It is now estimated that anywhere between 2% to 20% of American school children suffer from attention deficit/hyperactivity disorder (ADHD), the most common of the childhood psychiatric disorders. The signs and symptoms of ADHD are reduced attention and concentration, a short attention span, easily distracted, impulse behaviour and excessive activity, or hyperactivity. Children that are experiencing these symptoms often have a very difficult time at school, and may have delays in learning reading and writing.
The causes of ADHD likely involve both biological and environmental factors. As children born to parents with ADHD have an increased risk of developing the condition, genetics are thought to play a role. Other research has shown that brain structure or function may differ in patients with ADHD as evidence has shown some alterations in brain networks that govern emotions and attention. I believe stress and trauma can also play a major role in ADHD. Not only can childhood trauma increase risk factors for the development of adult ADHD, but children that have ADHD symptoms may also experience more stressful situations (school difficulties, friend and family conflicts etc.) which may lead to more complex and persistent symptoms of ADHD. Research has also shown a link between inflammatory diseases and a pro-inflammatory state and ADHD. Stress may also increase inflammation in the body, furthering behavioural disturbances. For many years, alternative health practitioners have also suggested a link between the gut microbiome and ADHD symptoms. New research published in the last year finally highlights that there is an association between the gut and behavioural symptoms such as ADHD.
It is apparent that the causes of the development of ADHD are complex and nuanced. This, combined with the fact that many children may not be getting enough exercise and are not getting enough hours outside, may be behind the reason that over diagnosis of ADHD is so common. Another resent massive review summarized this conclusion
"In this systematic scoping review of 334 published studies in children and adolescents, convincing evidence was found that ADHD is overdiagnosed in children and adolescents. For individuals with milder symptoms in particular, the harms associated with an ADHD diagnosis may often outweigh the benefits."
Conventional mainstream medicine relies on the stimulant drugs such as Adderall and Ritalin (methylphenidate). Although these medications may be helpful for the children that truly have ADHD, unfortunately many children may be taking these medications that do not truly require it. These drugs are not without side effects, such as sleep disturbances, appetite supression and racing heart rate. In my opinion, the use of medication requires a thoughtful review of risk vs benefit, on an individual basis. Obtaining a second opinion for the diagnosis of ADHD may also be beneficial to ensure the child truly has the condition.
Whether or not you choose to medicate your child, complimentary natural therapies have also shown to be helpful in the treatment and management of the condition. This includes possible dietary changes, supplementation and exercise.
Dietary Changes for ADHD
Although dietary changes have been highly questioned as an effective therapy for ADHD symptoms, we know food affects behavior of children by different ways such as food allergy, food intolerance and gut microbiome interaction. Although not all dietary changes may be helpful for all children experiencing ADHD symptoms, research shows the following dietary changes may provide benefit
Removing all food colouring and food additives from the diet
Removing gluten and diary if there is a sensitivity, allergy or intolerance to these food groups. Many parents may not know if there is a problem with these foods until they have had their child tested via a food sensitivity test and/or celiac testing if suspected. Elimination diets, with a proper re-introduction period may also prove to be helpful
Carbohydrate restriction, with an increase of healthy fat intake has also shown to be beneficial
Reducing refined sugar intake. Although research has not necessarily found a link between refined sugar and ADHD, many parents report that behavioural symptoms are amplified in their children after the intake of processed sugary foods.
Natural Supplements
Several natural supplements have been found to be beneficial in reducing symptoms. This reason for the improvement may be two fold as some children with ADHD have been found to be deficient in certain nutrients such as vitamin Bs, zinc, magnesium and iron. However certain nutrients like vitamin B, magnesium and probiotics may help support the child by improving the stress response, reducing inflammation, supporting the nervous system and/or benefiting the gut microbiome.
Vitamin B6 Vitamin B6 (pyridoxine) is involved in the production of serotonin. Early research has found that B6 supplementation increased serotonin levels and improved hyperactivity in ADHD. Other surveys have found that Vitamin B6 is lower in individuals with ADHD.
Magnesium is a mineral that has been shown to help helpful in relaxing the nervous system. Studies have found that individuals with ADHD may be deficient in this mineral. In a placebo controlled trial, using 200g of magnesium a day significantly decreased symptoms of ADHD in children aged 7-12 years old.
Iron is an essential trace element in the body that is important for oxygen transport, development, growth, and dopamine signaling. Iron stores are reflected in the body by the blood marker ferritin. Low ferritin levels have been seen in patients with ADHD. In a randomized placebo controlled study, children that had low ferrtin levels (defined by a ferriting of less than 30 ng/mL) had a significant decrease in ADHD symptoms after using a iron supplement for 12 weeks.
Zinc is a nutrient that is typically know to help the immune system function and improve wound healing. Zinc supplementation may be helpful to improve ADHD symptoms. Children with ADHD treated with Ritalin plus zinc supplements for six weeks received better behavioral ratings from teachers and parents than children who received Ritalin plus placebo. It is important to note that too much zinc may be harmful to the body and reduce copper stores. Making sure to dose zinc appropriately as well as balance it with copper is key.
Probiotics: many studies now show that the use of probiotics may help with ADHD. A double-blind pilot randomized placebo-controlled trial examined the possible effect of the probiotic strain Lactobacillus rhamnosus GG ATCC53103 (LGG) found a significant improvement in quality of life compared to the placebo group.
Omega 3 Fatty Acids. It is well known that the current typical Western diet is often devoid of omega 3 fatty acids and contains high amounts of omega 6 fatty acids. A UK-based study on school aged children discovered that omega-3 fatty acid insufficiency was common and associated with ADHD symptoms. Another Swedish study found that a supplement that contained a high amount of omega 3 fatty acid reduced ADHD symptoms in children after 6 months.
Phosphatidylserine (PS) is a component of the cell membranes within are bodies and is an important nutrient for the brain. This nutrient has been shown to help the neurotransmitter systems in the brain as well as improve cell membrane fluidity. A study has shown using PS supplements in children diagnosed with ADHD provided a significant improvement in ADHD symptoms, including short term memory, inattention and impulsivity.
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