A Study of Protein Metabolism, Microbiome and Investigational Probiotic Use in Patients With ALS

This will be an exploratory protocol of 10 patients and expect to screen approximately 25-30 patients. The purpose of our study is to examine amino acid levels in plasma pre and post prandial as well as longitudinal gut microbiome in ALS patients taking the investigational probiotic. 1. Purpose: Evaluate the clinical outcomes of muscle strength, clinical global assessments and spasticity in patients taking an Investigational probiotic. 2. Measure changes in questionnaires relating to subjective functional assessments, quality of life, and pain levels over 24 weeks. 3. Describe plasma amino acid levels before and after a protein food challenge in ALS patients of spinal and bulbar type. 4. Evaluate and describe the gut microbiome of patients with ALS. Design: This is a non-randomized, open-label, two-group pilot study of plasma amino acid levels, gut microbiome, and of investigational probiotic use in patients with ALS. Participants will be placed into two groups based on certain post-prandial amino acid levels. Patients will be stratified for eligibility based on the results of their amino acid profiles.