Oils in Diet

Oils are calorie-dense and as such can rapidly increase the calorie content for any food. So which oils have properties that are helpful and properties that aren't helpful?  And then, what is helpful and what isn't?

Oils that cause inflammation are not helpful.  Inflammation is the body's natural response to help it heal, so what is the body healing from when we consume an oil that causes inflammation?  No idea, but if we are consuming oils that cause inflammation daily we can be putting the body into a chronically inflamed state.  If the gut is inflamed absorption of nutrients is affected and ALS patients have huge, huge, huge nutrient absorption issues.  The body's ability to get rid of toxins through the liver is compromised, and toxic overload in the liver compromises mitochondria function and in ALS there's a problem with the mitochondria.

This article, http://authoritynutrition.com/6-reasons-why-vegetable-oils-are-toxic/, gives 6 reasons to not consume processed seed oils like soybean oil, sunflower oil, corn oil, canola oil, cottonseed oil, and safflower oil, and inflammation is one of them.  The six reasons are: 1) unnatural in large amounts, 2) mess up fatty acid composition of the body, 3) inflammation, 4) loaded with trans fat, 5) increased risk of cardivascular disease, 6) associated with other diseases.

The omega 6/omega 3 ratio is also affected by oil choices.  The importance of the omega6/omega 3 ratio, http://www.ncbi.nlm.nih.gov/pubmed/12442909, can not be understated.  ALS is an autoimmune disease and a high ratio helps to promote autoimmune diseases.  Inflammation compromises nutrient absorption, and there is inflammation with a high omega 6/omega 3 ratio.  An omega6/omega3 ratio of 2/1 or 3/1 suppresses inflammation.  Dig deeper, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835780/, and you can find that inflammation is also associated with protein catabolism, which is muscle tissue breakdown, another huge problem with ALS.

Coconut oil has a high concentration of medium-chain triglycerides.  With ALS, the mitochondria are not working properly and are not properly delivering energy to the cells, a part of the process that is leading to cell death.  These medium-length triglycerides provide energy that cells can use through the ketosis process.  Coconut oil also has other benefits (http://www.antiaginganswers.net/healthyfats.html):

Approximately 50% of the fatty acids in coconut fat are lauric acide. Lauric acid is a medium-chain fatty acid, which has the additional beneficial function of being formed into monolaurin in the human or animal body. Monolaurin is the anti-viral, antibacterial, and antiprotozoal monoglyceride used by the muman or animal to destroy lipid coated viruses such as HIV, herpes, cytomegalovirus, influenza, various pathogenic bacteria including Listeria monocytogenes and Heliobacter pylori, and protozoa such as Giaradia lambia. Some studies have also shown some antimicrobial effects of the free lauric acid.

Immunity boosting is an added benefit of coconut oil.

Olive oil's omega 6/omega3 ratio is an unfavourable 13:1, but it actually has anti-inflammatory properties because of other components in it. http://www.ncbi.nlm.nih.gov/pubmed/21443487.  You need both kinds of fatty acids, it is just the more 6s you have the more 3s you need to balance them.

Oils to avoid - omega 6:3

• soybean oil  - 6:1 
• sunflower oil - no omega 3
• corn oil - no omega 3
• canola oil - 2.5:1
• cottonseed oil - no omega 3
• safflower oil - no omega 3

Oils to consider

• coconut oil - no omega 3
• flaxseed oil - 0.3:1
• olive oil - 13:1

Walnuts are the highest omega 3 nut, and krill is the best source of omega 3.

All articles are a work in progress and are advisory for the reasons given.  Everyone should do their own research to verify or refute and make their own decisions about whether they think it is helpful or not.

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Glutathione System

Glutathione is your body's strongest anti-oxidant.  It is also your strongest detoxification molecule and your protein repair.  It is very import to protect your proteins from oxidative attack.

There are 3 phases to the human detoxification system:

1. activation
2. conjugation
3. transport

Transport has only recently been understood.  These are active transporters that discard the toxin that was changed through the activation and conjugation process.

Glutathione S-transferases have low expression in people with high methylmercury and sensitive to ethylmercury, compromising the ability to remove the toxin metals from the body.

All of your toxin leave the body through the same "door."  So, if your "doors" aren't working properly the body holds onto mercury, poly-aromatic hydrocarbons, pcps, etc., and a huge toxin problem.

