Holistic therapies for ALS

A friend of mine has just been diagnosed with amyotrophic lateral sclerosis (ALS). He’s been prescribed riluzole, but are there any complementary and alternative therapies that might be able to help?

A.P., via email 

Amyotrophic lateral sclerosis (ALS), or motor neuron disease (MND) as it’s known in the UK and Europe, is one of the most common neuromuscular diseases worldwide.1 A degenerative disorder that destroys the motor neurons, the nerve cells that control muscle movements, ALS often starts with muscle twitching, a weak limb or slurred speech and eventually causes problems walking, chewing, swallowing, speaking and breathing.

The average survival time for ALS is two to five years, but some people, like cosmologist and theoretical physicist Stephen Hawking, can live much longer.

There is no cure for ALS, at least according to mainstream medicine, but the drug riluzole—approved in both the US and UK for treating ALS—can prolong survival by about two to three months.2 Other conventional treatments are focused on relieving symptoms. Noninvasive ventilation, for example, where the patient is given a mask ventilator system to wear, usually overnight, may improve quality of life and extend survival by a few weeks for some.3

As for complementary and alternative medicine for ALS, the research is still in its infancy, with many studies only being conducted in animals so far. But there is promising evidence from studies in patients, especially in the realm of nutrition. 

It’s becoming clear that nutritional status is closely related to survival time in ALS and that diet and nutritional supplements can play an important role in managing the disease.4

An experienced naturopath or functional medicine practitioner would be a good call for your friend, as they can investigate potential causes and come up with holistic personalized plans. But here’s a general guide to the natural options that may be beneficial for ALS based on human studies.

Consider a high-fat diet 

Malnutrition and weight loss can negatively impact survival in ALS,5 so patients are usually offered nutritional support, especially if they experience trouble swallowing. One group of researchers looked at the effect of two different high-calorie food supplements on stabilizing body weight in ALS patients who were losing weight: one that was high in fat and another that was high in carbohydrates. Both diets were effective, but the one high in fat had a slightly
greater effect.6

Another study, albeit in animals so it may not apply to humans, found that a ketogenic diet, which is high in fat and low in carbohydrates, may slow the progression of ALS.7

Check for mineral deficiencies  

Some evidence suggests that deficiencies in zinc, calcium, magnesium and copper  may play a role in ALS.8,9 There don’t appear to be any clinical trials assessing the effects of supplementation with these minerals, but two case studies of copper-deficient patients given a diagnosis of ALS reported improvements in weakness after copper supplementation.9

Consider getting your levels tested and then supplementing with a high-quality mineral supplement. 

Supplement with vitamins

Certain vitamins may be beneficial for ALS, according to preliminary evidence. But bear in mind that the dosages used in the studies tended to be very high, so it’s important to see a qualified practitioner who can advise on safe, individual dosages and monitor your progress. 

Vitamin B12. Studies carried out in Japan suggest that ultra-high doses of methylcobalamin, a form of vitamin B12, may be helpful for ALS. Short-term trials have reported that the nutrient can slow muscle wasting and increase survival time in patients,10 while a long-term study found that methylcobalamin may reduce symptom progression and prolong survival if treatment is started early (within 12 months of symptoms starting).11

Dosage: High doses of 25–50 mg/day of methylcobalamin were given intramuscularly in the studies, so it would be essential to see a qualified practitioner for this treatment 

Vitamin E. Regularly taking vitamin E supplements was associated with a lower risk of dying of ALS in one study.12 And those with a high dietary intake of vitamin E as well as polyunsaturated fatty acids had a 50–60 percent reduced risk of developing ALS in another.13 In a placebo-controlled trial of patients taking vitamin E supplements alongside riluzole, although there appeared to be no effect in terms of motor function and survival time, the vitamin E group were less likely to progress from a milder form of ALS to the more severe form.14

Dosage: 500 mg/twice a day was used in the trial 

Vitamin D. Low vitamin D levels have been linked to ALS and specific symptoms.15 In one study, patients taking D supplements for nine months saw less decline compared to those not taking the supplements.16

Dosage: 2,000 IU/day was used in the study, but higher doses may be needed if levels are very low; ideally, get tested first

Opt for acupuncture 

One small clinical trial found that this traditional Chinese technique may be helpful for ALS. Acupuncture treatment twice daily for five days led to improvements in oxygen saturation and pulse rate in ALS patients, although the size of the improvements was small.17 

More impressive results have been reported in a couple of case studies. One noted improvements in speaking, sensation, walking and breathing in a 60-year-old man treated with Chinese scalp acupuncture and auricular (ear) acupuncture.18 In another, a 55-year-old woman treated with acupuncture for four months alongside the drug riluzole became free of  disabling symptoms.19

Try magnet therapy 

Repetitive transcranial magnetic stimulation (rTMS)—a noninvasive brain stimulation technique using magnets—is showing promise for ALS. In a six-month trial, patients receiving rTMS showed a slower rate of decline compared to those receiving a placebo treatment.20 Another controlled study reported that rTMS improved motor function and quality of life in ALS patients, although the effects were not long-lasting.21

Watch out for environmental pollutants 

Exposure to pesticides and heavy metals like lead, mercury and aluminum, all of which are widely found in our everyday environment, has been linked to ALS.22

And researchers have hypothesized that an impaired ability to break down these toxic pollutants because of differences in vital detoxification genes could underlie some cases of the disease.23

An experienced naturopath or functional medicine practitioner can suggest appropriate testing, such as hair tissue mineral analysis, to work out your exposure levels and then recommend a suitable holistic detox program. 

To find a functional medicine practitioner, visit the Institute for Functional Medicine website (www.ifm.org) or Natural Health Worldwide (www.naturalhealthworldwide.com). 

For some general guidance on detoxification and how to reduce chemical exposure, see WDDTY May 2021 and January 2020.

Exercise 

An individualized exercise program, prescribed by a physical therapist, can be helpful for improving body function and spasticity, evidence suggests. Moderate-load, endurance-type exercises for the limbs and trunk, performed for 15 minutes twice a day, were beneficial in one study,24 while another trial found that three times weekly resistance exercise in combination with daily stretching exercises was effective.25