Is alpha-lipoic acid better for insulin resistance or neuropathy?
ALA has clamp-technique-verified evidence for improving insulin sensitivity, but a 2024 Cochrane review found little to no effect on neuropathy symptoms specifically.
The short answer
These are genuinely two different questions with two different evidence levels. A clamp-technique study (600mg twice daily for 4 weeks) found real improvement in insulin sensitivity. Separately, ALA has a longstanding popular reputation for diabetic neuropathy, but a 2024 Cochrane review found little to no effect on neuropathy symptoms specifically -- weaker support than its reputation suggests. Anyone using ALA alongside insulin or glucose-lowering medication should monitor blood sugar closely, since it can lower it meaningfully.