In order of relevance
Please note: I do not sell or recommend any particular product listed in alphabetical order below. Several examples and product descriptions are given here but many more are available. Choose the product(s) that you feel, or have been professionally advised, would best fulfil your needs.
(ALS) Amyotrophic Lateral Sclerosis or (MND) Motor Neurone Disease are referred to as ALS/MND.
I have observed that whatever medications or supplements you may be prescribed or choose to take, the ability of your body to metabolise these medications and supplements is as important as the dose or product taken. This metabolisation process can be improved to some extent by using combinations of supplements rather than extra large doses of one or two.
The organ most heavily involved in the metabolisation of most medications and supplements, plus the elimination of harmful toxins from the body, is the liver. Liver function can be improved and optimised by following a few simple dietary principles, increasing hydration and (if you choose) taking certain herbal supplements. Please read the Liver Function page on this website for more information.
Many "supplements" are an extracted "active ingredient" from a food source or herb that, in its natural state, may contain numerous other beneficial elements, enzymes, etc. (phytonutrients) that may assist in the metabolisation of the supplement(s) being taken. It is a good idea therefore to "assist" supplemental medications - antioxidants for example - by also eating or juicing the fresh fruit and vegetables many of these are sourced from. An example would be to drink carrot juice as well as taking a beta carotene supplement. [Please note that excessive beta carotene consumption can be toxic. "More of a good thing" is not always better for you].
Here is a brief description of how free radicals and antioxidants work:
Free radicals play an important role in both health and disease and have been implicated in countless human disease processes. Free radicals are vital to human health. These molecules (Reactive Oxidant Species) are extremely important to human metabolic processes.
Any molecule can become a free radical by either losing or gaining an electron and molecules containing these uncoupled electrons are very reactive (unstable). Once free radicals are initiated, they can propagate by becoming involved in chain reactions with other less reactive (stable) types. The resulting chain reaction compounds generally survive longer in the body and therefore increase the potential for cellular damage.
A free radical has three stages: the initiation stage, propagation and finally, termination. They are terminated or neutralized, by nutrient antioxidants, enzymatic mechanisms or by recombining with each other. The aim is to balance free radical activity and antioxidant activity to achieve a state of balance (homeostasis).
Instead of taking 5000mg of vitamin E daily (ten large 500mg capsules), one may obtain a similar antioxidant effect by taking just 100mg (two small, tasteless tablets or capsules, easily blended with food if necessary) of high quality grape seed and/or pine bark extract. These contain an ingredient called OPC that is fifty times more efficient than vitamin E.
OPC has not been recommended to specifically treat ALS/MND but, as much of the research I have read refers to motor neurone oxidation, it seems likely that an efficient antioxidant in combination with other supplements may slow the progress of motor neurone destruction. The study I am conducting is designed to assess whether this hypothesis is valid. I have communicated with many people who have used OPC and have been told it was beneficial or, at worst, caused no negative side effects unless excessive doses were taken.
Please note that EVERYBODY IS DIFFERENT. What benefits one person may not suit another, that is why I have included information on a variety of antioxidants. I leave it to your judgement as to which antioxidant treatment, if any, you feel would be appropriate for you.
The use of OPC (grape seed/pine bark) extract has yet to be "proved" to benefit PALS but information I have collected from around the world tends to indicate that OPC, in combination with other supplements, is sometimes beneficial. The choice of OPC was made after considering cost, global availability, antioxidant efficiency compared to alternatives, availability of product data and apparent lack of side effects. The choice was prompted as much by logistical as clinical factors.
A month's supply of OPC extract is usually cheaper than 5000mg of vitamin E complex per day. There are many reputable brands of OPC to choose from but check that each tablet or capsule contains at least 50mg of OPC. Many contain varying quantities of grape seed and/or pine bark extract and possibly other additives but this does not necessarily indicate the OPC content. Make sure you discover how much actual OPC is contained in each capsule or tablet.
