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Alpha Lipoic Acid in Neuralisse: How Much, What Trials Found, Who Should Be Careful
Alpha lipoic acid is second in the Neuralisse blend, so each capsule holds at most about 175 mg in the best case. Most nerve trials gave 600 mg a day. Those trials, in people with diabetes, lowered symptom scores but not nerve test results. It can lower blood sugar, so people on diabetes medicine should ask a doctor first.
Written by the Goneuralisse editorial teamUpdated
The basics
What is alpha lipoic acid?
Alpha lipoic acid is a sulfur compound your body makes in small amounts. Cells use it to help turn food into energy. It is also called thioctic acid, and it works as an antioxidant in lab studies.
On the Neuralisse label it is the second name in a 575 mg proprietary blend. It is the most studied ingredient in the formula for nerve symptoms in diabetes. So its dose matters most.
| Label name | Alpha Lipoic Acid |
|---|---|
| What it is | Thioctic acid, antioxidant compound |
| Position in the blend | 2 of 6 (labels list blend ingredients from most to least by weight) |
| Amount per capsule | Not disclosed. At most about 175 mg by label order (part of the 575 mg blend). |
| Amount used in research | 600 mg a day in most trials (600-1,800 mg tested) |
| Strength of evidence | Moderate (symptom scores) |
| Main use studied | Studied for nerve symptom scores in people with diabetes |
| Main caution | Can lower blood sugar, adding to diabetes medicine; rare insulin autoimmune syndrome. |
The label prints no amount for alpha lipoic acid. Every figure for it on this site is worked out from the order of the blend.
Per capsule
How much alpha lipoic acid is in Neuralisse?
Best case, a capsule holds about 175 mg of alpha lipoic acid. That is roughly 29% of the 600 mg a day used in most nerve trials (SYDNEY 2 trial).
The math is short. The label prints 80 mg of magnesium from magnesium glycinate. Making 80 mg of magnesium takes about 400 to 567 mg of that compound, depending on the form. Subtract that from 575 mg, and at most about 175 mg is left for five ingredients. A blend lists items from heaviest to lightest (FDA, Labeling guide ch. IV). So alpha lipoic acid, in second place, could take all 175 mg only if the other four weighed almost nothing.
The real figure is likely lower: with the pure glycinate form, the space left for all five may be only about 8 mg. No trial we found tested 175 mg a day, and the label says "Do not exceed recommended dose," so extra capsules are not a way to close the gap.
The research
What do studies on alpha lipoic acid show?
Trials in people with diabetic nerve problems found lower symptom scores, but nerve tests did not clearly improve. A 2023 review of 10 trials with 1,242 people saw the drop in total symptom scores and no clear change in pain scale, vibration sense or nerve conduction (Hsieh 2023, oral ALA meta-analysis).
| Study | People | Daily dose | Length | Main finding |
|---|---|---|---|---|
| Hsieh 2023 meta-analysis (Hsieh 2023, oral ALA meta-analysis) | 1,242 in 10 trials | Mostly 600 mg (7 of 10 trials) | Varied | Lower total symptom scores; no clear gain on pain scale or nerve tests |
| SYDNEY 2 (SYDNEY 2 trial) | 181 | 600, 1,200 or 1,800 mg | 5 weeks | Scores fell 51%, 48% and 52% vs 32% on placebo; 600 mg gave the best balance |
| 4-year trial (LPI, Lipoic acid) | 421 | 600 mg | 4 years | Did not beat placebo on its main goal |
| One Neuralisse capsule | Not studied | At most about 175 mg | Daily, ongoing | No published trial |
Placebo helped a lot in SYDNEY 2: scores fell 32% with no active pill. Higher doses did no better than 600 mg, while nausea, vomiting and dizziness rose (SYDNEY 2 trial). For a deeper read, see our post on what the alpha lipoic acid research shows.
Safety
Can alpha lipoic acid lower blood sugar?
Yes. Alpha lipoic acid may help cells use glucose, so people on insulin or diabetes pills could see blood sugar drop too low (LPI, Lipoic acid). Memorial Sloan Kettering lists low blood sugar, nausea, vomiting and upset stomach among reported effects (MSKCC, Alpha-lipoic acid).
Talk to your doctor before you start Neuralisse, and check your blood sugar more often during the first weeks. Shakiness, sweating, confusion or a racing heart can mean low blood sugar.
