Attention Deficit Disorder (ADD)

Only medication can address the symptoms of Attention Deficit Disorder

There are a number of other factors such as diet and specific nutrient supplementation that may dramatically reduce the symptoms of Attention Deficit Disorder.

What is attention deficit-hyperactivity disorder?

Attention deficit–hyperactivity disorder (ADD or ADHD) is defined as age-inappropriate impulsiveness, lack of concentration, and sometimes excessive physical activity. ADHD has been associated with learning difficulties and lack of social skills. Obviously what constitutes “normal” in these areas covers a wide spectrum, and thus it is unclear which child suffers true ADHD and which child is just more rambunctious or rebellious than another. ADHD often goes undiagnosed if not caught at an early age, and it affects many adults who may not be aware of their condition.

ADHD is generally recognized by a pattern of inattention, distractibility, impulsivity, and hyperactivity estimated to affect 3 to 5% of school-aged children. Learning disabilities or emotional problems often accompany ADHD. Children with ADHD experience an inability to sit still and pay attention in class, and they often engage in disruptive behavior.

The symptoms of Attention Deficit Disorder are caused by a neurological dysfunction within the brain. Several studies using PET scans have confirmed that there is a definite difference in brain functioning between a group of individuals diagnosed with Attention Deficit Disorder and those without it. The underlying physiological mechanism which causes Attention Deficit Disorder is still not thoroughly understood and remains under scientific study. It is presumed that brain chemistry is out of balance and that specific chemicals called neurotransmitters may be lacking in individuals with Attention Deficit Disorder. In two research studies, when the Attention Deficit Disorder subjects were given their medication and rescanned, their brain activity appeared to be much more like that of the normal group. Another interesting finding of these studies is that the areas of the brain in the Attention Deficit Disorder group where brain activity was lower than in the normal group are known to be associated with such functions as attention and concentration as well as planning and organization. These are the very functions that are impaired in persons with Attention Deficit Disorder. PET scans are considered to be very invasive because they involve the injection of radioactive material into the individual and therefore are not appropriate for diagnostic purposes. To date only two studies of Attention Deficit Disorder using PET scans have been conducted.

Attention Deficit Disorder may be either inherited or acquired. Recent research in genetics has definitely shown that Attention Deficit Disorder runs in families. The specific chromosomes that are involved have not been fully identified though more clues are being discovered as research progresses. Like many other disorders, a child may have the symptoms while his parents may not. Usually there are aunts, uncles, grandparents or cousins with the disorder.

Attention Deficit Disorder may be acquired through various conditions that cause insult (damage) to the brain. During pregnancy and delivery these include the use of drugs during pregnancy, toxemia, infectious diseases, overexposure to radiation, prematurity, complicated delivery. After birth these include meningitis, encephalitis, seizures from fever, head injury and lead toxicity. Excessive use of sweets does not cause Attention Deficit Disorder though it may make the symptoms worse for some individuals who already have the condition.

Since many children with Attention Deficit Disorder appear to "outgrow" the condition it can also be looked at as a developmental disorder. Some children seem to develop the ability to pay attention and concentrate later than others just as there is a wide range to timing for developing the ability to walk, talk or be potty trained. In the past, children with Attention Deficit Disorder and other learning disabilities were labeled as "underachievers" in their younger years and then reclassified as "late bloomers" when their development in this area finally caught up with their peers.

Today, many adults look back and realize they had a learning disability or Attention Deficit Disorder as a child which they may or may not have been able to overcome. Some people with Attention Deficit Disorder become very successful. However, others continue to have significant symptoms as adults. Some were not able to adapt or compensate on their own and did not receive any help from teachers, parents or professionals. These individuals often dropped out of school and may today be social drop outs of one kind or another. It is for this last reason that children who exhibit signs of Attention Deficit Disorder or learning disabilities should receive all the help necessary and available to spare them the frustration and anguish often associated with these conditions.

The main drug treatment for ADHD, Ritalin® (methylphenidate), is similar to amphetamine drugs. Although methylphenidate is a stimulant, it has a paradoxically calming effect in individuals with ADHD.

Self Help:

Key nutritional supplements

• none

Other nutritional supplements that may be helpful

• Magnesium: (200 mg of magnesium per day for six months) Some children with ADHD have lowered levels of magnesium. In a preliminary controlled trial, 50 ADHD children with low blood levels of magnesium were given 200 mg of magnesium per day for six months. Compared with 25 other magnesium-deficient ADHD children, those given magnesium supplementation had a significant decrease in hyperactive behavior.

