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LOU GEHRIG'S DISEASE

Lou Gehrig's disease, also known as amyotrophic lateral sclerosis, is a progressive fatal nerve disease in which most victims die within 3 to 5 years. Several studies showed that minocycline protects nerves from dying in diseases such as Huntington's disease, Parkinson's disease, stroke, and traumatic brain injury. A study from Harvard study showed that minocycline prevents release of cytochrome c that activates an enzyme that enables cells to commit suicide and is a common feature of many disease that cause paralysis and loss of feeling. Minocycline delayed the onset of movement problems in the mouse and prolonged their lives. However, more recent studies failed to show benefit and some studies have shown harm (1b).

For 10 years most doctors have scoffed at athletes who take creatine to help make them stronger. While there is debate about the effectiveness of this chemical in making people stronger, recent research shows that it may help people with muscle wasting diseases such as Lou Gehrig's disease (Amytrophic Lateral Sclerosis or ALS), shaking diseases such as Parkinson's, and cognitive diseases such as Alzheimer's.

Creatine is a chemical that supplies energy to muscles when they cannot get all the oxygen that they need during intense exercise. Although the muscles of people with Lou Gehrig's disease do not have low levels of creatine, extra creatine may help them to contract more forcibly and reduce the weakening effect of the disease. Lou Gehrig ‘s disease is named after a baseball player who had Amyotrophic lateral sclerosis, which usually starts in people over 40 years of age as a mild weakness in the arms or legs or minimal difficulty speaking or swallowing. It often progresses rapidly to affect every muscle in the body, causing victims to require wheelchairs and eventually not have the strength to breathe.

Messages are sent along nerves by an electric current. When the current reaches the end of a nerve, the nerve secretes a chemical called a neurotransmitter, that passes to the next nerve to continue the message. Glutamate is a neurotransmitter that is secreted by a stimulated nerve and travels to the next nerve to activate it to continue the message. After it sends the message, glutamate is normally removed from the nerve junction. Most researchers feel that in Lou Gehrig's disease, glutamate continues to accumulate and stimulate the nerve until the nerve becomes exhausted and dies. The standard treatment, Riluzole, helps a little bit to stop nerves from processing glutamate so they can rest and recover.

Amyotrophic lateral sclerosis starts in either the brain or the spinal cord. Riluzole helps only those people whose amyotrophic lateral sclerosis starts in their brains and not those whose disease started in their spinal cords. There is no evidence that it can reverse the damage that is already done and one study does not mean that the drug is an effective treatment.

1b)(The Lancet Neurology. December 2007;6(12): 1045 - 1053). Efficacy of minocycline in patients with amyotrophic lateral sclerosis: a phase III randomized trial. Paul H Gordon MD a , Dan H Moore PhD d, Robert G Miller MD c, Julaine M Florence DPT g, Joseph L Verheijde PhD e, Carolyn Doorish BA a, Joan F Hilton ScD f, G Mark Spitalny MA c, Robert B MacArthur PhD b, Hiroshi Mitsumoto MD a, Hans E Neville MD h, Kevin Boylan MD i, Tahseen Mozaffar MD j, Jerry M Belsh MD k, John Ravits MD l, Richard S Bedlack MD m, Michael C Graves MD n, Leo F McCluskey MD o, Richard J Barohn MD p, Rup Tandan MD q, for the Western ALS Study Group

1a) Minocycline is the first non-toxic drug with a proven human safety record that has been shown to inhibit cytochrome c release. It also crosses the blood-brain barrier and is effective when taken orally, which makes it a good candidate for human clinical trials. Zhu S, Stavrovskaya IG, Drozda M, Kim BYS, Ona V, Li M, Sarang S, Liu AS, Hartley DM, Wu DC, Gullans S, Ferrante RJ, Przedborski S, Kristal BS, Friedlander RM. "Minocycline inhibits cytochrome c release and delays progression of amyotrophic lateral sclerosis in mice." Nature, May 2, 2002, Vol. 417, No. 6884, pp.74-78.

1) NEJM, March 3, 1994.

2) Neurology March, 1999. 5 to 10 grams creatine improves muscle strength 15 percent.

3) Nature Medicine March, 1999. Improves endurance in mice.

Checked 1/9/08

May 29th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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