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Do you have ALS? Probably not, and here’s why

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Do I have ALS?CausesTreatment methodsSeeking helpSummary
Amyotrophic lateral sclerosis (ALS) is a progressive disease that causes a loss of voluntary muscular control. ALS symptoms can be general, meaning diagnosis may take some time.  
Medically reviewed by Alana Biggers, M.D., MPH
Written by D. M. Pollock
Updated on October 26, 2023

ALS, or Lou Gehrig’s disease, is a progressive condition that affects your brain and spinal cord. It can lead to the decline of your motor neurons. These are the nerve cells responsible for voluntary muscle movements like chewing, talking, and walking.

Some of these general symptoms include:

  • slurring speech
  • dropping things
  • fatigue in your limbs
  • tripping

It can be difficult to receive a diagnosis for ALS due to the generalized symptoms you may experience throughout each stage of the condition. These symptoms are often the same as those that occur in various neurodegenerative conditions like multiple sclerosis (MS) and Parkinson’s disease.

How do you know whether you have ALS?

Older female clenching her hands to show ALS symptoms.
Photography by Eclipse_images/Getty Images

ALS is 20% more likely to develop in those assigned male at birth than those assigned female at birth and typically only develops after the age of 50 years.

As your motor neurons start to decline, they stop sending the signals responsible for muscular movements to your brain. This can cause muscles to twitch and begin to waste away. Eventually, your brain is unable to initiate any voluntary movements.

As this process starts, you may experience a variety of signs that will differ between individuals. Some of these signs are also the early symptoms of other neurodegenerative health conditions.

Examples of the most common early symptoms of ALS include:

Muscle weakness

A loss in muscle strength is the most common and obvious symptom of ALS. Progressive muscular weakness can mean that for people with ALS, everyday tasks like brushing their teeth or getting out of bed can be difficult.

Often, the most noticeable symptom is experiencing muscle weakness in the arms and legs. This is known as limb onset muscle weakness. It is also a symptom of limb-onset ALS, the most common type.

Sometimes, it may affect your throat muscles first, causing swallowing to become harder than usual.

This is a common symptom of other progressive health conditions, so if you notice feelings of weakness in your legs or arms, speak with a doctor.

Some of these other conditions include:

  • Parkinson’s disease
  • stroke
  • chronic fatigue syndrome
  • neuralgia

Slurring speech

Slurring your speech, or dysarthria, happens when you have trouble articulating your speech clearly. This is an early symptom of bulbar-onset ALS, which causes disruptions to your speech, breathing, and swallowing.

Dysarthria can feel like:

  • frequent coughing during eating
  • a gurgling voice after eating
  • buildup of saliva
  • shortness of breath while eating
  • food coming out of your nose during eating

In general, these symptoms are the result of damage to your brain. Therefore, there are many different possible causes.

Some include:

Uncontrollable laughing or crying

Some people with ALS may experience uncontrollable laughter or crying, which is also known as the pseudobulbar effect.

This can be the result of multiple health conditions:

According to a review from 2020, 50% of ALS cases report changes in behavior and language problems.

In fact, between 10% and 15% of people who experience this symptom of ALS have it so severely that they meet the criteria for a diagnosis of dementia.

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What can cause ALS?

According to the Centers for Disease Control and Prevention (CDC), the cause of most spontaneously occurring ALS cases remains unknown.

However, up to 10% of ALS cases are genetic. Researchers identify that a particular change to the C9ORF72 gene is responsible for up to 40% of people who develop familial ALS.

Some other risk factors for developing ALS include:

  • being between the ages of 55 and 75 years
  • being male
  • being of Caucasian and non-Hispanic descent, as these ethnic groups are more likely to develop ALS (however, anyone from any ethnicity can develop ALS)

How is ALS treated?

Unfortunately, there is no cure for ALS. However, there are a variety of treatments available to help manage symptoms and make living with the condition easier.

The treatments that a doctor may recommend to you will depend on your individual health needs and the stage of the condition. Treatment commonly involves several types of healthcare professionals, such as:

  • speech therapists
  • respiratory therapists
  • physical therapists
  • occupational therapists
  • nutritionists
  • neurologists

A doctor may also prescribe the following medications:

  • Riluzole (Rilutek): An oral tablet that can help reduce the degeneration of motor neuron damage and slow the progression of respiratory ALS symptoms.
  • Edaravone (Radicava): This medication is available in both an oral liquid form and via an intravenous infusion. It helps slow the decline in neuron degeneration and maintain their function.

Healthcare professionals may prescribe other medications to help you manage different symptoms of ALS, such as uncontrolled episodes of laughter, crying, or depression.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Lifestyle changes

Medical devices such as hoists, mattresses, and wheelchairs can help make your daily life easier and increase your comfort.

As your condition progresses, your healthcare team will advise you on the next steps for adjusting your daily routines to increase ease. For example, as speech gets harder, communication boards can help you retain your ability to talk with others.

When should you speak with a doctor?

If you experience unusual muscle weakness, difficulty with speech, or tingling sensations, it can be a good idea to speak with a healthcare professional.

These symptoms can often signify severe multiple health conditions such as brain tumors or ALS.

ALS takes between 9 and 12 months to diagnose, so seeking healthcare advice as soon as possible is important to ensure you give yourself the best chance to slow the progression of the condition.


The symptoms of early-onset ALS are generic and can be easily mistaken for other neurodegenerative health conditions, as well as stroke and brain tumors.

If you notice symptoms such as muscular weakness, trouble with speech, or muscular tingling, you should speak with a doctor as soon as possible. They can identify if you do have ALS and set up a treatment plan to slow the progression of your symptoms.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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