The biggest reason the transport system breaks down is inflammation, especially in the gut.

Some ways the system breaks:

• Not enough glutathione (can't make it or don't eat of it)
• A methylation disfunction
• Environmental exposures that cause oxidative consumption (use it up faster that you restore it)
• Environmental inflammation which turns down your synthesis

Genetic disorders can cause increased anemia, cognitive impairment, bladder cancer.  Genetics determine why some people are very debilitated by mercury and some people aren't.

Challenge Tests for measuring body burden for exposure to mercury do not really do that.

Liver is so important, it is worth the time to watch the 3 hours of videos in this post on how to detoxify for mercury.  The pathways to detoxifying are the same for biological toxins.


Food sources of glutathione says:

Milk thistle is an excellent source of the antioxidant compound silymarin. Silyarmin helps to prevent the depletion of glutathione in the liver. Glutathione is necessary for the liver to detoxify harmful substances. If the liver is damaged, glutathione concentrations are substantially reduced. In turn, the liver becomes more susceptible to further damage, making glutathione a vital element in the health of the liver. Cumin also has the ability to increase glutathione tissue levels. Cumin acts as a binding agent, elevating glutamate-cysteine complexes during gene expression.

Processing and cooking fruits and vegetables destroys glutathione.  The best sources are asparagus, potatoes, peppers, carrots, onion, broccoli, avocados, squash, spinach, garlic, tomatoes, grapefruit, apples, oranges, peaches bananas and melon.

Selenium is an important co-factor for the enzyme form of glutathione. Cereals, oats, Brazil nuts, walnuts, legumes, tuna, beef, poultry, cheese, eggs will help promote the production of glutathione.

Alpha lipoic acid, or ALA, promotes the synthesis of glutathione. Foods rich in alpha lipoic acid include: spinach, tomatoes, peas, Brussels sprouts, rice bran and mayonnaise. Eating these foods increases the bioavailability of this important antioxidant.

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Prebiotics - look after your gut and immunity

Something else to learn about, we need prebiotic foods, that is, foods that help to give us a healthy gut flora.

Boost your immunity naturally with prebiotics.

Leaky gut, prebiotics.

10 prebiotic foods

Ulcerative Colitis Management, prebiotics

Here's a list, http://www.onegreenplanet.org/natural-health/best-prebiotic-foods-for-optimal-digestive-health/

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Look after your spirit to promote healing

Stress and anxiety redirect the body's focus to the fight for flight response.  This is taking blood flow, and its healing and restorative power, away from mending the body.  It is also releases the stress hormones, which over time are damaging, and even more damaging when the body needs healing.

So, emotional hygiene is important.  Guy winch has a great Ted Talk on looking after your emotional hygiene. This doesn't so much teach you how to look after it, but show how it can affect us.

Then there are a ton resources out there.  The latest one I've seen is Reiki, which I am going to learn about, as it came with a recommendation from a highly trusted friend.  She's always led me to a better path.

Philosopher's notes are audio summaries by Brian Johnson the greatest wellness and success books ever written.  He goes back to Tao something like 1000 years ago, to modern day writers, like Martin Seligman.  The ones you purchase are about 20-25 minute summaries of books, but he also has one hundred 3 minute summaries which can give quick bites of positive living.  I purchase the longer summaries and I haven't purchased any book yet, but the summaries certainly help you to figure out which books you'd like to spend more time with.

And then there is Hay House.  Louise Hay is huge on how to protect your thoughts and improve the quality of your life.  I attended a Hay House conference in Denver about a year ago, after listening to a series in 2014 called "Start the new you."  They put together a complete package on wellness - mind, body, spirit - although not all of it fits everyone's beliefs or comfort zone, so you just take what you need from it.  I really like Kris Carr and I think she is a good one for anyone dealing with disease.  She was diagnosed 10 years ago with a rare stage 4 cancer and she has great advice on how to manage illness positively, and since her cancer didn't have a treatment, food has been her medicine.

And then I'm always looking and just found "The Science of Happiness," which I will be reviewing.

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Diet Books for ALS

Terry Wahls reversed her MS through diet and she adapted her diet especially for mitochondria, which are implicated all over the place in ALS, so the Wahl's Protocol is a good dietary plan to follow.  The quick and fast start is watch her Ted Talk, "Minding your mitochondria," as she outlines the essentials of her diet plan.

