ALSUntangled #79: alpha-lipoic acid

Alaina Giacobbe¹, James Hiana¹, Olivia Wang², Michael Benatar³, Paul Wicks⁴, Javier Mascias Cadavid⁵, Sartaj Jhooty⁶, Christopher McDermott⁷, Gary Pattee⁸, Tulio Bertorini⁹, Terry Heiman-Patterson¹⁰, Dylan Ratner¹¹, Paul Barkhaus¹², Gregory Carter¹³, Carlayne Jackson¹⁴, Keelie Denson¹⁵, Andrew Brown³, Carmel Armon¹⁶, Yuyao Sun¹⁷, Andre Nguyen¹⁸, Richard Bedlack¹, Xiaoyan Li¹

Affiliations

¹ Neurology Department, Duke University, Durham, NC, USA.
² Cognitive Science, University of Pennsylvania, Philadelphia, PA, USA.
³ Department of Neurology, University of Miami, Miami, FL, USA.
⁴ Wicks Digital Health, Lichfield, UK.
⁵ Neurology Department, Hospital Carlos III-La Paz, Madrid, Spain.
⁶ University of North Carolina, Chapel Hill, NC, USA.
⁷ Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK.
⁸ Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA.
⁹ Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
¹⁰ Neurology Department, Temple University, Philadelphia, PA, USA.
¹¹ Tulane University, New Orleans, LA, USA.
¹² Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
¹³ Providence St. Luke's Rehabilitation Medical Center, Spokane, WA, USA.
¹⁴ Department of Neurology, UT Health San Antonio, San Antonio, TX, USA.
¹⁵ Department of Neurology, Houston Methodist Hospital, Houston, TX, USA.
¹⁶ Department of Neurology, Shamir Medical Center, Be'er Ya'akov, Israel.
¹⁷ Department of Neurology, University of Kentucky, Lexington, KY, USA, and.
¹⁸ Duke University, Durham, NC, USA.

PMID: 40411245
DOI: 10.1080/21678421.2025.2507166

Review

ALSUntangled #79: alpha-lipoic acid

Alaina Giacobbe et al. Amyotroph Lateral Scler Frontotemporal Degener. 2025.

. 2025 May 24:1-5.

doi: 10.1080/21678421.2025.2507166. Online ahead of print.

Authors

Affiliations

¹ Neurology Department, Duke University, Durham, NC, USA.
² Cognitive Science, University of Pennsylvania, Philadelphia, PA, USA.
³ Department of Neurology, University of Miami, Miami, FL, USA.
⁴ Wicks Digital Health, Lichfield, UK.
⁵ Neurology Department, Hospital Carlos III-La Paz, Madrid, Spain.
⁶ University of North Carolina, Chapel Hill, NC, USA.
⁷ Sheffield Institute of Translational Neuroscience, University of Sheffield, Sheffield, UK.
⁸ Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA.
⁹ Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
¹⁰ Neurology Department, Temple University, Philadelphia, PA, USA.
¹¹ Tulane University, New Orleans, LA, USA.
¹² Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
¹³ Providence St. Luke's Rehabilitation Medical Center, Spokane, WA, USA.
¹⁴ Department of Neurology, UT Health San Antonio, San Antonio, TX, USA.
¹⁵ Department of Neurology, Houston Methodist Hospital, Houston, TX, USA.
¹⁶ Department of Neurology, Shamir Medical Center, Be'er Ya'akov, Israel.
¹⁷ Department of Neurology, University of Kentucky, Lexington, KY, USA, and.
¹⁸ Duke University, Durham, NC, USA.

PMID: 40411245
DOI: 10.1080/21678421.2025.2507166

Abstract

Alpha-lipoic acid (ALA) is a naturally occurring fatty acid. It serves as an essential cofactor for enzymatic reactions in mitochondrial energy production, is a potent antioxidant and has anti-inflammatory effects, which are plausible mechanisms in slowing ALS progression. In ALS preclinical studies, ALA slowed motor function decline and improved survival. There were self-reported cases of improved muscle strength in ALS patients when ALA was taken with numerous additional supplements, making it difficult to discern its efficacy. One small, 6-month open-label study showed improved quality of life, fatigue, and mood after participants took it with B vitamins and amino acids for the first 3 months. So far, no clinical trials have been published in people living with amyotrophic lateral sclerosis (PALS). Given the insufficient clinical data, we cannot endorse ALA and will support more research on its efficacy in slowing ALS progression.

Keywords: ALS; alpha lipoic acid; antiinflammation; antioxidant; oxidative stress.

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ALSUntangled #79: alpha-lipoic acid

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ALSUntangled #79: alpha-lipoic acid

Authors

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Abstract

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