Alpha lipoic acid as a dietary supplement and in skin care products.

Vitamin N (lipoic or thioctic acid) is a vitamin-like substance that has powerful antioxidant properties, is present in all cells of the human body, and is responsible for preserving youth.
This powder is yellowish in color, bitter in taste and with a specific odor; its appearance resembles hundreds of others known to chemistry. Meanwhile, possessing unique properties, he managed to win the respect of not only scientists and doctors, but also everyone who cares about their own health. For whom it is important to please the body with energy, protect brain cells and activate their work, speed up metabolism and maintain youth longer. So what is this special substance that can perform such miracles?

Unique "undervitamin"

It is known to the world under many names. The most common is lipoic acid. Analogue names: thioctic acid (international name), thioctacid, lipoate, berlithion, lipamide, para-aminobenzoic, alpha-lipoic acid, vitamin N. Regarding the last name, thioctacid is not a “full-fledged” vitamin, but rather a vitamin-like substance with similar properties B vitamins. Lipoic acid cannot be classified as a true vitamin precisely because of its unique abilities. Last but not least, due to its ability to be synthesized by the body itself (in the intestines).

Content:

• Unique "undervitamin"
• The more carbohydrates, the less vitamin N
• Useful acid
• Why does vitamin N deficiency occur and why is it dangerous?
• How to understand that there are already too many vitamins
• "Acid" dosages
• Food Sources of Vitamin N
• How to preserve maximum nutrition in food
• Interaction with other substances: benefits and harms
• Vitamin for sports
• The main defender of the liver...
• Vitamin for obesity
• How to lose weight with lipoic acid
• For pregnant
• Use in cosmetology
• The Latest Discovery About Vitamin N

On the other hand, while the “colleagues” of vitamin N are divided into separate groups - fat- and water-soluble, for lipoic acid there is no fundamental difference where to manifest itself: in fat, alcohol or water (acid salts react more quickly).

This natural antioxidant with universal properties is able to “make its way” into any cells of the human body, including the brain and blood vessels, and only there to fight the main pests - free radicals. Multiple experiments have proven the ability of thioctacid to protect DNA from damage. But it is precisely the violation of the structure of deoxyribonucleic acid that is called the main cause of aging of the body and the cessation of its viability.

Scientific experiments involving lipoic acid are ongoing. It is possible that the world is on the verge of the main discovery of all times - the elixir of eternal youth.

The unusual formula of vitamin N - a combination of fatty acid and sulfur - is capable of other “miracles”. Being an important element in the process of glycolysis, it converts sugar into energy. By enhancing the work of mitochondria, which play the role of “energy depots” in each cell, it affects the efficiency of the body, providing it with continuous sources of energy. And these mini-energy factories process “recyclables” - the breakdown products of amino acids, thus squeezing out the maximum benefit for the body.

It took scientists only a few years after the discovery of alpha-lipoic acid to learn how to synthesize the substance in the laboratory and determine that its structure is 1,2-dithiolane-3-valeric acid. The materials for the synthesis were beef liver and yeast. At the beginning of research, the substance was perceived as a hepatoprotector for the liver. But in the process of research, biochemists made a discovery: the entire human body is filled with substance N, it is in every cell. Then another equally important discovery: this powerful antioxidant performs the functions of insulin, lowering blood sugar levels. This made it possible to talk about lipoic acid as an effective medicine for diabetes.

In modern laboratories, two types of lipoic acid are “born”. Biochemists call them mirror isomers: R - right, S - left. The difference between the molecular compositions of both options is small, however, the human body agrees to fully accept only the R-sentence. But the synthesis of pure R-isomer is a rather expensive undertaking, so most pharmaceutical preparations with thioctic acid are a combination of left and right isomers in equal parts.

“Health Quartet” - a new concept of modern preventive medicine

In the last decade, interest in anti-aging medicine has especially increased. And this is quite understandable, since the life expectancy of the Earth's population is steadily growing and in a number of countries already exceeds 80 years. Accordingly, the number of age-associated diseases (the so-called diseases of civilization) is steadily growing, as well as the desire of people to remain healthy, active and beautiful for as long as possible. Good health, high resistance to stress and performance, external attractiveness and freshness - it is for the sake of these components of biological youth that people spend considerable resources on the fight against aging.

Today, humanity has come to understand that beauty and youth depend not only on the cosmetics that we use externally; scientists have proven that beauty comes from within. Regular physical activity, a balanced diet high in dietary fiber and vitamins, and giving up bad habits are the basis for good health and longevity. However, in today's ever-changing world, this is not enough.

Definition of the “Health Quartet” concept

Based on an understanding of the pathogenetic mechanisms of cellular aging and the development of the main diseases of civilization: obesity, atherosclerosis, arterial hypertension and type 2 diabetes, we formulated the concept of the “Health Quartet” - complex metabolic therapy. The concept of “metabolic therapy” implies treatment aimed primarily at maintaining or restoring the cell as the smallest unit of life, its physiological functions, tissue structure and the organism as a whole. The term “metabolic” emphasizes the nature of therapy aimed at restoring the hormonal and biochemical background corresponding to the patient’s 30–35 year age.

The components of the Health Quartet are:

1) sex hormones (maintaining their physiological level; hormone replacement therapy for deficiency of sex hormones); 2) vitamin D (maintaining its physiological level, taking vitamin D supplements if its deficiency is detected); 3) omega-3 polyunsaturated fatty acids (PUFAs) (continuous intake); 4) thioctic or alpha-lipoic acid (ALA) (continuous use).

Each component of the Health Quartet is justified and equally important.

Sex hormones: the source of youth, beauty and energy

In modern medical literature, one can often find an incorrect traditional understanding of sex hormones, according to which there are supposedly only “male” (androgens) or only “female” (estrogens, progesterone) sex hormones, the use of which is inappropriate, unacceptable and even dangerous in members of the opposite sex . We do not agree with this formulation of the question in principle! The fact is that all sex hormones (as well as vitamin D) are representatives of one hormonal family - steroid hormones, which are synthesized, firstly, from one biochemical precursor (7-dihydrocholesterol), and secondly, they have a common hormonal “progenitor” - prohormone" - progesterone, and thirdly, they are synthesized according to almost the same pattern in both men and women, which unites all these hormones into a unique hormonal system of sex steroid hormones. In this regard, the traditional division of sex hormones into “female” and “male” should be considered erroneous and incorrect. In the body of both men and women there is a natural synthesis of all sex steroid hormones (progesterone, androgens, estrogens), which are extremely necessary for a quality life in all periods.

Thus, estrogens in both sexes are the main regulators of bone metabolism, providing bone strength and protection against osteopenia/osteoporosis. In addition, estrogens in both sexes are active hormones responsible for cognition, memory, cognition and other functions of the central nervous system. In men, the vast majority of estrogens are formed from testosterone through aromatization, and without this biochemical process, testosterone does not have its full physiological effects in a man's body. Estrogens in men model libido and behavior, for which testosterone is also responsible. You can often hear the phrase that testosterone is the king of hormones and the hormone of kings! This is true, but every king must have a loyal retinue that will support him in difficult times, ensure the safety of the king and prevent the king from doing anything inappropriate. So it is estrogens that are such a kind of retinue for the king testosterone. In addition, as in women, estrogens in men are responsible for hydration processes and maintaining skin turgor, regulate the formation of skin collagen (skin elasticity), hair growth, spermatogenesis processes, etc. [1, 2].

It is known that with age, the level of sex hormones (estrogens, androgens, progesterone) decreases, ultimately manifesting itself in the state of menopause in women and age-related testosterone deficiency (andropause) in men (Fig. 1). From about age 30 onwards until the end of life, every year a man loses about 1.5–2.0% of free, most active testosterone. It is believed that men who initially have higher levels of testosterone in youth have a greater chance of not experiencing the manifestations of age-related androgen deficiency (AAD) for as long as possible (Fig. 2). Thus, unlike women, in the vast majority of whom menopause occurs in a rather narrow time interval (45–55 years), men have no such time limit from a physiological point of view, so we are talking about the potential timing of the onset of VAD, individual for each man [ 3–5].

A decrease in the level of sex hormones is one of the key moments in the initiation and development of the aging process and age-associated diseases. Modern doctors know that it is necessary to diagnose a deficiency of sex hormones as early as possible, without waiting for the main manifestations of menopause or andropause. Thus, the first signs of estrogen and progesterone deficiency in women are thinning and dryness of the skin and mucous membranes, the appearance of wrinkles, deterioration in the growth and quality of hair and nails, hot flashes, weight gain, irritability, episodes of depressive mood, the appearance of general weakness and apathy, pain syndrome . The first signs of androgen deficiency in both men and women are decreased libido, deterioration of sexual function, muscle weakness, and urinary disorders.

Sex hormone replacement therapy is now well studied. Typically, treatment for menopausal symptoms in women begins with combination (estrogens in combination with progesterone) replacement therapy drugs. It is very important to choose the right drug and its dose. Not only the amount of estrogens matters, but also the amount and form of the progesterone preparation, which should be as metabolically neutral as possible and not have any effects other than progestogen [5]. Today, the safest form of menopausal hormone therapy drugs are combination drugs containing 17-β-estradiol (bioidentical to natural estradiol) and dydrogesterone (the most metabolically neutral gestagen).

Testosterone preparations are used to correct androgen deficiency. Today, a large number of dosage forms of testosterone are licensed worldwide for intramuscular, subdermal (subcutaneous), transdermal (cutaneous), oral and buccal administration, which are equally safe and effective (level 1b, grade A) [4].

Appropriate sex hormone replacement therapy should be part of an overall health strategy for men with VAD and peri- and postmenopausal women, which also includes recommendations regarding lifestyle, diet, exercise, smoking cessation, cognitive training and safe levels of alcohol consumption [4, 5].

Vitamin D: the foundation of anti-aging metabolic therapy

Traditional ideas about vitamin D are associated primarily with its key role in calcium-phosphorus metabolism and the effect on bone mineral density [6]. Recently, there has been an enrichment of existing knowledge, and it is now known that vitamin D is essentially a steroid hormone with a number of important effects on various organs and tissues that are essential for a wide range of physiological processes and optimal human health.

In recent decades, the participation of vitamin D and its associated mechanisms in the prevention of the development of cancer transformations in various organs, autoimmune conditions and infectious diseases has been confirmed [7, 8]. Considerable material has been accumulated on the relationship between vitamin D deficiency and obesity, insulin resistance, adverse effects on glucose tolerance and the development of diabetes mellitus [9, 10].

In fact, a person needs a sufficient level of vitamin D throughout his life: from the newborn period to very old age, since it regulates the activity of extremely important genes (over 1000 genes localized on different chromosomes, which is about 3% of the entire human genome), a violation whose functions are naturally accompanied by low life expectancy and quality of life and accelerated human aging [11].

Vitamin D is synthesized in the human body independently from 7-dehydrocholesterol (a derivative of cholesterol, 7-DHT) under the influence of ultraviolet B rays (UVB) of sunlight or enters the body with certain foods, such as fish oil, butter, eggs, milk. Vitamin D, obtained from food and in the form of dietary supplements, and also formed during exposure to the sun, is biologically inert. To activate and convert into the active form of D-hormone [1,25(OH)2D] in the body, two hydroxylation processes must occur. Thus, by the term “vitamin D” we mean a whole group of biologically active substances, which includes inert vitamin D obtained from food and synthesized in the skin, an intermediate (transport or depot) form and an active metabolite of vitamin D (Table 1).

According to various studies, from 50% to 75% of the world's population suffers from vitamin D deficiency of varying severity [12]. Moreover, with age, vitamin D levels decrease, even in people living in regions with sufficient levels of insolation. Therefore, the problem of vitamin D deficiency in the human body is global in nature and attracts the attention of a huge number of specialists in various fields.

