{"entity":{"id":"alpha-lipoic-acid","kind":"technology","name":"Alpha-lipoic acid","aka":["ALA","Thioctic acid","R-lipoic acid"],"tldr":"Alpha-lipoic acid is an antioxidant sold for nerve pain and blood sugar. Small studies hint it might ease paclitaxel nerve damage or radiotherapy mouth soreness, but none is large enough to rely on, and as an antioxidant it could in theory blunt chemotherapy or radiotherapy. It can cause dangerously low blood sugar in some people, and accidental swallowing by children has caused seizures.","summary":"Memorial Sloan Kettering's About Herbs entry describes alpha-lipoic acid as an antioxidant cofactor used for diabetic neuropathy and glycaemic control, with mixed results in trials outside cancer. In oncology, small studies suggest it may help reduce paclitaxel-induced neuropathy and doxorubicin cardiotoxicity in breast cancer, briefly delay salivary gland dysfunction early in radiotherapy, and reduce or delay radiation-induced oral mucositis; none has been confirmed in an adequately sized trial. MSK cautions that because of its antioxidant properties it may antagonise chemotherapy and radiotherapy. The harms are specific: high doses cause low blood sugar, and alpha-lipoic acid can trigger insulin autoimmune syndrome (spontaneous hypoglycaemia) in genetically predisposed people, with about 27 cases reported, one misdiagnosed as an insulinoma; severe intoxication after high doses has caused death; and children who swallowed adult supplements have had seizures and clotting problems, including a teenager after about 30 mg/kg. It adds to the effect of diabetes drugs.","status":"phase-2","asOf":"2026-11-04","links":[{"label":"MSK About Herbs: Alpha-lipoic acid (page last updated 31 July 2026)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/alpha-lipoic-acid"}],"tags":["complementary","supportive-care","evidence:insufficient"],"related":["n-acetylcysteine-supplements","carnitine-acetyl-l-carnitine"],"cancers":[],"sections":["supportive-care","chemotherapy","nutrition-lifestyle"],"technologies":["integrative-oncology","dietary-supplements-treatment-interactions","cipn-recovery-and-treatment"],"targets":[],"drugs":["paclitaxel","doxorubicin"],"companies":[],"institutions":[],"pathways":[],"terms":["peripheral-neuropathy"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A mitochondrial enzyme cofactor that is both water- and fat-soluble and regenerates other antioxidants; the same antioxidant action is why it could protect cancer cells from treatments that work through oxidative damage.","strengths":["Small positive signals for chemotherapy neuropathy and mucositis worth testing properly"],"limitations":["No adequately sized oncology trial","Possible interference with chemotherapy and radiotherapy","Insulin autoimmune syndrome, severe hypoglycaemia and poisoning in children"]},"route":"/technologies/alpha-lipoic-acid/","neighbours":{"technology":[{"id":"carnitine-acetyl-l-carnitine","kind":"technology","name":"Carnitine and acetyl-L-carnitine","route":"/technologies/carnitine-acetyl-l-carnitine/"},{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: interactions and harms","route":"/technologies/dietary-supplements-treatment-interactions/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"n-acetylcysteine-supplements","kind":"technology","name":"N-acetylcysteine (NAC) supplements","route":"/technologies/n-acetylcysteine-supplements/"},{"id":"cipn-recovery-and-treatment","kind":"technology","name":"Nerve damage from chemotherapy: what recovers, and what helps","route":"/technologies/cipn-recovery-and-treatment/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"nutrition-lifestyle","kind":"section","name":"Diet, Exercise & Lifestyle","route":"/fronts/nutrition-lifestyle/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"}],"term":[{"id":"peripheral-neuropathy","kind":"term","name":"Peripheral neuropathy (chemotherapy-induced)","route":"/terms/peripheral-neuropathy/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}