Talk:Lipoic acid/Archive 1

Things to do
-Please check out the recommendations for the peer review above (click on "archived"). They suggest using Nicotinamide adenine dinucleotide as an example of what the article should look like.

-The article is too long and has too many references. Try to stick to recent reviews and not get bogged down in the details of every research article. The lengthy historical list is unnecessary. I propose we list only uses for lipoic acid that are in clinical trials or are approved for use instead of listing every case study.

-I suggest we don't have a section on the basic research on the function of administered lipoic acid and just stick to the established medical knowledge. What a "function" for an administered compound would be is not clear. Qchristensen (talk) 09:23, 10 April 2014 (UTC)

The list of possible benefits should be an actual list, not a run-on sentence.

Lipoic acid has been the subject of numerous research studies and clinical trials. Lipoic acid was shown:


 * to be hepatoprotective
 * to improve liver circulation, and treat chronic liver diseases,      including:
 * jaundice
 * hepatitis
 * cirrhosis
 * hepatic coma
 * to treat diabetes,  and diabetic neuropathy
 * to alter carbohydrate metabolism,

The tag soup makes it nearly impossible to edit, though.

Minor Note
The use of the word "vicinal" in the second sentence of the opening paragraph is incorrect. "Vicinal" only relates heteroatoms and functional groups to one another through their positions on the carbon framework not through their own heteroatomic connections. For the two sulfur atoms to be vicinal they would have to be bound to adjacent carbons, say C7 and C8 or C6 and C7 instead of C6 and C8. — Preceding unsigned comment added by 149.155.222.31 (talk) 15:58, 8 June 2012 (UTC)
 * I agree, and have rephrased the sentence to avoid misuse of the word. Thanks for catching the problem and reporting it here. -- Ed (Edgar181) 16:39, 8 June 2012 (UTC)

Adverse effects
This may be a serious adverse effect when used in higher dosages.

Mechanisms of antioxidant and pro-oxidant effects of -lipoic acid in the diabetic and nondiabetic kidney.

This study demonstrates that dietary supplementation with 30 mg/kg -lipoic acid for 12 weeks in rats prevents the increase in albuminuria and development of glomerulosclerosis and tubulointerstitial fibrosis associated with diabetic nephropathy. Our studies indicate that one of the mechanisms by which -lipoic acid exerts this renoprotective effect in rats is via decreasing oxidative stress, specifically, by reducing NADPH-induced generation of O-2 and regulating the expression of NADPH oxidase subunits. Most interestingly, our study shows that the dietary supplementation with the same dose of -lipoic acid is associated with a decline in renal function and development of glomerulosclerosis and tubulointerstitial fibrosis in the nondiabetic kidney in rats. Thus, these findings indicate that, although -lipoic acid is renoprotective in diabetic nephropathy in rats, it has detrimental effects to the healthy kidney in rats. Ref Article — Preceding unsigned comment added by 108.9.222.194 (talk) 16:04, 2 December 2012 (UTC)