I believe grape seed/pine bark extract (an Oligameric Proanthocyanidin Complex or OPC) to be one of the most effective antioxidants cheaply, widely and readily available. Extensive clinical trials and it's application to other disorders and diseases show it to be "completely harmless". I was diagnosed with ALS/MND many years ago and have sampled several brands of OPC in addition to numerous other supplements and my prescribed medication and have experienced no negative side effects.
The following list of antioxidants - none of which have been "proven" to be effective in the treatment of ALS/MND - is included for your information. Some are not readily available worldwide. Some are relatively expensive and the efficacy of others is not confirmed for treating ALS/MND.
Some PALS claim that certain supplements are beneficial in slowing the progress of the disease or merely improving general wellbeing (see Feedback). I cannot personally recommend any particular product but include information here to enable you to research them further.
in alphabetical order
ALLOPURINOL is a prescription drug, primarily used for the treatment of gout. Although it is not, strictly speaking, an antioxidant it does suppress the body's production of an oxidation catalyst (an enzyme called xanthine oxidase). If an ALS/MND patient wants to try this therapy, a doctor must prescribe allopurinol. It is manufactured by several companies and therefore may have a different name on the packaging when prescribed. The dosage is 200mg/day to start, working up to 600mg/day.
I originally included allopurinol in my Clinical Study but would probably not do so again in the light of what I have discovered about antioxidants since then. Dr Stanley Appel, Baylor College of Medicine, Department of Neurology MDA/ALS Clinic may be able to supply information on long term Allopurinol use to treat ALS/MND
In the article "antioxidant drugs block in vitro the neurotoxicity of CSF from patients with amyotrophic lateral sclerosis" (Terro, F. at al *Neuro Report*, v7, n12, pp1970-72, Aug 12, 1996) the authors measured neuronal death in rat cortical cell cultures exposed to cerebro-spinal fluid (CSF) from ALS patients. The CSF was quite neurotoxic but Vitamin E and allopurinol separately protected cells. In combination they "completely prevented the neurotoxicity of ALS CSF." The authors conclude, "A combination of allopurinol and vitamin E may be useful in ALS therapy." Note that Vitamin E has already been shown to delay onset of ALS-like symptoms in ALS mice. It is becoming accepted that a vitamin E complex (including gamma tocopherol) is better than ordinary vitamin E (containing only d--alpha tocopherol) in treating neurodegenerative disorders.
ALPHA LIPOIC ACID (ALA) is both a water and lipid (fat/oil) soluble, sulfur containing antioxidant. Alpha lipoic acid plays an important function as an enzyme in the pyruvate dehydrogenase complex. Discovered several decades ago, it wasn't until recently that it's activity as a potent free radical scavenger was demonstrated. As a "chain-breaking" antioxidant, it has been shown to play a pivotal role in the regeneration of the redox reaction between vitamin C, E, and glutathione. Alpha Lipoic Acid can add an electron to both *used* C and E in the body to put them back to work. Alpha lipoic acid has received funding to investigate if the known degenerative processes of oxidative damage can be slowed.
ALA has benefits beyond those of other antioxidants. It appears to reduce the risk of conditions aggravated by free radicals. Any one antioxidant is not "ideal" in itself. "From a therapeutic viewpoint, few natural antioxidants are ideal," says molecular and cellular biologist Lester Packer, Ph.D. "An Ideal therapeutic antioxidant would fulfil several criteria. These include absorption from the diet, conversion in cells and tissues to unusable forms' a variety of antioxidants actions (including interactions with other antioxidants) in both membrane and aqueous phases, and low toxicity.
Passwater says. "Lipoic acid not only protects the nervous system, but also may be involved In regenerating nerves." He adds that lipoic acid's antioxidant function is of major importance and helps protect the body against about 80 diseases.
Lipoic acid has been used for decades to protect the liver and detoxify the body of heavy metal pollutants, such as excessive iron, copper and toxic metals such as cadmium, lead and mercury. Studies have shown no serious side effects with the use of alpha-lipoic acid but it is not recommended for pregnant women without proper supervision.
