Be a Liver Lover: Alpha Lipoic Acid and Other Supplements Offer Hope
James J. Gormley
September 29, 2008
Quick: what is the largest organ inside your body that weighs about three pounds, is shaped like a football that´s flat on one side and is located under your ribs on your right side? If you guessed the liver, you´re right.
Although it may not be a pretty organ it is an extremely important one that has a month-long health observance named after it by the American Liver Foundation (www.liverfoundation.org), called Liver Awareness Month.
Reasons to love our liver abound since this organ does all of the following, and more: saves up energy; makes bile to help break down food; keeps pollution from hurting us; stops cuts from bleeding too long; kills germs; gets rid of toxic chemicals; and helps build muscle.
According to the foundation, liver disease affects one in 10 Americans, or about 30 million people — including children.
Liver disease begins with inflammation. If left untreated, especially over time, inflamed liver tissue starts to scar or become fibrous, which is called fibrosis. If fibrosis is not treated or healed, irreversible damage can occur, called cirrhosis; this can lead to liver cancer. If the liver loses most or all of its function, a life-threatening condition called liver failure can result.
To make matters worse, there is also hepatitis C, a disease of the liver that is caused by the hepatitis C virus, or HCV. While it is fortunate that 15 to 40 percent of people who contract HCV are able to successfully fight off the virus within the first six months, sadly most of the patients who are not able to get rid of the virus wind up developing a long-term, chronic hepatitis C infection.
One of the most common reasons for liver transplants, more than four million Americans have been infected with hepatitis C and the virus is responsible for 8,000 to 10,000 deaths every year.
New Hope Emerges: Nutritional Supplementation
In recent years, enlightened medicine has brought popularity to a variety of botanical liver lovers, including milk thistle, which has been used for what we now know as liver disease since the 12th century.
Today, research often attributes milk thistle´s liver supportive effects to a compound complex in milk thistle, called silymarin, which is extracted from the milk thistle seed.
Other nutrients and herbal extracts that have attracted scientific interest, of late, in liver protection include: selenium, zinc, probiotics and branched-chain amino acids.
One nutrient, however, that has been the subject of research and which shows the greatest promise for liver health has curiously not yet attained the level of popularity enjoyed by milk thistle; it is: alpha lipoic acid.
Alpha lipoic acid (or ALA) was first discovered by University of Illinois enzymologist Irwin Gunsalus in 1948 and described and characterized by University of Texas biochemist Lester J. Reed in March 1951.
It is a natural substance that, according to ALA pioneer Burt Berkson, M.D., in the December 2007 edition of the Townsend Letter for Doctors and Patients, is the "rate-limiting factor for the production of energy from carbohydrates." In other words, without alpha lipoic acid we could not obtain energy from the food we eat and we could not stay alive.
The first large-scale human clinical studies using alpha lipoic acid in the U.S. were conducted by Berkson, Frederick C. Bartter, M.D., and other scientists at the National Institutes of Health (NIH) in the 1970s. The researchers gave the nutrient to 79 people with severe liver damage; 75 of those, according to Berkson, recovered full liver function.
More recently, in 1999 Berkson published three case reports using a triple-antioxidant supplement regimen in patients with liver disease, including chronic hepatitis C infection. After several months of treatment with a combination of alpha lipoic acid, selenium and silymarin, all three patients recovered most or all of their liver function, avoided liver transplantation and went on to live healthy, productive lives free of the symptoms of liver disease.
From 2006 to 2008, a number of studies in humans and animals have shown that alpha lipoic acid can provide important improvements in the following: recovery following liver surgery; protection from chemotherapy side effects and chemical poisoning; liver regeneration; and protection against liver and kidney damage from acetaminophen-containing drugs (e.g., Tylenol, Anacin-3 and Percocet).
Considering that acetaminophen poisoning sends over 56,000 people to emergency rooms each year in the U.S., these study results are all the more impressive.
It doesn´t hurt, of course, that alpha lipoic acid also helps in the areas of nerve health (e.g., diabetic neuropathy), metabolic health (e.g., insulin resistance and weight control) and brain health.
In an industrialized society heavily burdened by pollution and toxic chemicals, alpha lipoic acid has emerged, and rightly so, as a nutritional beacon of hope for many.
References
American Liver Foundation. October is Liver Awareness Month [press release]. September 17, 2008 (www.liverfoundation.org). Website accessed September 27, 2008.
American Liver Foundation. The progression of liver disease [fact sheet]. Website accessed September 27, 2008 (www.liverfoundation.org/education/info/progression).
Gormley J. Powerful antioxidant for liver protection and body detoxification: milk thistle. Better Nutrition 58(2):56-61, 1996.
