Lipoic Acid has a variety of benefits:

Antioxidant

Lipoic acid can regenerate vitamin C from its oxidized form, dehydroascorbic
acid. Lipoic acid can also potentially regenerate other antioxidants. Lipoic
acid increases the levels of glutathione, a very important antioxidant
normally found in our cells and responsible for mopping up all types of
toxins and free radicals. Glutathione supplements, however, are not helpful
since glutathione does not have the ability to cross cell membranes.
Fortunately, both laboratory and animal studies have shown that lipoic acid
can stimulate the production of this antioxidant. This is particularly
important during periods of excessive stress or exposure to radiation or
toxic substances.

Lipoic acid also acts as a powerful antioxidant in the brain and is likely to
protect brain cells from toxins.

Burning Mouth Syndrome

Burning mouth syndrome (BMS) has features of a neuropathy and could be
related to the production of the toxic free radicals that are released in
stress situations. Alpha-lipoic acid is an antioxidant able to increase the
levels of intracellular glutathione and eliminate free radicals. A study
conducted for two months on 60 patients with constant BMS showed treatment
with alpha-lipoic acid significantly improved symptoms compared to placebo.
This improvement was maintained in over 70% of patients at the 1 year
follow-up.

Diabetes

Lipoic acid is helpful in diabetics, including those with diabetic neuropathy
and diabetic nephropathy (kidney disease). Oxidative stress plays a central
role in the pathogenesis and progression of late microangiopathic (small
vessel) complications in diabetes mellitus. Treatment of diabetic patients
with the lipoic acid reduces oxidative stress and urinary albumin excretion,
and slows the progression of endothelial cell damage. The dose for diabetics
may range from 50 to 300 mg daily.

Diabetic Neuropathy

High blood sugar levels for prolonged periods can be toxic to nerves in the
body. Diabetics who don’t control their blood sugar eventually start losing
sensation in their feet. Other problems follow resulting from damage to
various nerves that supply internal organs. Even impotence can result due to
loss of nerve sensation in genital organs. However high blood sugar may not
be the only culprit. Diabetics are usually under high oxidative stress and
this probably contributes to their neurological problems.

Several studies indicate that lipoic acid has beneficial effects on
diabetic neuropathy, party due to its actions as an antioxidant, and also by
improving the circulation to tiny blood vessels supplying nerve tissue.

Erectile Dysfunction

Lipoic acid and gamma-linolenic acid interact synergistically to improve
nitric oxide-mediated neurogenic and endothelium-dependent relaxation of
corpus cavernosum in experimental diabetes. Whether lipoic acid helps those
with sexual dysfunction is not known.

Memory

Feeding lipoic acid and acetyl-l-carnitine to old rats improves performance
on memory tasks by lowering oxidative damage and improving mitochondrial
function.

Loss of Smell (Olfactory)

Lipoic acid may help regenerate loss of smell after a cold.

Additional conditions where lipoic acid may be helpful
Research in humans with lipoic acid is still incomplete. However, lipoic acid
may theoretically be useful in a variety of medical conditions, including
coronary artery disease, hypertension, high cholesterol, Alzheimer’s disease,
and Huntington’s disease.

Dosage

The ideal dose of lipoic acid is not known at this time. As a daily
maintenance, a dose of 20 to 50 mg seems reasonable. Higher doses may be
required to treat or prevent diabetic complications or other medical
conditions.

Dr. Sahelian’s personal experience

When I take about 30 to 50 mg of lipoic acid in the morning, I notice a
slight visual enhancement along with a mildly relaxed sense of well-being. I
think lipoic acid is one of the most important and beneficial supplements
available.

The combination ginkgo biloba and ginseng can promote fast, accurate thinking, improve short and long-term memory retention and reduce mental fatigue. The results were presented at a National Institute of Mental Health seminar in July.

Extracts from the leaves of the ginkgo biloba tree have been used therapeutically in China for millennia. According to fossil records, the ginkgo tree has been around for over 200 million years and is one of the oldest still existing tree species on earth. Individual trees live up to 1,000 years. Ginkgo, like ginseng, is mentioned in the traditional Chinese pharmacopoeia. Ginkgo extracts are among the most widely studied and prescribed drugs in Europe to alleviate symptoms associated with a wide range of conditions including the therapy of age related mental decline.

