How can Cannabinoids help in the fight against ALS?

Author: Lucie Garabasova

Amyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease that affects motor neurons in the brain and spinal cord. This progressive disease leads to loss of muscle control, weakness, and eventually complete paralysis. Despite advances in medicine, there is still no cure for ALS. However, in recent years, there has been growing interest in the potential therapeutic benefits of cannabinoids such as CBD (cannabidiol) and CBG (cannabigerol). Can these natural compounds help alleviate ALS symptoms?

How does ALS manifest?

ALS (amyotrophic lateral sclerosis) manifests as the gradual failure of motor neurons, leading to loss of muscle control. The disease progresses from mild difficulties to complete paralysis.

Main symptoms of ALS:

Muscle weakness and atrophy

• Often starts in the hands, feet, or speech muscles.
• Patients may notice difficulties grasping objects or frequent falls.

Muscle twitching (Fasciculations) and cramps

• Often visible under the skin, mainly on the arms, legs, and tongue.
• Cramps can be painful and uncomfortable.

Muscle stiffness and spasticity

• Muscles become rigid and difficult to control, leading to impaired mobility.

Speech and swallowing difficulties (Dysarthria and Dysphagia)

• Words become less understandable.
• Food and liquids may cause choking.

Breathing difficulties

• Gradual weakening of respiratory muscles leads to difficulty breathing and fatigue.

No pain or sensory impairment

• ALS primarily affects motor neurons, so senses (touch, sight, hearing) remain intact.

Preserved mental capacity

• Most patients retain intellect and awareness.
• A small percentage may develop frontotemporal dementia.

How does ALS typically begin?

• The onset is gradual, usually asymmetrical (e.g., weakness in one hand).
• Sometimes the first symptoms appear in speech or swallowing.
• The disease gradually spreads to more muscle groups.

Diagnosing ALS (Amyotrophic Lateral Sclerosis)

ALS is a neurological disease that affects motor neurons, and its diagnosis is often challenging since there is no single test to definitively confirm ALS. Doctors must rule out other diseases with similar symptoms and carefully analyze the patient’s clinical picture.

Main steps in ALS diagnosis:

1. Medical History and Physical Examination

2. Electromyography (EMG)

• A key test for diagnosing ALS.
• Measures electrical activity in muscles to determine if nerves are functioning properly.
• In ALS patients, signs of denervation and reinnervation of muscles are present.

3. Nerve Conduction Study (NCS)

• Determines if peripheral nerves conduct signals correctly.
• Helps differentiate ALS from other nerve disorders, such as neuropathies.

4. MRI of the brain and spinal cord

• Used to rule out other neurological diseases such as tumors, multiple sclerosis, or cervical myelopathy.

5. Lumbar puncture (Spinal Tap)

• In some cases, helps rule out infectious or autoimmune diseases affecting the nervous system.

6. Laboratory tests

• Blood tests to exclude other causes of muscle weakness, such as metabolic disorders or autoimmune diseases.
• Genetic testing (if hereditary ALS is suspected).

7. Monitoring symptom progression

• Since ALS is a progressive disease, doctors often observe patients over time to determine if symptoms worsen and align with typical ALS progression.

Differential diagnosis – What needs to be ruled out?

• Myasthenia gravis
• Multiple sclerosis
• Cervical myelopathy
• Neuropathies (e.g., Guillain-Barré syndrome)
• Muscular dystrophies
• Lyme disease

How long does ALS diagnosis take?

The diagnosis of ALS usually takes several months as other conditions need to be ruled out. Early recognition and initiation of symptomatic treatment can significantly improve the patient’s quality of life. If ALS is confirmed, patients are typically referred to specialists such as neurologists, physiotherapists, and palliative care teams who assist with symptom management and overall care.

ALS (amyotrophic lateral sclerosis) can have both hereditary and sporadic forms, with most cases (90–95%) arising without an apparent genetic cause. The exact mechanism of ALS onset is not yet fully understood, but scientists believe a combination of genetic and environmental factors plays a role.