Kim Cherry recommended "The Better Brain book" and if you check out his story, he's done incredibly well in his battle with this disease and seems to have reversed the degree the disease had progressed.

Gut issues keep showing up so "Meals that Heal," give great recipes to help fix gut issues, and "Grain brain" is also going to help fix gut and brain issues.

Familiarize yourself with excitotoxins and eliminate them.  They are doing 100 times more damage to an injured brain than a healthy one.  My previous two posts have information on excitotoxins.  With an injured brain excitotoxins are able to cross the blood brain barrier easier because these body defenses are damaged.

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Viral response problem in ALS - holistic whole body approach

This study, Mount Sinai Researchers establish link between ALS and the body's response to viral infection, is showing a faulty response to a viral infection which they say:

Findings from this new research study indicate that specific genetic alterations make senataxin less capable of moderating the inflammatory response to particular pathogens, which can lead to persistent inflammation and disease progression.

This is fitting with my theory of the disease, which is that it is a pathogen that sets it off.

So, a holistic whole body approach would need to include a diet that does the following:

Heals mitochondria

Detoxifies the liver

Contains foods with anti-bacterial and anti-viral properties

Reduces inflammation

At the same time, excitotoxins need to be removed from the diet. When the brain is injured it is 100 times more sensitive to excitotoxins, so it is especially important to remove excitotoxins.  Foods with excitotoxins include:

• Glutamic Acid
• MSG
• Anything glutmate (Monopotassium glutamate, magnesium diglutamate, etc)
• Hydrolyzed anything, (Hydrolyzed vegetable protein, hydrolyzed soy protein, etc)
• Vegetable protein
• Textured protein
• Plant protein
• Autolyzed anything (Autolyzed plant protein, autolyzed yeast extract, etc)
• Yeast extract
• Malt extract
• Soy Sauce Extract
• Yeast nutrient
• Caseinate
• Carrageenan
• Aspartame
• Sodium Cyclamate
• Nutrasweet
• Broth
• Stock

Exceptionally high excitotoxin foods are:

• gravies, salad dressings (especially diet)
• soups (Campbell's is the worst)
• diet foods and drinks
• liquid amino acid preparations 

Foods with anti-bacterial properties can be found here.  Foods with anti-viral properties can be found here.  Finally, anti-inflammatory foods can be found here.

Then there are supplements to help.

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Excitotoxicity

This is a great talk about your brain, https://www.youtube.com/watch?v=tTSvlGniHok

This is a great summary of this information.

This 2004 article has advice on defending against excitotoxins, although I seriously question the amino acid suggestion.

At the same time, excitotoxins need to be removed from the diet. When the brain is injured it is 100 times more sensitive to excitotoxins, so it is especially important to remove excitotoxins.  Foods with excitotoxins include:

• Glutamic Acid
• MSG
• Anything glutmate (Monopotassium glutamate, magnesium diglutamate, etc)
• Hydrolyzed anything, (Hydrolyzed vegetable protein, hydrolyzed soy protein, etc)
• Vegetable protein
• Textured protein
• Plant protein
• Autolyzed anything (Autolyzed plant protein, autolyzed yeast extract, etc)
• Yeast extract
• Malt extract
• Soy Sauce Extract
• Yeast nutrient
• Caseinate
• Carrageenan
• Aspartame
• Sodium Cyclamate
• Nutrasweet
• Broth
• Stock

Exceptionally high excitotoxin foods are:

• gravies, salad dressings (especially diet)
• soups (Campbell's is the worst)
• diet foods and drinks
• liquid amino acid preparations 

Foods with anti-bacterial properties can be found here.  Foods with anti-viral properties can be found here.  Finally, anti-inflammatory foods can be found here.

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Neurologists need to read this

The medical profession has not been healers when it comes to ALS.  Indeed, they tell people there is nothing they can do that they are going to die in 2-5 years.

I love this doctor's story and in particular his statement:

Inspired by Mike Sabin and with Bernardo in my mind, I realized it makes no sense to resign ourselves just because we are told nothing can be done. What goes on in our brain is still in the shadow of scientific knowledge. António Damásio and any neuroscience researcher will say the very same thing. Therefore, we do not have to sit idly and accept the prognosis associated with ALS without a fight, regardless of whatever medicine or any other branch of science reports.

