By Krysteena Stephens, M.A., IMFT and Victoria Dunckley, M.D.

ADHD keys to treatment
The key to optimal treatment is augmenting with natural methods

Typically, in both children and adults, treatment for ADD/ADHD involves use of psychotropic medication designed to reduce the inattentiveness, hyperactivity and impulsive behavior that are characteristic of the disorder. These medications work by activating the brain’s frontal lobe, which governs executive functioning (“getting things done”), working memory (storing and manipulating information in “the mind’s eye”), social behavior, and emotional control. While stimulants and other ADHD medications have been shown to improve these symptoms—particularly in the short term—many patients (and parents of patients) seek natural treatments either to augment or to reduce/replace medical treatments.  Here are five evidence-based natural methods you can implement to improve brain blood flow, reduce nervous system inflammation, and support healthy brain chemistry:

  1. GET MOVING: It is well known that regular, moderate exercise can help improve mood, regulate sleep, and increase energy. However, more recent studies are also finding that exercise improves a whole host of neurological processes associated with attention, memory and behavior. One study from 2013 in the Journal of Pediatrics reported that children with ADHD who performed a quick, 20-minute bout of moderate aerobic exercise showed improvements in reading, arithmetic, and impulse control directly following exercise compared to a 20-minute reading session.[*] Exercise is also known to strengthen very specific parts of the brain such as the hippocampus, an area associated with memory and learning. In one brain imaging study, the hippocampus was actually larger in children who were considered “higher-fit.” So not only does exercise make us feel and look great, but it literally makes us smarter!
     
  2. TAKE YOUR VITAMINS (AND MINERALS!): Vitamins that are also antioxidants (such as vitamins A, C and E) lower inflammation, protect fatty cell membranes, and support many cellular metabolic processes in the brain, and thus may indirectly improve cognition and behavior symptoms in ADHD.  Adequate stores of B vitamins are also required for numerous nervous system functions, and optimal amounts are thought to support a sense of well-being. But generally speaking, the research regarding direct beneficial effect on ADHD is more robust for minerals.

    In a double blind, placebo controlled study monitoring the effects of zinc plus methylphenidate (Ritalin, a common stimulant), parents and teachers were asked to monitor and scale the behaviors of 44 children diagnosed with ADHD and found that both parent and teacher ratings improved over a 6-week period for the children taking 15mg of zinc per day along with methylphenidate while the control group’s (methylphenidate alone) ratings did not. This makes sense as the mineral zinc is crucial for the proper functioning of the brain chemical and hormone norepinephrine (involved in attention and memory), as well as GABA, a calming neurotransmitter.

    Regarding iron, lower stores—as opposed to iron blood levels—are correlated with more severe ADHD symptoms, and iron deficiency is common in ADHD diagnosed individuals.  Research suggests that children with ADHD with low ferritin (a measure of iron stores) may benefit from iron supplementation. Consuming iron-rich foods like spinach, chicken, oysters, and turkey on a regular basis will help boost iron stores; iron supplementation should be implemented under doctor supervision since too much can cause constipation and/or be toxic.[†] Magnesium is another mineral found to be low in children with ADHD, and supplementation has been shown to reduce hyperactivity. Magnesium also promotes deeper sleep, muscle relaxation, and normal electrical signaling. Daily supplementation of fish oil may be another natural remedy helpful in treatment of ADHD symptoms as demonstrated in a study of children whose symptoms significantly decreased over a 12-week period when supplementing with fatty acids.

    In general, aside from eating a clean diet with abundant organic fruits and veggies, taking a pharmaceutical-grade multivitamin with chelated minerals along with high-grade fish oil supplement may improve both cognitive and behavior symptoms directly and indirectly, especially over time.  Appropriate blood tests may include a ferritin level for iron, red blood cell magnesium levels, and serum or red blood cell zinc levels to help assess whether additional supplementation is needed; blood tests are not always definitive, however, and should be used in conjunction with clinical information.
     