The 14-week, double-blind, placebo-controlled, trial studied the cognitive effects of the herbal combination in 256 healthy volunteers between the ages of 38 and 66 years. The volunteers performed a battery of tests using the Computerized Cognitive Assessment System, a validated testing method accepted by the FDA and used to assess the effect of cognitive enhancing products. The study showed the group of volunteers receiving the active herbal combination had statistically significant improvements in cognitive function compared to the control group receiving placebo. The combination product was well tolerated by study volunteers.

While previous research has documented the effects of ginkgo biloba on memory in older people, this study clearly shows that this specific formulation of standardized Gingko biloba and Ginseng extracts enhanced mental performance in a younger healthy population.

Wesnes KA, Faleni RA, Hefting NR, Hoogsteen G, Houben JJ, Jenkins E, Jonkman JH, Leonard J, Petrini O, van Lier JJ. The cognitive, subjective, and physical effects of a ginkgo biloba/panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacol Bull. 1997;33(4):677-83

Ray Sahelian, M.D., is a physician certified by the American Board of Family Practice. He resides in Marina Del Rey, California.
Website: http://www.raysahelian.com

While scientists have not fully determined the actual causes of Alzheimer’s
disease, a number of treatment options have been proposed. These include the
use of antioxidants, blocking the breakdown of acetylcholine, and improving
blood flow to brain cells. There are currently no effective pharmaceutical
drugs for treating AD. If someone you know has AD, I believe it is
worthwhile exploring nutritional therapies.

Vitamins E and C
It’s quite likely that quite a number of different antioxidants are
beneficial. A highly publicized article in The New England Journal of
Medicine reported that the daily use of 1,000 units of vitamin E was
effective in slowing the progression of this disease. Researchers at the
Rush
Alzheimer’s Disease Center, Rush University, in Chicago, Illinois, found
through an epidemiological survey that the use of vitamin E and C
supplements
reduces the risk of developing AD.

Blocking the Breakdown of Acetylcholine
Another approach that has been tried is to prevent the degradation of
acetylcholine, the brain chemical associated with learning and memory. This
can be achieved by providing drugs that block the activity of the enzyme
cholinesterase, which breaks down acetylcholine. Two of these drugs are
tacrine (Cognex) and donezepil (Aricept).

A Chinese herbal extract called huperzine A has been shown in
preliminary studies to block cholinesterase even more potently than tacrine.
Early
studies indicate that huperzine A is much safer than tacrine.

Improving Blood Circulation
Any step taken to reduce atherosclerosis, or hardening of the arteries, is
likely to improve blood circulation to the brain. A study in The Journal of
the American Medical Association had good news about the herb ginkgo biloba.
Therapy with 40 mg of ginkgo three times a day for one year had a positive
effect in patients with AD. There are several compounds in ginkgo that
improve circulation and act as blood thinners and antioxidants.

Combination Therapy
The nutritional approach to treating patients with AD is still very new, and
there are no standards that have been developed. It may take trial and error
to find the ideal regimen for each patient.
In addition to antioxidants, ginkgo, and huperzine, B vitamins at about two
to five times the RDA should be helpful.

Include plenty of fresh fruits and vegetables in order to obtain
important carotenoids and flavonoids. Vitamin E, between 200 and 400 units a
day, preferably of mixed tocopherols, should be taken with a meal. The
dosage for vitamin C is 250 mg once or twice a day.
A 40-mg dose of ginkgo twice daily with breakfast and lunch is recommended.
Huperzine A is an exciting addition to the nutritional armamentarium of
natural therapies for AD. A dosage of 0.02 to 0.05 mg per day can be tried
instead of the standard cholinesterase inhibitors.

Summary
Finding an effective therapy for AD is very challenging. However, with a
great deal of patience, and trial and error, it is likely that a combination
of nutrients can be found that can improve quality of life and cognitive
function. Even though many nutritional options have been presented in this
article, it is important not take all of these supplements at the same time,
but to gradually add one, and then another, in low dosages in order to
determine the effectiveness of each addition. The use of nutrients is
especially appropriate in the treatment of AD since currently there is no
effective pharmaceutical therapy for this condition.

Ray Sahelian, M.D., is the author of the newly published Mind Boosters: A
Guide to Natural Supplements That Enhance Your Mind, Memory, and Mood (St.
Martins Press, $14.95, 2000). For more details, updates, and to ask
questions, see http://www.raysahelian.com.

Le Bars, P.L., et al. 1997. A placebo-controlled, double-blind randomized
trial of an extract of ginkgo biloba for dementia. JAMA 278:1327-1332.

Morris, M.C., et al. 1998. Vitamin E and vitamin C supplement use and risk
of incident Alzheimer disease. Alzheimer. Dis. Assoc.
Disord.Sep;12(3):121-6.