Berkson BM. Alpha lipoic acid and liver disease. Townsend Letter. December 2007.
Reed LJ. From lipoic acid to multi-enzyme complexes. Protein Sci 7:220-224, 1998.
Berkson BM. A conservative triple antioxidant approach to the treatment of hepatitis C; combination of alpha lipoic acid (thioctic acid), silymarin and selenium: three case histories. Med Klin (Munich) 94 (Suppl 3):84-89, 1999.
Berkson BM et al. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha lipoic acid/low-dose naltrexone protocol. Integ Cancer Ther 5(1):83-89, 2006.
Dünschede F et al. Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by alpha lipoic acid in humans. World J Gastroenterol 12(42):6812-6817, 2006.
Dudka J. Decrease in NADPH-cytochrome P450 reductase activity of the human heart, liver and lungs in the presence of alpha lipoic acid. Ann Nutr Metab 50(2):121-125, 2006.
Dünschede F et al. Protection from hepatic ischemia/reperfusion injury and improvement of liver regeneration by alpha lipoic acid. Shock 27(6):644-651, 2007.
Dünschede F et al. Protective effects of ischemic preconditioning and application of lipoic acid prior to 90 min of hepatic ischemia in a rat model. World J Gastroenterol 13(27):3692-3698, 2007.
Anandakumar PP et al. Antioxidant DL-alpha lipoic acid as an attenuator of adriamycin induced hepatotoxicity in rat model. Indian J Exp Biol 45(12):1045-1049, 2007.
Abdel-Zaher AO et al. The potential protective role of alpha-lipoic acid against acetaminophen-induced hepatic and renal damage. Toxicology 243(3):261-270, 2008.
CBC News. Use of Tylenol-type pain relief in babies linked to asthma: study. September 19, 2008 (website accessed September 28, 2008: www.cbc.ca/health/story/2008/09/19/asthma-child.html).
Becić F et al. Pharmacological significance of alpha lipoic acid in up to date treatment of diabetic neuropathy. Med Arh 62(1):45-48, 2008.
Pershadsingh HA. Alpha-lipoic acid: physiologic mechanisms and indications for the treatment of metabolic syndrome. Expert Opin Investig Drugs 16(3):291-302, 2007.
Hager K at al. Alpha-lipoic acid as a new treatment option for Alzheimer´s disease: a 48-months follow-up analysis. J Neural Transm Suppl 72:189-193, 2007.
Although it may not be a pretty organ it is an extremely important one that has a month-long health observance named after it by the American Liver Foundation (www.liverfoundation.org), called Liver Awareness Month.
Reasons to love our liver abound since this organ does all of the following, and more: saves up energy; makes bile to help break down food; keeps pollution from hurting us; stops cuts from bleeding too long; kills germs; gets rid of toxic chemicals; and helps build muscle.
According to the foundation, liver disease affects one in 10 Americans, or about 30 million people — including children.
Liver disease begins with inflammation. If left untreated, especially over time, inflamed liver tissue starts to scar or become fibrous, which is called fibrosis. If fibrosis is not treated or healed, irreversible damage can occur, called cirrhosis; this can lead to liver cancer. If the liver loses most or all of its function, a life-threatening condition called liver failure can result.
To make matters worse, there is also hepatitis C, a disease of the liver that is caused by the hepatitis C virus, or HCV. While it is fortunate that 15 to 40 percent of people who contract HCV are able to successfully fight off the virus within the first six months, sadly most of the patients who are not able to get rid of the virus wind up developing a long-term, chronic hepatitis C infection.
One of the most common reasons for liver transplants, more than four million Americans have been infected with hepatitis C and the virus is responsible for 8,000 to 10,000 deaths every year.
New Hope Emerges: Nutritional Supplementation
In recent years, enlightened medicine has brought popularity to a variety of botanical liver lovers, including milk thistle, which has been used for what we now know as liver disease since the 12th century.
Today, research often attributes milk thistle´s liver supportive effects to a compound complex in milk thistle, called silymarin, which is extracted from the milk thistle seed.
Other nutrients and herbal extracts that have attracted scientific interest, of late, in liver protection include: selenium, zinc, probiotics and branched-chain amino acids.
One nutrient, however, that has been the subject of research and which shows the greatest promise for liver health has curiously not yet attained the level of popularity enjoyed by milk thistle; it is: alpha lipoic acid.
Alpha lipoic acid (or ALA) was first discovered by University of Illinois enzymologist Irwin Gunsalus in 1948 and described and characterized by University of Texas biochemist Lester J. Reed in March 1951.
