Can You Prevent ALS?

Amyotrophic lateral sclerosis (ALS) is a progressive neurological condition without an exact cause. However, genetics and environmental factors—such as viruses, exposure to toxins, and physical trauma—are believed to play a role in the disease's development. While ALS cannot be prevented, some treatments can slow the progression of the disease.

This article discusses whether ALS is preventable, its risk factors, current treatment options, and how to live well with the disease.

Can You Prevent ALS?

ALS cannot be prevented. However, researchers have found that carotenoids (a pigment found in plants) might play a role in helping to prevent neurodegenerative diseases, such as ALS, or delay the onset of symptoms.

Carotenoids

Carotenoids are orange, red, green, and yellow pigments in fruits and vegetables. High concentrations of carotenoids can be found in green leafy vegetables, such as broccoli, kale, spinach, and coriander.

Oxidative stress, caused by increased levels of free radicals in the body, leads to inflammation. Carotenoids act as antioxidants—substances that help prevent or delay cell damage in the human body.

ALS involves inflammation and destruction of the nerves that tell muscles to contract. Research has shown that carotenoids can help prevent neuroinflammation.

Causes of ALS

Unfortunately, no one knows for sure what causes ALS. However, genetic and environmental factors contribute to the increased risk of developing the disease.

When ALS runs in families—around 5% to 10% of all cases—it is sometimes caused by a defect in the C9ORF72 or SOD1 genes.

Environmental factors might also increase the risk of ALS, although more research is needed in this area. These factors include:

• Viruses
• Infection
• Exposure to toxins
• Physical trauma
• Diet
• Long-term participation in strenuous physical activity

Slowing the Progression of ALS

A few medications approved by the Food and Drug Administration (FDA) have been shown to slow the progression of ALS symptoms, including:

• Rilutek (riluzole): This medication decreases levels of glutamate (a neurotransmitter) in the body, which can help reduce damage to the motor nerves. In current clinical trials, this medication has increased survival by a few months. Rilutek is taken orally (by mouth).
• Radicava (edaravone): This medication is delivered intravenously, directly into the bloodstream through an IV. It reduces oxidative stress in the body to help slow functional decline for individuals with ALS.
• Relyvrio (sodium phenylbutyrate/taurursodiol): This drug was approved by the FDA in September 2022. It comes in powder form and is mixed with water before consumption. This medication also helps slow functional decline for people diagnosed with ALS.

Living With ALS

While medication is the primary treatment for ALS, other interventions can help relieve symptoms caused by ALS, such as decreased mobility and pain.

Rehabilitation

Rehab therapists can help address symptoms resulting from ALS.

• Physical therapy: This therapy addresses range-of-motion issues that develop with ALS and provides interventions that help decrease the pain from muscle spasms or immobility. Physical therapists also teach individuals with ALS how to use mobility devices (such as a cane or walker) and assist with wheelchair positioning when the individual is no longer able to walk.
• Occupational therapy: This therapy helps individuals remain independent with activities of daily living for as long as possible. Occupational therapists teach people with ALS how to use adaptive devices for tasks such as eating, dressing, grooming, and bathing.
• Speech therapy: As ALS progresses, it causes weakness in the head and neck muscles. Speech therapists help individuals with ALS learn new communication methods as speech deteriorates. Speech therapists also provide treatment for swallowing difficulties that develop as ALS progresses.
• Respiratory therapy: Respiratory therapists teach people with ALS how to breathe and cough more effectively as the muscles that perform these functions weaken. These therapists also recommend appropriate mechanical ventilation once the individual can no longer breathe on their own.
  

Psychotherapy

Receiving an ALS diagnosis can cause significant psychological challenges. Some individuals with this condition also develop depression or have significant anxiety about how their life will change. Psychotherapy (talk therapy or mental health counseling) can help improve the overall quality of life for people with ALS.

Summary

There is no way to prevent ALS. However, there are interventions available that can slow the progression of the disease, help an individual maintain independence as long as possible, and reduce pain and discomfort that can occur as the disease progresses.

Treatments for ALS include medications to help slow nerve damage, rehabilitation therapies, and psychotherapy.