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Avatar universal

HR--mixing ALA and R -ALA dangerous?

HR,
Just in case you happen to be around, I wish I could get you to comment on something.
I have been told that mixing alpha lipoic acid and R fraction lipoic acid is a bad thing and has a very toxic effect.  I was  distressed to hear this because it means I've poisoned Joe.  I didn't do it for more than a few weeks but since I'm trying to heal him,not kill him, it was upsetting.  This can certainly be a minefield but you are the ultimate word for me.
I know you are very busy but thought I would just try since you surprise us with a visit from time to time.
Ev
Best Answer
Avatar universal
MEDICAL PROFESSIONAL
The question if mixing "ALA' and R-Lipoic acid could be toxic is really very simple to answer.

ALA is a racemate , that is a mixture of S and R Lipoic acid, 50% each approx, because the classical chemical synthesis process cannot distinquish the left and right form of the molecule.
In nature only the R-form exists. the left or S-form has the ability to block somewhat the enzymatic reactions where R-lipoic acid acts as a coenzyme. This is tolerated to some degree but obviously not a good thing. In a mouse model with impaired liver function the S =L form causes severe toxicity, but we humans can take this nonnatural chemical and while it cannot participate in the coenzyme functions of the natural R-form  ( rather tends to block it) , it might still have some antioxidant effects.

At any rate adding ALA to R-lipoic acid will simply have the effect that the ALA mixture is now shifted towards the R-form, from say 50/50 to 70/30, obviously depending on the relative amounts in the two formulations. Since in humans the 50/50% mix at least does not have any visible ill effects, it is less likely that a 70/30 mix will have any toxic effects.
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Avatar universal
Prior to and during my 48 weeks of TX I did IV's of H202, ALA and Glutathione. I checked with my UCLA Hep Dr and he said there were no issues with this.

The IV's helped with anemia a lot and my viral load prior to TX went down 1.7 mm.

If it works for you that is all that matters.
Helpful - 0
233616 tn?1312787196
Good to see you again HR!!

I'm wondering if the chirality issue isn't more important for liver patients than any others, especially in late stages. Ability to convert is based on having enough cells left to deal with the processes, right?

Would you say the L-ALA toxicity increases commensurate to the extent of the disease?

On this same note, I've been reading things about absorption that are somewhat conflicting. Of course, I've never known any MD, other than yourself, who admitted that the left chirals were problematic let alone cautioned against them. Often, when they prescribe vitamins, they choose the left chirals, and I've never comprehended this, other than they are man-made cheaper versions they haven't much to recommend themselves.

If you have time, could you comment then on how this same idea might relate to vitamin D in all it's forms. Many in this forum are on Vitamin D in some form, but few of us understand there are safety issues with these lipids as well.

thanks so much.


mb
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Avatar universal
Thanks to everyone for there help.  It looks like Joe will live through his poisoning.  :>)  I need to be a lot more careful.  Joe is in a good place right now while using the Hep Tech products and I certainly don't want to mess it up.
Ev
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Avatar universal
Thank you so much.  You are my true hero.  I can't stand to think where Joe would be now without your help.  He is with us and we are still enjoying our lives and our children.
I can't really say enough and don't want to embarass you but suffice it to say that your supplements ideas helped a whole lot.
Sincerely,
Ev
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Avatar universal
i would love to read why Dr. Berkson thinks the S from is better.  the r form is the one being employed in clinical trials for MS, heart disease etc.  

perhaps the following has something to do with HR's recommendation.