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What about this?

What about beta-lactam antibiotics?

Earlier Packard research showed that overexpression of glutamate transporters in mouse models delays onset of symptoms and extends life. More recent Center-assisted studies showed that beta-lactam antibiotics – they boost transporter numbers – also delays disease onset, slows its progression and prolongs life.

Another paper talked about calcium:

"There is a fair amount of evidence that calcium homeostasis is altered in ALS, more speciifically 75% in sALS but not FALS, and that low levels of the calcium binding proteins parvalbumin and calbindin-D28K contribute to selective vulnerability by decreasing the ability of motor neurons to handle an increased calcium load, with cell injury and death as the consequence."

Threonine is good for collagen, elastin and muscle tissue and a study showed upping some amino acids can help with some of the problems.

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What about the winners?

There are people out there that say they have cured, slowed down, and/or reversed some of their ALS.  So, time to have a look.

Kim Cherry tells his story of how he reversed his ALS.  He had/has the bulbar ALS.  This is where he says his first break in the disease came,

Doctor Jared Nielsen specializes in neurological issues, and had really helped a niece’s husband after a severe head injury. Doctor Nielsen determined I had a gluten sensitivity, mercury poisoning, and some issues with fungus. He recommended a protocol that included a gluten free diet, and supplements.  Much of the protocol included in the theories of Dr. David Perlmutter, a neurologist out of Florida.

He did not immediately notice a benefit, but was noticing improvements roughly 6 weeks later.

I looked at the site further and found a checklist of where to start, http://www.alswinners.com/start-up-check-list.html.

Then there is the supplement list.  Kim Cherry's story is worth following and learning about.

Then there is Eric Edney who developed the simple strategy of where Cherry started:

Step1:  Stop the progression of the disease by eliminating toxins and clearing toxins from the body, and
Step 2: Restore the body through proper nutrition and exercise.

Eric's plan is here.

Cherry feels that he got better results with his program which also included oxygen therapy.  The oxygen therapy is something I am not familiar with.  Cherry believed in the therapy enough to invest $25k in it.  His results are impressive.

I love this guy's story, https://www.youtube.com/watch?v=Hh8k32VsxLA

And there there is Steven Shackel and he has been putting together information for years.

And then Dr Craig Oster graduated from hospice in 2008 and he's been rebuilding muscle and strength.  He has an incredible team of advisers on his site.

Others are listed in the healing chronicles.

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The Complexity of ALS

Mechanisms need to be reviewed.

According to Russell in clinical pharmacology the most common

The most common disease-causing mutation occurs in the superoxide dismutase (SOD1) gene, although other mutations have been identified^[6]. The dysfunctional SOD1 enzyme forms a complex with copper and zinc ions within the mitochondria, leading to protein unfolding and aggregation. This accumulation disrupts the mitochondrial membrane potential and acts as a catalyst for further mitochondrial dysfunction. Cellular adenosine triphosphate (ATP) production is decreased and calcium homeostasis is disturbed, triggering apoptosis and leading to cell death^[7].

So, the calcium/zinc balance need to be looked at.  How does diet affect those.  Is it better to increase calcium and reduce zinc, or the opposite.  Something as simple as this is probably not monitored at all, is probably easy to have huge ranges in various patients and can probably change outcomes dramatically.  So, a patient could be trying something that worked for someone else and another finds it makes no difference.

There are so many different checks and balances taking changing that place in this disease.

My thoughts on the best treatment option at this point is to have a team and that team needs to include a biochemist, a pharmacist, an ALS neurologist, a dietitian, a homeopath, a herbalist, a botanist, a heptologist, a nephrologist, a hematologist, a cytologist, immuologist, someone with expertise in histamines and maybe a few others with expertise.  This is just what comes to mind thinking about this based on the research that I've done in the past 10 days.

What I see happening in the literature is one piece being studied at a time, and I think a bigger and broader view of all of the mechanisms and inter-relations need to be worked on.  These mechanisms are broken and so diet is critical and can dramatically change perceptions of what is working.  I had a thought, which I forgot, but where that thought led me is to Dr Joneja, and her site, the low histamine chef, and that particular link has something about cell methylation, which I've already blogged about.  There is also references to DAO all over this site, which I've come across in my reading to learn about ALS, so that mechanism needs to be looked at in diet as well.

