Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Alpha lipoic acid (ALA) has been investigated as a potential agent to reduce some of the side effects associated with chemotherapy, particularly chemotherapy-induced peripheral neuropathy (CIPN). The rationale for its use is based on its antioxidant properties and its established role in treating diabetic neuropathy. Chemotherapy agents, especially platinum-based drugs (like cisplatin and oxaliplatin), are known to induce oxidative stress and nerve damage, mechanisms that ALA may theoretically counteract.

Several small clinical studies and pilot trials have examined ALA’s effect on CIPN. Some open-label and randomized trials suggest modest benefit, such as reduced neuropathy symptoms when ALA is used as an adjunct to standard care. However, results have been inconsistent, with a number of studies finding no significant improvement compared to placebo. Systematic reviews and meta-analyses generally conclude that evidence is limited and of low quality, with insufficient data to make a strong recommendation for routine use of ALA in this context.

While ALA is generally well tolerated, there is ongoing concern that antioxidants might interfere with the efficacy of chemotherapy, though current evidence is inconclusive on this point. Thus, ALA is sometimes used off-label for chemotherapy-induced neuropathy, but the overall level of scientific validation remains low to moderate (rated 2/5), and its use should be individualized and discussed with a healthcare provider.

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