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Long-term clinical trials, including one that lasted four years, found no serious safety concerns at these levels.7 Most people tolerate ALA well, but some mild side effects can occur, especially at higher doses: Digestive issues like nausea, bloating, or stomach upset Skin reactions, including rash or itching Low blood sugar, especially when taken with diabetes medications These side effects are usually temporary and mild, but they appear more frequently at doses of 1,200mg/day or higher.3 4 Medication interactions ALA may interact with several medications and should be used with caution in these cases:39 Diabetes medications (e.g., insulin, metformin) ALA can help lower blood glucose, which may enhance the effects of diabetes drugs and increase the risk of hypoglycemia