Lipoic acid both interacts with its antioxidant partners vitamin E and vitamin C and also helps to conserve them. When the body is deficient in lipoic acid, other antioxidants do not network together properly.
Our bodies make lipoic acid but it is usually not enough, so we rely on potatoes, tomatoes, peas, spinach, broccoli, red meat, etc. to supply what we need for optimal health. An expert panel has recommended 50mg of ALA daily to prevent diseases caused by free-radicals. In Germany it is prescribed to treat diabetic and alcoholic neuropathies and liver disease. For information on its use in treating ALS/MND
Alpha lipoic acid can be purchased online
Please note: It has been suggested that Alpha Lipoic Acid may leach mercury from amalgam fillings and release it into the body. If you have amalgam fillings you may want to consider this possibility. Other research may indicate precisely the opposite  so, as always, it is up to the individual to assess the benefits or otherwise of this supplement. Its benefits appear to outweigh any potential drawbacks in most cases.
REFERENCES  Packer, Lester, Ph.D., et al. "Alpha-Llpoic Acid As A Biological Antioxidant," Free Radical Boilogy and Medicine 19:227-25O, 1995. Also - Passwater Richard A., Ph.D. Lipoic Acid: The Metabolic Antioxidant. New Canaan, Conn. Keats Publishing, Inc., 1995 pp. 7-8.
ANTIOXIDANT BOOSTER from Nutraceutical Systems consists of 5 antioxidants in one capsule. Scientific studies have suggested that coenzyme Q10, alpha lipoic acid and acetyl L-carnitine may increase cellular energy production, while protecting the cells from free radical damage. In addition, these three antioxidants have been shown to protect the heart and brain.
Each capsule contains: Acetyl L-Carnitine 300mg, Alpha Lipoic Acid 150mg, CoEnzyme Q10 100mg, Grape Seed Extract 100mg, Lutein 6 mg and Zeaxanthin 300 mcg (from 120 mg standardized 5% lutein extract from marigold flower).
ASTAXANTHIN is a carotenoid compound usually made from a microalg called Haematococcus pluvialis. Some forms are indissoluble (many antioxidants are fat or water soluble). As beta carotene (a preliminary stage of vitamin A) is sometimes recommended as an antioxidant for ALS/MND and Astaxanthin supplies carotenoids, it should be safe to take - although a precise dosage has yet to be established.
Astaxanthin has been claimed to be ten times more effective than beta carotene and 100 times more effective than vitamin E in preventing lipid peroxidation. However, as vitamin E and Astaxanthin possibly work in different ways it may be advisable to take both as they could complement each other.
La Haye Laboratories at made a product called astaZanthinTM containing 1mg astaxanthin in softgel capsules. These may still be available.
The company has published extensive research on astaxanthin and positive results generally tend to indicate it could possibly be used to treat neurodegenerative disorders. They have also documented that it has anti inflammatory, anti tumor, immune system and beneficial liver enzyme boosting properties. These properties are likely to be helpful in treating ALS/MND. astaZanthinTM also contains omega 3 and 6 fatty acids and rice bran oil, is fat soluble and has been demonstrated to cross the blood brain barrier (beta carotene does not).
AZULENIC RETINOID COMPOUNDS are compounds related to Vitamin A and retinoic acid. A new type of azulene-containing retinoid has been synthesised and is similar in size and shape to Vitamin A, but its electronic properties are different. This is due to the stabilising effect of azulene on the chemical bonds in the molecule. New azulenic retinoids might also be effective anti-oxidants and free radical scavengers.
The University of Hawai`i, Office of Technology Transfer and Economic Development, 2800 Woodlawn Drive, Suite 280 Honolulu, HI 96822 may have information on these compounds.