It is a natural substance that, according to ALA pioneer Burt Berkson, M.D., in the December 2007 edition of the Townsend Letter for Doctors and Patients, is the "rate-limiting factor for the production of energy from carbohydrates." In other words, without alpha lipoic acid we could not obtain energy from the food we eat and we could not stay alive.
The first large-scale human clinical studies using alpha lipoic acid in the U.S. were conducted by Berkson, Frederick C. Bartter, M.D., and other scientists at the National Institutes of Health (NIH) in the 1970s. The researchers gave the nutrient to 79 people with severe liver damage; 75 of those, according to Berkson, recovered full liver function.
More recently, in 1999 Berkson published three case reports using a triple-antioxidant supplement regimen in patients with liver disease, including chronic hepatitis C infection. After several months of treatment with a combination of alpha lipoic acid, selenium and silymarin, all three patients recovered most or all of their liver function, avoided liver transplantation and went on to live healthy, productive lives free of the symptoms of liver disease.
From 2006 to 2008, a number of studies in humans and animals have shown that alpha lipoic acid can provide important improvements in the following: recovery following liver surgery; protection from chemotherapy side effects and chemical poisoning; liver regeneration; and protection against liver and kidney damage from acetaminophen-containing drugs (e.g., Tylenol, Anacin-3 and Percocet).
Considering that acetaminophen poisoning sends over 56,000 people to emergency rooms each year in the U.S., these study results are all the more impressive.
It doesn´t hurt, of course, that alpha lipoic acid also helps in the areas of nerve health (e.g., diabetic neuropathy), metabolic health (e.g., insulin resistance and weight control) and brain health.
In an industrialized society heavily burdened by pollution and toxic chemicals, alpha lipoic acid has emerged, and rightly so, as a nutritional beacon of hope for many.
References
American Liver Foundation. October is Liver Awareness Month [press release]. September 17, 2008 (www.liverfoundation.org). Website accessed September 27, 2008.
American Liver Foundation. The progression of liver disease [fact sheet]. Website accessed September 27, 2008 (www.liverfoundation.org/education/info/progression).
Gormley J. Powerful antioxidant for liver protection and body detoxification: milk thistle. Better Nutrition 58(2):56-61, 1996.
Berkson BM. Alpha lipoic acid and liver disease. Townsend Letter. December 2007.
Reed LJ. From lipoic acid to multi-enzyme complexes. Protein Sci 7:220-224, 1998.
Berkson BM. A conservative triple antioxidant approach to the treatment of hepatitis C; combination of alpha lipoic acid (thioctic acid), silymarin and selenium: three case histories. Med Klin (Munich) 94 (Suppl 3):84-89, 1999.
Berkson BM et al. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha lipoic acid/low-dose naltrexone protocol. Integ Cancer Ther 5(1):83-89, 2006.
Dünschede F et al. Reduction of ischemia reperfusion injury after liver resection and hepatic inflow occlusion by alpha lipoic acid in humans. World J Gastroenterol 12(42):6812-6817, 2006.
Dudka J. Decrease in NADPH-cytochrome P450 reductase activity of the human heart, liver and lungs in the presence of alpha lipoic acid. Ann Nutr Metab 50(2):121-125, 2006.
Dünschede F et al. Protection from hepatic ischemia/reperfusion injury and improvement of liver regeneration by alpha lipoic acid. Shock 27(6):644-651, 2007.
Dünschede F et al. Protective effects of ischemic preconditioning and application of lipoic acid prior to 90 min of hepatic ischemia in a rat model. World J Gastroenterol 13(27):3692-3698, 2007.
Anandakumar PP et al. Antioxidant DL-alpha lipoic acid as an attenuator of adriamycin induced hepatotoxicity in rat model. Indian J Exp Biol 45(12):1045-1049, 2007.
Abdel-Zaher AO et al. The potential protective role of alpha-lipoic acid against acetaminophen-induced hepatic and renal damage. Toxicology 243(3):261-270, 2008.
CBC News. Use of Tylenol-type pain relief in babies linked to asthma: study. September 19, 2008 (website accessed September 28, 2008: www.cbc.ca/health/story/2008/09/19/asthma-child.html).
Becić F et al. Pharmacological significance of alpha lipoic acid in up to date treatment of diabetic neuropathy. Med Arh 62(1):45-48, 2008.
Pershadsingh HA. Alpha-lipoic acid: physiologic mechanisms and indications for the treatment of metabolic syndrome. Expert Opin Investig Drugs 16(3):291-302, 2007.
Hager K at al. Alpha-lipoic acid as a new treatment option for Alzheimer´s disease: a 48-months follow-up analysis. J Neural Transm Suppl 72:189-193, 2007.
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