Drug-Free Solutions to Attention Deficit Disorder
By Steve Holmes and Mark Olson, M.Sc.
The number of children with behavior and learning disorders in America has reached epidemic proportions. Children who display inattentive, non-compliant or hyperactive behaviors do not have a disease or disorder in the orthodox sense; instead, they may be suffering from a condition of abnormal brain chemistry due to a number of possible factors.
Medical scientists have come up with the term Attention Deficit Disorder (ADD) to identify these children who, by definition, have difficulty paying attention, do not work well with others, or simply do not follow instructions. These symptoms are a serious indicator of a lifetime of potentially worsening hardships including depression and instability. Those afflicted stand to suffer long-term problems in learning, socialization and behavior, and are at a high risk for psychopathology in adulthood.
Once ADD was medically defined, pharmaceutical companies raced for an answer in the form of a drug. Unfortunately, the most successful treatment thus far has been central nervous system stimulants such as Ritalin® (methylphenidate). While these drugs appear to be effective for psychological, educational and social disorders, many professionals feel they only offer a temporary solution, since these drugs do not permanently change behavior patterns.
Worse, Ritalin often carries side effects with it, as verified by the Physicians' Desk Reference (PDR). According to the PDR, methylphenidate can cause a number of harmful symptoms including nervousness, insomnia, tachycardia and loss of appetite. With continued use, the drug can even lead to psychotic episodes, dependency and perhaps, addiction.
It's no wonder, then, that Ritalin is defined as a class II drug--a controlled substance. Other drugs in this class include cocaine, methamphetamines and methadone--all categorized for their high abuse potential and severe side effects. As tolerance increases, drug dosages also may need to be increased, and to stop treatment suddenly can cause drastic side effects. Despite this readily available information, America has increased its administration of the drug by nearly 300 percent since 1990.
A more sensible approach to ADD would be to examine the core problem, and then build a solution based on the cause. While most sources maintain that the cause is still largely unknown, a number of progressive researchers have narrowed down several key factors. Nutritional deficiencies, neurochemical imbalances, food allergies and hypoglycemia are top suspects. Other related factors include poor eating habits, synthetic food additives and preservatives, and environmental toxins. Based on these findings, ADD should be addressed by providing these children with adequate nutritional support, while also monitoring their diet and environment.
Essential Fatty Acids
It is important to keep in mind that during a child's early years, the delicate nervous and endocrine systems are still in the developmental stages. Researchers have found that in children with ADD, these systems may not be developing correctly due to specific nutritional deficiencies. The most commonly implicated deficiencies include essential fatty acids (EFAs), phospholipids, and vitamins and minerals--all of which are essential for healthy brain, neuro- and endocrine function. Other nutritional components, including certain herbs and trace minerals, can be helpful against the condition as well.
EFAs are termed essential because they are vital for proper growth and neurological development, and humans lack the enzymes required to produce them. Therefore, they must be derived from a proper diet or through supplementation. The EFA docosahexaenoic acid (DHA), a polyunsaturated omega-3 fatty acid commonly found in fish oils, is perhaps the most important nutrient needed by children suffering from ADD.
DHA is naturally concentrated in the brain, where it is critical for the healthy transmission of nerve impulses and cell membrane functionality. Several studies have shown that DHA supplementation has a positive effect on the symptoms of ADD, Attention Deficit Hyperactivity Disorder (ADHD) and related disorders. Researchers at Purdue University compared boys with ADHD to boys who were considered normal and found that the ADHD boys had significantly lower serum and red blood cell levels of DHA than the normal boys.
Phosphatidylserine (PS), a natural phospholipid found in the brain, is another important nutritional compound for children with ADD. It plays an important role in several metabolic and pharmacologic functions, and studies have documented its positive effects on the brain neurotransmitters--acetylcholine, serotonin, norepinephrine and dopamine--that are intimately linked to behavior. This may be one explanation why PS supplementation can help improve behavior, cognitive function, concentration, attention and memory.
