with HIV, has drawn our attention to the concern that alpha lipoic acid may produce symptoms of hypothyroidism in some people. Partly due to this concern, NYBC has also reduced ALA in our ThiolNAC, such that 3 tabs/day equals 400mg – below the dosages generally of concern in Lark’s analysis. Symptoms of hypothyroidism may include fatigue, low body temperature, weight gain, hair loss, splitting fingernails, depression, memory problems, muscle weakness, elevated cholesterol, and/or skin that is dry, rough or scaly. NYBC recommends monitoring the thyroid while taking ThiolNAC or ALA by itself.

 Lark Lands notes the following: Although it is not clear what percentage of people this may affect, in some people it appears that alpha-lipoic acid may block the proper conversion of T4, the storage form of thyroid hormone, into T3, the active form. This was first noted in animal research with alpha-lipoic acid, and has since been reported by a number of people known to me. When this occurs, people will develop the symptoms of hypothyroidism (which may include fatigue, low body temperature, weight gain, hair loss, splitting fingernails, depression, memory problems, muscle weakness, elevated cholesterol, and/or skin that is dry, rough or scaly).

For this reason, it is important to monitor the thyroid, first at baseline, before lipoic acid is taken, and then after the first month or two of taking lipoic acid, to see if there have been any adverse effects. If not, it probably means that the thyroid is unlikely to be affected. However, it will still be wise to check the TSH level (a blood test that is an indicator of thyroid function) at least once or twice yearly, or any time that symptoms that could be related to low thyroid appear, as some people have taken 600 mg daily doses for lengthy periods (even up to five years in one case known to me) before TSH levels became elevated outside of the normal healthy range.

It is clear that this problem does not develop in everyone who uses lipoic acid. Some people seem to tolerate doses of 600 mg or even more daily with no problems, while others have developed serious thyroid problems with doses ranging from 500 mg to 1000 mg daily. In the people known to me who have been affected in this way, discontinuing the lipoic acid allowed the thyroid problems to disappear quite quickly. I personally experienced this when taking lipoic acid. My TSH had become seriously elevated, remaining at an abnormally high level for more than a year, and I had developed symptoms of hypothyroidism, including serious fatigue.

Within six weeks of discontinuing the lipoic acid, my symptoms vanished and my TSH returned to normal and stayed there. I had made no other changes of any kind so it is clear to me that the lipoic acid was the problem for me that caused hypothyroidism. Since then, I have so far discovered four other people who developed similar problems while taking it. However, since alpha-lipoic acid is otherwise an excellent supplement, for all the reasons listed above, this does not mean it should be completely written off. Just do monitor the thyroid if you choose to take it!

NYBC’s recommends that if you are on thyroid medication, it may be best to avoid lipoic at high doses (over 400mg/day). 

 http://nybc.wordpress.com/2011/11/20/alpha-lipoic-acid-a-caution-about-potential-hypothyroidism-from-lark-lands/