What are the treatment approaches for ALS?

Currently, ALS treatment focuses primarily on slowing disease progression and alleviating its symptoms. Standard therapies include medications like riluzole and edaravone, which may slightly extend survival or slow disease progression. In addition to pharmacological treatment, physiotherapy, speech therapy, and overall supportive care play crucial roles.

Cannabinoids and their potential in ALS treatment

Cannabinoids are natural compounds found in the cannabis plant that interact with the endocannabinoid system in the human body. This system regulates numerous biological functions, including pain, inflammation, and neuroprotection, which are essential in neurodegenerative diseases such as ALS.

CBD – Neuroprotective effects and symptom relief

CBD is known for its anti-inflammatory, antioxidant, and neuroprotective properties. Studies suggest that it may help alleviate some ALS symptoms, such as:

• Muscle Spasticity and Cramps – CBD has muscle-relaxing effects and may relieve painful cramps often experienced by ALS patients.
• Pain – CBD acts as a natural analgesic that can help manage chronic pain associated with ALS.
• Anxiety and Depression – ALS patients often face psychological challenges such as depression or anxiety, and CBD may help alleviate these issues.

Research published in BMC Neurology suggests that a combination of THC and CBD in an oromucosal spray form may effectively reduce muscle spasticity in ALS patients.

CBG – A lesser-known but promising Cannabinoid

CBG is another cannabinoid with neuroprotective and anti-inflammatory properties. Preclinical studies indicate that it may:

• Support neuron health and slow their degeneration.
• Reduce neuroinflammation, a key factor in ALS progression.

Italian scientists have shown in their study that a combination of CBD and CBG can suppress nerve tissue inflammation, which could be highly beneficial for ALS patients. However, further research is needed to confirm these effects in human patients.

Future research and the potential use of Cannabinoids

Although preliminary studies suggest that cannabinoids may offer relief from some ALS symptoms, more extensive clinical trials are needed to confirm their efficacy and safety. Today, some patients use CBD as a complementary therapy to alleviate symptoms, with some reporting positive effects on their quality of life.

Real Experience with Using CBD and CBG for ALS

I have been an active person all my life—I cycled, loved hiking, and walked hundreds of kilometers in the mountains. At the end of 2021, I started experiencing neurological issues such as body tingling, stabbing sensations, limb numbness, electric shocks in my legs, painful chest tightness, and more. I initially increased my magnesium intake, but unfortunately, the problems did not subside and instead worsened.

In the spring of 2022, muscle twitches, bone pain, and tendon pain around my ankles, knees, and hips appeared. I had to stop cycling because I could no longer endure the pain of sitting on the saddle. Gradually, I began having difficulty walking, as Achilles tendon pain made it nearly impossible. I went from walking ten (or even thirty on weekends) kilometers a day to struggling to walk one kilometer to work. My calves and wrists started aching, I couldn’t hold a kettle full of water or a pan, and I couldn’t get up from a squat. Constant body tremors followed me everywhere. Within a few months, my leg muscles started to disappear, and I lost an extreme amount of weight.

After a neurological examination, I was informed that they suspected ALS. They told me there was no cure and that they would only monitor me…

I searched the internet for alternative treatment options and tried herbal tinctures, but because the alcohol in them upset my stomach, I had to stop using them.

So, I started taking CBD from Cannadorra. Initially, I took only 1-2 drops of 10% CBD per day, irregularly. After about six months, I switched to regular use. Since I tolerated the treatment well, I started taking one drop of stronger 20% CBD twice a day after about three weeks and soon increased to three times a day. I also added 5% CBG. In total, I took 1-2 drops of each (20% CBD oil and 5% CBG) three times a day. About half an hour after taking CBG, I would feel a mild headache.

The following month, I gradually increased the dosage to three drops of each, three times a day, and added hemp oil with fish oil and CBD.