Lifestyle changes that may be helpful

• Smoking: Smoking during pregnancy should be avoided, as it appears to increase the risk of giving birth to a child who develops ADHD.
• Metal exposure: Lead and other heavy-metal exposures have been linked to ADHD. If other therapies do not seem to be helping a child with ADHD, the possibility of heavy-metal exposure can be explored with a healthcare practitioner.

Dietary changes that may be helpful

• The Feingold diet: This diet was developed by Benjamin Feingold, MD, on the theory that salicylates (chemicals similar to aspirin that are found in a wide variety of foods) are an underlying cause of hyperactivity. This theory is not validated in all studies on the subject. As many as 10–25% of children may be sensitive to salicylates. The Feingold diet also eliminates synthetic additives, dyes, and chemicals, which are commonly added to processed foods. This diet, in any form, is complex and requires help from an experienced healthcare professional.
• Hypoallergenic diet: Some studies have shown that eliminating allergenic foods and additives from the diet can help children with attention problems.
• Dietary sugar: Some parents believe that sugar may aggravate ADHD. Girls who restrict sugar have been reported to improve more than boys who restrict sugar. While most studies have not found sugar to stimulate hyperactivity, except in rare cases, the experimental design of these studies has been questioned.

Dietary Modification

The two most studied dietary approaches to ADHD are the Feingold diet and a hypoallergenic diet. The Feingold diet was developed by Benjamin Feingold, M.D., on the premise that salicylates (chemicals similar to aspirin that are found in a wide variety of foods) are an underlying cause of hyperactivity. In some studies, this hypothesis does not appear to hold up.1 However, in studies where markedly different levels of salicylates were investigated, a causative role for salicylates could be detected in some hyperactive children.2 As many as 10 to 25% of children may be sensitive to salicylates.3 Parents of ADHD children can contact local Feingold Associations for more information about which foods and medicines contain salicylates. The Feingold diet also eliminates synthetic additives, dyes, and chemicals, which are commonly added to processed foods. The yellow dye, tartrazine, has been specifically shown to provoke symptoms in controlled studies of ADHD-affected children.4 Again, not every child reacts, but enough do so that a trial avoidance may be worthwhile. The Feingold diet is complex and requires guidance from either the Feingold Association or a healthcare professional familiar with the Feingold diet.

In one study, children diagnosed with ADHD were put on a hypoallergenic diet, and those children who improved (about one-third) were then challenged with food additives. All of them experienced an aggravation of symptoms when given these additives.5 Other studies have shown that eliminating individual allergenic foods and additives from the diet can help children with attention problems.6 7

Some parents believe that consuming sugar may aggravate ADHD. One study found that avoiding sugar reduced aggressiveness and restlessness in hyperactive children.8 Girls who restrict sugar have been reported to improve more than boys.9 However, a study using large amounts of sugar and aspartame (NutraSweet®) found that negative reactions to these substances were limited to just a few children.10 While most studies have not found sugar to stimulate hyperactivity, except in rare cases,11 the experimental design of these studies may not have been ideal for demonstrating an adverse effect of sugar on ADHD, if one exists. Further studies are needed.

Lifestyle Modification

Smoking during pregnancy should be avoided, as it appears to increase the risk of giving birth to a child who develops ADHD.12

Lead13 and other heavy-metal exposures14 have been linked to ADHD. If other therapies do not seem to be helping a child with ADHD, the possibility of heavy-metal exposure can be explored with a health practitioner.

Nutritional Supplement Treatment Options

Some children with ADHD have lowered levels of magnesium. In a preliminary, controlled trial, children with ADHD and low magnesium status were given 200 mg of magnesium per day for six months.15 Compared with 25 other magnesium-deficient ADHD children, those given magnesium supplementation had a significant decrease in hyperactive behavior.

A deficiency of several essential fatty acids has been observed in some children with ADHD compared with unaffected children.16 17 One study gave children with ADHD evening primrose oil supplements in an attempt to correct the problem.18 Although a degree of benefit was seen, results were not pronounced.

B vitamins, particularly vitamin B6, have also been used for ADHD. Deficient levels of vitamin B6 have been detected in some ADHD patients.19 In a study of six children with low blood levels of the neurotransmitter (chemical messenger) serotonin, vitamin B6 supplementation (15–30 mg/kg body weight per day) was found to be more effective than methylphenidate (Ritalin®). However, lower amounts of vitamin B6 were not beneficial.20 The effective amount of vitamin B6 in this study was extremely large and could potentially cause nerve damage, although none occurred in this study. A practitioner knowledgeable in nutrition must be consulted when using high amounts of vitamin B6. High amounts of other B vitamins have shown mixed results in relieving ADHD symptoms.21 22

Contraindications

Refer to the individual supplement for information about any side effects or interactions.