Q: Is it true that taking alpha lipoic acid may be a problem if I'm also taking thyroid medication?

A: While I've heard this, I've not seen it in clinical practice. ALA is unique in that it functions as both a fat- and water-soluble antioxidant that can easily cross cell membranes.

A host of studies attest to its benefits in mitigating a variety of diseases associated with increased free radical damage.1 It is therefore widely recommended.

As far as side effects with thyroid medications, there is an older report that suggests ALA interferes with the conversion of the thyroid hormone triiodothyroxine (T3) to thyroxine (T4) when taken concurrently with T4 replacement. In other words, T3 was reduced when measured in the bloodstream after ALA administration.2 Unfortunately, I've not seen any follow-up to this study. Because of the first report, however, I would be cautious with someone who is taking large dosages of ALA—say 800-1,200 mg—who is also on T4 thyroid-replacement therapy.

Generally, the main potential side effect with ALA supplementation is that it may reduce glucose and insulin levels in diabetics—and this is actually one of the primary reasons to give ALA, so it's not really a side effect. That said, diabetics taking ALA supplements should work with their physicians to monitor and adjust any medication that they may be using.

Q: I know that phosphatidylserine may be useful in memory loss, but can it also help with stress?

A: Yes, it can be helpful. The primary role of phosphatidylserine in the human brain is to maintain the fluidity of cell membranes. Normally, the brain can manufacture sufficient levels of PS, but in certain situations it may not. As you mention, there have been some studies that suggest PS supplementation may improve age-related brain changes.

Trials have shown statistically significant improvements in elderly patients given PS (compared with placebo) both in terms of behavioral and cognitive parameters.3 The typical dosage has been 100 mg three times daily.

In addition, recent research has shown PS dampens the cortisol response to both physical and mental stress.4 We release cortisol when we experience a stressful event. This is important in an acute situation, as cortisol speeds our reaction time, sends blood to muscle tissue, increases glucose into the bloodstream, and shuts down digestive processes, among other things. In other words, it gets us ready to act quickly.

However, having cortisol chronically turned on can be a problem. One study with 80 people showed that using 400 mg/day of PS for three weeks seemed to exert a specific positive effect on emotional responses to a stressor.5 That is, it blunted the elevation in cortisol. This suggests that PS may be useful in someone faced with chronic stress.

References
1. Bilska A, Wlodek L. Lipoic acid—the drug of the future? Pharmacol Rep 2005;57(5):570-7. Review.
2. Segermann J, et al. Effect of alpha-lipoic acid on the peripheral conversion of thyroxine to triiodothyronine and on serum lipid-, protein-and glucose levels. Arzneimittelforschung 1991;41(12):1294-8.
3. Cenacchi T, et al. Cognitive decline in the elderly: a double-blind, placebo-controlled, multicenter study on efficacy of phosphatidylserine administration. Aging (Milano) 1993;5(2):123-33.
4. Benton D, et al. The influence of phosphatidylserine supplementation on mood and heart rate when faced with an acute stressor. Nutr Neurosci 2001;4(3):169-78.
5. Hellhammer J, et al. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PS) on the endocrine and psychological responses to mental stress. Stress 2004;7(2):119-26.

Natural Foods Merchandiser volume XXVIII/number 3/p. 110