Conditions:
Amyotrophic Lateral Sclerosis
Related Terms
•
Lou Gehrig's Disease, ALS
Principal Proposed Treatments
•
· There are no well-established natural treatments for amyotrophic lateral sclerosis.
Other Proposed Treatments
•
Vitamin E, BCAAs, L-Threonine, Creatine, Vitamin B12, CoQ10, Genistein, Guanidine
Amyotrophic lateral sclerosis (ALS) is a nerve disorder that causes progressive muscle weakness. It usually begins with weakness in the hands or feet, which then spreads to the rest of the body. Affected muscles become spastic (tight and prone to spasm) and ineffective. As the weakness spreads, speaking, breathing, and swallowing become difficult. ALS is always fatal, and most people die within 3 years of being diagnosed. However, for reasons that are unclear, some individuals (such as the physicist Stephen Hawking) live much longer.
The cause of ALS is unknown and there is no cure for the disorder. Physical therapy can help the muscles maintain strength and flexibility for a time. Drugs such as baclofen may reduce muscle spasms and cramping. Eventually, individuals with ALS must be fed through a tube and sustained on a ventilator.
Proposed Treatments for Amyotrophic Lateral Sclerosis
Vitamin E
Vitamin E is a potent antioxidant, capable of fighting dangerous natural substances known as free radicals. It has been hypothesized that free radicals might play a role in ALS, and that, therefore, antioxidants might slow the progression of the disease.
In this 1-year double-blind placebo-controlled trial, 289 individuals with ALS were given the drug riluzole plus either vitamin E (alpha-tocopherol, 500 mg twice daily) or placebo.26
To the disappointment of researchers, use of vitamin E failed to improve survival time or measurably improve movement ability. However, according to one measurement of the severity of the disease, vitamin E did appear to increase the time participants remained in the milder part of ALS before progressing to severe ALS. It isn't yet clear whether this finding represents a true benefit or a statistical fluke. (When researchers look at enough measures of a disease, benefit will tend to be seen in one or two simply as the result of chance.)
BCAAs
BCAAs (branched-chain amino acids) are most well-known as a sports supplement, but have also been tried as a treatment for ALS. The theory behind this treatment is that people with ALS might not metabolize the substance glutamate properly. Glutamate plays a major role in nerve function. Since BCAAs help the body to metabolize glutamate, they could be useful for ALS. However, at best, BCAAs have been found only modestly effective in ALS, and study results have been mixed.1–6
One very small double-blind placebo-controlled study found that people treated with BCAAs for one year maintained muscle strength and the ability to walk longer than those on placebo.7 However, other studies found no effect,8,9 and one actually found a slight increase in deaths during the study period among those treated with BCAAs compared to placebo.10
L-Threonine
L-threonine, an essential amino acid, has been tried for ALS because, like BCAAs, it affects glutamate metabolism. Open trials and one double-blind study have shown some short-term improvement in symptoms, but in other research the results have not been impressive.11–14
Creatine
Another sports supplement, creatine, has been tried for ALS based on studies showing that it can improve muscle performance in certain situations. Evidence from animal and open human trials suggest that creatine may improve strength and slow the progression of the disease.15,16,17 However, double-blind human studies are needed to discover whether creatine is truly a useful treatment for ALS.
Other Supplements
Other nutrients that have been tried for ALS with some promising results include vitamin B12, CoQ10, genistein, and guanidine.18–22 However, there is no solid evidence as yet that they are effective.
Numerous other nutritional supplements have been tried for ALS that appear to be ineffective. These include multivitamins, AMP, and policosanol.23,24
One very small trial tested a combination pill containing amino acids, antioxidants, and the calcium-channel blocker nimodipine, finding some evidence that it might slow the progression of the disease.25
View References
Last reviewed March 2002 by Medical Review Board
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