A Naturopathic Perspective on ALS

What is ALS?

Amyotrophic Lateral Sclerosis (ALS), more commonly known as Lou Gehrig’s Disease, is a progressive neurodegenerative disorder that results in weakness, muscle atrophy, paralysis, and ultimately death. While there is no known specific cause of ALS, there are multiple theories that focus on genetic mutations, oxidative stress, and neuroinflammation. Increased risk also comes from certain occupational hazards, repeated concussions, exposure to heavy metals and pesticides, and electromagnetic fields. There are 120 genes implicated in ALS, and recent research suggests that a combination of certain genetic mutations and environmental exposures may lead to the development of the disease. 

Common signs and symptoms of ALS include poor coordination and dexterity, hyperreflexia, muscle spasticity, and muscle weakness. A patient may notice changes in speech and swallowing as the disease progresses, along with cognitive impairment. 

Conventional management of ALS typically involves a large team of providers that includes primary care, neurology, therapy (speech, physical, and occupational), along with psychotherapy and nutritional support. Multiple pharmaceutical medications are available, but primarily focus on symptom management, as supporting quality of life is the main goal of ALS treatment. 

Microbiome and ALS

Microbiome support may be necessary for some patients with ALS because it is common to see changes in digestion and bowel movements with disease progression. Even without digestive complaints, microbiome support can still be beneficial, as there is a strong connection between the gut and the brain. Recent research shows that patients with ALS may have imbalanced flora, low levels of butyrate-producing bacteria, and elevated levels of pro-inflammatory flora (E. coli, Bacteroides). They have also noted impairments in short-chain fatty acids, bile acids, and lipid metabolism. 

While not approved in the United States for ALS, case studies in other countries have documented the use of Fecal Microbiota Transplantation (FMT) in patients with ALS, resulting in improved respiratory and muscle function. Though case studies are limited, they highlight the important connection between the gut and the brain in neurodegenerative conditions, like ALS. 

Fatty Acids and ALS

Research has shown that fatty acids have neuroprotective and anti-inflammatory effects, and since neuroinflammation is a hallmark of ALS, they may help reduce neuroinflammation and slow disease progression. Higher dietary intake of polyunsaturated fatty acids (PUFAs), particularly alpha-linolenic acid (ALA), has been associated with longer survival and slower disease progression in patients with ALS, underscoring the importance of nutritional support when caring for someone with ALS. 

If you or someone you love has been diagnosed with ALS and is looking for additional support, our providers are ready to listen to your concerns and help create a collaborative plan that supports symptoms and overall quality of life. We may discuss dietary, nervous system, microbiome, and supplemental support. We may also discuss different functional testing options to better understand your individual needs. 

Not sure if you’re ready for an appointment? We have other ways we can help support you with our online classes! Learn the functionality of your nervous system and how to best support it in our newest class series! Our Nervous System class is broken down into three parts. Dr. Alexander covers the anatomy and physiology of your nervous system in part one, providing the basis for its function. Part two goes into depth with specific diseases such as Alzheimer’s, Parkinsons, MS, and POTS. Stay tuned: Part three of this class will be available in the next few weeks and will provide you with ways to keep your nervous system in tip-top shape to help prevent disease.

(Want a sneak peek at the class? Dr. Alexander has made this free intro video so you can see if this class is right for you. Click HERE to watch.)

If you’re a current patient and want more info on these classes, please reach out to your RNM practitioner. They can provide you with more details and discount codes!

References:

• Gautam P, Vishwakarma RK, Nath M, Nath G, Pathak A. Microbiota Dysbiosis in Amyotrophic Lateral Sclerosis: A Systematic Review of Human Studies. Mol Neurobiol. 2025;63(1):10. Published 2025 Nov 7. doi:10.1007/s12035-025-05481-5 
• Yan J, Chen H, Zhang Y, et al. Fecal microbiota transplantation significantly improved respiratory failure of amyotrophic lateral sclerosis. Gut Microbes. 2024;16(1):2353396. doi:10.1080/19490976.2024.2353396 
• Bjornevik K, Cortese M, Furtado JD, et al. Association of Polyunsaturated Fatty Acids and Clinical Progression in Patients With ALS: Post Hoc Analysis of the EMPOWER Trial. Neurology. 2023;101(7):e690-e698. doi:10.1212/WNL.0000000000207485
• Masrori P, Van Damme P. Amyotrophic lateral sclerosis: a clinical review. Eur J Neurol. 2020;27(10):1918-1929. doi:10.1111/ene.14393
• Brotman RG, Moreno-Escobar MC, Joseph J, et al. Amyotrophic Lateral Sclerosis. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556151/