Clinical trials didnt see double-digit percentage weight drops until participants reached 1.7 mg and stayed there for at least 12 weeks (Rubino et al., JAMA 2021)
However, some secondary measures of nerve impairment did improve, especially in participants with higher cardiovascular risk and moderate BMI.7 Shorter-term trials have shown that 600mg/day of oral racemic ALA reduced neuropathy symptoms like burning, tingling, and numbness in as little as 35 weeks.4 20 A 2010 meta-analysis concluded that oral ALA can improve symptoms of diabetic neuropathy, but noted variability in effect sizes across trials and better results with intravenous administration.1 Despite promising results from some trials, a recent systematic review evaluating eight randomized controlled trials indicates that findings on ALA's effectiveness in treating diabetic neuropathy symptoms are inconsistent.23 While ALA proved safe and tolerable across these studies, the review concluded that definitive evidence supporting significant benefits is limited
Further, mitophagy was proposed as a specific therapeutic target to advance treatments of ischemic stroke [540]
Common culprits include red meat, soda, and alcohol
Weeks 19 through 24: 12mg weekly (maintenance begins) The final step to full maintenance dose
You start low, observe closely, and adjust based on what your body tells you
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