ALS

Many of us remember the ice bucket challenge that went around a few years ago: participants would turn a bucket with icy water on top of their heads to promote awareness and increase research on ALS, Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s disease.

While overall rare, the condition is the most common neurodegenerative disease of motor nerves. This means, ALS affects the ability of patients to move, irreversibly damaging the nerves controlling muscles.

Senses and cognitive abilities are not affected, with Steven Hocking being the most famous example of a genius brain continuing to work in near fully incapacitated body.

The name of the condition explains the main pathologic findings: “lateral sclerosis” refers to the fact that neurons in the lateral areas of spinal cord become replaced with “sclerotic” scar-like tissue, and that results in “amyotrophy” - muscle atrophy due to lack of neuronal stimulation to the muscles.

This is a devastating condition, with median survival rate of just 3 years after the diagnosis. While there is a familial form, most of the cases are sporadic. The lack of coherent understanding of pathophysiology of this condition affects the ability to design the effective treatments and improve patients’ prognosis. Meanwhile, most healthcare practitioners are looking for tools that could possibly decrease the progression of the disease, help detect it earlier, or decrease the risk of its development.

As Naturopathic physicians, we can contribute to the search of potential risk factors and possibly to the risk reduction helping our patients achieve optimal health.

Most researchers agree that the following mechanisms, while not being exclusive, contribute to the risk of development of ALS:

• Oxidative stress. Mutations in enzymes that normally scavenge the superoxide radicals were detected in patients with some forms of ALS. While Naturopathic therapies are not capable of correcting malfunctioning enzymes, we can offer multiple tools in reducing the oxidative stress.
• Mitochondrial damage. Somewhat related to oxidative stress, as mitochondria are first to fall victims to excessive oxidation, decreased ability to produce ATP adds a devastation to neurons. We can suggest nutrients, lifestyle corrections, and exercises that can help improve mitochondrial health
• Glutamate pathways over-activation was also shown to contribute to the neurodegeneration. While fine tuning neurotransmitter balance is difficult, naturopathic physicians are uniquely positioned to evaluate and help balance neurotransmitters.
• Exposure to environmental toxins: this is probably the largest and the most diverse category of factors that could contribute to ALS development, and NDs are well experienced in helping guide the patient through possible testing, interpretations, and detoxification measures. Some of the examples include:
  • Heavy metals: lead, mercury, and selenium have been linked to increased risk of ALS. Naturopathic doctor will advise on available tests and interventions related to heavy metal exposures and toxicity
  • Pesticides/ organophosphates: as exposure to these compounds is linked to many neurodegenerative conditions, we can help patients identify appropriate testing and interpret the results, as well as design a detoxification protocol to mitigate possible risk.
  • Cyanotoxins: some of the latest research seem to support contributory role of cyanobacteria/ blue-green algae produced toxin to development of ALS. Perhaps, there is a need to look into water and food supply, as well as toxic load on the body.

Medical community can’t save people diagnosed with ALS yet. NDs are aiming at finding and addressing all possible risk and disease modulating tools that have been validated in research available today. As practitioners of holistic approach, we can assess environmental, nutritional, lifestyle, and other aspects of the patients’ lives and help decide on appropriately measured interventions.