Lipoic acid (also known as alpha-lipoic acid, ALA) is a naturally occurring antioxidant that has been studied for its potential hepatoprotective effects, including in liver conditions such as cirrhosis. The scientific rationale for its use is based on its antioxidant properties, ability to regenerate other antioxidants like glutathione, and reduction of oxidative stress, which is a key factor in liver injury and progression of cirrhosis.

A limited number of preclinical studies (animal models and in vitro experiments) have demonstrated that lipoic acid supplementation can reduce liver fibrosis, decrease markers of oxidative damage, and improve liver enzyme profiles. Some small human studies and case reports have reported improvements in liver function tests and subjective symptoms in patients with liver diseases, such as chronic hepatitis and cirrhosis, following lipoic acid administration. However, these studies are generally of low methodological quality, have small sample sizes, or lack placebo controls.

There is not yet robust, large-scale clinical trial evidence specifically supporting lipoic acid’s efficacy in the treatment or reversal of established cirrhosis in humans. Most clinical guidelines do not currently recommend its use for this indication. Thus, while there is a plausible scientific basis and some preliminary research, the overall evidence remains limited, and lipoic acid should not be considered a proven or primary therapy for cirrhosis at this time.