Possible Bias
It is quite possible that the author has a bias. I do not have the technical background to confirm. In the Effects section, the article references Alpha lipoic Acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. The reference's abstract says: It is unclear if the significant improvements seen after 3–5 weeks of oral administration at a dosage of >600 mg/day are clinically relevant. . The author summarizes the article as: There is no corresponding clinical benefit taking it by mouth. .
 * So the effects of oral administration are not clinically significant. I've clarified. Alexbrn talk 06:10, 31 March 2014 (UTC)
 * What happened to stick to the source? Why is it inappropriate to simply state the original study authors uncertainty? Is this not having your cake and eating it too?Khimaris (talk) 21:39, 31 March 2014 (UTC)
 * What "uncertainty"? They found no clear clinical benefit. This is faithfully rendered for the general reader as: "there is no good evidence of meaningful benefit". For comparison see the DARE summary: "Oral administration resulted in statistically but not clinically significantly improvements". Alexbrn talk 21:54, 31 March 2014 (UTC)
 * The study concludes with: "It is unclear if the significant improvements seen with the oral administration of alpha lipoic acid are clinically relevant." The Dare summary is not an actual part of the article as far as I can tell. It also doesn't state how it derived clinically significant when the original paper stated uncertainty. You should use a separate source if you want to use "there is no good evidence of meaningful benefit" that differs from what the actual paper has in it.Khimaris (talk) 22:28, 31 March 2014 (UTC)
 * DARE is part of Cochrane - expert peer-reviewed abstracts. It was just to show my wording is a faithful wording for the general reader. Alexbrn talk 22:36, 31 March 2014 (UTC)
 * I don't care what DARE is part of. You've added information to the article without properly attributing it. The current source is the original article. Either remove the statement or add a second source for DARE's position on the study. I would do it myself but it would obviously be reverted.Khimaris (talk) 22:47, 31 March 2014 (UTC)
 * We summarize secondary sources here, we do not cobble together primary sources to try to undermine high quality secondary sources. If you have a high quality secondary source that contradicts the Cochrane review, please present it. Otherwise, trying to go around WP:MEDRS will not get us anywhere. Yobol (talk) 02:35, 1 April 2014 (UTC)
 * Yobol, who is this "we" you speak of and who gave "we" the authority to make such flippant statements? I've asked Alex this and I will ask you: Why is it unreasonable to say that Cochrane's review of the literature did not find a any trials?
 * My head explodes that I have to fight tooth and nail to add such a simple statement to an article. It makes no god damned sense. Khimaris (talk) 03:19, 1 April 2014 (UTC)
 * I have no problem expanding the fact there have been no RCTs discussing dementia; I do have a problem with people adding WP:OR saying there have been without appropriate WP:MEDRS compliant sourcing. "We" is a discussion of what all editors of medical content should be following, specifically WP:MEDRS. You can choose not to follow WP:MEDRS, but you will likely soon find your edits reversed as "we" should be following them. Yobol (talk) 03:27, 1 April 2014 (UTC)
 * I'm calling bullshit again. WP:MEDRS is a guideline. I disagree with some of the regulations but I've been following it. Yet somehow "we" get to pick and choose what gets added and how it is worded. There is nothing in WP:MEDRS nor WP:MEDMOS that requires articles to be specifically worded in the fashion you and Alexbrn have chosen. Hopefully "we" can get to the point of not shrieking "FOLLOW MEDRS" and actually address the issues at hand. — Preceding unsigned comment added by Khimaris (talk • contribs) 03:55, 1 April 2014 (UTC)
 * Calling "bullshit" carries no weight if you don't accept the underlying sourcing principles in use here at Wikipedia. MEDRS is the guideline that is the application of the WP:V policy to biomedical content, so saying "but it's just a guideline" isn't convincing.  You need to provide a really compelling reason--one strong enough to sway consensus--that an exception to the general rule of the guideline should be made here.  You haven't done that.    04:09, 1 April 2014 (UTC)
 * Guidelines and principles are not laws. Please be aware of this fact. Khimaris (talk) 04:27, 1 April 2014 (UTC)
 * Sure, Wikipedia isn't a legal system or a courtroom, see WP:NOT for all the things Wikipedia is not.   04:37, 1 April 2014 (UTC)
 * Wikipedia isn't a place to disseminate unwarranted condescension, but I think you know that by now...Khimaris (talk) 04:46, 1 April 2014 (UTC)

It looks like has proposed language in an edit that might stick, to resolve this specific content dispute over LA in dementia. I would like to suggest that this section be closed and if there are remaining issues with this content, other bits, or the article in general, that they be re-opened under new sections. Starting out with accusations of bias is no way to productively work toward WP:CONSENSUS, which we all know is the foundation of WP. Jytdog (talk) 08:39, 1 April 2014 (UTC)
 * "It is unclear if the significant improvements ..are clinically relevant" does not equal "There is no corresponding clinical benefit" 129.78.56.133 (talk) 05:02, 9 June 2015 (UTC)

Stepping back
just want to note that this article is a mess. way too technical in some aspects and not enough plain english. lots of content in the lead that is not in the body. am working on cleaning it up... Jytdog (talk) 07:03, 1 April 2014 (UTC)
 * ok, first pass is done. needs a lot more work. Jytdog (talk) 08:34, 1 April 2014 (UTC)

“Lipoic acid is cofactor for at least five enzyme systems. Two of these are in the citric acid cycle through which many organisms turn nutrients into energy.”