Those at risk for developing vitamin D deficiency include infants, the elderly, people with limited sun exposure (less than two hours a day), dark-skinned people, obese people, people with diseases associated with fat malabsorption, and people living in countries located to the north. 35th parallel in the northern hemisphere (i.e. the entire territory of Russia) [13, 14].

As studies have shown in recent years, to maintain health it is necessary to maintain a blood level of vitamin D (in the form of transport 25(OH)D3 form) of at least 40 ng/ml. Only achieving such a concentration of 25(OH)D3 makes it possible to several times reduce the risk of developing age-associated diseases, such as osteoporosis, type 2 diabetes mellitus (DM), various types of cancer and autoimmune diseases, and increase life expectancy compared with those , whose blood level of 25(OH)D3 is 25 ng/ml or lower [15, 16].

Cholecalciferol (vitamin D3) preparations are traditionally used to treat vitamin D insufficiency and deficiency. The scheme for selecting the dose of vitamin D3 preparation depending on the initial concentration of 25(OH)D3 is shown in Fig. 3. It should be noted that the use of vitamin D3 preparations is absolutely safe, since this form of vitamin D is inactive and is further metabolized in the body to hormone D, depending on individual needs.

Omega-3: why don't Eskimos have heart attacks?

In 1956, Professor Hugh Sinclair, interested in why the Greenlandic Eskimos had virtually no cardiovascular diseases, reported to Oxford the data of his research and observations, indicating that the reason for such an amazing paradox was the Eskimo diet, which consisted exclusively of fish and seal oil - natural sources of omega-3 PUFAs. The works of H. Sinclair did not receive due recognition in their time, but subsequent research confirmed the existence of the “Eskimo legend” and identified the reason for its existence.

Indeed, among the Greenlandic Eskimos, statistics recorded an unprecedentedly low incidence of myocardial infarction - 2:100,000 of the population (for comparison, in California today this figure is 280:100,000!), very rare cases of bronchial asthma and an almost complete absence of diabetes mellitus Type 2! A multifactorial analysis of data obtained over a quarter of a century showed that the reason for the paradox lies in the high content of omega-3 polyunsaturated fatty acids in the diet, namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) [17, 18].

Thus began the era of accumulation of data on essential omega-3 PUFAs (EPA and DHA) as the basis of rational therapy aimed primarily at the prevention of cardiovascular diseases, and in general - at the prevention and treatment of age-associated diseases.

Today, there is a necessary evidence base sufficient to state that every person living in a region with a depleted content of omega-3 PUFAs in the diet (the entire territory of Russia) should, in addition to food, take drugs containing EPA and DHA to prevent age-associated diseases, non-communicable chronic diseases, increasing the duration and quality of life in general [19].

The current dose for an adult Russian is a constant daily intake of 2000 mg of omega-3 PUFAs, calculated as the sum of EPA and DHA, in addition to food. The range of optimal doses to achieve therapeutic goals is from 3 to 4 g/day. The maximum therapeutic dose is 8 g/day.

How can you characterize the indications for prescribing omega-3 PUFA drugs? In fact, the entire life cycle of a person must be considered as an indication. Indeed, we must obtain all essential components either from food or in the form of medications. There is no other alternative.

Being a substrate for the production of cytokines, some hormones, omega-3 PUFAs serve as signaling regulatory molecules involved in the construction of myelin sheaths, cell membranes, ensuring their functionality, regulation of permeability, fluidity, elasticity, are activators of normal stem cell division, activators of the synthesis of regulatory proteins, are responsible for cognitive functions and dozens of various others.

Indications for the administration of omega-3 PUFAs are [19]:

• all cardiovascular diseases, including coronary heart disease, heart failure, arrhythmias, arterial hypertension, cardiac arrhythmias, prevention of sudden coronary death;
• obesity, insulin resistance, diabetes mellitus type 1 and 2;
• neuropathy of any origin, Alzheimer's disease, dementia, multiple sclerosis;
• autoimmune diseases (rheumatoid arthritis, scleroderma, juvenile arthritis);
• bronchial asthma;
• arthrosis, arthritis, osteoporosis;
• alopecia, atopic dermatitis, psoriasis, etc.

Given that EPA and DHA are essential fatty acids and have a half-life of approximately 8 hours, we recommend taking the daily dose throughout the day.

Important criteria for choosing a specific drug for prescription and administration are, in addition to the cost of treatment, the amount of EPA and DPA in the capsule, the concentration of these acids in the capsule. According to our observations and theoretical justifications, it is advisable to use drugs in which the concentration of EPA + DHA is at least 50%.

Alpha lipoic (thioctic) acid: protection against oxidative stress

Oxidative stress is a failure of the body's antioxidant system in which cells are exposed to excessive levels of either molecular oxygen or its reactive species (ROS) - free radicals. Free radicals are unstable atoms and compounds that act as aggressive oxidizing agents and, as a result, damage vital structures of the body. Free radicals are formed when exposed to unfavorable environmental factors (poor environment, smoking, chronic intoxication, UV irradiation). In addition, the production of free radicals can increase with diabetes and insulin resistance, obesity, arterial hypertension, and age-related decreases in sex hormones in both men and women. Also, the production of free radicals is an integral part of the aging process [20, 21].

Alpha lipoic acid (ALA) and its metabolic intermediate, dihydrolipoic acid, are among the most effective endogenous antioxidants [22]. ALA was first isolated in 1951 by LJ Reed and his colleagues from bovine liver and was originally called “vitamin N”, which emphasized its indispensability and importance for the function of nervous tissue (vitamins are essential substances obtained from food, N - “neuro”). . However, its chemical structure is not a vitamin; moreover, it is formed in small quantities in the body, which does not allow it to be classified as an absolutely essential fatty acid. However, it is worth noting its extremely low content in food, while under conditions of oxidative stress there is an increased consumption of ALA, and its daily requirement for an adult reaches about 300 mg per day [23].

Unfortunately, its therapeutic value is underestimated, and its indications for use are unreasonably narrowed. Meanwhile, based on ideas about the biochemical properties of ALA (Table 2), the history of its study and proven effectiveness in treatment, including neuropathy of any etiology, the indications for its use should be significantly expanded [24]. In addition, ALA is not only a universal antioxidant, but also increases the effectiveness of any other therapy.

Alpha lipoic acid is a unique, complete component of the Health Quartet, which is extremely necessary in the presence of manifestations of oxidative stress. In the absence of pronounced manifestations of oxidative stress, alpha-lipoic acid is also necessary for every person, starting from the age of 35–40, since around this age the body’s natural antioxidant defense begins to weaken. The average daily therapeutic dose of ALA, in our opinion, should be 300–600 mg. In therapeutic practice, ALA tablets, ALA capsules and intravenous injections are traditionally used.

The need to use the “Health Quartet” as the basis of preventive and anti-aging therapy is beyond doubt, and its main task is not only the prevention and treatment of age-associated diseases, but also increasing the length and quality of life.

Literature

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2. Tyuzikov I. A., Kalinchenko S. Yu., Vorslov L. O., Tishova Yu. A. The role of estrogens in the male body. Part 2. Particular clinical endocrinology and pathophysiology of estrogens in men // Andrology and genital surgery. 2015; 1:23–30.
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L. O. Vorslov*, 1, Candidate of Medical Sciences I. A. Tyuzikov**, Candidate of Medical Sciences, Professor RAE S. Yu. Kalinchenko*, Doctor of Medical Sciences, Professor D. A. Gusakova*** Yu. A. Tishova*, Candidate of Medical Sciences

* Federal State Budgetary Educational Institution of Higher Professional Education RUDN, Moscow ** Clinic of Professor Kalinchenko, Moscow *** Federal State Budgetary Institution National Medical Research Center of the Ministry of Health of the Russian Federation, Moscow

1 Contact information

The more carbohydrates, the less vitamin N

Vitamin N reserves in the human body are replenished in several ways:

• in the process of synthesis;
• with food consumed;
• from dietary supplements.

Humans, like most living organisms, are capable of independently producing lipoic acid. The synthesis process occurs directly in the intestine with the participation of bile. True, the dose produced in this way is often not enough for the full operation of all systems, and with age this productivity fades away.

The second source of thioctacid is food. But the rule that works with other vitamins does not apply in the case of substance N again. Even a proper and balanced diet with foods rich in lipoid acid will not reveal the full potential of the substance. This paradox was explained by nutritional scientists: enzymes in the human body cannot fully break down alpha-lipoic acid to a state in which it is absorbed. So it turns out that once it enters the digestive system, a small part of the vitamin is absorbed, forming its own “depots” in the kidneys, liver and heart. The remains are excreted in the urine.

Carbohydrates can weaken the absorption of lipoic acid. There is a certain relationship between the two components: the richer the diet in carbohydrates, the less vitamin N the body absorbs.

This statement by scientists prompts another thought: how did people manage to live then until they learned to synthesize the substance in laboratories, and how those who do not take pharmaceutical forms of thioctacid continue to live today. There is no mystery in the explanation. A long and happy life without lipoic acid “shines” for absolutely healthy organisms, without metabolic problems, who do not suffer from diabetes and who have not accumulated free radicals. Today such conditions sound like fantasy. Bad habits, unhealthy lifestyle and poor environment have a detrimental effect on a person. And if a hundred years ago humanity could easily do without pharmaceutical analogues of vitamin N and live to a ripe old age in an active state, now not everyone can do this. And oncological diseases reaching epidemic levels and early decline of the body are, sadly, a normal situation for modern people.

Useful acid

And although thioctic acid is not considered an essential substance for the body in the scientific community, its role for humans is sometimes truly irreplaceable.

1. Antioxidant. In its antioxidant properties, lipoic acid is not inferior to the more well-known ascorbic acid and vitamin E. Moreover, in combination with other antioxidants, it enhances their active capabilities.
2. Effect on blood vessels. Vitamin N strengthens the walls of blood vessels, protects against damage, the influence of harmful substances and prevents the formation of blood clots. It has a certain effect in the treatment of multiple sclerosis, varicose veins, thrombophlebitis.
3. Enzymatic activity. Lipoic acid plays the role of an enzyme that accelerates the absorption of glucose by cells. By influencing the activity of mitochondria, it controls the process of lipid metabolism. The combination of insulin, adrenaline and thioctacid promotes more active energy production.
4. Body cleanser. The chemical formula of lipoic acid allows it to bind and remove salts of heavy metals such as mercury, arsenic, and lead from the body. Thus, it promotes rapid detoxification after poisoning.
5. Liver protector. The hepatotropic abilities of vitamin N protect liver cells from the harmful effects of poisons and prevent tissue degeneration in cirrhosis and hepatitis.
6. For the nervous system. Effective in use for Alzheimer's disease and alcoholic polyneuropathy. Alcohol causes damage to nerve cells in the brain and spinal cord, causing pathological conditions in people who abuse alcohol. Vitamin N regenerates damaged areas of nerve tissue.
7. Ophthalmology. The beneficial effect of lipoic acid on eye cells and the ability to sharpen vision are the reasons for the use of the substance for the treatment of ophthalmic diseases.
8. Leather. Vitamin N is effective for skin problems. In combination with other substances, it relieves acne and teenage acne.
9. Immunity. Being an antioxidant, it creates a protective environment for the body against viral and infectious diseases. Effective in the treatment and prevention of ARVI.

In addition, it is worth remembering thioctic acid if you need to reduce cholesterol or sugar levels.

