Amyotrophic Lateral Sclerosis (ALS) is a complex disease that, although there is currently no definitive cure, can be managed with a combination of clinical and supportive strategies aimed at improving quality of life. In addition to pharmacological therapies and multidisciplinary care, some natural remedies and complementary approaches can help alleviate symptoms, supporting the physical and emotional well-being of those affected.
What is ALS and what are its symptoms
ALS is a neurodegenerative disease that selectively affects motor neurons, the nerve cells responsible for voluntary movement. Over time, this leads to muscle weakness, cramps, spasticity, speech and swallowing difficulties, and eventually involvement of the respiratory muscles.
The typical age of onset is in late middle age, although individual variability is wide. Early recognition of initial signs (such as stumbling, loss of grip strength, nocturnal cramps, or fasciculations) allows for rapid access to diagnosis and a specialized care pathway.
From an epidemiological perspective, ALS affects approximately 2–3 people per 100,000 each year in Europe; in Italy, regional registry data confirm similar values, with some areas recording peaks above 3 cases per 100,000 inhabitants.
Median survival from symptom onset ranges between 2 and 5 years, with a significant portion (10–20%) exceeding 10 years. It has also been documented that care in multidisciplinary centers provides benefits in survival and quality of life compared to generalized local management.
ALS symptoms
ALS symptoms vary depending on the initially affected area (limbs, bulbar, respiratory) and the rate of progression.
Among the most common symptoms are:
- asymmetric muscle weakness,
- cramps and fasciculations,
- spasticity,
- dysphagia (difficulty swallowing),
- dysarthria (difficulty speaking).
Natural remedies in the treatment of ALS symptoms
The care pathway for ALS is primarily based on approved medications and multidisciplinary management, which represent the essential clinical reference. Alongside these, some natural approaches can be cautiously integrated to relieve specific symptoms, always in consultation with the neurologist and care team.
In the following sections, we will examine some remedies and practical guidance on how to incorporate them into daily treatment, with a concrete goal: not to stop the disease, but to reduce the impact of symptoms and support residual functionality.
This type of approach can help slow functional progression of ALS, improve quality of life, and provide tools to make more informed choices among the various available support options.
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Nutrition and supplements to support nervous system health.
Maintaining good nutritional status is a fundamental clinical objective: studies show that weight loss and malnutrition are associated with worse prognosis and functionality in ALS patients. European guidelines recommend an indicative energy requirement of 30–35 kcal/kg, to be personalized based on individual characteristics, with periodic assessments of dysphagia and careful consideration of enteral support if weight loss persists. A high-calorie diet can be well tolerated and, in small clinical trials, has shown signals of benefit on survival and disease progression.
Regarding supplements, substances such as vitamin D, omega-3 fatty acids, and turmeric have been investigated for their potential neuroprotective role. However, available results remain preliminary and inconclusive. For this reason, supplementation should always be evaluated case by case with the care team.
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Anti-inflammatory herbal therapies.
Some plant-derived compounds have shown antioxidant and anti-inflammatory properties that may offer complementary support.
· Curcumin: several preclinical studies have shown neuroprotective effects through modulation of oxidative stress and inflammation. However, absorption and potential drug interactions require medical evaluation before use.
· Polyphenols: substances such as green tea and resveratrol have shown beneficial effects in experimental models, mainly through antioxidant and mitochondrial modulation mechanisms. Clinical evidence in humans remains limited.
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Physical exercise and physiotherapy to improve mobility and muscle strength.
Aerobic and resistance exercise, at moderate intensity and under supervision, can preserve function and respiratory capacity without damaging muscles. Exhaustive efforts should be avoided, and loads and recovery should be personalized.
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Stress management and psychological well-being techniques.
Mindfulness techniques and brief psychological interventions, adapted to ALS, show improvements in quality of life, anxiety, and mood. Online or virtual reality programs are under development and can be sustainable for patients and caregivers.
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Neurostimulation and the use of essential oils.
