November 20, 2011
Alpha lipoic acid: a caution about potential hypothyroidism from Lark Lands
NYBC has recently learned from our colleague Lark lands, long known for her expertise in supplementation stategies for people with diabetes and people with HIV, that for, some people, there may be a risk of hypothyroidism in taking alpha lipoic acid, especially at higher doses:
Lark Lands notes the following: Although it is not clear what percentage of people this may affect, in some people it appears that alpha-lipoic acid may block the proper conversion of T4, the storage form of thyroid hormone, into T3, the active form. This was first noted in animal research with alpha-lipoic acid, and has since been reported by a number of people known to me. When this occurs, people will develop the symptoms of hypothyroidism (which may include fatigue, low body temperature, weight gain, hair loss, splitting fingernails, depression, memory problems, muscle weakness, elevated cholesterol, and/or skin that is dry, rough or scaly). For this reason, it is important to monitor the thyroid, first at baseline, before lipoic acid is taken, and then after the first month or two of taking lipoic acid, to see if there have been any adverse effects. If not, it probably means that the thyroid is unlikely to be affected. However, it will still be wise to check the TSH level (a blood test that is an indicator of thyroid function) at least once or twice yearly, or any time that symptoms that could be related to low thyroid appear, as some people have taken 600 mg daily doses for lengthy periods (even up to five years in one case known to me) before TSH levels became elevated outside of the normal healthy range.
It is clear that this problem does not develop in everyone who uses lipoic acid. Some people seem to tolerate doses of 600 mg or even more daily with no problems, while others have developed serious thyroid problems with doses ranging from 500 mg to 1000 mg daily. In the people known to me who have been affected in this way, discontinuing the lipoic acid allowed the thyroid problems to disappear quite quickly. I personally experienced this when taking lipoic acid. My TSH had become seriously elevated, remaining at an abnormally high level for more than a year, and I had developed symptoms of hypothyroidism, including serious fatigue. Within six weeks of discontinuing the lipoic acid, my symptoms vanished and my TSH returned to normal and stayed there. I had made no other changes of any kind so it is clear to me that the lipoic acid was the problem for me that caused hypothyroidism. Since then, I have so far discovered four other people who developed similar problems while taking it. However, since alpha-lipoic acid is otherwise an excellent supplement, for all the reasons listed above, this does not mean it should be completely written off. Just do monitor the thyroid if you choose to take it!
NYBC’s recommends that if you are on thyroid medication, it may be best to avoid lipoic at high doses (over 400mg/day).
March 28, 2008
Lark Lands on the 7 Deadly Sins for those wishing to live long and well with HIV
We’re re-printing below an excerpt from a piece Lark Lands wrote several years ago, because it still has much solid advice for people with HIV/AIDS. A medical journalist and longtime AIDS treatment educator and advocate, Lark was a pioneer in focusing attention on an integrated, “holistic” approach to HIV disease. She served as science editor for POZ magazine, and has also been a contributor to Canadian AIDS Treatment Information Exchange (CATIE) publications.
The title of this piece is “The 7 Deadly Sins for those wishing to live long and well with HIV.” This excerpt has to do with nutrient needs (but see also the other sections, including those on gastrointestinal health and maintaining muscle mass.)
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Sin #2: Ignoring the nutrient needs that both the disease and the medicines create.
Whether or not you’re taking antiretrovirals, your body is fighting an ongoing battle. It needs higher levels of nutrients to do that. You can’t power the body’s immune response or build replacement immune cells without the nutrient building blocks. You need to consume:
–good levels of protein
–good levels of unrefined complex carbohydrates (brown rice instead of white; whole-grain breads, crackers, cookies and pasta instead of those made with nutrient-poor white flour)
lots of fresh fruits and vegetables
–moderate amounts of good fats every day (monounsaturated fats like olive oil are best; avoid the partially hydrogenated oils found in margarines, shortenings and many baked goods and snack foods. Read the labels!)
–lots of healthful liquids (water, juices, teas — not chemical- and sugar-loaded junk drinks)
That’s how you power your body to keep up the immense battle against HIV. Numerous studies have shown that disease progression is faster in people with low levels of nutrients, so remember, nutrients are one of your best weapons against HIV. (Always make sure that the food you eat and the water you drink is safe.)
Nutrients can also help prevent or reduce the side effects and toxicity of medications while improving their absorption. You can help your body handle all the pills you’re taking by giving it good nutrition, lots of healthful fluids, appropriate supplementation and plenty of liver and kidney support.
With liver-toxic drugs: Consider L-carnitine (or L-acetyl-carnitine), and the nutrients that maintain glutathione levels in the liver — alpha-lipoic acid, vitamin C, vitamin E, N-acetyl-cysteine (NAC) and L-glutamine. Depending on drug interactions (check!), silymarin (milk thistle extract) may also be useful.
To help with kidney stress: Drink lots of water throughout the day. Aim for a large glass every hour or so, especially each time you pop your pills.
Don’t forget that nutrient supplementation can often help reduce or possibly eliminate HIV-related symptoms such as fatigue, skin problems, diarrhea and gas, memory loss, neuropathy and more. In order to manage a difficult disease long-term, you need to feel good!