The feeling of fatigue and drowsiness does not leave you, spend little time in the fresh air - the brain is definitely experiencing a lack of oxygen. It is also possible to correct the situation and enhance mental activity with the help of products or pharmaceutical preparations containing vitamin N.

Other properties of alpha lipoic acid:

• improves thyroid function;
• protects against harmful ultraviolet radiation;
• serves as a growth factor;
• has an antispasmodic effect;
• choleretic substance;
• prevents the growth of fatty tissues;
• reduces appetite;
• restores the heart muscle.

Thioctic acid is also used:

• when you need to remove dark circles and puffiness under the eyes;
• to tighten pores and get rid of dull or yellowish skin;
• to reduce acne scars;
• for eczema, psoriasis, dermatoses;
• to smooth out small wrinkles;
• to get rid of chronic fatigue, increase attention and improve memory;
• for pathologies of the cardiovascular system;
• for type 2 diabetes;
• for the treatment of muscle degeneration;
• for the prevention and treatment of viral infections.

A modern view on the possibilities of using alpha-lipoic acid

Alpha lipoic acid (ALA) is a powerful antioxidant, which makes it possible to use it for the treatment and prevention of a wide range of diseases. The ability of ALA to influence inflammation, apoptosis, blood flow, endothelial dysfunction, activation of neurotransmitters, and metabolic processes determines its widespread use in various fields of medicine.

One of the promising areas for the use of alpha-lipoic acid is neurogenic erectile dysfunction against the background of obesity and metabolic syndrome. Several alpha-lipoic acid preparations are used in Russia, but the greatest practical experience has been accumulated with the drug Espa-lipon, which was one of the first to appear on the Russian market and has proven itself in terms of effectiveness.

Table 1. Differentiated approach to the treatment of metabolic disorders with lipid accumulation in hepatocytes

Clinical pharmacokinetics

Alpha lipoic acid is a disulfide derivative of octanoic acid [1]. ALA is a natural coenzyme of the mitochondria of a multienzyme complex that catalyzes the oxidative decarboxylation of alpha-keto acids such as pyruvate and alpha-ketoglutarate. ALA is a powerful antioxidant, which determines the possibility of its therapeutic use. The structural formula and properties of ALA were discovered in 1951, its first clinical trials were conducted in the same year, and the use of alpha-lipoic acid in humans began in 1970. Early research on the use of ALA was carried out against the backdrop of insufficient understanding of the mechanisms of its action and concerned mainly with lipid and carbohydrate metabolism.

Alpha lipoic acid is both fat- and water-soluble, so it can penetrate into any tissue of the body, providing an antioxidant effect not only outside, but also inside the cell. It also activates the activity of other antioxidants - vitamins A, C, glutathione and coenzyme Q10. ALA has unique properties that make it possible to use it for the treatment and prevention of a wide range of diseases, primarily of the peripheral nervous system and brain, since nervous tissue is extremely sensitive to the toxic effects of free radicals. Traditionally, ALA is used in the treatment of diabetic polyneuropathy. However, the toxic effect of free radicals, including the development of neuropathy and one of its early manifestations - neurogenic erectile dysfunction, is observed in a number of other conditions, such as diabetes mellitus (DM), obesity, aging, long-term use of medications (toxic neuropathy ), metabolic syndrome, metabolic liver diseases.

Pathogenetic use of alpha lipoic acid

The effect of ALA has been well studied in healthy volunteers and diabetic patients. The pharmacokinetic characteristics of ALA when administered intravenously do not differ in healthy people and patients with diabetes; a linear relationship was found between the concentration of ALA in plasma and the dose of the drug administered intravenously in the range from 200 to 1200 mg [2]. When taking tablets in healthy people, the linear dependence of the concentration of ALA in plasma on the dose of the drug was within the range of 50–600 mg. With any method of administration, after 24 hours there is no ALA left in the plasma, since it enters the liver, heart, and kidneys, where it accumulates, followed by excretion [1].

A study of the bioavailability of ALA in healthy subjects when taking tablets on an empty stomach or immediately after breakfast showed that food significantly reduced plasma ALA concentrations. In this regard, it is recommended to take ALA tablets immediately after sleep, 30–45 minutes before meals. ALA undergoes beta-oxidative degradation and is excreted in the urine as metabolites [2]. Numerous experimental studies have demonstrated that ALA is a powerful antioxidant due to its participation in the resynthesis of vitamin E and the ability of ALA to bind free radicals. It has also been suggested that ALA is an antioxidant that protects the sulfhydryl groups of the glucose transporter system, which in turn leads to increased insulin-dependent glucose utilization [1].

Oxidative stress and edema due to plasma extravasation, which develop after traumatic injury to brain tissue, are known to play an important role in the secondary mechanisms of brain dysfunction. The literature considers the possibility of using antioxidant therapy, including ALA, in these cases. In an experiment after traumatic brain injury, ALA reduced the severity of oxidative stress, swelling of brain tissue, and histopathological changes [3]. A number of antioxidants, including ALA, reduce the activation of apoptosis caused by ethanol. A clinical open study of 56 patients with alcoholic polyneuropathy revealed a decrease in positive and negative neuropathic symptoms when taking ALA at a dose of 300 mg daily, and ALA was more effective than thiamine.

In Russia there are several preparations of alpha-lipoic acid, but the greatest practical experience has been accumulated with the drug Espa-lipon, which was one of the first to appear on the Russian market (1995) and has proven itself to be a highly effective remedy. Thanks to optimal dosages, the availability of oral and infusion forms of release, German quality and affordable price, Espa-lipon can be used as widely as possible in modern medicine.

Clinical Applications of Alpha Lipoic Acid

ALA can be used in many diseases, including pathologies of the central nervous system associated with oxidative stress and inflammatory changes. ALA inhibits the migration of T cells into the structures of the central nervous system. It has been shown that ALA can suppress the activity of cells that determine the immune response by inhibiting interleukins in them and stimulating cAMP. Fibroblasts from patients with Alzheimer's disease revealed pronounced oxidative stress associated with mitochondrial dysfunction. In the treatment of Alzheimer's disease, ALA is considered as one of the methods of neuroprotection. The neuroprotective capabilities of ALA are realized by improving mitochondrial function. It has been shown that ALA increases the production of acetylcholine in the brain by activating choline acetyltransferase and increasing the production of acetyl-coenzyme A, reduces cerebral oxidative stress and the synthesis of inducible nitric oxide synthase, which is the basis of its neuroprotective effect and makes it possible to use it in neurodegenerative processes. In two open-label clinical trials, 600 mg ALA was given to patients with Alzheimer's disease for 12 to 48 months and noted a slowing of disease progression in mild dementia (ADAScog

1. reduce the level of lipid peroxidation;
2. bind and inactivate toxic substrates in the hepatocyte as a result of increasing the synthesis of detoxifying substances;
3. block the activity of mesenchymal-inflammatory reactions;
4. slow down the progression of fibrosis [5].

Great importance is attached to basic therapy, including:

• cessation of the action of etiological factors;
• complete exclusion of alcohol;
• a diet rich in proteins (1 g of protein per 1 kg of body weight) and water-soluble vitamins, but low in fats;
• normalization of blood glucose, lipids, and uric acid levels in the presence of corresponding disorders.

As a rule, in case of fatty hepatosis with a known etiology, the absence of complications and normal biochemical test results, basic therapy turns out to be sufficient and adequate, and regression of fatty degeneration is observed after 3–6 months. In some cases, with the alcoholic etiology of the process, parenteral administration of water-soluble vitamins (B1, B6, B2, PP, B12, C) in standard therapeutic doses for 10–14 days is required in addition to basic therapy [6]. The main indications for drug therapy are: the development of steatohepatitis and fatty hepatosis of unknown etiology or the inability to stop the action of etiological and additional risk factors for its development [3, 7]. The choice of a specific drug or their combinations in the treatment of metabolic liver damage is influenced by many factors: the etiology and leading pathogenetic links of the process, the degree of activity, the presence of systemic and concomitant diseases, the cost of drugs and, importantly, the knowledge and experience of the doctor (Table 1). The widespread use of alpha-lipoic acid preparations (for example, Espa-lipon) for liver diseases causes the following effects of ALA [1, 5]:

• the ability to reduce the level of lipid peroxidation (binds free radicals and free tissue iron);
• participation in the oxidation of fatty acids and acetate (prevents the development of fatty liver steatosis);
• decarboxylation of beta-keto acids (energy supply to the cell and prevention of the development of ketoacidosis);
• increased transmembrane transport of glucose into the cell (accumulation of glycogen in the cell, increase in its energy balance);
• suppression of nitric oxide synthesis by hepatocytes (prevention and relief of rheological disorders and vascular disorders).

Alpha-lipoic acid preparations are recommended for use in alcoholic and non-alcoholic steatohepatitis, and in fatty steatosis to prevent progression and development of complications. Treatment can be carried out as monotherapy and in combination with other antioxidants and hepatoprotectors.

Currently, there are isolated publications on the effectiveness of treatment of patients with liver diseases associated with the hepatitis C virus, a combination of Espa-lipon 300 mg 2 times a day, silymarin 300 mg 3 times a day and selenomethionine 200 mcg 2 times a day, taken for year [8]. Additionally, a complex of vitamins B, C, E and microelements were prescribed. By the end of the one-year course of treatment, all patients achieved an improvement in clinical and biochemical parameters without eliminating the hepatitis C virus. This study showed that if it is impossible to carry out adequate antiviral therapy (the presence of side effects and contraindications, the ineffectiveness of previous therapy), the use of hepatoprotectors significantly improves the quality of life patient data. Thus, given the wide range of actions to restore almost all types of metabolism in the hepatocyte, alpha-lipoic acid preparations (for example, Espa-lipon) should find widespread use in the treatment of metabolic liver diseases of alcoholic and non-alcoholic origin.

One of the promising areas for the use of alpha-lipoic acid, which we widely use in our work, is neurogenic erectile dysfunction (ED) against the background of obesity and metabolic syndrome. Diagnosis of neurogenic ED, which can be considered a clear clinical manifestation of the negative effect of oxidative stress, leading to a decrease in the secretion of nitric oxide (the main neurotransmitter) by cavernous nerves, is quite simple (Kalinchenko-Rozhivanov method). Determination of penile neuropathy is carried out using the Tiotherm device, which has two different ends - metal (cold) and plastic (warm). Patients with neuropathy cannot distinguish the difference between a cold end and a warm end.

According to epidemiological studies, the incidence of diabetic neuropathy (DN) in diabetes varies from 5 to 100% depending on the examination methods used. Differences in incidence are due to the use of different criteria for diagnosing DN [9]. According to the prevailing point of view, the earliest and most common form of DN is diabetic peripheral polyneuropathy (DPN). 7.5% of patients with newly diagnosed type 2 diabetes already have clinical and laboratory manifestations of DPN [9]. However, according to our numerous studies, the earliest and most common form of DN in men with diabetes is erectile dysfunction, which significantly worsens the quality of life not only of the man, but also of the married couple, and is also the cause of the development of depression, which negatively affects the ability to achieve carbohydrate compensation. exchange.

We studied the clinical and epidemiological characteristics of neurogenic forms of sexual dysfunction in men with diabetes [10]. A continuous one-time study included 611 patients with diabetes (representative sample) living in various regions of the Russian Federation. All patients were surveyed using the International Index of Erectile Function 5 (IIEF-5) questionnaire and Aging Male Symptoms according to Heinemann. The degree of compensation of carbohydrate metabolism was assessed by the level of glycated hemoglobin (HbA1c) (the norm is up to 6.4%). Screening for diabetic polyneuropathy was carried out by studying vibration, temperature and tactile sensitivity of the lower extremities (NDS scale according to Young and TSS scale). To identify neuropathy of the genital organs, vibration, tactile and temperature sensitivity of the penis was assessed using the Kalinchenko-Rozhivanov method. To study the hemodynamics of the penis, Doppler ultrasound was performed using a Minimax Doppler Fono device from Minimax with a 10 MHz sensor. Statistica software package (StatSoft Inc., USA, version 6.0) was used for statistical data processing.