The mentioning that alpha lipoic acid is not one of the required nutrients seems to be written to specifically imply that it may not be of use or necessary for regular metabolic function but then the above quoted is completely the opposite.
 * Lipoic acid is made by the body, so is not a vitamin (required nutrient). It is still an important cofactor. Qchristensen (talk) 14:36, 25 June 2015 (UTC)

I agree this is ALA page is a mess and gets lost in too many side notes and not enough on the proven benefits. After reading it, you leave with more questions and a sense that this reference is inadequate and should not be given as a reference to those inquiring on the subject.
 * Part of the problem is that there are a lot of "benefits" that are unproven. This all started shortly after the structure of lipoic acid was solved, when a doctor administered low levels intravenously to 12 patients with various diseases. One patient in a coma woke up. Must be an amazing miracle drug, right? Qchristensen (talk) 14:36, 25 June 2015 (UTC)

Btw, does it cross the blood brain barrier? Does it detox heavy metals? These are not mentioned. This tells me this reference is just incomplete and written from dismissive or unintended but ignorant perspective rather that a full spectrum of a scientific educated knowledge. — Preceding unsigned comment added by 38.88.222.106 (talk) 21:03, 18 February 2015 (UTC)
 * As I recall from my thesis work, lipoate can chelate metals to some extent. I don't recall ever finding conclusive evidence that it can do this when administered therapeutically, although it has been administered for this. Qchristensen (talk) 14:36, 25 June 2015 (UTC)

Problems with "Biological Function" and "Activity in Mitochondria"" section
There are major factual problems with this section. The section describes non-mitochonrial things. The mitochondria doesn't have an acetoin dehydrogenase, for example. I'll clean up this section a bit Qchristensen (talk) 07:26, 10 April 2014 (UTC)
 * Done Qchristensen (talk) 09:50, 10 April 2014 (UTC)

Decreasing lipoic acid levels
I took out the paragraph on the phenomenon of decreasing lipoic acid levels in sick patients. The references were not reputable (were very old and in obscure journals) and the research yielded no clear conclusions for this article. Qchristensen (talk) 10:07, 10 April 2014 (UTC)

Uses
Hello, I added PUBMED 9607614 - ALA in liver metabolism & disease. It seems there was some severe amputation of this article over years(?) and just about anything related to anything beneficial about this topic has been cut out. All the cites are right here ^^ some need to be returned x1987x(talk) 05:38, 26 January 2015 (UTC)
 * as Alexbrn mentioned in his edit, that was a very old source, and the use was experimental. Per WP:MEDMOS the "uses" section should reflect actual use, not research. Jytdog (talk) 14:48, 26 January 2015 (UTC)
 * "there was some severe amputation of this article over years(?) and just about anything related to anything beneficial about this topic has been cut out" as is the norm for anything related to nutrition.. 129.78.56.133 (talk) 04:56, 9 June 2015 (UTC)

"should reflect actual use, not research" Why? There are Dozens of wiki articles of substances that are scientifically studied, researched and demonstrated in scientific literature. As is the case with Julone and cancer and there is a whole page for substances being “studied” on wiki for Favipiravir. Are only pharmaceuticals approved for posting the “research” http://en.wikipedia.org/wiki/Favipiravir

Sure, mentioning that people have studied it for use in liver metabolism and disease is valid. However, most of these ideas have very little support and so are only ideas. Qchristensen (talk) 14:29, 25 June 2015 (UTC)

Blacklisted Links Found on Lipoic acid
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Assessment comment
Substituted at 22:05, 29 April 2016 (UTC)

Additional Verification
I removed the additional verification tag from March 2014. Scanning through the article there were only several citation needed tags which were for minor statements such as labeling in Japan. The majority of the sources are from peer reviewed journals so while I have not seen the prior edits of the page from 2014 when the original tag was placed, the current edit does not in my opinion require the additional verification box.

