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Updated 12/6/2023

[PubMed: 32212340] (Among 20 adults with multiple sclerosis given either 600 mg of an R enantiomer of ALA or 1200 mg of a racemic mixture of the R and S enantiomers for 7 days and then crossed over to the other dosage, absorption and ALA[R] plasma concentration areas under the curve were similar for the 2 forms but gastrointestinal side effects were greater with the 1200 mg dosage

This phenomenon is attributed to the expression of key enzymes of the glycolytic pathway (hexokinase, fructose-6-phosphate activating enzyme, and pyruvate kinase), which are not normally present in the proximal tubules (Guder and Ross, 1994