An increase in the prevalence of ED in older age groups has been revealed. With age, both men and women experience a decrease in the secretion of sex hormones - important endogenous antioxidants, which aggravates the manifestations of oxidative stress, and in a number of patients without diabetes is the leading cause of its occurrence. In addition, we found that the neurogenic form of ED in patients with type 1 and type 2 diabetes occurred before the first clinical manifestations of distal diabetic neuropathy in no less than 37.4 and 51.9% of cases, respectively. This feature makes it possible to use the neurogenic form of ED as an early clinical prognostic sign of the development of distal diabetic neuropathy. It should be noted once again that diabetes mellitus is not the only cause of the development of neurogenic erectile dysfunction. When determining the sensitivity of the penis became routine practice, we began to identify a sufficient prevalence of ED in men without diabetes. We were able to identify several reasons for the development of neurogenic ED, on the basis of which we propose the following classification of neurogenic ED:

1. Diabetic neurogenic ED.
2. Traumatic neurogenic ED (often observed after operations on the pelvic organs and penis).
3. Toxic neurogenic ED (develops against the background of alcohol intake, long-term use of medications, uremia, liver damage, vitamin deficiency; neuropathy developed against the background of infections, systemic diseases, allergic diseases).
4. Age-related neurogenic ED (develops against the background of decreased testosterone secretion).

Timely use of ALA for neurogenic erectile dysfunction in the setting of obesity is a prevention of the development of vascular erectile dysfunction, which is quite difficult to treat and precedes more serious vascular disasters such as stroke and coronary heart disease. Oxidative stress, hypercholesterolemia, endothelial activation and monocyte adhesion are the links in the formation of atherosclerotic lesions of the vascular wall.

The experiment proved that the administration of ALA reduced the size of atherosclerotic plaques in the abdominal aorta, which was accompanied by a decrease in the content of fatty and inflammatory cells in the aortic wall. ALA improved the vascular response to angiotensin II, acetylcholine and insulin, and reduced oxidative stress. The use of ALA reduces free radical damage to myocytes due to oxidative stress during myocardial ischemia. In the experiment, the administration of ALA led to a significant decrease in apoptosis, a decrease in lipid peroxidation, and an increase in the activity of glutathione in the mitochondria of cardiomyocytes, which prevented the development of irreversible disorders of cardiac function. In the ISLAND study, taking ALA tablets at a dose of 300 mg as monotherapy in patients with metabolic syndrome for 4 weeks led to an increase in endothelium-dependent vasodilation of the brachial artery, which was accompanied by a decrease in plasma interleukin-6 and plasminogen activator-1. Thus, the effect of ALA on endothelial dysfunction, realized through its effect on anti-inflammatory and antithrombotic mechanisms, has been shown [11].

Pilot studies have shown that ALA reduces apoptosis associated with oxidative stress but stimulates apoptosis in various cancer cells. An experiment on cell culture showed that ALA dose-dependently inhibits the proliferation of human breast cancer cells and activates the process of apoptosis in them. Similar results were obtained for lung cancer cells, with ALA activating apoptosis in cancer cells through both caspase-independent and caspase-dependent pathways. Doctors from New Mexico (USA) described the case of a patient with pancreatic cancer with liver metastases, whose condition improved after ALA infusions in combination with low-dose naltrexone. The patient was alive and well 78 months after initial presentation. Cisplatin, a widely used anticancer drug, increases lipid peroxidation and decreases the activity of antioxidant enzymes in renal tissue. Treatment with cisplatin can cause acute kidney damage, and irreversible filtration impairment may occur. The experiment showed that ALA reduces the symptoms of acute kidney injury by reducing the expression of inflammatory adhesion molecules and apoptosis processes. Chemotherapy with cisplatin and paclitaxel can cause damage to peripheral nerves due to dysfunction of the mitochondrial apparatus of cells. The experiment showed that ALA can prevent the development of polyneuropathy by reducing oxidative stress and protecting mitochondria from damage when using these drugs [12].

Conclusion

Thus, an analysis of experimental and clinical studies indicates the universality of the antioxidant effect of ALA in the vascular bed and cytoplasm of the cellular structures of various organs. The ability to use alpha-lipoic acid to influence inflammation, apoptosis, blood flow, endothelial dysfunction, activation of neurotransmitters, and metabolic processes allows us to consider its preparations as a potential drug in various fields of medicine. We believe that in all patients with neurogenic erectile dysfunction, the use of alpha-lipoic acid should be a course regimen, and discontinuation of the drug is possible only after complete restoration of sexual function and elimination of the causes of oxidative stress (elimination of obesity, metabolic syndrome, toxic factors).

Why does vitamin N deficiency occur and why is it dangerous?

A lack of any of the microelements needed by the body is a problem, and a complex one. Also, vitamin N deficiency is just the tip of the iceberg; the essence of the problem lies much deeper and can have serious consequences.

Vitamin N deficiency is caused by:

• unbalanced diet;
• deficiency of vitamin B1 and proteins;
• liver diseases;
• dermatitis.

In the case of hypovitaminosis N, it is impossible to name a point-by-point list of possible symptoms that should signal a deficiency of the substance. Meanwhile, a long-term lack of vitamin gives rise to serious health problems.

First of all, the nervous system suffers. Convulsions, dizziness, and polyneuritis appear. And all because instead of thioctic acid, pyruvic acid accumulates in the body, and it destroys nerve cells.

Another consequence is liver dysfunction. The next stage of the disease is hepatitis and pathological degeneration of healthy organ cells into adipose tissue, the formation of bile occurs with disruptions.

Lipoic acid deficiency also affects blood vessels. And you will have to pay for an unbalanced diet with the development of atherosclerosis.

Having analyzed the possible consequences of hypovitaminosis N, it is not difficult to compile a list of possible signals. But the presence of these symptoms no longer just warns of a slight decrease in the level of alpha-lipoic acid in the body, but signals serious consequences.

Contact your doctor immediately if:

• muscle cramps recur regularly;
• dizziness appeared;
• discomfort is felt in the liver area;
• a coating appeared on the tongue;
• there is an unpleasant odor from the mouth;
• dark spots appeared on the body, a foul smell of sweat appeared;
• There are brown circles under the eyes.

Any of the above symptoms is a signal of alarm.

Side effects and contraindications

Contraindications to the use of alpha-lipoic acid for women are the presence of individual intolerance to the components, detection of an allergic reaction, detection of increased gastric acidity and diagnosis of anemia. Do not drink alcohol while using the drug. If you violate this recommendation, you may encounter problems such as seizures and changes in the blood's ability to clot.

Use of the drug in quantities greater than the daily dose of alpha-lipoic acid for women may lead to adverse reactions. They are expressed in disruption of digestive processes and the appearance of nausea. In some cases, headaches, skin rashes, and calf muscle cramps are detected.

How to understand that there are already too many vitamins

It is not clear by whom and when the invented principle “The more, the better” has found its application in few places. In most cases, it only serves as an example of bad manners and bad taste. And in the story with vitamins, it can even put you on a hospital bed.

Meanwhile, it is worth understanding: vitamin N obtained from food can never provoke an overdose of the substance in the human body.

The only cause of hypervitaminosis is the synthetic form of thioctic acid, taken in a dosage significantly higher than the daily norm.

It is a little easier to determine an overdose of lipoic acid than its lack in the body. Symptoms traditional for hypervitaminosis:

• increased stomach acidity;
• heartburn;
• pain in the pit of the stomach;
• diarrhea;
• skin allergies: urticaria, itching, inflammation.

In most cases, getting rid of unpleasant symptoms is easy: just give up the synthetic vitamin. But it’s even better to forget about the practice of arbitrarily prescribing medications or vitamins for yourself, and then also about. There are doctors for these purposes. Only they, after carefully studying various blood tests and other examinations, are able to prescribe an adequate dose of deficient minerals and vitamins.

Anti-aging cosmetics. Everything you wanted to know

In the endless world of the beauty industry, anti-aging drugs can be found everywhere - from face creams and decorative cosmetics to nutritional supplements. Today the segment is so developed that it satisfies the needs of a wide range of age categories. Not only those who want to turn back the clock and become younger again, but also supporters of early prevention will find a remedy for themselves.

And this is not surprising, because the task of anti-aging is no longer just the reduction of various types of wrinkles, now it is also protecting the skin, regulating the level of hydration, evening out the tone, and stimulating the appearance of new cells.

Research shows that consumers want to get rid of at least seven signs of aging: dryness/dehydration, wrinkles around the eyes, deep forehead wrinkles and nasolabial folds, they also want to brighten the skin, reduce pores and increase elasticity, strengthen the oval of the face and restore original volumes .

A product like this is guaranteed to be swept off the shelves. Does it really exist and what ingredients are capable of such a miracle? Advertising and marketing statements from manufacturers sometimes only confuse the situation.

What should you pay attention to when choosing such funds?

Prevention of aging is a new trend in anti-aging care. A good anti-aging product should not only rejuvenate, but also neutralize damage, preventing aging. Day after day, your skin is exposed to environmental aggression: sun, temperature changes, smog, and so on. All this leads to dryness and, as a result, early wrinkles.

Although an advertising campaign typically focuses on a single innovation agent, the best products contain multiple agents. For example, the combination of alpha-lipoic acid (an antioxidant) and DMAE in Dr. Perricone's cosmetics.

Our cells are made up of many different components that affect the aging process, and, unfortunately, we have not yet invented an ingredient that would affect each of them. Pay attention to combination formulations that include growth factors, antioxidants and synthetic peptides, as well as minerals and vitamins that enhance the effectiveness of the effect. If the ingredients are compatible with each other, you will get your money's worth.

Consumers are always looking for something new, and in this regard, the cosmetics industry fully caters to their needs. Every day a new discovery arises and within a week it is already used in some kind of drug. But an educated buyer should look for ingredients that have been proven to be effective by several scientific studies, which we'll talk about now:

Alpha hydroxyl acids

All skin types need exfoliation. As skin ages and surface cells shed more slowly, the result is skin that looks dry, tired, and gray. The natural life cycle of a cell from birth to desquamation, when you are young and healthy, is approximately 28–30 days; for aging skin, this cycle is already 45–60 days.

Therefore, mature skin needs help in removing dead cells. AHA acids are the most popular home exfoliation product. In addition to excess scales, they help get rid of pigmentation, wrinkles and crow's feet.

Low dosages of AHA acids not only exfoliate dead cells, but also work as moisturizing agents, high concentrations act as peelings that stimulate the production of collagen and elastin. Be sure to pay attention to the packaging; it is better if the peeling is packaged in an opaque bottle.

Antioxidants in cosmetics

The skin is constantly exposed to free radicals that are formed under the influence of environmental factors. This is mainly UV radiation, smog, heavy metals, microorganisms. The role of oxidative stress in the process of premature skin aging has been proven repeatedly.

Damage accumulates in cells, including fibroblasts, mutations and damage appear in DNA. This means that your skin will begin to create misshapen cells, such as being unable to generate healthy collagen. Antioxidants can stop these processes.

When purchasing such products, pay attention to packaging and storage - you should not buy transparent jars in a light-filled store window. Antioxidants lose their potency when exposed to prolonged exposure to oxygen and sunlight. The main working antioxidants are alpha lipoic acid, beta glucan, coenzyme Q10, grape seed extract, green tea, vitamins C and E, pomegranate extract.