Even comments on some of these sites are useful, for example:

"folic acid, which is synthetic, and can block methylation. Methylfolate (Metafolin, Folapro) or Folinic acid," and methylation is important here."

There are even links in a discussion about depression.  This article links to this guest editorial about Decreased Mitochondrial Function and Increased Brain Inflammation in BipolarDisorder and Other Neuropsychiatric Diseases.  It makes reference to the lack of understand as to how various brain inflammation disorders show up in a whole range of problems, from speech impairments to MS, etc., and the cruncher:

0 In fact, mitochondrial DNA was shown to be secreted from neuroblastoma cells inside membrane-enclosed exosomes.21 All these findings, taken together, may constitute a ‘‘triple jeopardy’’ for the brain: (a) decreased mitochondrial ATP production, (b) further reduction by diversion of ATP to support proinflammatory, and (c) extracellular ATP and mitochondrial DNA release, which can stimulate autoimmune/autoinflammatory reactions

This study, Gliotoxicity of the cyanotoxin, β-methyl-amino-alanine (BMAA), looks at a number of the mechanisms from BMAA, and has huge supporting evidence of the mechanism of ALS.

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Reading a courageous woman's blog, learned about Spirochetes.

I have been reading Stacy Neild's blog.  She started it right before she found out she had a motor neuron disease.

So, what I've been reading in the literature is that there is liver disease that tends to go with ALS, and reading Stacy's blog, this is what was found in her journey.

The first few days of our treatment focused on detoxification of Stacy's body, with extra attention on her liver. It was also a time of testing - blood, excretions and lung function.Some results from this time are:-Stacy's Liver is not able to keep up with its filtering job, so her red blood cells and her plasma have accumulated various imperfections.-She has some small tube like bacteria in her blood called spirochetes. These are linked to a range of diseases - fire up google if you are keen. -Her immune system is not functioning effectively. In some aspects it is not reacting to destroy antigens as it should, and in other situation it is hyper sensitive to some antigens and is over reacting and wearing itself out creating a response.

So, then I looked up spirochetes and I found:

Spirochetes disease: Infection with a type of bacteria which is often found in mud, sewage and polluted water. Symptoms are determined by the species involved. Diseases caused by this bacteria include Treponema infection and borreliosis. More detailed information about thesymptoms, causes, and treatments of Spirochetes disease is available below.

Last year at the lake house the water tower broke and there was also a problem with the sewage that Norma and Jay were working on.  We were up the July long weekend helping to raise the new water tower, but Norma and Jay were dealing with issues around that for a while before that.  Another connection?

Apr 5 Update:

More on microbes as a source.  Was Lou Gehrig's disease caused by tap water?  There is a lot of information about beta-methylamino-L-alanine (BMAA), which is a toxin causes by these algea blooms. 

Wiki is also a great source of information, http://en.wikipedia.org/wiki/Beta-Methylamino-L-alanine.

This is a huge discussion about cyanobacterias.

Trying to measure this stuff.

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ALS increasing, what can clustered data tell us?

I found this 2005 report, Amyotrophic Lateral SclerosisA report on the state of research into the cause, cure, and prevention of ALS, and what jumps off the pages for me are:

• ALS is increasing in western societies, in particular in women and in younger age brackets.
• There have been a couple places identified where the incidence of ALS is 50 to 100 times the norm, which is Guam and the Kii peninsula in Japan.  In Guam there has been a steady decline in the rate of ALS making researchers believe that is may be related to traditional practices.
• There are incidents of married couples both getting ALS, which is highly improbable.
• Increases were most dramatic in Canada and the US, especially between 1979 and 1997, and follow-up show it was still increasing in the year 2000.
• A small number of studies show detectable evidence of viruses in the spinal cord of some ALS patients.

So this cluster data really interests me.  So, I did a bit of a search on Guam and I found this book, Science of Pacific Island People: Fauna, Flora, Food and Medicine.  

And then I look at the Kii Penisula in Japan and do a search and I find this article "False sago palm harbours deadly amino acid."  And, what do I read in what I have access to in that report???