  3. CONSUME MORE PROTEIN:  Research indicates that ADHD symptoms are caused by an imbalance in the catecholaminergic systems in the brain areas that control memory, motor functioning and emotional regulation. The two most abundant catecholamines in the brain are the neurotransmitters dopamine and norepinephrine, and both are derived from the amino acid tyrosine. (Amino acids are precursor elements (building blocks) of neurotransmitters, are themselves derived from proteins, and are involved in nearly every biochemical process that the body needs to grow and thrive.) Eating a high protein diet could theoretically enhance and regulate neurotransmitter systems in the brain while assisting in keeping ADHD symptoms at bay. In fact, studies show that daily breakfast boosts cognition and academic performance, and that protein intake boosts levels of available catecholamines in the brain, keeping the individual alert and attentive.  Although many alternative or integrative practitioners recommend specific amino acids or blends for ADHD, there is little direct evidence to support their use at this time.
     
  4. CUT BACK ON SUGAR: Excessive sugar intake activates the same reward pathways in the brain that are involved in drug addiction, and may act on the same systems that trigger hyperactivity. Reports by teachers regarding their beliefs about sugar consumption typically highlight the increase in behavioral issues for symptomatic as well as normative children.  Refined sugar also induces erratic blood sugar levels, and both low and high sugar levels may affect cognition. Aside from the usual culprits including soda, candy and cookies, watch out for chips, crackers, and other processed or packaged foods. Canned foods and condiments, especially ketchup, tend to have very high sugar levels as well.
     
  5. TAKE A SCREEN BREAK: Last year the American Academy of Pediatrics released updated “screen-time” guidelines that included placing limitations on screen time for adolescents and teens to 2 hours or less per day as well as cutting out all screen use for children under 2 years of age. Increasingly, researchers are discovering effects of excessive screen usage among children and adolescents, including  inattentiveness, aggression, and antisocial or oppositional behaviors. A longitudinal study performed in the Netherlands tracked nearly 4000 preschool aged children who watched television for an hour or more per day and noticed not only an increase in negative behaviors for children who were already considered problematic, but also an emergence of behavioral issues from children who were said to have no behavioral issues prior to the study. Screens also contribute to additional ADHD-like symptoms such as issues with memory and learning as reported by another researcher who tracked children’s cognitive performance following a bout of computer gaming. The findings suggest that gaming may impact not only sleep quality but also lead to significant declines in verbal memory.

    Consistently, research has shown that screen-time in the evening (or worse, just before bedtime or after lights-out) contributes to sleep issues. Furthermore, light from any screen device suppresses melatonin and impairs cognition, so it’s not just stimulating content or activity that does the trick. Clearly, the alarming rise of screen usage in recent years is affecting our children and their developing brains. Abiding by healthy screen time guidelines will assist in putting a halt to the increase in screen-time and its associated behavioral issues, but ADHD children may need a 3-4 week “electronic fast” to help reset circadian rhythms and brain chemistry.

We’re all affected by the so-called modern lifestyle, but kids and adults with ADHD seem to be more affected, perhaps because their brains are more sensitive, or perhaps because they simply have more energy to burn. If there’s an overlying message here, it’s to return to Mother Nature: think how our ancestors lived, and try to imitate it as closely as possible. They moved to hunt, grow, gather and pick their food; they were active during daylight hours and rested at night; and they were not exposed to artificial light, artificial foods, or artificial play.  Mother Nature cannot be fooled!

For more help with the impact of electronics on attention and impulse control, see Reset Your Child's Brain: a Four Week Plan to End Meltdowns, Raise Grades and Boost Social Skills by Reversing the Effects of Electronic Screen Time. 

[*] Healthy children showed improvements in cognition as well, but the ADHD group showed additional improvements in behavioral control.

[†] In the aforementioned study, the children took 80mg of iron daily for 12 weeks in the form of ferrous sulfate.

About the Author

Victoria L. Dunckley, M.D.

Victoria L. Dunckley, M.D. is an integrative child, adolescent and adult psychiatrist, the author of Reset Your Child's Brain, and an expert on the effects of screen-time on the developing nervous system.  

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