Retinol

Lately everyone has been discussing retinoids - derivatives of vitamin A. In nature, the most common form is retinol (an unsaturated alcohol), but it is produced only in the body of animals. There are also carotenoids - for example, beta-carotene, which are found in plants and are precursors to vitamin A. Thus, advertising “natural, plant-based vitamin A” is incorrect - it simply does not exist.

In the list of components you can find the following names: retinol, retinyl palmitate, retinyl acetate, retinoic acid, retinal. They can really smooth out wrinkles. Many consumers, due to redness and peeling during use, think that retinoids are exfoliants and prefer acids, but this is completely wrong.

Exfoliants affect exclusively the top layer of skin, improving its appearance, while retinoids act in a completely different way - they thicken the epidermis, stimulating the production of collagen, elastin and hyaluronic acid.

When choosing a product, pay attention to the packaging - retinoids are very quickly destroyed by UV radiation and contact with oxygen, so if you are offered a transparent jar with a regular lid, there is no active retinol there. Working compositions must be in a vacuum opaque dispenser.

Peptides

A relatively new ingredient on the cosmetic market, causing a lot of controversy. In the world of biochemistry, peptides are chains of amino acids. Essentially, peptides transmit signals from cell to cell that are necessary to initiate certain reactions.

For example, palmitol oligopeptide and palmitol tetrapeptide-7 are some of the most popular “synthetic peptides” on the market. This mixture mimics the appearance of broken collagen, causing the skin to respond by producing more collagen and elastin, as well as hyaluronic acid, which is known to counteract the “prune effect” associated with mature skin.

Such peptides are created to solve many problems of aging skin, as well as to prevent aging.

UV filters

Prevention is definitely better than cure. Although our region is not the sunniest, it is better to choose a day cream with a UV protection factor (SPF) of at least 10–15.

Without protection from the sun's rays, in just a few minutes of exposure per day, but throughout our lives, our skin undergoes changes, photons interact with DNA and can cause a mutation that gradually accumulates. As a result, the skin loses its ability to heal itself. Exposure to UV rays destroys collagen, causing your skin to age much earlier than it otherwise would.

And although the list of anti-aging ingredients is not as long as we would like, there are a huge number of their combinations in different carriers for completely different skin types and needs. Therefore, finding exactly your product may take some time, but the result is worth it.

Tatiana Morrison

Photo thinkstockphotos.com

"Acid" dosages

As is the case with some other beneficial substances, scientific minds cannot agree on what the daily dose of lipoic acid should be.
Therefore, the concept of “norm” was pushed into the framework between half a milligram and 30 mg. In some cases, the upper bar is raised to 50-80 mg, and in exceptional cases – to 800 mg/day. However, the most common recommended dose for adults is 25-50 mg daily. Comparative table of consumption rates

This norm “works” for healthy people leading a normal lifestyle. In other cases, the dosage is adjusted according to the body's requirements. Increased daily norms cannot be taken for longer than the recommended period - the body is able to “get hooked” on artificial “feeding” and eventually abandon its own production of the substance. Also, you should not buy vitamin N for children unless necessary, especially for infants. Babies will receive everything they need from their mother’s milk, while older ones will receive everything they need from their daily food.

A higher daily dose of lipoic acid is needed:

• people who play sports professionally (their norm reaches 100-200 mg of thioctacid);
• whose work involves contact with poisons and radioactive substances;
• pregnant women and women during lactation (but only under the supervision of a doctor);
• after severe nervous disorders, stress;
• when consuming large amounts of proteins;
• spending a lot of time in cold rooms or outside in winter;
• diabetics (consume 400 mg of alpha lipoic acid per day);
• those engaged in active mental work or for the prevention of neurodegenerative disorders (up to 600 mg);
• for obesity (maximum dose 1800 mg/day).

When determining your own daily intake of lipoic acid, you need to remember that there are two isomers of thioctacid - right and left. The dosage indicated above is based on preparations containing equally two versions of laboratory acid. The dose of drugs containing exclusively the R-isomer is automatically divided into 2.

And further. In any case, the parallel use of lipoic acid and alcohol is strictly prohibited.

The interval between eating and taking the drug is at least an hour. For medicinal purposes, the course of treatment is at least 8 weeks. There is no need to “prescribe” yourself a vitamin for prevention, for heart disease, fractures, colds or other health problems without consulting a doctor.

Food Sources of Vitamin N

When asked what contains the most lipoic acid, jokers answer: in pharmacy vitamins. This is actually true. But you can’t eat the “feed” of the pharmaceutical industry all your life. After all, Mother Nature also takes care of her children and has hidden some reserves of vitamin N in delicacies of animal and plant origin. So, it’s time to find out which foods contain thioctic acid, especially since a healthy body is able to provide itself with the daily requirement of the substance from food.

Leading foods containing the most vitamin N:

• offal (heart, kidneys, liver);
• red meat (beef, lamb, turkey);
• dairy products (milk, sour cream, cream, cottage cheese, kefir);
• eggs;
• yeast;
• mushrooms;
• leafy vegetables (spinach, cabbage);
• legumes;
• rice;
• Wheat groats;
• fruits.

Interaction with other substances: benefits and harms

Do you think it’s only human nature to have friends and enemies? Vitamins also have a circle of “friends”, and they bring more benefits to the body, enhancing each other’s abilities. For lipoic acid, the list of “friends” and “enemies” looks like this:

• fat-like substances (with their help, the body absorbs vitamin N more easily);
• vitamins, F;
• vitamins and (thioctacid “protects” and enhances their effect in the fight against free radicals);
• B vitamins (strengthen the effectiveness of thioctic acid);
• alcohol and fatty foods weaken the effect of vitamin N.

Interaction with other drugs:

• antibiotics and sugar-containing medications “disarm” vitamin N;
• drugs for the treatment of cancer partially neutralize lipoic acid;
• insulin and antidiabetic drugs reduce the effect of thioctacid on the body.

Some diseases, such as those of the gastrointestinal tract, have a negative effect on the absorption or synthesis of vitamin N.

Vitamin for sports

It is generally accepted that women are more interested in the benefits of vitamins and minerals. They, beauties and caring mothers, are destined by their “status” to be aware of everything that has a positive effect on the beauty and health of the family. This is only a half-truth. Information about the benefits of vitamins and microelements is just as important for men, especially those who see themselves in sports and, in particular, in bodybuilding. For them, who regularly lose energy in the gym, it is especially important to know what microelements and how to take them to gain muscle mass.

Athletes know that vitamin N is the “king” among useful substances. Under its influence, fat melts before our eyes, and muscles gain mass day after day. And at the same time - no feeling of fatigue or weakness.

The rate of lipoic acid intake for athletes may vary depending on the load and type of training.

Speed-strength exercises require 100-200 mg of vitamin N per day. During competitions – 150-250 mg daily. Endurance training includes a vitamin menu of 400-500 mg, during competitions - 450-600 mg/day.

In some cases, the intake of lipoic acid is determined by a specially designed program. In this case, at the initial stage, you should drink vitamin N in doses not exceeding 100-200 mg/day, eventually increasing to 400-600 mg per day. The daily portion should be divided into equal shares and drunk three times a day. But sports nutritionists do not recommend going beyond the 600-milligram maximum. This is the upper limit of the vitamin portion for athletes. Increasing this dose will not have any effect on either fat burning or muscle building.

Sometimes the question arises as to what can replace vitamin N in a sports diet. Conjugated linoleic acid is similar in the principles of its effect on the body of athletes. It, being nothing more than a partially modified form of lipoic acid, also regulates the ratio of fat and muscle tissue, reducing sebaceous deposits on the abdomen and enhancing muscle growth.

The main defender of the liver...

The relationship between liver health and lipoic acid is so close that sometimes it is even difficult to understand what cannot exist without what. On the one hand, problems with the liver are a signal that the body has stopped producing vitamin N. On the other hand, most diseases of this organ are treated with drugs that contain thioctacid.

The definition of “liver disease” refers to many diseases - from hepatitis to cirrhosis. The consequences of most of them are very sad, especially if you do not follow the treatment program. The liver is the main “filter” of the human body, which also requires regular cleansing. In such cases, lipoic acid takes on the role of a cleaner.

Scientists discovered the positive effect of α-lipoic acid on liver cells back in the last century. The substance not only creates reliable protection for the gland, but also restores damaged areas of the organ and prevents pathological degeneration. Thanks to lipoic acid, glutathione (a specific antioxidant synthesized in the liver) is consumed to a lesser extent, which has a beneficial effect on it, damaged by hepatitis or cirrhosis. Thioctacid is an effective drug for the treatment of hepatitis C and B; it is increasingly used in traditional therapy. It has also proven itself positively in the treatment program for gallstones.

Typically, the daily requirement for vitamin N in people with liver disease is 75 mg. The dose is regulated by the attending physician. As experiments show, a month's course of treatment with α-lipoic acid is enough for the first positive changes in the structure of the liver to become noticeable in patients with hepatitis or diagnosed with alcoholic fatty liver degeneration. The risk of developing malignant cells in the gland is reduced, fat metabolism in the tissue is stabilized.

...And diabetics

Diabetes is not so terrible as its consequences, in particular diseases that develop against the background of the “sweet disease”. One such complication is diabetic polyneuropathy, which affects nerve endings throughout the body.

Medicine calls alpha-lipoic acid a powerful tool in the treatment of disease. Through experiments it was established: 600 mg of the drug, taken intravenously and in the form of tablets/capsules, can affect the rate of development of the disease and reduce clinical manifestations.

At the initial stage of treatment, many are interested in how long it takes for IV therapy. The course of rehabilitation for each patient is determined individually. For some, 3-week injections are enough; in other cases, treatment lasts up to 6 months. A program of 15 droppers of alpha-lipoic acid solution is considered optimal. Then, over the next month or two, the patient takes 600 mg of berlition daily.

Thioctic acid: antioxidant therapy for neurological diseases

The use of thioctic acid in medical practice is largely associated with the development of ideas about “oxidative stress” and lipid peroxidation as a fairly universal pathogenetic mechanism of cell and tissue damage [24]. The antioxidant effect of thioctic acid is due to the presence of two thiol groups in the molecule (hence the prefix “thio”), as well as the ability to bind free radicals and free tissue iron (preventing its participation in lipid peroxidation) [10]. Thioctic acid not only has independent antioxidant potential, but also provides powerful support for the work of other antioxidant units in the body [23]. In this regard, its protective effect is closely related to homeostasis in the glutathione and ubiquinone system [8]. The production of reactive oxygen species increases significantly with inflammation, immunological disorders, hypoxia, hyperoxia, exposure to drugs, radiation, and antioxidant deficiency.

Thioctic acid is one of the most powerful antioxidants used in the treatment of diabetic neuropathy [2, 25]. Thioctic acid is a coenzyme of key enzymes in the Krebs cycle, which explains its effectiveness. An additional advantage in the mechanism of action of thioctic acid is its clearly documented effect of glucose utilization [15]. The high efficiency and pathogenetic effect of thioctic acid have been proven by numerous experimental and clinical studies. The adequate and rational use of thioctic acid preparations is based on the results of numerous studies (ALADIN I, ALADIN II, ALADIN III, ORPIL, NATHAN, DECAN, SYDNEY), which tested the dose, frequency of administration and course duration (Table 1).

