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Amyotrophic Lateral Sclerosis (ALS) (Lou Gehrig's Disease)

What is Amyotrophic Lateral Sclerosis?

Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) is a degenerative neuromuscular disease. ALS destroys motor neurons, the nerves that control movement, resulting in loss of motor function and eventual paralysis. Respiratory failure due to nerve damage that affects the muscles that control breathing is the most common cause of death in ALS patients.

There are two main forms of ALS: sporadic and familial. While familial ALS is typically caused by hereditary genetic mutations, the cause of sporadic ALS (comprising 90% of all cases) is not completely understood. It is generally believed that sporadic ALS is caused by multiple factors that converge to damage motor neurons, including oxidative stress and glutamate toxicity, among others.

Natural interventions such as vitamin B12 and ginseng, in addition to conventional therapies, may help slow disease progression and improve quality of life by targeting multiple pathogenic mechanisms of ALS.

What are the Causes and Risk Factors for Amyotrophic Lateral Sclerosis?

  • Genetic mutations
  • Oxidative stress
  • Glutamate (an important neurotransmitter) accumulation and toxicity
  • While causal relationships have not been established, exposure to heavy metals, pesticides, and other environmental toxins has been linked with ALS development.

What are the Signs and Symptoms of Amyotrophic Lateral Sclerosis?

Note: Early symptoms vary depending on which muscles are affected first. Common symptoms can include:

  • Tingling in fingers or toes
  • Cramping in arms or legs
  • Difficulty with tongue and facial movements, including chewing and swallowing

What are the Conventional Medical Treatments for Amyotrophic Lateral Sclerosis?

  • Riluzole—blunts the effects of glutamate accumulation and can extend survival by a few months
  • Edaravone—a free radical scavenger that can reduce oxidative stress
  • Other treatments may help relieve symptoms and improve quality of life:
    • Non-invasive positive pressure ventilation
    • Medications to relieve painful muscle cramps
    • Medications to reduce excessive salivation
    • Physical, occupational, and speech therapy
    • Mobility aids

What are Emerging Therapies for Amyotrophic Lateral Sclerosis?

  • Stem cell therapy
  • Multiple proteins and mutations have been linked to ALS pathogenesis. Gene replacement therapy and pharmaceutical interventions are being explored as potential treatments.
  • Insulin-like growth factor-1 (IGF-1) modulates neuronal growth and function, and injections may help slow disease progression, but results have been mixed.
  • Many other treatments are being explored. More updated information can be found online at the ALS Association website.

What Nutritional Interventions May Be Beneficial for Amyotrophic Lateral Sclerosis?

  • Vitamin B12. Vitamin B12 deficiency has been associated with nerve damage in animal models. High intramuscular doses in ALS patients have been shown to slow muscle wasting.
  • Zinc. Mutations in the superoxide dismutase enzyme (which stabilizes superoxide radicals and is implicated in the pathology of certain kinds of ALS) can decrease its affinity for zinc and cause it to become toxic to motor neurons. Altering brain zinc levels is being explored in many nervous system diseases.
  • Ginseng. Ginseng significantly delayed the onset of symptoms in an animal model of ALS. Ginseng may also protect motor neurons from apoptosis and membrane damage.
  • Ginkgo biloba. Ginkgo biloba has antioxidant properties that have shown in experimental models to protect against glutamate-induced excitotoxicity and neuronal death due to oxidative stress.
  • Coenzyme Q10 (CoQ10). Patients with ALS have a higher percentage of oxidized CoQ10. Administering CoQ10 in an animal model of ALS extended lifespan.
  • Acetyl-L-carnitine. Acetyl-L-carnitine has been found to reduce neuromuscular degeneration and increase lifespan in animal models of ALS. Acetyl-L-carnitine also appears to enhance the growth and repair of neurons.
  • Lipoic acid. Lipoic acid is an antioxidant shown to protect cells against glutamate-induced excitotoxicity. In one study, administering lipoic acid improved survival in a mouse model of ALS.
  • Whey protein. Protein supplementation may help improve the nutritional and functional status of ALS patients. Preliminary data suggest whey protein may protect motor neurons from oxidative damage.
  • Creatine. In several animal studies, creatine has been shown to provide protection against neurodegenerative diseases. Additionally, a small study found that creatine supplementation improved muscle strength in ALS patients.
  • Other natural interventions that may be helpful for ALS patients are glutathione and N-acetyl-cysteine (NAC), green tea, pycnogenol, and resveratrol.