Insulin autoimmune syndrome
A rare reaction, called insulin autoimmune syndrome, has been linked to alpha lipoic acid. About 27 cases were reported, mostly in Japan, in people with a certain genetic makeup (MSKCC, Alpha-lipoic acid). Health Canada reviewed it and found the low blood sugar episodes went away once people stopped the product (Health Canada, ALA hypoglycemia).
See our medicines and Neuralisse guide for the other drug cautions in the blend.
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Should you take alpha lipoic acid with food?
Food lowers how much alpha lipoic acid reaches the blood. Taking it with a meal cut peak levels by about 30% in research summarized by the Linus Pauling Institute (LPI, Lipoic acid).
The Neuralisse label gives no time of day. It says only to take one capsule daily. The capsule also holds CoQ10, which is absorbed better with food. So the two ingredients pull in opposite directions.
Pick one time and keep it steady. Breakfast is an easy anchor. On diabetes medicine? Ask your doctor which time suits you.
Our view
Is the alpha lipoic acid in Neuralisse worth it?
It contains a well-researched compound, but in an amount the research did not test.
In its favor
- The most studied nerve-related ingredient in the formula
- Second in the blend, after magnesium glycinate
- Named clearly on the label
Against it
- Exact amount hidden inside the blend
- Best case about 175 mg, below the 600 mg trial dose
- Trials showed symptom score changes, not better nerve tests
- No trial of Neuralisse itself
You can compare all six amounts on our Supplement Facts breakdown.
Before you start
What should you ask your doctor about alpha lipoic acid?
Bring the bottle and these three questions.
- Could this lower my blood sugar with the medicine I already take?
- Should I check my glucose more often for the first few weeks?
- Have my numbness or tingling been checked for causes like low vitamin B12?
Neuralisse is a dietary supplement, not a treatment for diabetic nerve damage or any disease. New or worsening numbness, burning, weakness or a foot sore that will not heal needs a medical visit, and fast if it starts suddenly.
FAQ
Alpha lipoic acid in Neuralisse: common questions
How much alpha lipoic acid is in Neuralisse?
The label does not say. Because it is second in a 575 mg blend that must also supply 80 mg of magnesium, the best case is about 175 mg per capsule. The true amount could be much lower. Most nerve trials used 600 mg a day.
What does alpha lipoic acid do for nerves?
In trials of people with diabetic nerve problems, 600 mg a day lowered total symptom scores more than placebo. A 2023 review of 10 trials found no clear change in pain scale or nerve test results. Neuralisse itself has not been studied, and it is not a nerve treatment.
Can alpha lipoic acid cause low blood sugar?
Yes, it can. It may add to the effect of insulin and diabetes pills, and rare cases of insulin autoimmune syndrome have been reported. If you take diabetes medicine, ask your doctor before starting and check your glucose more often at first.
Should I take alpha lipoic acid on an empty stomach?
Food lowers peak blood levels of alpha lipoic acid by about 30%. The Neuralisse label gives no timing, and its CoQ10 is better absorbed with food, so a steady daily time, such as breakfast, is a reasonable choice. Ask your doctor if you take diabetes medicine.
What are the side effects of alpha lipoic acid?
Reported effects include nausea, vomiting, upset stomach and low blood sugar. Nausea and dizziness became more common at higher doses in trials. A rare autoimmune reaction causing low blood sugar has been reported and cleared after people stopped the product.
Can I take extra Neuralisse capsules to reach 600 mg of alpha lipoic acid?
No. The label says to take one capsule daily and not to exceed the recommended dose. Extra capsules would also raise your magnesium and every other ingredient. If you want a studied dose, discuss a separate plan with your doctor.
Who wrote this
Written and reviewed by
A small team that reads the bottle label line by line, checks every number against public health sources (NIH, NCCIH, MSKCC, FDA, FTC, CDC) and rewrites it in plain English. We do not write for the manufacturer, and we update a page whenever the label, the prices or the evidence changes.
Last updated . See our editorial standards and how we check reviews. This website is run by a U.S. authorized merchant, not by the manufacturer. This site is paid a commission when you buy through its order links.
Keep reading
More about Neuralisse
Ingredients
All six Neuralisse ingredients in label order, with the most each capsule can hold and what research used.
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Medicines and Neuralisse
A medicine-by-medicine interaction table, a daily spacing schedule, and the questions to ask your pharmacist.
Read moreSupplement Facts
Every line of the Neuralisse label typed out, with the blend math the label does not show.
Read moreU.S. authorized Neuralisse merchant
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