A multicenter, randomized, double-blind study (SYDNEY II) assessed the effectiveness of thioctic acid in the treatment of patients with diabetic polyneuropathy (DPN) [1, 3]. The study was conducted from 2004 to 2006, it involved 87 patients with diabetes mellitus (DM) of type 1 and 2, who were undergoing inpatient (National Healthcare Institution Central Clinical Hospital No. 1 of JSC Russian Railways) and outpatient treatment (Department endocrinology of the State Educational Institution of Additional Professional Education of the Russian Medical Academy of Postgraduate Education (Roszdrav). The SYDNEY study concluded that intravenous alpha lipoic acid for 3 weeks. causes a significant reduction in neuropathic symptoms and neurological objective symptoms that are painful for patients. Considering the dose-dependent effect of side effects, the optimal dosage is 600 mg of thioctic acid. The authors concluded: as a result of a comprehensive clinical and neurophysiological study of patients with type 1 and type 2 diabetes, it was noted that the earliest EMG indicator of sensory nerve damage in diabetes is a decrease in the action potential. Pain reduction occurred from the 2nd week. taking thioctic acid at a dose of 1800 mg/day, from the 4th week. reception - at a dose of 1200 mg and only by the 5th week. - while taking 600 mg of thioctic acid [3]. In patients with DPN (n=24) participating in the study, using thioctic acid at a dose of 1800 mg/day for 3 weeks. neuropathic symptoms and neurological deficits decreased; the incidence of side effects was comparable to the placebo group [29].

In medical practice, a number of thioctic acid preparations are used for therapeutic purposes, which are represented by its three main salts: ethylenediamine, trometamol and megluminic [12]. One of the drugs whose active substance is thioctic (alpha-lipoic) acid is Thiogamma® (pharmaceutical (Germany)). Thiogamma® is a meglumine salt of alpha-lipoic acid, polyethylene glycol is used as a solubilizer, their advantages are to suppress the formation of free radicals, improve the energy metabolism of neurons, and restore impaired endoneurial blood flow. The drug is available in the form of tablets containing 600 mg of the drug, a solution for intravenous infusion in bottles containing 600 mg of the drug in the form of meglumine salt, and ampoules. Meglumine (N-methyl-D-glucamine) is known to be used as a stabilizer in many pharmaceutical products [12]. Meglumine is also used to reduce the toxicity of gadolinium in magnetic resonance contrast media. It is used as the antimonate meglumine to treat leishmaniasis. It was demonstrated that in the experiment, mice accepted a dose of up to 1 g/kg when administered intraperitoneally without side effects. There is only one report of the development of an anaphylactic reaction in a patient with osteoid osteoma after the use of gadoteric and gadopentetic acid during an MRI study. No descriptions of other negative effects of meglumine could be found. Thus, we can conclude that of all the stabilizers used for the manufacture of dosage forms of thioctic acid, meglumine is the least toxic.

Instructions for use of the drug Thiogamma® were approved on 04/15/1999 by the State Pharmacological Committee of the Ministry of Health of Russia, re-registration on 05/24/2010 (for tablet forms), 02/29/2012 (for injection forms) [19]. The drug is prescribed 1 r./day 300–600 mg, taken without chewing, with a small amount of liquid. According to the ALADIN I study [28], the effect of alpha-lipoic acid on positive neuropathic symptoms at doses of 600 and 1200 mg is practically the same. In a clinical study of 3 weeks of intravenous alpha-lipoic acid, side effects (headache, nausea, vomiting) were more common with 1200 mg (32.6%) than with 600 mg (19.8%) with placebo. (20.7%) [28]. It was concluded that a dosage of 600 mg of alpha-lipoic acid is optimal both from the point of view of clinical effectiveness and taking into account the possibility of developing side effects.

The clinical use of thioctic (alpha-lipoic) acid (in particular, Thiogamma®) is based on the many biochemical and physiological effects of this substance [6]. The main mechanisms of action of Thiogamma®, according to those set out in the Methodological Recommendations of V.V. Gorodetsky (2004) [8], can be presented as follows:

• influence on energy metabolism, glucose and lipid metabolism (participation in the oxidative decarboxylation of keto acids) with activation of the Krebs cycle; increased uptake and utilization of glucose by the cell and oxygen consumption; increase in basal metabolism; normalization of gluconeogenesis and ketogenesis; inhibition of cholesterol formation;
• cytoprotective effect: increased antioxidant activity (direct and indirect through the vitamin C/E, cystine/cysteine ​​and glutathione systems); stabilization of mitochondrial membranes;
• influence on the reactivity of the body: stimulation of the reticuloendothelial system; immunotropic effect; anti-inflammatory and analgesic activity (associated with antioxidant effects);
• neurotropic effects: stimulation of axon growth, positive effect on axonal transport, reduction of the harmful effects of free radicals on nerve cells, normalization of abnormal glucose supply to the nerve, prevention and reduction of nerve damage in experimental diabetes;
• hepatoprotective effect: accumulation of glycogen in the liver, inhibition of lipid accumulation in the liver (in some pathological conditions), increased activity of a number of enzymes, improvement of the functional activity of the liver;
• detoxification effect (FOS, lead, arsenic, mercury, sublimate, cyanides, phenothiazides, etc.).

The main indications for the use of the drug Thiogamma® in the treatment of diseases accompanied by neurological symptoms are focused on diabetic and alcoholic polyneuropathy [18]. Currently, thioctic (alpha-lipoic) acid, in particular Thiogamma®, is the most effective agent in the treatment of peripheral polyneuropathy, which has been confirmed by large-scale multicenter long-term studies, such as the ALADIN Study (Alpha-Lipoic Acid in Diabetic Neuropathy) [16]. However, the antioxidant activity of thioctic acid is used in many areas of medicine [10] (Table 2).

Thioctic (alpha-lipoic) acid is a powerful lipophilic antioxidant and is rightfully considered the “gold standard” for the pathogenetic treatment of diabetic polyneuropathy (DPN) [8]. A number of studies have shown that the use of alpha-lipoic acid at a dose of 600 mg/day intravenously or orally for 3 weeks. up to 6 months reduces to a clinically significant extent the main symptoms of DPN, including pain, paresthesia and numbness. It is known that the cause of a 50–70% decrease in the rate of insulin-dependent transmembrane glucose transport in diabetes is oxidative stress. The basis for treating DPN with thioctic (alpha-lipoic) acid drugs is the fact that in diabetes there is a deficiency of alpha-lipoic acid, and alpha-lipoic acid (which has a powerful antioxidant effect), in turn, increases the bioavailability of glucose in insulin-dependent and non-insulin-dependent tissues , increases the absorption of glucose by peripheral nerves to normal levels, and also promotes an increase in endoneurial glucose reserves, which has a beneficial effect on the restoration of energy metabolism of nerves. It is believed that the administration of thioctic acid is advisable for insulin-resistant forms of diabetes [10]. In this case, it is considered optimal to prescribe an intravenous drip of alpha-lipoic acid solution at the beginning of treatment for 3 weeks. (15 droppers) followed by taking 600 mg of the drug in tablet form (1 r./day 30–40 minutes before meals) for 1–2 months. [8].

The effectiveness of Thiogamma® in DPN has been convincingly demonstrated in many clinical studies. At the Sofia Medical University (Bulgaria), T. Tankova et al. (2000) conducted a randomized, open, placebo-controlled study [7–9] to evaluate the effectiveness of the drug Thiogamma® using a 2-stage prescription regimen: after a period of intravenous infusions, the drug was administered orally. A constant dose of 600 mg/day was used, intravenous administration was carried out for 10 days, oral administration for another 50 days. A pronounced clinical effect appears after the first 10 days of therapy. When compared with the control group, in patients receiving Thiogamma®, the intensity of spontaneous pain in the legs decreased by 40%, and vibration sensitivity, which was significantly reduced before treatment and determined in various areas of the foot, increased by 35%. By the end of the course of therapy, positive dynamics were noted in reducing the severity of pain according to VAS and increasing vibration sensitivity. Positive dynamics of indicators characterizing the severity of damage to the autonomic nervous system were also obtained: over 60 days of therapy, manifestations of autonomic neuropathy decreased by 40% and the drop in systolic blood pressure during an orthostatic test decreased by 2.5 times, which indicates an improvement in the function of the autonomic nervous system.

As part of another monocenter, randomized, double-blind, placebo-controlled study, 120 patients with type 1 and type 2 diabetes were examined, of which 60 received placebo and 60 received alpha-lipoic acid (at a dose of 600 mg in 225 ml of saline at a time of intravenous drip administration 30–40 min) [1]. We studied the effect of this drug on the clinical manifestations of DPN, electromyographic (EMG) indicators, indicators of quantitative sensory and autonomic testing in 60 patients with type 1 and type 2 diabetes. The duration of the study was 4 weeks. Positive neuropathic symptoms were chosen as the main criterion for the clinical effectiveness of the study drug due to the fact that they primarily disrupt the patient’s quality of life. An improvement in the distal latency indicator in an EMG study indicates that the main unpleasant sensations (pain, burning, numbness, paresthesia), which worsen the patient’s quality of life, decreased during alpha-lipic acid therapy due to improved peripheral nerve function. Thus, the drug has been shown to be highly effective in relation to most of the studied indicators of the condition of peripheral nerves. It was concluded that thiocotic (alpha-lipoic) acid preparations can be successfully used in the treatment of symptomatic DPN.

In a study by I. I. Matveeva et al. [13], conducted in the “Diabetic Foot” office of the Izhevsk Endocrinology Center, examined 126 patients with newly diagnosed type 2 diabetes (screening), who were prescribed the drug thioctic acid intravenously for 10 days at a dose of 600 mg, subsequently in tablets of 600 mg. mg daily for 8–10 weeks. Based on the results of the study, it was concluded that the drug thioctic acid is highly effective in the treatment of distal DPN, clinical symptoms and the condition of peripheral nerves improve, oxidative stress and insulin resistance decrease.

In another study [14], 50 patients with diabetic and hypothyroid distal symmetric sensorimotor polyneuropathy were prescribed the drug Thiogamma®, first at a dose of 600 mg (equivalent to 1167.70 meglumine salt of alpha-lipoic acid) intravenously, drip for 10 days, 1 injection per day , the injection rate was no more than 50 mg/min. It is also important to note that a distinctive feature of the drug Thiogamma® is the release form, which allows the drug to be administered intravenously, by drip, without requiring prior dilution. Then, for 30 days, patients took Thiogamma® 600 mg in the morning and on an empty stomach. During the study, the author came to the conclusion that among all forms of DPN, the greatest effect of using the drug Thiogamma® was noted in the treatment of acute sensory polyneuropathy and radiculoplexopathy; in the treatment of progressive sensorimotor polyneuropathy, the use of Thiogamma® also showed a statistically significant therapeutic result. In relation to hypothyroid polyneuropathy, Thiogamma® showed high efficiency, in particular for reducing and eliminating pain, however, the positive dynamics during treatment with Thiogamma® clearly correlated with adequate replacement therapy with thyroid hormones.

In a study by E. Yu. Komelyagina et al. (2006) [11] presented the results of a comparison of the effectiveness of two options for treating DPN with thioctic acid drugs: option 1 - oral administration of 1800 mg/day (600 mg 3 times/day) for 4 weeks. (n=15) and 2nd option - oral administration of 600 mg/day for 3 months. (n=15). The study showed that in both modes of use, the drug thioctic acid provides a significant reduction in the severity of neuropathic complaints in patients with diabetes with a satisfactory level of compensation for carbohydrate metabolism. Based on the results of the study, the authors came to the conclusion: “... the choice of treatment regimen for DPN using thioctic acid drugs is individual and depends on the specific situation: in case of severe pain symptoms, a shorter course with a high dosage of the drug (1800 mg/day for 4 weeks. ), with unexpressed symptoms - a longer course with a lower daily dosage (600 mg/day for 3 months)...".