CAROTENOIDS are a group of antioxidant nutrients found in many fruits and vegetables. They are more easily absorbed in supplement form and even more effective if taken with highly coloured fruits and vegetables such as carrots, tomatoes, watermelon, beets, etc. high in carotenoids. Like all antioxidants, carotenoids work better in combination than if taken alone. For example, betacarotene boosts the antioxidant activity of lycopene Wahlqvist, et al American Journal of Clinical Nutrition 1994 Vol 60,936-943. Carotenoids include Betacarotene, Alphacarotene, Cryptoxanthin, Lycopene, Lutein and Zeaxanthin. Each performs a slightly different function at a different level and is dependant on other carotenoids for its effectiveness. Synthetic carotenoids have little biological effect and should be avoided. Ensure you choose naturally derived carotenoids suspended in an oil base.
CHOCOLATE carries high levels of chemicals known as phenolics according to researchers at the University of California, Davis. The study showed that chocolate can contribute a significant portion of dietary antioxidants but it remains to be seen whether phenolics consumed in food products actually provide a protective antioxidant effect in the body. A 1.5 ounce piece of milk chocolate contains nearly the same amount of phenolics as a 5 ounce glass of red wine. The phenolic compounds in chocolate exhibit an antioxidant effect equal to or greater than that of red wine. It is not known if the different chemical structures of chocolate phenolics versus wine phenolics alter their effects on the body. If dietary phenolics do act as antioxidants in the body, then chocolate would likely be a good source of those antioxidants.
Please note that milk added to tea negatesmost of the antioxidant effect of the tea. It would seem logical to assume that dark - milk free - chocolate would have a greater antioxidant effect than milk chocolate. Unfortunately, the fats and excessive sugar added to chocolate may tend to stress the liver so I would not personally eat chocolate as an antioxidant source.
COENZYME Q-10 Because of its strong antioxidant properties, coenzyme Q-10 is used by patients with degenerative neurological diseases such as ALS/MND at major medical centers, including the University of Rochester Medical School and the University of California at San Diego. The hope is that coenzyme Q-10 can slow down progression of the diseases. Andrew Weil MD personally takes 100 milligrams of coenzyme Q-10 once a day with food as a general health-booster and feels it is harmless. Dr. Weil is a nationally-known physician and director of the Program in Integrative Medicine at the University of Arizona and also a graduate of Harvard College and Harvard Medical School. He has published many books on health and healing. See Dr. Weil's website
Coenzyme Q10 (CoQ10) or ubiquinone is an essential cofactor of the electron transport chain as well as a potent free radical scavenger in lipid and mitochondrial membranes. Feeding with CoQ10 increased cerebral cortex concentrations in 12- and 24-month-old rats. In 12-month-old rats administration of coenzyme Q10 resulted in significant increases in cerebral cortex mitochondrial concentrations of coenzyme Q10.
Oral administration of coenzyme Q10 markedly attenuated striatal lesions produced by systemic administration of 3-nitropropionic acid and significantly increased life span in a transgenic mouse model of familial ALS. It has been previously demonstrated that administration in these same mice with vitamin E resulted in a delay in disease onset but no increase in survival time.
The data suggest that the antioxidant action and preservation of mitochondrial function apparently provided by CoQ10 may contribute to neuron cell protection from free radical effect upon membranes, thus resulting in longer survival seen in these transgenic animals. This suggests that Coenzyme Q10 may be better strategy than vitamin E in treatment of neurodegenerative diseases in increasing survival time. Oral administration of CoQ10 increases both brain and brain mitochondrial concentrations. The results provide further evidence that CoQ10 can exert neuroprotective effects that might be useful in the treatment of neurodegenerative diseases.
This information was copied from the Neuropathology Digest -ALS for August 1998 and is provided for information purposes only: (Proc Natl Acad Sci U S A 1998 Jul 21;95(15):8892-8897 Coenzyme Q10 administration increases brain mitochondrial concentrations and exerts neuroprotective effects. Matthews RT, Yang L, Browne S, Baik M, Beal MF Neurochemistry Laboratory, Neurology Service, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA).