Concerns About Potential ALS Diagnosis at 25
As a 25-year-old male, I find myself grappling with certain concerning symptoms. For some time now, I’ve been dealing with persistent twitching throughout my body, a tremor specifically in my left arm, and what appears to be muscle wasting in that arm. It's worth noting that my grandmother was diagnosed with ALS at age 60. I first noticed my left arm looking smaller a few years back but didn’t pay much attention to it at the time. Following my concerns, I consulted both a neurologist and my primary care physician, but the neurological examinations yielded normal results. Additionally, my blood tests produced no significant findings, with my creatine kinase (CK) levels being relatively low at 66, suggesting minimal muscle breakdown; notably, no one else in my family has been diagnosed with ALS. My grandmother had three children who now are all in their fifties and show no signs of the disease. On my mother's side, my great-grandmother passed away at 88, suffering from dementia, but that seems to differ greatly from my current worries. My neurologist, who specializes in tremors (although I question the extent of his expertise regarding my case), along with my PCP, both expressed doubt about a potential ALS diagnosis. This series of symptoms began after experiencing significant stress from the birth of my child, which led to heightened anxiety and disrupted sleep. My doctor prescribed Lexapro, and it was shortly thereafter that I became aware of the widespread twitching in my body. About a year prior, I had also encountered severe soreness in my legs and cramping in my feet, which I attributed to my occupational activities. Lately, I have developed a peculiar clicking sensation during swallowing at certain angles, and I’ve observed an asymmetry at the back of my throat for about three years now, although various doctors have reassured me that this is normal. Given that this has persisted for two months, I’m left wondering if I should pursue further evaluations or additional specialists, especially since my neurologist did not recommend an electromyography (EMG), and my PCP suggested against it as well. My family has begun to express their concern regarding my health, so I would greatly value any insights or opinions from others who might have had similar experiences or expertise in this area.
Answers (1)
2/15/2026, 5:30:45 PM
OpenHealth AI
It's understandable to feel concerned given your symptoms and family history, but both your neurologist and primary care physician's reassurances are important to consider. Your symptoms, including twitching and tremors, could stem from various causes unrelated to ALS, especially given your relatively young age and the normal findings from your neurological examinations and blood tests.
Explanation
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Twitching and Tremors: These can arise from anxiety, stress, or benign fasciculation syndrome, particularly if they emerged after a stressful life event. Stress and anxiety can cause physical symptoms, including muscle twitching and tremors.
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Muscle Wasting: Mild muscle atrophy can occur for multiple reasons that aren’t necessarily linked to ALS, including disuse, or even stress-related changes. Your normal CK levels further support that significant muscle breakdown is unlikely.
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Family History of ALS: While having a family member with ALS can heighten concerns, the expression of this disease is complex, and the fact that your immediate family members are healthy reduces the likelihood of a genetic form of the disease.
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Symptom Variability: The clicking sensation while swallowing and the throat asymmetry may be related to heightened awareness or anxiety and not necessarily indicative of a severe neurological condition given the reassurances from multiple doctors.
Next Steps
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Focus on Stress Management: Since the symptoms began after a stressful period, consider integrating stress-reducing activities into your routine. Try relaxation techniques such as deep breathing, meditation, or yoga.
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Keep a Symptom Diary: Document your symptoms, when they occur, and any triggers you notice (like stress, fatigue, or specific activities). This may help identify patterns and aid in discussions with healthcare providers in the future.
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Follow-Up on Symptoms: Since your doctors didn't recommend further tests, monitor your symptoms closely. If they persist or worsen, consider seeking a second opinion from another neurologist, ideally one with expertise in movement disorders.
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Engage Your Support System: Talk openly with your family about your feelings and concerns. Having a support system can alleviate anxiety.
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Lifestyle Considerations: Prioritize adequate sleep, regular physical activity, and a balanced diet to support overall health and well-being.
It's completely valid to seek further clarity, but try to balance this with the reassurance you've received. If discomfort persists, do advocate for further examination and ensure your concerns are communicated effectively. Remember, you are not alone in this, and many people navigate similar experiences successfully.
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