The range of use of drugs containing thioctic acid, both as monotherapy and as part of complex therapy, is constantly expanding. In a comparative open randomized study [5], conducted at the Department of Occupational Diseases of the St. Petersburg State Medical Academy named after. I. I. Mechnikov, evaluated the effectiveness of the drug, the active substance of which is thioctic acid, in the complex treatment of manifestations of vibration disease (syndrome of vegetative-sensory polyneuropathy of the extremities, angiodystonic syndrome). Use at a dosage of 600 mg daily as part of complex therapy for 21 days significantly reduces the frequency of subjective complaints of patients, leads to a persistent reduction in relapses of pain in the extremities, a decrease in the frequency of attacks of vasospasms, enhancing the effect of therapy in general. Thus, the effectiveness of this drug has been shown in relation to vascular tone, blood filling and venous outflow, which, according to the authors, causes the development of anti-inflammatory, anti-edematous, analgesic effects and contributes to the normalization of homeostasis.

Research by M. Senoglu et al. (2009) [27] showed the effectiveness of alpha-lipoic acid against such clinical symptoms as pain, paresthesia, hypoesthesia in patients with compressive radiculopathy due to discoradicular conflict. The results of this study correlate with a study in which M. Ranieri et al. (2009) [26] assessed the effectiveness of the additional use of a combination of alpha-lipoic and gamma-linolenic acid in a 6-week rehabilitation program for patients with discogenic radiculopathy when compared with a similar group of patients receiving only a rehabilitation program. A case of effective use of the drug thioctic acid (600 mg/day for 1 month) as part of complex therapy in a patient with stage III Lyme disease (neuroborreliosis, changes in the central nervous system, damage to the cranial nerve, peripheral polyneuropathy due to neuroborreliosis) is described [4].

Employees of the Clinic of Neurology and Neurosurgery of the Medical Faculty of the Russian State Medical University (now Russian National Research Medical University) E. I. Chukanova et al. (2001–2014) [20–22] a number of studies were conducted to evaluate the effectiveness of the use of thioctic acid in the treatment of patients with discirculatory encephalopathy (DE) and when prescribed in complex pathogenetic therapy of vascular cognitive impairment. Based on the example of a study of 49 patients with DE, it was shown [20] that when prescribing thioctic acid in a dosage regimen of 600 mg 2 times / day for 7 days, switching to 600 mg 1 time / day for 53 days orally in 30 min before meals allows you to achieve a positive effect by the 7th day of treatment (at a dose of 1200 mg/day); when the dose is reduced to 600 mg/day (from the 8th day of treatment), the positive effect of the drug on the dynamics of the neurological status is maintained and is most pronounced by 60th day. Positive dynamics were noted in the neurological and neuropsychological status of patients with DE. Based on the results of the study, it was concluded that thioctic acid is effective not only in the treatment of patients with DE with elevated glucose levels, but also in patients with cerebrovascular insufficiency without diabetes [20]. In a study of a group of 128 patients with DE [21], a pharmacoeconomic analysis of the effectiveness of treatment with thioctic acid was conducted in patients with different stages of chronic cerebral vascular insufficiency. The drug thioctic acid was prescribed orally at a daily dose of 600 mg 2 times/day for 7 days, switching to 600 mg 1 time/day for 23 days 30 minutes before meals. The study established: in patients with stage I DE. — regression of asthenic syndrome, vestibular ataxia, axial reflexes; in patients with stage II DE. — increasing the effectiveness of influencing the indicators of the “movement” scale, ataxia, pseudobulbar syndrome; in patients with stage III DE. — a positive effect on the indicators of the “movement” scale, ataxia (frontal and cerebellar), pseudobulbar syndrome, which persisted until the 12th month. observations, and also showed a statistically significant effect on the dynamics of the amyostatic syndrome score. The authors of the study concluded that treatment with thioctic acid in patients with DE leads to significant clinical improvement, reduces the risk of strokes during the course of the disease and reduces the percentage of disease progression in patients with stage I and II DE. A small percentage of side effects were noted. Thioctic acid is well tolerated by patients, including patients of older age groups. Thioctic acid therapy is preferable from an economic point of view compared to the cost of treatment of patients in the control group who received antihypertensive and antithrombotic therapy, which is associated with its high effectiveness in influencing the risk of TIA, stroke and progression of DE.

Conclusion

The data available today allow us to recommend that a doctor prescribe the drug Thiogamma® in the treatment of patients with neuropathy of somatogenic origin. The developed scheme of 2-stage administration of the drug Thiogamma® is successfully used with a high degree of efficiency: intravenous infusions of the finished solution of the drug Thiogamma® for 10 days (in bottles of 50 mg of solution for infusion of 12 mg/ml, which is equivalent to 600 mg of thioctic acid, with the time of intravenous drip administration for 30–40 minutes) followed by administration of the tablet form of the drug (600 mg/day) for 50 days. From the point of view of clinical effectiveness and taking into account the possibility of side effects, a dosage of thioctic (alpha-lipoic) acid of 600 mg/day is optimal. Individual approach to the dosage regimen: for severe pain symptoms - a shorter course with a high dosage of the drug (1800 mg/day for 4 weeks), for less severe symptoms - a longer course with a lower daily dosage (600 mg/day for 3 months).

It is important to note that a distinctive feature of the drug Thiogamma® is its release form, which allows the drug to be administered intravenously, by drip, without requiring prior dilution.

Literature

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2. Ametov A.S., Strokov I.A., Samigullin R. Antioxidant therapy of diabetic polyneuropathy // Breast cancer. 2005. T.13. No. 6. pp. 339–343.
3. Ametov A.S., Soluyanova T.N. Efficacy of thioctic acid in the treatment of diabetic polyneuropathy // Breast Cancer. 2008. No. 28. P. 1870–1875.
4. Antelava O.A., Ushakova M.A., Ananyeva L.P. and others. Clinical manifestation of neuroinfection in Lyme disease against the background of immunosuppressive therapy // Breast Cancer. 2014. No. 7. pp. 558–563.
5. Artamonova V. G. Lashina E. L. Use of the drug thiolept (thioctic acid) in combination therapy of vibration disease // Journal of Neurology and Psychiatry named after. S. S. Korsakova. 2011. T.111. No. 1. P.82–85.
6. Vorobyova O. V. Thioctic (alpha-lipoic) acid - spectrum of clinical use // Journal of Neurology and Psychiatry named after. S. S. Korsakova. 2011. T.111. No. 10. P.86–90.
7. Galieva O.R., Janashiya P.Kh., Mirina E. Yu. Treatment of diabetic neuropathy // Breast cancer. 2005. T.13, No. 10.
8. Gorodetsky V.V. Treatment of diabetic polyneuropathy and other dystrophic-degenerative and inflammatory diseases of the peripheral nervous system with metabolic drugs // Methodological recommendations. M., 2004. 30 p.
9. Janashiya P.Kh., Mirina E.Yu., Galieva O.R. Treatment of diabetic neuropathy // Breast cancer. 2005. No. 10. P.648–652.
10. Ivashkina N.Yu., Shulpekova Yu.O., Ivashkin V.T. Do we all know about the healing capabilities of antioxidants? // RMJ. 2000. No. 4. P. 182–184.
11. Komelyagina E.Yu., Volkova A.K., Myskina N.A. and others. Comparative effectiveness of various regimens of oral administration of thioctic acid (thioctacid bv) in the treatment of painful forms of diabetic distal neuropathy // Farmateka. 2006. No. 17: https://medi.ru/doc/144422.htm
12. Korpachev V.V., Borshchevskaya M.I. Dosage forms of thioctic acid // Problems of endocrine pathology, 2006, No. 1: https://farmak.ua/publication/338
13. Matveeva I.I., Trusov V.V., Kuzmina E.L. and others. Frequency of distal neuropathy and experience with the use of Thioctacid in patients with first diagnosed type 2 diabetes // https://medi.ru/doc/144420.htm
14. Pimonova I. I. Use of the drug Thiogamma for diseases of the peripheral nervous system // https://www.medvestnik.ru
15. Rachin A.P., Anisimova S.Yu. Polyneuropathy in the practice of a family medicine doctor: diagnosis and treatment // Breast Cancer. 2012. No. 29. pp. 1470–1473.
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18. Tiogamma®: instructions for use: https://www.novo.ru/aptekan/tiogamma.htm
19. Chukanova E.I. The influence of Thioctacid on the clinical manifestations and course of dyscirculatory encephalopathy // Breast Cancer. 2010. T.18. No. 10. P.1–4.
20. Chukanova E.I., Chukanova A.S. Use of antioxidant drugs in complex pathogenetic therapy of vascular cognitive impairment // Breast Cancer. 2014. No. 10. pp. 759–761.
21. Chukanova E.I., Sokolova N.A. Efficacy of thioctacid in the treatment of patients with dyscirculatory encephalopathy // https://medi.ru/doc/144418.htm
22. Alpha lipoic acid therapy. Thiogamma. Scientific review. Verwag Pharma GmbH and Co., 2003.
23. Arivazhagan P., Juliet P., Panneerselvam C. Effect of DL alpha-lipoic acid on the status of lipid peroxidation and antioxidants in aged rats // Pharmacol. Res. 2000. Vol. 41(3). P. 299–303.
24. Gurer H., Ozgunes H., Oztezcan S. et al. Antioxidant role of alpha-lipoic acid in lead toxicity // Free Radic. Biol. Med. 1999.Vol. 27(1–2). P. 75–81.
25. Jacob S., Ruus P., Hermann R. et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial // Free Radic. Biol. Med. 1999. Vol. 27(3–4). P. 309–314.
26. Ranieri M., Sciuscio M., Cortese AM et al. The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of life // Int. J. Immunopathol. Pharmacol. 2009. Vol. 22 (3 Suppl). P. 45–50.
27. Senoglu M., Nacitarhan v. , Kurutas EB et al. Intraperitoneal Alpha-Lipoic Acid to prevent neural damage after crush injury to the rat sciatic nerve // ​​J. Brachial. Plex. Peripher. Nerve. Inj. 2009. Vol. 4. P. 22.
28. Ziegler D., Hanefeld M., Ruhnau KJ et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant α-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study) // Diabetol. 1995. Vol. 38. P.1425–1433.
29. Ziegler D., Nowak H., Kempler P. et al. Treatment of symptomatic diabetic polyneuropathy with antioxidant α-lipoic acid: a meta-analysis // Diabetic Med. 2004. Vol. 21. P. 114–121.

Vitamin for obesity

Just a few decades ago, it never occurred to anyone that excess weight, along with cardiovascular diseases, would soon be named one of the main problems of the century. “Getting rid of excess is easy! To lose weight, you need to reduce the portions you consume per day!” – skinny people who have no idea about the causes of obesity never tire of giving advice. An overweight person is not always a glutton. Stress, poor environment, irregular nutrition (often due to a specific work schedule), “sedentary” work, heredity - these are not all the reasons for possible excess weight gain caused by metabolic disorders. And the metabolism, as luck would have it, if it is disrupted, is often in the direction of slowing down. So we get a paradox with a “glass of water”, which turns into fat deposits on the sides.

And the pharmaceutical industry never tires of replenishing the arsenal of pharmacies with weight loss products. And the plump people are buying everything at breakneck speed, so as not to accidentally miss a miracle pill that can get rid of fat in a month/week/day. But, as in the old joke, we have two news for you: good and bad. The bad thing is that miracles don’t exist and you can’t lose weight in a day. And now - a good one: a pill for excess weight was invented a long time ago. It modestly lies on the shelves of all pharmacies in the world with a price tag of a penny. It is also called modestly - lipoic acid, or vitamin N, or has some other trade name, but in parentheses the name common to all countries is always indicated - thioctic acid.

