Amyotrophic+lateral+sclerosis+(ALS)

Amyotrophic lateral sclerosis, or ALS, also referred to as Lou Gehrig's disease, is a neurodegenerative disease characterized by a progressive deterioration of motor neurons in the spine and brain that regulate movement. In the early stage of the disease, voluntary movement becomes impaired, marked by difficulty moving the arms and legs, speaking clearly, swallowing or even breathing. Eventually, complete paralysis may occur.  TCM Pattern Differentiation 

Liver/kidney yin deficiency (righteous vacuity)
If liver yang is hyperactive and liver wind internally stirs, there will be obvious spasticity of the muscles and flesh, spasm and contracture of the four limbs, a red tongue with a scanty coating, and a wiry, forceless pulse. San Yin Jiao (Sp 6), Tai Xi (Ki 3), Gan Shu (Bl18), Shen Shu (Bl 23), Yin Ling Quan (Sp 9), Huan Tiao (GB 30), and Tai Chong (Liv 3). Use even supplementing/even draining technique.
 * Main symptoms:** Muscle and flesh atrophied, weak, and without strength especially the lower limbs, lower and upper back pain and weakness, dizziness, tinnitus, heart vexation, heat in the hands, feet, and heart, possible night sweats, seminal emission, menstrual irregularity,
 * Tongue:** red, scanty coating
 * Pulse**:fine, rapid
 * Treatment principles:** Supplement and boost the liver and kidneys, fill the essence and boost the marrow, level the liver and extinguish wind
 * Commonly used formulas:** Hu Qian Wan(Crouching Tiger Pills), Zuo Gui Wan (Return the Left [Kidney] Pills) with added flavors.
 * Modifications:** If liver wind internally stirs, one can use Zhen Gan Xi Feng Tang (Settle the Liver & Extinguish Wind Decoction) plus Rhizoma Gastrodiae (Tian Ma), Ramulus Uncariae Cum Uncis (Gou Teng), and Flos Chrysanthemi Morifolii (Ju Hua) to level the liver and extinguish wind. Or one can use Tian Ma Gou Teng Tang (Gastrodia & Uncaria Decoction) plus Radix Polygalae Tenuifoliae (Yuan Zhi) and Rhizoma Acori Graminei (Shi Chang Pu).
 * Acupuncture Treatment:** One can choose

Spleen/kidney yang vacuity (righteous vacuity)
One can also moxa at Guan Yuan (CV 4), Shen Shu (Bl 23), and Zu San Li (St 36).
 * Main symptoms:** Atony of the muscles and flesh of the four limbs, weakness, and lack of strength, shortness of breath, disinclination to talk, fear of cold, chilled limbs, a somber white facial complexion, torpid intake, loose stools, possible sweating, seminal emission, urinary incontinence, clear, long urination, edema of the lower legs
 * Tongue:** pale red tongue, a fat, tender tongue with teeth marks and a white tongue coating
 * Pulse:** deep, slow, forceless or vacuous, weak pulse
 * Treatment principles:** Warm and supplement the spleen and kidneys
 * Commonly used formulas:** You Gui Wan (Return the Right [Kidney] Pills) plus Si Jun Zi Tang (Four Gentlemen Decoction), Gui Fu Li2 Zhong Tang (Cinnamon & Aconite Rectify the Center Decoction)
 * Acupuncture & moxibustion**: Qu Chi (LI 11), He Gu (LI 4), Wai Guan (TB5), Huan Tiao (GB 30), Zu San Li (St 36), Yang Ling Quan (GB 34), San Yin Jiao (Sp 6), and Yang Fu (GB 38). Use supplementation technique.