Although this cycad is found all over the Western Pacific, from Japan to Australia, people eat its fruit only in certain areas, including the islands of Guam and Rota. The plant is also used in traditional medicine in the Kii Peninsula of Japan, and the Jaya region of New Guinea. It is mainly in these regions that a devastating neurological disease, known as Guam disease, is found. It resembles Parkinson's and Alzheimer's diseases, as well as a disease called amyotrophic lateral sclerosis. The brain and spinal cord degenerate, leading to dementia, paralysis and death.

And another report on ALS in the Kii Penisula says it was decreasing in the 60s and 70s and then started to increase again in the 90s in Hohara, shown in this map.

Another report dismisses a "cycad" as the cause.

There are a ton of other herbs used for traditional medicines and that knowledge of traditional medicines as been declining, but there also seems to be a push to bring it back.

One of the things the 2005 report says that I concur with is that some people are saying the disease is increasing because people are living longer, but if people are getting at a younger age, then this living longer has nothing to do with it.

Another thing, if mitochondria are showing problems well ahead of people noticing any symptoms, there could be a disconnect with people thinking something more recent being involved in the onset of their disease.

Now, married couples, that could be common exposure, food or microbe.

The viruses in the spinal cord could be related to leaky gut, and I found this about it.  

The barrier function becomes compromised, so that bacteria, viruses, undigested food particles and toxic waste products can leak from the inside of your intestines through the damaged digestive lining into your bloodstream, where they're transported throughout your body and can trigger your immune system to react. The end result is inflammation in various parts of your body, leading to a wide variety of symptoms like bloating, cramps, fatigue, food sensitivities, flushing, achy joints, headache and rashes.

When the 2005 report says:

In the absence of a clear understanding of the genetic or viral origin of sporadic ALS Epidemiology of ALS   (or the possible interaction of genetic susceptibility, viral infection, and exogenous factors in bringing about the disease),

I think they are dead on suggesting it is a combination of genetics, viral infection and then something else setting it off.

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What are Metallothioneins? And what about Astrocytes?

Metallothioneins are somehow involved in cell regulation around metals.

According to research by Tokuda etal there is something wrong with how the cell is processing functions around copper, which use these Metallohioneins.  "The upregulation of endogenous MTs by dexamethasone, a synthetic glucocorticoid, significantly improved the disease course and rescued motor neurons in SOD1G93A mice."

Author: Tokuda, E., Watanabe, S., Okawa, E. and Ono, S. I. Year: 2015 Title: Regulation of Intracellular Copper by Induction of Endogenous Metallothioneins Improves the Disease Course in a Mouse Model of Amyotrophic Lateral Sclerosis

How does this get improved by diet and or supplements?  What does the body need to help itself with this process?

This read of Astrocytes is really interesting.  These guys give off glutamate, which is in excess in the brains of people with ALS.  But according to Davoli etal they also give off H2S and there are high levels of H2S in the spines of ALS patients and it is believe to come from the Astrocytes and microgilia.

Author: Davoli, A., Greco, V., Spalloni, A., Guatteo, E., Neri, C., Rizzo, G. R., Cordella, A., Romigi, A., Cortese, C., Bernardini, S., Sarchielli, P., Cardaioli, G., Calabresi, P., Mercuri, N. B., Urbani, A. and Longone, P. Year: 2015 Title: Evidence of hydrogen sulfide involvement in amyotrophic lateral sclerosis

This really is saying a lot,  Interpretation: This study unravels H2S as an astroglial mediator of motor neuron damage possibly involved in the cellular death characterizing ALS

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More research review for ALS

There are more associations for genetics than previously thought.  Using pooled DNA sequencing researchers found that about 1/3rd of ALS is genetically linked.


There are blood brain barrier problems with ALS and so they are looking at that:

Inhibiting the blood-brain and spinal cord barrier's drug efflux transporters improves the efficacy of ALS treatment with riluzole in a mouse model.

So how can diet improve this?

ACE Inhibitors may help

The use of angiotensin-converting enzyme inhibitors (ACEIs) was associated with a significant reduction in the risk of developing amyotrophic lateral sclerosis (ALS) in a new case-control study conducted in Taiwan

Could "Leaky Gut" be increasing microbes and cause a whole range of these diseases?  Better take probiotics.  Leaky gut diet should also help, http://thepaleodiet.com/paleo-foods-heal-leaky-gut/

This is about a mechanism for a malfunctioning protein which is believed to be responsible for ALS.

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