Scientists are discovering that the trillions of tiny bacteria living in our stomachs might play a role in ALS, a serious disease that affects nerve cells. This review looks at how diet, special supplements, and other ways to change gut bacteria could potentially help slow down ALS. While there’s no cure for ALS yet, researchers are exploring whether improving gut health through food choices and probiotics (good bacteria) might be a helpful addition to current treatments. This is an exciting new area of research that could open up new possibilities for people living with ALS.

The Quick Take

  • What they studied: Whether changing the bacteria in your gut through diet, probiotics, and other methods could help treat or slow down ALS (amyotrophic lateral sclerosis)
  • Who participated: This is a review article that examined many existing studies rather than testing people directly. It summarizes what scientists have learned from previous research about gut bacteria and ALS
  • Key finding: Studies suggest that people with ALS have different gut bacteria than healthy people, and that diet, probiotics, prebiotics, and certain vitamins may influence how ALS develops and progresses
  • What it means for you: If you or someone you know has ALS, paying attention to diet and gut health might be a helpful addition to standard medical treatment, though more research is needed to confirm these benefits. This should never replace prescribed ALS treatments

The Research Details

This is a narrative review, which means researchers read through many existing studies about gut bacteria and ALS, then summarized what they learned. Instead of conducting their own experiments with patients, the authors gathered information from other scientists’ work to create a comprehensive overview of the topic.

The review focuses on how the bacteria in our digestive system (called the microbiome) might affect ALS development. It examines several potential approaches: changing diet, taking probiotic supplements (which contain beneficial bacteria), taking prebiotic supplements (which feed good bacteria), using vitamins, and even considering fecal microbiota transplantation (transferring healthy bacteria from one person to another).

This type of review is useful for understanding what we currently know about a topic and identifying areas where more research is needed, but it doesn’t provide the strongest level of evidence on its own.

Understanding how gut bacteria might influence ALS is important because current ALS treatments are very limited. If diet and gut health can help slow the disease, it would give patients and doctors additional tools to manage this serious condition. This research approach helps identify promising directions for future studies that could test these ideas more rigorously

As a review article, this study summarizes existing research rather than generating new experimental data. The strength of the conclusions depends on the quality of the studies it reviewed. Readers should understand that while the connections between gut bacteria and ALS are interesting, they are still being investigated and aren’t yet proven treatments. More rigorous clinical trials are needed before these approaches can be recommended as standard care

What the Results Show

The review found that people with ALS have measurably different gut bacteria compared to people without the disease. This suggests that changes in the microbiome may be connected to ALS development or progression.

Diet appears to be one of the most important factors influencing gut bacteria composition. Different foods feed different types of bacteria, so changing what you eat can shift which bacteria thrive in your digestive system. The review suggests that certain dietary patterns may be beneficial for ALS patients, though specific recommendations require more research.

Probiotics (supplements containing beneficial bacteria) and prebiotics (foods that feed good bacteria, like fiber) show promise in early studies. Some research indicates these might help reduce inflammation and support nerve health, though the evidence is still developing.

Vitamins, particularly B vitamins and vitamin D, appear to play roles in nerve health and immune function, which could be relevant to ALS management.

The review also discusses fecal microbiota transplantation (FMT), a procedure where bacteria from a healthy person’s stool are transferred to a patient. This treatment is already used for certain intestinal infections and could potentially be adapted for ALS, though this remains highly experimental. The review notes that while this approach is intriguing, much more research is needed before it could be considered for ALS patients

This review builds on growing evidence that gut bacteria influence brain health and neurological diseases. Previous research has shown connections between the microbiome and conditions like Parkinson’s disease and Alzheimer’s disease. This work extends that understanding to ALS, suggesting that the gut-brain connection may be important across multiple neurological conditions. However, ALS-specific research is still in early stages compared to other neurodegenerative diseases

This is a review of existing studies, not original research, so it’s limited by the quality and quantity of ALS-microbiome studies available. Many studies examined are small or preliminary. The review cannot prove that changing gut bacteria causes changes in ALS progression—only that associations exist. Most research is still in laboratory or animal studies rather than human trials. The review doesn’t provide specific dietary recommendations because the evidence isn’t yet strong enough. Long-term effects of probiotics and other interventions in ALS patients remain unknown

The Bottom Line

For ALS patients: Discuss gut health strategies with your neurologist before making changes. A balanced diet rich in fiber and whole foods may support healthy gut bacteria (moderate confidence). Probiotics may be worth exploring under medical supervision, though evidence is still developing (low to moderate confidence). Standard ALS medications should remain your primary treatment (high confidence). For general population: This research doesn’t apply to people without ALS at this time

People recently diagnosed with ALS or their caregivers should be most interested in this research. Those with family history of ALS may find it relevant for prevention discussions. People with other neurodegenerative diseases might also benefit from similar approaches, though research is disease-specific. This should NOT replace standard medical treatment for ALS

Changes to gut bacteria can occur within days to weeks of dietary changes, but effects on ALS progression would take much longer to observe—likely months to years. Don’t expect immediate improvements in ALS symptoms from dietary changes alone. Any benefits would likely be gradual and work best as part of comprehensive ALS management

Want to Apply This Research?

  • Track daily fiber intake (target 25-35 grams) and note any changes in digestive comfort or energy levels. Record which probiotic-rich foods you consume (yogurt, kefir, sauerkraut, kimchi) and any digestive changes. Monitor overall symptom progression weekly using a simple 1-10 scale to identify patterns
  • Start by adding one fiber-rich food daily (beans, whole grains, vegetables) and one probiotic-rich food daily. Keep a food diary within the app to identify which foods make you feel better. Set reminders for consistent meal timing, as this supports healthy gut bacteria. Share reports with your healthcare provider monthly
  • Use the app to create a baseline of current diet and symptoms, then track changes over 8-12 weeks. Generate monthly reports showing fiber intake, probiotic consumption, and symptom patterns. Compare trends quarterly to identify what dietary changes correlate with feeling better. Share data with your medical team to inform treatment decisions

This review discusses emerging research on gut bacteria and ALS, but these approaches are not yet proven treatments. ALS is a serious medical condition requiring care from qualified neurologists. Do not stop or replace prescribed ALS medications based on this information. Always consult your healthcare provider before making dietary changes, starting supplements, or trying new treatments. While diet and gut health may play supportive roles, they cannot cure ALS. This information is for educational purposes only and should not be considered medical advice.