From the databaseWhat the row says.
Every entry follows the same shape: what is happening, the mechanism, and the recommendation.
Scope
Supplement × Prescription
Last verified
June 4, 2026
CautionEmerging evidence
What is happening. Alpha-Lipoic Acid may lower glucose and add to the glucose-lowering effects of Pioglitazone.
Mechanism. Additive insulin sensitization, reduced carbohydrate absorption, or insulin secretagogue effects can increase hypoglycemia risk in combination regimens.
Recommendation. Increase glucose monitoring when starting, stopping, or changing the supplement; coordinate diabetes medication adjustments with the prescriber.
Stack Score
How it moves the number.
Effect on the composite score
If both Alpha-Lipoic Acid and Pioglitazone are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are at /methodology/stack-score.
SourcesSources, by evidence tier.
Every claim on this page is cited. PMIDs link straight to PubMed.
Reference material
1- 1Natural Medicines diabetes supplement interaction reviews.Needs sourceNo link