Respiratory rehabilitation with inspiratory/expiratory muscle training can increase maximal respiratory pressures and support function. Peripheral/magnetic neuromodulation techniques also appear promising but are still experimental. For sleep and anxiety, aromatherapy (e.g., lavender) has positive meta-analyses in general populations; in ALS, it can be considered as a relaxing support. In daily life, some people incorporate mild scents and small evening rituals – for example, oil blends from the Dream line by Eusphera – integrating them with standard sleep hygiene practices.
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Neuroprotective and anti-inflammatory properties of CBD.
The endocannabinoid system helps regulate pain, muscle tone, and inflammatory processes in the nervous system. In ALS, clinical evidence is still limited: patient questionnaires and small pilot studies have reported possible relief of symptoms such as spasticity and cramps.
A “proof-of-concept” trial with a THC:CBD combination indicated improved spasticity in some patients, but larger studies are needed to confirm its efficacy.
The hypothesis of a neuroprotective action comes mainly from preclinical studies on cells and animal models, suggesting an anti-inflammatory and protective effect on motor neurons.
CBD: a complementary natural remedy in the treatment of ALS symptoms
Before introducing cannabidiol into the treatment of ALS symptoms, it is essential to consult a neurologist to evaluate goals, current medications, and monitoring. CBD formulations available on the market vary; selection and method of use require caution and adherence to current regulations.
H3 - What CBD can do for ALS symptoms
Here is where the literature, although not definitive, indicates potential complementary benefits:
● Reduction of neuropathic pain: Cannabinoids overall have shown modest but clinically relevant relief in chronic neuropathic pain. These studies were not specifically conducted for ALS but provide a rationale for symptomatic use when pain “burns” or “stings” and first-line treatments are insufficient. Attention should be paid to side effects and risk/benefit balance on a case-by-case basis.
● Relief of muscle spasticity and cramps: Evidence here is stronger. As noted previously, in a “proof-of-concept” trial on people with motor neuron disease, a THC:CBD ratio spray reduced spasticity symptoms with an acceptable tolerability profile; confirmation in larger samples is still needed.
● Neuroprotective effect: The idea that CBD may protect motor neurons comes mainly from preclinical models, where signs of degeneration are reduced and inflammation is more “suppressed.” Clinical trials with CBD-rich extracts in ALS have been initiated to test this hypothesis; complete results are still pending.
● Reduction of nervous system inflammation: Pharmacologically, CBD interacts with pathways related to oxidative stress and inflammatory cytokines. This supports the points above (pain, spasticity), but direct clinical evidence in ALS remains preliminary.
● Improvement of sleep quality: Better sleep can positively impact perceived pain, cramps, and overall quality of life. In other neurological conditions, such as multiple sclerosis, cannabinoid-based preparations have shown benefits for sleep disturbances as well as spasticity; this suggests a potentially transferable effect for ALS patients, although dedicated studies are needed.
● Reduction of disease-related anxiety and stress: Some studies in non-ALS populations indicate an anxiolytic effect of CBD under acute stress. In clinical practice, this may translate into complementary support, to be integrated – not replaced – with structured psychological care.
● Support for general emotional well-being: Surveys of people with ALS report that some patients perceive relief of symptoms (spasticity, pain, appetite, mood) with cannabis/CBD. These are questionnaire data and should be interpreted with caution but help explain why some patients choose to discuss CBD use with their clinical team.
In summary, CBD may play a complementary role in managing certain symptoms, especially when the goal is to ease spasticity, pain, anxiety, and sleep disturbances. Its effect on disease progression, however, remains unproven. For this reason, consultation with a neurologist, evaluation of ongoing therapies, and careful monitoring of efficacy and tolerability are essential.
H3 - Dosage, safety, and interactions with other treatments
CBD interacts with liver enzymes (CYP3A4, CYP2C19) and may increase the risk of altered liver transaminases, especially in combination with drugs such as valproate or clobazam; drowsiness and gastrointestinal disturbances have been reported.
CBD product lines recommend monitoring liver enzymes at the start and during use. In clinical practice, the rule “start low, go slow” applies, personalizing according to comorbidities, polypharmacy, and goals.
Self-medication should be avoided, and all herbal or supplement preparations currently in use should be reported to the physician.