Spleen/kidney qi & yin dual vacuity (righteous vacuity)
Membranacei (Huang Qi), Radix Codonopsis Pilosulae (Dang Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Sclerotium Poriae Cocos (Fu Ling), etc.
 * Main symptoms:** Atony, weakness, and lack of strength of the muscles and flesh of the four limbs, a dry mouth but no desire to drink, scanty intake, loose stools or dry, parched stools, shortness of breath, disinclination to talk, dizziness, tinnitus, scanty sleep, impaired memory, low back pain and lower leg weakness,
 * Tongue:** red tongue with a scanty coating
 * Pulse**: soggy,fine or fine, rapid pulse
 * Treatment principles**: Boost the qi and nourish yin, bank and supplement the spleen and kidneys
 * Commonly used formulas:** Shen Ling Bai Zhu San (Ginseng, Poria & Atractylodes Powder) plus Liu Wei Di Huang Tang (Six Flavors Rehmannia Decoction) or Zuo Gui Wan (Return the Left [Kidney] Pills) plus Radix Panacis Ginseng (Ren Shen), Radix Astragali
 * Acupuncture & moxibustion:** One can choose Zu San Li (St 36), Yin Ling Quan (Sp 9), Tai Xi (Ki 3), San Yin Jiao (Sp 6), Qu Chi (LI11), Guan Yuan (CV 4), Qi Hai (CV 6), etc.

Yin & yang dual vacuity (righteous vacuity)

 * Main symptoms:** The late stage of this disease when the muscles and flesh fall downward and there is paralysis, fear of cold, chilled limbs, superficial edema of the face and limbs, a weak, diminutive voice, vertigo and dizziness, tinnitus, dry mouth and parched throat, tidal fever, red cheeks, a somber white facial complexion,spontaneous perspiration or night sweats, seminal emission, urinary incontinence, possible vexatious heat in the hands, feet, and heart
 * Tongue:** pale red tongue, either a small, skinny tongue or a fat tongue with teeth marks, a scanty coating,
 * Pulse:** deep, fine, forceless pulse
 * Treatment principles:** Supplement both yin and yang
 * Commonly used formulas:** Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pills) plus Plastrum Testudinis (Gui Ban), Carapax Amydae Sinensis (Bie Jia), Placenta Hominis (Zi He Che) or Gui Pi Tang (Restore the Spleen Decoction) plus Liu Wei Di Huang Wan
 * Acupuncture & moxibustion:** Qu Chi (LI 11), He Gu (LI 4), Hou Xi (SI 3), Wai Guan (TB 5), Huan Tiao (GB 30), Fu Tu (St32), Zu San Li (St 36), Yang Ling Quan (GB34), San Yin Jiao (Sp 6), Tai Xi (Ki 3), Shen Shu (Bl 23), Pi Shu (Bl 20), Qi Hai (CV 6), Guan Yuan (CV 4), Lian Quan (CV 23), etc.

Damp heat (evil repletion)
The symptoms of this are atony, weakness and lack of strength of both lower limbs, slight swelling and numbness of the toes of the feet, liking for chill and aversion to heat, a heavy body and a yellow facial complexion, chest and epigastric glomus and fullness, sticky, stagnant, not crisp stools, reddish, astringent urination
 * Main symptoms:** Undisciplined eating and drinking or overeating of fatty, thick-flavored foods damages the spleen and stomach. Thus the spleen loses its fortification and transportation and damp evils collect internally. If these become depressed and endure, they transform heat and this results in damp heat smoldering internally.
 * Tongue:** dark red tongue with a slimy, yellow coating
 * Pulse**: soggy or slippery, rapid
 * Treatment principles:** Clear and disinhibit dampness and heat
 * Commonly used formulas:** Er Miao Wan (Two Wonders Pills) or Bie Xie Fen Qing Yin (Dioscorea Hypoglauca Separate the Clear Drink) with added flavors
 * Acupuncture & moxibustion:** One can choose Pang Guang Shu (Bl 28), Zhong Ji (CV 3), Yin Ling Quan (Sp 9), Tai Xi (Ki 3), San Yin Jiao (Sp 6), Zu San Li (St 36), Xing Jian (Liv 2), Wei Zhong (Bl 40), etc.

