Introduction:

Lou Gehrig’s disease, scientifically known as ALS (amyotrophic lateral sclerosis), is a formidable adversary, relentlessly progressing and causing muscle weakness and paralysis. It strikes at the very core of our motor function, as it devastates the brain and spinal cord’s motor nerves. Ranked third, after Alzheimer’s and Parkinson’s, ALS is among the most prevalent neurodegenerative diseases, affecting 450,000 people globally. Although it often surfaces after the age of 50, a minority of cases manifest in younger individuals. In August 2021, a review surfaced in the journal Biomedicines, shedding light on the potential to prevent many cases of ALS through dietary and lifestyle choices, and the power of supplementation.

Niacin (B3) and NAD: A Vital Link

At the heart of this endeavor lies niacin (B3), a B vitamin that the body transforms into NAD (nicotinamide adenine dinucleotide). NAD plays a pivotal role in brain cell energy production, protecting against toxic substances (excitotoxicity) and states of reduced blood flow (cerebral ischemia). It preserves the integrity and function of brain cell axons, supports mitochondrial function (where nerve cell energy originates), and synthesizes glutathione—an essential brain cell antioxidant that thwarts damage and death caused by oxidative stress. NAD also activates longevity and survival genes in brain cells, such as the Sirtuin-6 gene. In the world of ALS, a recurring discovery is the depletion of NAD levels in the brain, and this depletion tends to align with age-related declines. For those genetically predisposed to ALS, the presence of the SOD1 mutation is a key risk factor. SOD1, an antioxidant that typically safeguards brain cells from free radical damage, falters in individuals with the SOD1 mutation. This malfunction leads to free radical accumulation, triggering nerve cell death and the onset of Lou Gehrig’s disease. Encouragingly, both animal and preliminary human studies suggest that supplementing with NAD or its precursors, such as niacin (B3), can replenish brain NAD levels. This, in turn, shields nerve cells from demise and amplifies glutathione synthesis—an essential antioxidant that can partially compensate for the lack of free radical protection stemming from the defective SOD1 enzyme. Interestingly, like NAD, glutathione has been found to be lower in the brains of ALS patients compared to healthy individuals.

The Bright Side: Antioxidants and Supplements

Halting free radical damage to the brain has emerged as a recent medical focus, resulting in the approval of the antioxidant drug edaravone for ALS therapy. However, edaravone isn’t the sole promising avenue. For instance, high-dose melatonin administration (300 mg/day via rectal suppository), alongside oral melatonin supplementation and a blend of other supplements, has yielded encouraging results. This comprehensive approach led to the recovery of lost muscle function, slowed the progression of ALS, and extended the lives of patients. Additionally, the antioxidant supplement NAC (N-acetylcysteine) has proven to replenish brain glutathione levels and displayed remarkable potential in preventing ALS in animal models.

Practical Measures to Reduce ALS Risk

To summarize the essence of this investigation and render it practical, here are a few considerations for potentially reducing the risk of developing Lou Gehrig’s disease during your lifetime:

1. High-Potency Multivitamin and Mineral Supplement: Include a daily high-potency multiple vitamin and mineral supplement containing 50 mg of vitamin B3 (niacin). This can combat the age-related decline in brain NAD levels associated not only with ALS but also with Alzheimer’s, Parkinson’s, and Huntington’s diseases. Opt for a high-potency formula with increased antioxidant vitamins such as vitamin C (1,000 mg), vitamin E (400 IU), beta-carotene (15,000 IU), and selenium (200 mcg).
2. Melatonin Supplementation: After turning 40, consider taking 1-3 mg of melatonin an hour before bedtime daily. Melatonin acts as a brain antioxidant, preventing motor nerve death—an essential factor in ALS prevention and treatment. It also promotes deep sleep, bolsters immune function, and guards breast and prostate cells against cancer-associated changes.
3. Glutathione Synthesis Support: Beyond 45-50 years of age, a daily supplement that aids the synthesis of glutathione is recommended. Such a supplement typically includes NAC (N-acetylcysteine), alpha-lipoic acid, L-glutamine, and milk thistle (source of silymarin).
4. Coenzyme Q10 (CoQ10): Taking 30-100 mg/day of CoQ10 after 45 years of age may be a prudent measure in the prevention of neurodegenerative diseases. This holds particularly true for Parkinson’s disease but may also have implications for Alzheimer’s and ALS.
5. Infusions: For the highly motivated, consider consulting an integrative or anti-aging medical professional after 45-50 years of age. They can administer intravenous glutathione (1,000 mg) and/or NAC (500-1,000 mg) once every month or two, ensuring optimal brain levels of these essential compounds. IV administration of NAD, typically at dosages of 250, 500, or 750 mg, is also an option. Sublingual NAD products are available in the market, offering a route to efficient NAD delivery to the brain, bypassing digestive degradation.

If this topic intrigues you, delve into the comprehensive review article from 2019. Find the link provided below for a more in-depth exploration of ALS and potential prevention strategies.

Reference

1. Obrador E et al. NAD+ precursors and antioxidants for the treatment of amyotrophic lateral sclerosis. *Biomedicine*. 2021, 9(8): 1000. [Read the full study here](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394119/).

Dr. Meschino