Insulin autoimmune syndrome (Hirata Disease) in European Caucasians taking alpha-lipoic acid

Researchers reviewed reports of European adults who developed insulin autoimmune syndrome, a rare condition in which the immune system makes antibodies that affect insulin. The people had repeated episodes of very low blood sugar after taking alpha-lipoic acid, a supplement sometimes used for nerve pain or blood sugar health. Their blood tests showed unusually high insulin levels and insulin antibodies. Symptoms generally improved after stopping alpha-lipoic acid and receiving medical care. This was a case review, not a controlled trial.

What this means for you: These reports suggest alpha-lipoic acid can rarely trigger serious low blood sugar in susceptible people. They do not show how often this happens or prove that the supplement causes it in everyone, so most people should not treat this as a routine risk without discussing personal factors with a clinician.