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ALA on Mounjaro: glucose, A1C and thyroid result record
A record for the first three months of taking alpha-lipoic acid with Mounjaro: what you take, a weekly line for fasting readings and stomach symptoms, and space for A1C and thyroid results. The trial panel shows the doses and side effects that were actually studied.
Starting point
ALA product and formR-ALA or standard (racemic)
ALA mg per day and time taken
Mounjaro dose and injection day
Sulfonylurea, insulin or metformin: names and doses
A1C before starting, and date
TSH and free T4 before starting, if checked
Weekly line for the first 12 weeks
| Week | Mounjaro dose | ALA mg a day | Fasting readings this week | Any reading below 70 mg/dL | Nausea, vomiting or heartburn | Dizziness |
|---|---|---|---|---|---|---|
Lab results
| Date | A1C | TSH | Free T4 | Other result | Reviewed by |
|---|---|---|---|---|---|
Doses and side effects in the ALA trials
- SYDNEY 2 (181 people with diabetic neuropathy, 5 weeks): 600, 1,200 and 1,800 mg once daily were tested; nausea, vomiting and vertigo rose with dose.[1]
- The SYDNEY 2 authors judged 600 mg once daily the best balance of benefit and risk.[1]
- NATHAN 1 (4 years, 600 mg once daily): serious adverse events in 38.1% on ALA versus 28.0% on placebo.[2]
- In a 6-month trial of 38 adults with type 2 diabetes randomized to placebo or 300 to 1,200 mg a day, fasting glucose and A1C trended down with dose.[3]
- Mounjaro's label: with a sulfonylurea or insulin, the risk of low blood sugar may rise, and a lower dose of those medicines may reduce it.[4]
Act on these
- Low blood sugar signs listed for Mounjaro include dizziness, sweating, confusion or drowsiness, headache, blurred vision, shakiness and a fast heartbeat.[4]
- Diarrhea, nausea and vomiting can cause a loss of fluids (dehydration) that may lead to kidney problems: tell your provider if they keep going.[4]
To ask at the next visit
- Should my sulfonylurea or insulin be adjusted while I take ALA?
- Which fasting reading should make me call you?
- Is a TSH check worth doing before I start, or only if I feel unwell?
- Is my ALA dose close to what was studied for the reason I take it?
- If nausea builds after an injection, should I pause ALA first?
Sources for the facts on this sheet
- Ziegler D, Ametov A, Barinov A, et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care 2006. PMID 17065669. https://pubmed.ncbi.nlm.nih.gov/17065669/
- Ziegler D, Low PA, Litchy WJ, et al. Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care 2011. PMID 21775755. https://pubmed.ncbi.nlm.nih.gov/21775755/
- Porasuphatana S, Suddee S, Nartnampong A, et al. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study. Asia Pac J Clin Nutr 2012. PMID 22374556. https://pubmed.ncbi.nlm.nih.gov/22374556/
- Eli Lilly and Company, via DailyMed. Mounjaro (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-27. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.