RESULTS: As anticipated from the preliminary study, NaRLA is less prone to polymerization, completely soluble in water, and displays significantly higher Cmax and AUC values and decreased time to maximum concentration (Tmax) and T1/2 values than RLA or rac-LA. In order to significantly extend Cmax and AUC, it is possible to administer three 600-mg RLA doses (as NaRLA) at 15-minute intervals to achieve plasma concentrations similar to those from a slow (20-minute) infusion of LA.  (Altern Med Rev 2007;12(4):343-351)

Helpful - 0
979080 tn?1323433639
In the end I go with what shows clinical results for me and leave the scientific part to the scientists to debate.
The ALA I take is working great.Take blood sugar for example , overall
bloods  , before and after repeated FibroScans ....
I do not have to question it anymore.
One of the SOC sx is to become diabetic. My last glucose NON fasting
was 77 , that is the ALA working as an insulin sensitizer.
Helpful - 0
Avatar universal
Thank you very much for this interesting info. It is true that the body can use either S or R form of the molecule, because our enzymes are designed a certain way (it is like the lock and the key), and only a molecule of a certain shape can fit. It is true for amino acids-they also come in S and R form and one of the forms is useless.
Helpful - 0
148588 tn?1465778809
Quick explanation of 'mirror-image' molecules (no guarantee of accuracy since it's a sales pitch):

http://www.raysahelian.com/lipoic.html

"If you're taking a conventional lipoic acid supplement, you're likely only getting half or less of the benefit of natural lipoic acid. The reason for this is that most alpha lipoic acid products on the market have both forms of lipoic acid: the synthetic S form, and the natural R form. R-lipoic acid is much more potent (2 times on average) than commonly sold synthetic lipoic acid which contains both the R and S forms. The S form is chemically the mirror image of the R form and cannot be used by the body, hence it is useless. Thus, 50 mg of R- alpha lipoic acid is equivalent to 100 mg of the synthetic version. "

Also old thread explaining this concept as it applies to NAC.

http://www.medhelp.org/posts/Hepatitis-C/HR-NAC/show/347671
Helpful - 0
979080 tn?1323433639
oral and IV

oral:
Metabolic Maintence 300mg 3x day plus a multi B. MM has a very good one
as well .
IV :
McGuff Compounding Pharm. , CA  (ALA of European Source! usually Italy)

He used to import IV - ALA from Germany until customs problems in US.
In Germany it came from Ratiopharm.
Since I go to Germany I got myself oral ALA  from Ratiopharm . Same quality ! You need prescription for it in Germany and it is of garanteed purity and
quality just as any other rx medication.

I decided to go with Dr. Berksons recommendations since he in my mind is
the authority on it with clinical exeperience from the 70`s to present day.

Much of today`s supplements compounds come from China and are therefore
suspect to purity and quality in a market that is not regulated !


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Avatar universal
Bali, what kind of ALA does Dr Berkson recommend?
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Avatar universal
A knowledgeable person I know off-line told me and I'm so glad to have found out.  I will try to bump this to the top a few evenings because there is still a chance HR might drop by.
After having mixed the two for a while, Joe got sick with nausea and other gastro -intestinal problems and I stopped the pills for a few days until he felt better and resumed slowly but I don't think I ever added the extra ALA again for which I'm thankful and he hasn't been sick anymore.  In the course of conversation with my friend it just happened to come up that these two products should never be mixed.  Well, it suddenly made sense  why Joe got sick and it about made me sick that I'd done it. What it amounts to is that I tried to save money by buying only 3 of the products from Hepatitis Technologies and tried to add some of the things that would have been in the Hepto Boost   which I'd left out.  It contains R-ALA and I had ALA on hand but it never even occurred to me these aren't mixable.  Well, it won't happen again.  I want others to hear this too that is why I hope to verify it by HR.  Sometimes frugality backfires.
Joe is looking and feeling pretty good and we have been taking a brisk walk everyday which is helping both of us.
Ev
Helpful - 0
979080 tn?1323433639
I am no use either because I always follow Dr. Berkson when it comes to ALA
and he is not for the R-ALA version , so I never took it.
If you have not done so already pm Mike .
Helpful - 0
Avatar universal
Hi Evangelin,

I hope HR answers but why do you think this? Did someone here say this to you? Could Bali help you if HR is not around?

I remember Copyman posted something about possibly toxic levels but those tests were done on rats in such astronomically high doses that I didn't think it was applicable to the relatively tiny quantities people consume in pill form.

You sound alarmed and I'm sorry I can't help.

Susan
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