The unique properties of this substance help regulate fat and carbohydrate metabolism in the body, reduce cholesterol and blood glucose levels, and improve liver function.

But how do these beneficial properties affect the process of weight loss? How to lose weight with lipoic acid and is it even possible?

Vitamin N is fundamentally different from all “diet pills.” Most anti-obesity drugs, weight loss programs and diets are aimed at active fat burning, which subsequently has an even worse effect on the already disrupted metabolic process. Lipoic acid has a different tactic: it does not burn fat, but converts it into energy, which, from the point of view of nature, is more correct and beneficial for the body, and has a better result.

How vitamin N is useful for losing weight:

• reduces weight without fasting;
• normalizes rather than changes metabolism;
• improves the functioning of the gastrointestinal tract;
• prevents the development of gallstone disease;
• strengthens blood vessels and heart muscle;
• has a positive effect on vision;
• eliminates stretch marks.

Use at home

Lipoic acid for facial skin has different methods of application, including participation in the preparation of home cosmetics. This is a safe and effective way to use ALA. The fact is that all the ingredients are taken independently - that is, the composition is transparent. And the effectiveness of such products is justified by the content of organic components.

Therefore, masks with the addition of lipoic acid are popular among women. Numerous reviews speak about this. With the right composition you can get rid of acne, wrinkles, sagging and other pressing problems.

This is interesting! After 20 years, the body's protection against free radicals gradually weakens, which leads to the process of premature aging. Vitamin N, which we produce ourselves, helps us cope with this task. However, with age, its reserves are depleted, so after forty years there is an urgent need for ALA.

How to lose weight with lipoic acid

But still, lipoic acid is not a magic wand. The principle of its operation is explained by the rational laws of chemistry. And in order for the weight loss process to begin and continue without interruption, you should follow certain recommendations.

1. A combination of vitamins and sports. No one has canceled moderate physical activity for those losing weight. Of course, it is possible without them. But! So we took a tablet of thioctacid and are waiting for it to work... But what exactly are we waiting for? Lipoic acid is already working - several fat cells have already been converted into energy and are looking for a way out. The only way to get rid of “bonus” strength is physical activity. On the other hand, dumbbells or running will protect against sagging on a thin body.
2. Cut the calories a little... If you expect maximum results, then the effort should be maximum. During the fight against obesity, it is important to clear the refrigerator of “bad” carbohydrates.
3. ...But no fasting. Losing weight with the help of lipoic acid is probably the only program in the world that not only does not prohibit you from eating when you want - it prohibits you from not eating. No low-fat protein diets or starvation menus of “grass and water”! Malnutrition combined with alpha lipoic acid causes side effects that are dangerous to your health!

Dosages

The process of losing weight for many over time turns into a game of chance. We lost the first kilogram, rejoiced and raised the bar to five. They dropped five - they wanted five more. Sometimes the struggle with excess weight turns into madness: even those who are already clearly underweight continue to lose weight. The outcome of such weight loss is usually disastrous.

Lipoic acid is not a drug that you can drink in large quantities uncontrollably. How much vitamin N tablets to take per day and for how long is determined by your doctor.

The instructions for use describe in detail all the indications and contraindications for taking lipoic acid. The method of using the drug for weight loss provides dosages from 25 to 400 milligrams per day, but, like any other medicine, it is taken under the constant supervision of a doctor. It is advisable to take vitamin N as a remedy for excess weight before breakfast, during dinner, or immediately after training.

Lipoic acid really works wonders in the fight against obesity. But she is not omnipotent either. You cannot achieve the desired result if you eat your vitamin with cakes and fried potatoes. Meanwhile, thioctacid is respected not only by doctors and nutritionists. In cosmetology, the beneficial properties of acid are also actively used in preparations for facial skin, hair, and nails.

Alpha lipoic acid in home cosmetology: recipes

Natural masks containing alpha-lipoic acid are indispensable for the dermis. The main reason for this lies in the fact that organic compounds of LA enrich the action of the other components.

Lipoic acid is actively used for face masks also because the substance is compatible with all skin types. Check out effective homemade organic recipes.

For acne

Lipoic acid gets rid of acne due to its cleansing properties. The product helps get rid of acne, neutralizes inflammation and normalizes the production of sebaceous glands.

To make a mask, we will take the following products:

• 1 ml tea tree ether;
• 1 ml LA;
• 15 ml honey, melted in a water bath;
• 1 tbsp. l. olive pressing.

When the honey has cooled, mix it with the rest of the ingredients - do not store the mixture, use it immediately. Exposure time: 15 minutes. The course consists of 10 sessions, which are held every other day. Further, maximum twice a week.

For wrinkles

The mask produces a rejuvenating effect.

Set of components:

• 1 drop of LC;
• 9 drops of vitamin C;
• 15 ml jojoba oil.

The ingredients are mixed into a homogeneous mass. After 15 minutes the mixture is washed off. Procedures are carried out for a maximum of 2 rubles. in Week.

Moisturizing effect

The mask moisturizes and nourishes - ideal for dry dermis.

Components:

• 1 tsp. aloe;
• 1 tbsp. l. pressing sea buckthorn;
• 1 ml LA;
• 3 drops vit. C.

Time: 15 minutes. Carry out twice every seven days for 30 days.

Restorative

This is a universal mask that will suit any type of dermis.

Compound:

• 1 ml LA;
• 15 ml panthenol;
• 15 ml avocado oil.

The mask is kept for 15 minutes, done twice a week for 30 days, then once every 1-2 weeks.

For pregnant

When planning pregnancy, it is important to replenish all vitamin depots of the body. After all, very soon a woman will have to “feed” not only herself, but also the child, whose health at first completely depends on the health of the mother. But the course of vitamin therapy should be determined by a doctor, especially since in gynecology the emphasis is on vitamins responsible for women’s health.

Only the attending doctor can adequately determine which vitamin and in what doses a woman needs for prevention or treatment, which form of the drug is best suited, and which microelements it is better to stay away from.

It is especially important not to engage in vitamin therapy without permission during pregnancy and breastfeeding. During this special period, many doctors generally prohibit their patients from taking dietary supplements and vitamin preparations. Meanwhile, laboratory studies have shown how lipoic acid (in adequate doses) is beneficial for pregnant women. Vitamin N reduces the risk of miscarriage and abnormal development of the nervous system of the unborn baby.

Benefits of thioctic acid for women's health:

• gives additional energy;
• important for kidneys and liver;
• prevents toxicosis;
• removes toxins from the body;
• controls blood glucose, cholesterol and lipid levels;
• creates a barrier to ultraviolet radiation;
• regulates the functioning of the thyroid gland.

Use in cosmetology

The skin on the face is the most delicate, but at the same time most often susceptible to the negative effects of the sun, wind, and frost. Therefore, more often than other areas, it requires careful care. And α-lipoic acid is best suited for facial skin as a “tasty” nourishment.

By the nature of its effect on the epidermis, thioctic acid is more reminiscent of vitamins A, E, C - it protects against free radicals and improves metabolism at the cellular level. But in addition to this, vitamin N effectively rejuvenates the skin, tightens it, and gets rid of wrinkles and acne. This vitamin of youth is found in all anti-aging creams (both the most expensive and very cheap). Lipoic acid is responsible for beautiful skin in the décolleté and neck area, making it soft, smooth and tender.

By regularly using thioctacid externally, you can forget about skin imperfections in the form of small acne scars or minor injuries, pustules and pimples.

Creams containing alpha-lipoic acid relieve swelling, inflammation, cracks, and protect collagen molecules from destruction.

Lipoic acid for cosmetic purposes can be used as a finished product or prepared independently by enriching a cream, tonic or lotion with vitamin N. The yellow powder is first dissolved in alcohol or oil and then added to the finished cosmetic product. If you don’t like this form of release, you can buy the vitamin in ampoules or capsules at the pharmacy and add it to cosmetics in this form.

How to properly dilute vitamin

1. Skin cleansing oil. Add a few milliliters of alpha lipoic acid in liquid form or a few milligrams in powder. Stir.
2. Serum for moisturizing. Vitamin saturation should not exceed 1 percent.
3. Tonic. Dilute lipoic acid in alcohol, stir thoroughly and pour the mixture into tonic.
4. Cream. Dilute the powder in an oil base (or add the vitamin in liquid form), mix with the cream.

Adviсe

1. You cannot heat up the vitamin mixture and then cool it - it loses its beneficial properties.
2. Store the finished fortified cosmetic product in a cool, dark place.
3. If you feel a burning sensation after using the drug, reduce the percentage of vitamin saturation. Therefore, to begin with, fortify cosmetics with a small portion of lipoic acid.
4. In case of contact with mucous membranes, rinse with plenty of water and consult a doctor.

Two beauty recipes

And now it’s time to find out how to prepare a delicious skin product at home, the effectiveness of which is no worse than expensive creams.

Remedy No. 1

You will need:

• alpha lipoic acid – 1 ml;
• ascorbic acid – 8 ml;
• 10 ml syringe;
• fragrant water;
• kudesan (coenzyme in water-soluble form).

Draw ascorbic acid and lipoic acid into the syringe. In a separate container, mix coenzyme and fragrant water. Soak a cotton pad with the prepared acid mixture and apply it to your facial skin. Wait until the vitamin mix is ​​absorbed. Spray your face with a mixture of coenzyme and fragrant water. After 15-20 minutes, wipe the skin with any tonic.

The result is radiant, soft skin with a beautiful color.

Remedy No. 2

You will need:

• macadamia nut oil – 10 ml;
• lipoic acid – 2 ml;
• green tea or grape extract.

Dissolve lipoic acid in nut oil and mix thoroughly. Add a little vitamin-containing extract (optional). Apply the finished mixture onto the face with massage movements. Keep the oil mask on for 20 minutes. Blot your face with a paper towel to remove any remaining product.

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The result is moisturized and vitamin-enriched facial skin.

Thioctic acid in cosmetology

Testimony from cosmetologists suggests that lipoic acid compounds for the skin improve the absorption of A and C.

Alpha lipoic acid is found in facial products. The main advantage of the substance is its anti-aging properties. In restorative creams and serums, ALA is used as an auxiliary ingredient. There are many cosmetic products for skin with alpha lipoic acid on the market. The beauty industry is not deprived of this, which is good news. How to choose a suitable cream containing lipoic acid? The task will be made easier by purchasing branded products.

TOP 10 preparations for facial skin with alpha lipoic acid:

1. Aravia Lipoic Revitalizing Mask is a professional mask with restoration effects. Aravia Lipoic Revitalizing Mask is of Russian origin.
2. Anti-aging Essenc is an anti-aging facial product with a lifting effect, produced in Switzerland.
3. Laura from the company Evalar (Russian production) - cream with peptides for wrinkles.
4. Creative Silver - Israeli silver mask.
5. Lsme Wheitening Melasma - has a whitening effect (made in Thailand).
6. Alfa Gokujyun is a Japanese professional facial product with lipoic acid.
7. Antioxidant Face Creme from Nutribiotic is an imported cream made in the USA.
8. FarmStay is a product with horse oil extract that produces a moisturizing effect (South Korea).
9. Firming DMAE is a professional moisturizing tonic (America).
10. CLC Wrinkle Away is an Israeli product with a lifting effect.

All of the above creams and other products with alpha-lipoic acid have good indications and positive reviews from cosmetologists.

Note! Before using creams, serums, etc., read the contraindications listed in the instructions.

You can buy high-quality preparations for facial skin with alpha-lipoic acid in stationary city pharmacies, specialized retail outlets, and order online.