If other editors think additional verifications are needed, can you please address these individually in the talk page as at this point, I believe while certain specific points or claims might need additional verification, overall the article does not require the warning box. Eframgoldberg (talk) 19:13, 28 November 2016 (UTC)
 * Please read WP:MEDRS. "peer reviewed" is not what MEDRS calls for.  Most of the refs are primary.  Jytdog (talk) 19:18, 28 November 2016 (UTC)
 * Taken from WP:MEDRS
 * "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies. Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early in vitro results which don't hold in later clinical trials."


 * The majority of the article covers non-medical aspects such as synthesis, biological function, uses, etc. and only one section covers clinical research. Therefore for most the article primary references such as those published in peer reviewed journals are suitable, especially as many of the citations contain multiple references. If there are specific citations or claims which need to be verified, please itemize or list them otherwise I suggest the box be removed. — Preceding unsigned comment added by Eframgoldberg (talk • contribs) 19:27, 28 November 2016 (UTC)

Lowering reference quality
User:Fortibus please explain why you added content based on a 5 year old source and 4 year old source, trying to write more positive content than the more recent alllows, in this diff. This is continuing the discussion we started at your Talk page here Jytdog (talk) 19:47, 1 February 2017 (UTC)


 * Some background for third parties... There was a scientific review of intravenous and oral administration of ALA in the treatment of diabetic neuropathy that Jytdog deleted and replaced with a lengthy scientific review of diabetic neuropathy in general. The review he posted had one section that listed the results of one meta-analysis done in 2004. This one meta analysis only looked at intravenous use of ALA.


 * My reviews were around 2011 and 2012 and looked at both oral and intravenous ALA. I put them back into the article. For doing this I was accused of an "edit war" because it is "invalid to try to over rule newer MEDRS sources with older ones." However this is not what I did.


 * First of all, I kept Jytdog's edit in the article, I never "over ruled" anything. I wanted to keep the review of oral ALA because he deleted it from the article and it is of interest to many people. Since my reviews are more recent than 2004 I would even argue that they are more up-to-date than his is. I'm happy to work through the issue in good faith. I believe both of our references have their place. His reference actually has additional information that can be put into the article, while my references look specifically at oral vs i.v. ALA (which his doesn't).


