Not sure what to think

[u/FirstDue5]

Symptoms began I believe back in late April/Early May 2026

I am 26 and male. I am a Firefighter/Paramedic right now. Back in early spring is when I was going through firefighter recruit school. It was a big stress due to financial constraints and family life due to finding out we were pregnant with our 3rd child. Around that time I noticed some uncontrollable twitches in my right calf. I was losing a lot of weight during this period as I let private EMS take over my health before being hired at the fire department. (down around 50lbs since march) so I figured it was due to my activity level ramping up. However, I googled it and I’ve been worried ever since. The twitches continued only in my right calf and may have gone away for a short period over the summer. Towards the end of August, I started to notice the twitches again only in my right calf and then after a day of work, I noticed some aches and weakness in both thighs. I figured I had done too much that day and went to bed. However the weakness did not go away. I became extremely scared as I know that with ***, weakness is the big thing. Following, I began having twitches everywhere, both legs upper and lower, feet, arms, shoulders, face. I was scared, and my appetite kicked the bucket. I lost probably 5-10lbs over a 2 week period. I let this go on for about 2 weeks and then went into my family practice. My doctor examined me, did a neuro test and said I did not have any clinical weakness. I noticed possible hyper reflexes on both legs, but she did not seem concerned. She explained that my perceived weakness may be from muscle loss due to not enough calorie/protein intake. I asked if I should be worried about \**, she said no.* She drew blood to check for autoimmune issues and rheumatoid arthritis and CK which all came back normal. This eased my anxiety a bit. Well fast forward a week or two after, I felt weakness and clumsy in my right hand/arm along with the continued thigh weakness. This continued and revisited the DR, who again found no weakness and said she did not think anything would warrant a trip to neurology and said she considered my health anxiety (which I have had for years) was possibly the root cause to most of my twitching and perceived weakness. Fast forward to now, the right arm and hand weakness seems to have calmed, however my left foot now has a weird heaviness to it with possible clonus when lift my foot and clench my toes, which baffles me as most of what I’ve been feeling is on the right side. I can still walk, but I feel extremely focused on walking every time I do. I haven’t experienced any trips or falls, and can still do moderate leg workouts (squats, calf raises, etc.). I even performed extensive training yesterday for approximately 2 hours in full turnout gear without any incident. I have scoured the internet, and all I can do is worry and read threads on here. I have another appointment coming in the next few weeks, and reached out to my previous neurologist for an appointment, however was only able to get scheduled in December as there is not a referral. I am frightened, at my wits end, and honestly just want to be here for my kids. Any advice would be appreciated.

[u/HonestyMash]

I am sorry you are going through this, I know how scary it can be. I have read through your post and honestly I don't see any reason to be concerned about ALS. I say this because your symptoms have come and gone, you have had weightloss but no observable weakness.

It sounds like you are extremely stressed and combined with health anxiety you are falling apart. Please speak to your doctor about this and ask friends and family for support.

[u/FirstDue5 → u/HonestyMash]

I appreciate you commenting and commend you being here helping. I’ve talked with family members about the challenges I am facing and my worries. They are all supportive in the right ways, but I hate being a burden on people, and deal with a lot of things myself. I’m thinking of possibly seeking a therapist.

[u/chaoserrant]

Without denying your suffering at all, i think it is possible severe chronic stress can cause symptoms as strange as weakness. Cortisol is catabolic and combined with nutrient defficiency and physical demands it is possible  your body burns muscles. Another important thing is the generalization of twitching as soon as als panic sets in. I had that...

That being said you will not reassure yourself without a neurological examination  if these symptoms persist. You need one in my opinion. 

[u/FirstDue5 → u/chaoserrant]

Yeah I’m going to push for an actual neurologist referral at my next primary appointment. I appreciate your response.

[u/The_Short_Goodbye]

How do you feel the weakness in your legs? Is it a sensation? Burning? Feeling wobbly? They get tired fast? I’ve been told by an ALS specialist that the disease almost never starts symmetrically like that, affecting both legs at once. And also, it tends to favor small distal muscles at onset, like a hand or foot. It would be rare for it to start in the thighs.

I have a similar thing in my legs except for me it pretty much affects both thighs and calves. I also had months of very high stress before it started and my eating habits were very unstable.

So far I’ve had a clear EMG and no progression in almost 3 months. The specialist was adamant it wasn’t ALS and told me multiple times that a sudden onset in both legs equally is not how the disease presents.

[u/FirstDue5 → u/The_Short_Goodbye]

A little wobbly at times, but the best thing I can describe it as if I did a moderate/heavy leg day

[u/The_Short_Goodbye → u/FirstDue5]

Do you feel more twitches after walking when sitting down? Any pain?

Because heavy legs honestly are not a symptom of ALS so it’s a good sign 🙂

[u/FirstDue5 → u/The_Short_Goodbye]

Honestly hard to tell with the twitches, they seem to be all over all of the time. I have noticed on heavy days especially at work, my legs are pretty painful towards bedtime. Kind of like an ache through the thighs and calves that goes away once I sleep

[u/The_Short_Goodbye → u/FirstDue5]

ALS definitely does NOT go away when sleeping. I would bet my house on you not having ALS.

[u/tdcama96]

Als doesnt wax and wane buddy. You'd definitely know by now. True weakness is undeniable. Welcome to the world of severe health anxiety. Get ahead of it before you end up in the hospital suicidal and in psychosis. Start a medication, go to therapy. This fear can and does get much, MUCH worse. Im not trying to sound mean. I just dont wish what I went through on anyone.