Alicja Zajdel, Daniel Wolny

Alpha-lipoic acid: properties and therapeutic benefits in light of current data

2026-06-19

Subject of the study. Alpha-lipoic acid (also known as thioctic acid, or ALA) is produced endogenously in significant amounts in animal tissues and can be obtained through the diet. It acts as a coenzyme in the oxidative decarboxylation of alpha-keto acids and is essential for glucose metabolism and ATP production. In the body, ALA (the oxidized form) is easily converted to its reduced form, dihydrolipoic acid (DHLA). Both ALA and DHLA are potent natural antioxidants. They not only scavenge reactive oxygen species and chelate metal ions but also increase levels of reduced glutathione and enhance the activity of antioxidant enzymes, thereby promoting systemic redox homeostasis. The pleiotropic nature of ALA presents both opportunities and challenges for therapeutic applications.

Research objective. The aim of this review is to identify and provide a synthetic analysis of the scientific evidence describing the therapeutic potential of ALA. Areas for further research are identified, the results of which could allow for the expansion of therapeutic indications for the use of medicinal products containing ALA.

Methodology for literature search and selection. The literature review was conducted using PubMed, Scopus, and Google Scholar, covering publications from January 2016 to March 2026, using the following keywords: “lipoic acid” or “thioctic acid”, “pharmacokinetics”, “safety”, “toxicity”, “therapeutic efficacy”.

Results. The study discusses the pharmacokinetic properties of ALA and DHLA, their mechanisms of action, and their potential applications in the treatment of diabetes, cardiovascular and neurological diseases, and infections. Evidence suggests that ALA, even at high doses, can be considered a safe and well-tolerated therapeutic option that improves the quality of life for patients affected by various conditions. However, a significant portion of clinical trials exhibit methodological heterogeneity, small sample sizes, short follow-up periods, and varying dosing regimens, which limits the strength of the conclusions.Conclusions. Although ALA demonstrated promising effects on biochemical and inflammatory markers and has been associated with symptom relief and functional improvement across many conditions, the overall strength of the evidence remains moderate and should be interpreted with caution given the methodological limitations of the available studies. There is a legitimate need for well-designed, properly randomized controlled trials with standardized reporting of results and longer follow-up periods to provide higher-quality evidence confirming the relevance of ALA in clinical practice.

Keywords: pharmacokinetics, thioctic acid, lipoic acid, therapeutic efficacy.

© Farm Pol, 2025, 81(12): 731–743