 * Finally, regarding the accusation that i'm "trying to write more positive content", please keep in mind that we've never met and don't know each other. Don't assume bad faith or act like you know my intentions. I'm not trying to do anything except provide accurate and informative content.
 * Fortibus (talk) 20:10, 1 February 2017 (UTC)
 * The ref i brought for diabetic neuropathy is from 2015 -  - and it says "ALA has been found to be well tolerated, however it must be delivered intravenously for symptom relief." I made no judgements about you - i described the edits.  Jytdog (talk) 20:52, 1 February 2017 (UTC)
 * You're correct that your reference makes that statement, however it provides no source or supporting data to back it up. A review of the scientific literature should contain a collection of sources supporting it's conclusions. Read through the sources in that review and you will only find one meta-analysis from 2004 that concerns intravenous ALA use only.
 * A newer review does not necessarily mean a better review. The comment about "only intravenous" is unsupported in your review and is contradicted by my scientific reviews. To reflect the state of the matter most accurately I'm arguing that we should keep both reviews (as I did in my edit). I encourage you to search for any source within the document you referenced that looks at oral ALA use. I looked very closely but i'm open to the idea that I missed it.
 * Let me just add that WP:MEDRS does not say to use newer sources at all costs, in every situation. It's a rule of thumb that should be applied with common sense. It admits that "assessing reviews may be difficult" and to watch out for Recentism.
 * Fortibus (talk) 21:47, 1 February 2017 (UTC)
 * You clearly have not read and are engaged with [{WP:MEDRS]]. This is not an issue of RECENTISM; it is about using the highest quality sources we can. Please read and engage with MEDRS. Thanks. Jytdog (talk) 22:24, 1 February 2017 (UTC)
 * I have read MEDRS. And I think we're in agreement - this is an issue of quality sources. Why do you think your review is of a higher quality than mine? I am genuinely open to changing my mind, but as a said above, your reference only sources a meta-analysis from 2004 that doesn't look at oral ALA use. My references simply added the missing oral ALA piece.
 * This is the meta-analysis from your source: https://www.ncbi.nlm.nih.gov/pubmed/14984445. It clearly states in the "Aim" and "Methods" sections that its purpose was to only look at intravenous use. "To determine the efficacy and safety of 600 mg of alpha-lipoic acid given intravenously over 3 weeks in diabetic patients with symptomatic polyneuropathy."
 * I repeat, this is the only source that your review mentions. How am I to believe this is a high quality source with regard to oral ALA use?
 * Fortibus (talk) 22:40, 1 February 2017 (UTC)
 * How about this Jytdog? A 2016 systematic review that references the oral administration research. It's also newer than your review. Can we agree on this? https://www-ncbi-nlm-nih-gov.librarylink.uncc.edu/pubmed/26822889
 * Fortibus (talk) 22:58, 1 February 2017 (UTC)
 * Your link is through uncc. look at it. Jytdog (talk) 01:23, 2 February 2017 (UTC)
 * Sorry, I get access to full articles through there. See this link: https://www.ncbi.nlm.nih.gov/pubmed/?term=26822889 Fortibus (talk) 01:24, 2 February 2017 (UTC)

ALA for treatment of multiple sclerosis
The article only mentions ALA as a treatment for MS refering an older publication from 2008. There are new results as https://clinicaltrials.gov/ct2/show/study/NCT01188811?sect=X4301256 and http://www.neurologyadvisor.com/aan-2016-coverage/potential-treatment-benefit-of-lipoic-acid-in-ms/article/490542/. — Preceding unsigned comment added by 77.57.40.156 (talk) 14:13, 29 April 2017 (UTC)

what is it used for
what is it used for 47.155.97.10 (talk) 06:46, 8 January 2022 (UTC)


 * to make your pee smell Jawz101 (talk) 22:00, 10 February 2022 (UTC)

Nobody figured out that the Quick facts templates, displayed in Android Dark mode, are unreadable at white type on a light yellow background ? !
Nobody figured out that the Quick facts templates, displayed in Android Dark mode, are unreadable at white type on a light yellow background ? ! SalineBrain (talk) 20:19, 29 March 2022 (UTC)

"...too expensive to be practical as a complementary therapy for obesity."
This costs about US$20 for 240 600 mg capsules OTC. If the recommendation for use in obesity treatment is under 600mg per day, this would suggest an annual cost of about US$30. I am not sure how this is considered too expensive. DavidFarmbrough (talk) 14:59, 23 May 2022 (UTC)

Toxicity?
There are two case reports of fatal outcome following ingestion of 6000 mg of lipoic acid. These sources are not secondary, so I'll try to look up in some books/reviews. --CopperKettle (talk) 10:28, 17 April 2023 (UTC)

Might prevent visual deterioration in mutations of MECR
Hi! I came across a rare mitochondrial disease, caused by mutations affecting the MECR gene, and judging by case reports, lipoic acid may prevent deterioration of vision in patients. Very interesting, but I guess some secondary source would be needed to mention this in the article. Cheers from Yekaterinburg, --CopperKettle (talk) 10:12, 17 April 2023 (UTC)
 * Treatment with lipoic acid is mentioned here in a GeneReviews review - Does that count as a solid secondary source? --CopperKettle (talk) 10:36, 17 April 2023 (UTC)