QUESTION: Are there times when alpha lipoic acid is not helpful to use? I have a 33yo F patient with Lyme disease. Majority of her sxs are nervous system related – first beginning with Bell’s Palsy. We are doing antimicrobial work, detox and elimination support. I recommended the ALA because of it’s neuroprotective nature as a fat soluble antioxidant. I recently found out she has amalgam fillings, the most recent ones were put in 3 years ago. Is ALA problematic with someone who has had somewhat recent Mercury-containing fillings put in? When wouldn’t you use ALA?
ANSWER: Of course ALA maintains GSH levels and activity, and is generally helpful in most inflamed and ill people. Generally in regard to ‘complications’ with Lyme and related infections and thiols (mono like NAC and ALA, di-forms like DMPS, DMSA) revolve mostly around their ability to disrupt biofilms (a real thing) which can aggravate the chronically infected. It isn’t all a bad thing but people don’t know why they are aggravating. Other issues however revolve around the mobilization of metals, in one with newer mercury fillings there is already a lot floating around (metals) so they need help out of the body. In that setting the mono-thiols like ALA do help as “shepherd molecules” at the kidney to allow the metals to eliminate through the renal system in a more efficient manner. (Note that most of the older concerns about “mobilization” of metals was based on animal experiments with recently toxified (injected with a metal) animals so the distribution effects of thiols were due to the toxification process rather than the thiol). So in sum ALA is normally helpful – but in one with amalgams and / or chronic infections (aside from removing the amalgams) they need to be monitored for signs of immune activity (biofilm disruption) as well as likely needing more detox associated with the fillings.