It may not be possible to prevent amyotrophic lateral sclerosis (ALS), but avoiding exposure to toxins and other potential triggers may lower the chance of developing it in those at risk.

ALS, also known as Lou Gehrig’s disease, is a type of motor neuron disease (MND). Experts do not know exactly why it develops, but frequent concussions, smoking, and exposure to pesticides and other toxins may contribute.

However, research is underway to develop strategies to prevent or lower the risk of ALS in those at risk.

In this article, we look at strategies that might help prevent or slow the progression of ALS.

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There is currently no way to prevent ALS, but experts are studying the genetic features, known risk factors, and affected populations to try to find one.

ALS likely begins long before symptoms appear. By the time a person receives a diagnosis, the damage is irreversible. This can make it hard to treat.

Learn more about the symptoms of ALS.

Symptoms of ALS become more severe over time and will eventually be fatal. ALS progresses without remission, although the speed of progression varies among individuals.

The symptoms stem from damage to the motor neuron system, which includes the nerves in the spinal cord and brain that are responsible for movement. Damage to these nerves can lead to ALS, possibly years after the harm occurs.

Avoiding repeated exposure to activities and substances that damage these nerves may help prevent ALS from developing, including in people with a genetic predisposition.

Medication may help reduce the effects of ALS. However, the main goal of treatment is to help manage symptoms.

Scientists are investigating ways to slow or prevent ALS in those at risk. This could include genetic intervention, identifying drugs with a protective action, and reducing exposure to known risks. However, far more work is currently needed.

Experts do not know what causes ALS, but they believe there may be an interaction between genetic and environmental factors. If a person has specific genetic features, they may develop ALS under certain circumstances.

Learn more about the genetic link with ALS.

Environmental factors that may increase the risk include:

  • frequent concussions, which increase the risk of brain and spinal cord injuries
  • smoking
  • working in the military
  • exposure to:
    • pesticides
    • neurotoxins, such as cyanobacteria, which is present in green algae and surrounding water
    • heavy metals such as lead and manganese

However, researchers have not linked levels or times of exposure between specific triggers and the appearance of ALS. It can be hard to identify exposures. For instance, even banned pesticides can remain in the soil for several years.

ALS can run in families, suggesting an inherited genetic trait, and scientists have identified some genetic changes that might be present. In some cases, however, there is no apparent family history.

The rate of progression of ALS varies among individuals, but there is little evidence that any strategy can currently slow the development.

One medication, riluzole (Rilutek), may slightly improve survival times and a person’s ability to function.

Another drug, edaravone (Radicava), appears to improve survival rates for up to 30 months compared with people not using the drug. However, it does not seem to improve a person’s ability to grip or carry out other functions.

The survival rate appears to be better if a person:

  • has mild obesity when ALS first appears
  • receives a diagnosis at a younger age
  • has a higher forced vital capacity — the amount of air a person can forcibly breathe out after taking a deep breath
  • has symptoms that appear first in the limbs and trunk (limb onset ALS) rather than the face, head, and neck (bulbar onset ALS)
How can I get more information and support?

Here are some links to organizations that can help people manage ALS and support loved ones.

ALS is eventually fatal, but the progression varies among individuals.

The average survival rate is currently 3 to 5 years, although around 30% of people live longer than 5 years, and 10% live at least another 10 years after diagnosis.

Here are some questions people often ask about ALS.

Who is most at risk of ALS?

Experts say around 10% of cases run in families, but 90% of people with ALS have no family history.

Familial cases affect males and females equally. When there is no family history, males are twice as likely as females to develop ALS.

Whether they inherit it or not, people who develop ALS probably have an underlying genetic feature that makes development more likely, but scientists are still working to identify it.

Overall, males have a 1 in 350 chance of developing ALS at some time, and females have a 1 in 400 chance. On average, ALS appears at age 64 years, but the highest risk is around age 75 years.

How can I prevent ALS naturally?

It is not currently possible to prevent ALS, but tips that may help include:

  • avoiding smoking
  • using a helmet when doing activities where there is a risk of falls or concussion
  • choosing foods grown without pesticides
  • taking precautions when working with or storing chemicals

What triggers ALS to start?

In some cases, there is no clear trigger, but exposure to toxins, frequent concussions, and smoking may increase the risk.

It is not always possible to prevent ALS, but people may lower the risk by avoiding:

  • activities that lead to frequent concussions
  • exposure to pesticides and other toxins
  • smoking

Currently, there is no cure for ALS, but some medications may help slow its progression very slightly. As scientists learn more about the risk factors, genetic features, and so on, they hope to move toward developing prevention strategies. However, more research is necessary.