Blood stasis (evil repletion)
The symptoms of this are atrophy and lack of strength of the muscles and flesh of the four limbs, pitting edema, bluish purple of the affected area, dry, parched skin, contracture and spasm of the joints
 * Main symptoms:** This is mostly seen in enduring atony condition. The qi and blood obstruct and stagnate in the vessels and network vessels resulting in static blood pattern.
 * Tongue**: dark but pale tongue or a dark red tongue, a skinny, small tongue, static macules
 * Pulse**:fine, choppy, forceless
 * Treatment principles:** Boost the qi and nourish the blood, quicken the blood and transform stasis
 * Commonly used formulas:** Xue Fu Zhu Yu Tang (Blood Mansion Dispel Stasis Decoction) or Bu Yang Huan Wu Tang (Supplement Yang & Restore the Five [Viscera] Decoction) with added flavors

Phlegm turbidity (evil repletion)
The symptoms of this are lack of clarity in the voice, the sound of phlegm in the throat, coughing and vomiting of white colored, sticky phlegm, chest and epigastric glomus and fullness, nausea, stickiness and sliminess within the mouth, a dry mouth but no desire to drink, loose, watery stools VFNX**Acupuncture & moxibustion:** Zu San Li (St 36), Feng Long (St 40), Pi Shu (Bl20), San Yin Jiao (Sp 6), Yang Ling Quan (GB 34), Qu Chi (LI 11), Jian Yu (LI 15), He Gu (LI 4), Tai Chong (Liv 3), Tai Xi (Ki 3), etc. 
 * Main symptoms:** Due to spleen qi vacuity weakness, the spleen loses its fortification and transportation. Thus water dampness collects and stagnates. If this endures, it brews and engenders phlegm turbidity.
 * Tongue:** pale red tongue with a slimy, white coating
 * Pulse:** soggy, relaxed pulse.
 * Treatment principles:** Dry dampness and transform phlegm

Other Herbal Treatment Options:
hu qian wan (hidden tiger pill) [ Subhuti Dharmananda] Yi Sui Tang (Boost the Marrow Decoction) Kampo Tx: Rikkunshito (Liu Jun Zi Tang) - "appears to exert neuroprotective effects by preventing glutamate-induced cell death through the deactivation of an enzyme called glycogen synthase kinase-3β" [April 20, 2011, issue of "Experimental Neurology,"] 

Nutritional Recommendations
 **Vitamins and Minerals** **Herbal Supplements** **Other Dietary Supplements**     <span style="background-color: #ffffff; display: block; font-family: Arial,Helvetica; text-align: left; vertical-align: baseline;">Sources: [] see also [] on flaccidity syndrome [] -ITM w/ MS [] - ITM [] - nutritional
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Vitamin B12**] : up to 25 mg daily, sublingual or administered intramuscularly (IM).
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Vitamin E**] (Gamma E Tocopherol/Tocotrienols): one to two softgels per day with food.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Zinc**] : 15 mg daily. ALS patients can also consider taking 1 mg of copper in conjunction with zinc.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Ginseng**] : 400 mg daily.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Ginkgo biloba**] : Ginkgo Biloba Standardized Extract, one capsule per day.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**CoQ10**] : 1200 mg daily.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Creatine**] : Micronized Creatine, two to four capsules per day with or without food.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**DHEA**] : A typical starting dose of DHEA is 15 mg to 75 mg. Blood testing is recommended after three to six weeks to make sure levels of this hormone are optimal.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Glutathione**] : L-Glutathione, L-Cysteine and C, one capsule one to three times per day before food.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**N-Acetyl Cysteine**] : one capsule one to three times per day.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**R-lipoic acid**] : one to two capsules per day.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Acetyl-L-Carnitine**] : one to four capsules per day on an empty stomach with water or juice.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Mega Green Tea Extract**] : one capsule per day with or without food. Decaffeinated green tea is available for people sensitive to caffeine.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Resveratrol**] : 20 mg daily.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Selenium**] : 200 mcg daily. This may be administered in conjunction with a calcium channel blocker, such as nimodipine. Calcium channel blockers are available only by prescription.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Super Curcumin**] : 900 mg
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Mitochondrial Energy Optimizer**] . This is a special antioxidant blend available only through the Life Extension Foundation. Please note that this product contains the proper doses of R-dihydro-lipoic acid and acetyl-L–carnitine arginate. Therefore, individuals may eliminate them from the list above if they take this product.
 * <span style="background-color: #fff4e6; font-family: Tahoma,Geneva,sans-serif;"> [|**Vinpocetine**] : 5 mg daily.