Sano, M., Ernesto, C., Thomas, R.G., et al. 1997. A controlled trial of
selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease.
N. Engl. J. Med. 336:1216-1222.

Xu, S.S., et al. 1995. Efficacy of oral huperzine-A on memory, cognition,
and behavior in Alzheimer’s disease. Chung Kuo Yao Li Hsueh Pao
16(5):391-5.

The study, which began in 1993, measured changes in cognitive function of
individuals in an entire residential community of older persons. The study,
conducted over a three-year period, surveyed participants about their usual
diet including their use of vitamin supplements. Participants’ cognitive
function was measured through a series of performance exams including the
testing of recollection of details from a lengthy story.

Martha Morris, ScD, principal author of the study and assistant professor in
the department of internal medicine at Rush-Presbyterian-St. Luke’s Medical
Center, Chicago, presented details of her findings in Washington at the
World Alzheimer’s Congress 2000 on July 11, 2000.

“This study is important because most of the previous research has focused
on antioxidant nutrients as treatment therapy in persons who already have
Alzheimer’s or Parkinson’s disease. There is limited study on whether
dietary intake of antioxidant nutrients can protect against the disease from
ever occurring,” said Morris.

Los Angeles physician Ray Sahelian, M.D., author of the newly published book
Mind Boosters: A Guide to Natural Supplements That Enhance Your Mind,
Memory, and Mood (St. Martins Press, $14.95, 2000), says, “I recommend my patients take between 30 and 200 international units of Vitamin E a day, along with 100 to 250 mg of vitamin C. Although people do not notice an immediate
effect on memory from taking antioxidants, these vitamins serve as insurance. You pay your monthly fee now, but you earn the benefits years later.”

Several studies have been done over the past few years with huperzine A both
in China and the United States. These studies have shown that Huperzine A is
many times more effective and selective than tacrine (a
cholinesterase-inhibiting pharmaceutical drug) in inhibiting cholinesterase
(Cheng 1996). Huperzine A has also been found to be beneficial in patients
with Alzheimer’s disease. Scientists at Zhejiang Medical University, in
Hangzhou, China administered 0.2 mg of huperzine A to fifty patients with
Alzheimer’s disease for a period of eight weeks and compared the results to a
group who received placebo pills (Xu 1995). The study was done in a double
blind, placebo controlled and randomized manner. The results showed 58
percent of the patients treated with huperzine A had improvements in memory,
cognition, and behavioral functions whereas only 36 percent of those on
placebo improved. No severe side effects were found. Blood pressure, heart
rate, electrocardiogram, electroencephalogram, liver and urine tests did not
show any major abnormalities. The researchers say, “Huperzine A is a
promising drug for symptomatic treatment of Alzheimer’s disease.”

This club moss extract may also benefit older individuals with dementia. A
study was conducted with fifty-six patients suffering from multi-infarct
dementia (multiple small strokes) and one hundred patients with senile memory
disorders (Zhang 1991). The dose used for multi-infarct dementia was 0.05 mg
twice a day for four weeks, whereas that for senile memory disorders was 0.03
mg twice a day for two weeks. Most patients had an improvement in memory. A
few reported slight dizziness, but this did not affect the therapeutic
effects.
Huperzine was even mentioned in the Journal of the American Medical
Association as a possible herbal therapy for Alzheimer’s disease (Skolnick
1997).

Availability
Huperzine A is sold either by itself in dosages of 0.05 mg, or in lower
dosages combined with other mind-boosting nutrients.

My Personal Experience
I took a capsule containing 50 micrograms (0.05 mg) of huperzine A in the
morning at 9 AM on an empty stomach. Within an hour I could feel a subtle
effect. This consisted mostly of feeling slightly more alert and focused.
Over the next hour I took two additional capsules and then ate breakfast. My
focus and concentration were slightly improved all day long and well into the
evening. It didn’t seem that huperzine A had any effect on mood, libido, or
appetite. No side effects occurred.
One study has shown that huperzine A is absorbed rapidly when taken orally,
distributed widely in the body, and eliminated at a moderate rate (Qian
1995). This rapid absorption and moderate elimination is consistent with my
observation of the effects within an hour and the continuation of the effects
late into the evening.

Recommendations
Huperzine A appears to be a promising alternative to cholinesterase inhibitor
drugs used in Alzheimer’s disease. More studies are required to determine its
long-term safety and side effect profile. Until we learn more about this
herbal extract, I would recommend its use be limited to the therapy of AD,
and preferably under medical supervision.