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ALS Worldwide
January 27, 2015

Supplements and Vitamins

Nutritional supplements include vitamins, minerals, herbs, natural food supplements, and other products used to boost the body’s nutritional content. They can be used to improve overall health and energy; to provide immune support and reduce the risk of illness; to improve athletic and mental performance; and to support the healing process. Supplements are treated as food and not regulated as drugs, and are generally safe.

Proper nutrition is particularly critical for ALS patients, as malnutrition can exacerbate muscular weakness and vulnerability to infection. Therefore, all patients should maintain a nutritious, weight-maintaining diet.

Jeffrey Rosenfeld, PhD, MD of UCSF Fresno, has published an excellent article, Nutrition and Dietary Supplements in Motor Neuron Disease, that discusses many of the various supplements beneficial for ALS. Some of the highlights are discussed here.

As an extract from the periwinkle plant, Vinpocetine is known for stimulating memory. It appears to enhance cerebral blood flow, has neuroprotective properties, and it may minimize upper motor neuron symptoms. While its benefits have not been scientifically proven, it is regularly used in Eastern Europe for both Parkinson's Disease and Alzheimer's Disease. Recommended dosage is initially 5 mg daily for several days. If no adverse side effects occur, gradually increase to the suggested dosage of 10 to 20 mg daily after a morning meal.
Vitamin E
Vitamin Emis an antioxidant, a substance that helps to reduce free radicals that can cause cellular damage, and oxidative stress—a buildup of free radicals—may play a role in the development of ALS). A 2011 clinical trial showed that high-dose Vitamin E may help slow progression of ALS. Recommended dosage is 500 mg twice daily.
Vitamin D
Vitamin D has been studied for its antioxidant, anti-inflammatory and potential neuroprotective properties. An early study at Harvard Medical School found that ALS patients taking at least 2,000 IU daily of Vitamin D experienced a slower decline in ALSFRS symptoms. Vitamin D may also delay the progression of ALS. Vitamin D3 may also be beneficial because it is the form of vitamin D obtained from sunlight. Recommended dosage of Vitamin D is 2,000 IU daily. Recommended dosage of Vitamin D3 is minimum 2,000 to 3,000 IU daily, taken with food.
Oxidized forms of the coenzyme Q10, known as CoQ10, may offer neuroprotective properties to those with mitochondrial oxidative damage. Three Japanese researchers at Iwate Prefectural Ninohe Hospital in Iwate, Japan, conducted a study exploring the role of mitochondrial oxidative damage and oxidative DNA damage in ALS. Their results suggest that both factors play a large role in sporadic ALS.  Daily dose should be discussed with your physician or neurologist, but generally can be as high as 3000 mg per day. 
Melatonin, a supplement usually used to aid sleep, also shows antioxidant benefit—and may thus combat oxidative damage. To avoid lethargy and sleepiness, discuss dosage with your doctor. Discuss dosage with your doctor but generally dosage should be no more than 5 mg as a sleep aid.
Creatine – Alpha Lipoic Acid – L-Carnitine
Creatine may combat motor neuron loss in ALS, enhancing survival and motor performance. It might be particularly effective in combination with additives such as riluzone, celecoxib or minocycline. Doses range from 5 to 10 mg/day.
Alpha-Lipoic acid is an antioxidant that delayed impaired motor performance in SOD-1 mice. Dose generally 250 mg, 3x/day (consult your doctor).
L-Carnitine may inhibit mitochondrial damage; it also delayed symptom onset and prolonged motor function in SOD-1 mice. 4-8 grams (4000-8000 mgs.) daily in divided doses, preferably on an empty stomach

Please consult your physician or neurologist to determine which supplements are most appropriate for you.