Several important studies have also shown that B vitamins may be essential for children with ADD. In fact, certain B vitamin deficiencies are directly associated with reduced mental performance. This makes sense when one considers that these vitamins are essential for the proper development of the nervous system, metabolism and psychiatric health. Vitamin B-6, B-12 and folic acid deficiencies are specifically implicated in behavioral problems, as well as in depression and personality disorders.
Vitamin B-6 is essential for optimal brain function, in part because it acts as an important coenzyme for the synthesis of the brain neurotransmitters GABA, dopamine and serotonin. Researchers in Spain observed that vitamin B-6 and folic acid supplementation clinically improved both behavior and school performance in students exhibiting problems in these areas.
With vitamin B-12 deficiencies, neurologic and psychiatric disturbances are often present, along with symptoms of depression and dementia. This was observed by scientists at Baylor University Medical Center, who noted that patients with low levels of vitamin B-12 and folic acid had diminished neurotransmitter function, which ultimately contributed to neurologic and psychiatric conditions. Children with behavioral disorders should, therefore, take adequate dosages of these B vitamins along with betaine, a natural compound that works synergistically with the B vitamins.
Other research shows that certain mineral deficiencies can contribute to ADD, hyperactivity and other abnormal behaviors. The results of a Canadian study, for example, showed that adolescents with behavior problems often had striking iron deficiencies. Another mineral, magnesium, was found to be deficient in the plasma of children with behavioral problems. Two studies revealed that low magnesium levels were a common factor in hyperactive children between the ages of four and 13. When these children received magnesium supplementation, noticeable behavior improvements corresponded. Unfortunately, however, according to Mildred Seelig, executive director of the American College of Nutrition, about 80 percent of American children exhibit magnesium deficiencies.
Overall, mineral deficiencies, in conjunction with chronic exposure to heavy metals, can lead to mineral imbalances that exacerbate neurological dysfunction. It has been proposed that this combination may lead to the replacement of heavy metals into the vital enzyme-mineral complexes that drive the metabolic cascades of the brain. If the body lacks the proper minerals that it requires, it may accept and store dangerous metals such as lead, mercury and aluminum instead.
Many clinicians believe that the consumption of sugary or refined carbohydrate foods can trigger behavior problems in children by wreaking havoc with their blood sugar. In one study, scientists performed glucose tolerance tests on several hundred hyperactive children and found that the majority exhibited abnormalities in their glucose metabolism. These imbalances often develop into hypoglycemia, which provokes the release of adrenaline and other hormones that can trigger hyperactive behavior.
Research has firmly established several nutrients and herbs that can help promote favorable sugar metabolism. For example, the trace mineral chromium, which plays a key role in balancing blood sugar, can help the body to regulate insulin. The native Indian herb Gymnema sylvestre has also been shown to improve blood sugar imbalances. In fact, animal studies show it can help normalize blood sugar by optimizing serum insulin levels. Another beneficial herb called Opuntia streptacantha has repeatedly demonstrated positive effects on blood sugar levels.
Finally, the powerful antioxidant lipoic acid can also help, as it acts as a co-factor for a number of important enzymes responsible for the conversion of food into energy. Clinical studies show that lipoic acid can help normalize blood sugar levels by increasing cellular uptake through the burning of glucose. These supplements can be used individually or together with a balanced diet to help regulate blood sugar in children with behavior problems.
Food sensitivities also play into the behavioral disorders; therefore, affected children should be tested for the most common food allergens. The top five include milk, wheat, corn, chocolate and citrus. Parents should also prevent their children from consuming all foods with preservatives, additives and colors.
The best approach to ADD and related disorders begins in the refrigerator and extends into the vitamin cabinets. The ideal diet should be high in vegetable proteins and whole grains with plenty of fresh fruits and vegetables. Tryptophan-rich foods are also recommended, including turkey, fish, wheat germ, yogurt and eggs. The diet should then be supported with the essential fatty acids, phospholipids, nutrients and herbs listed in this article.
"Smart nutrients," or nutritional supplements with known neuro-enhancing effects, such as activated soy phosphatides, tyrosine, glutamic acid, choline and inositol can also help to improve mood, mind, memory and behavior problems. These compounds play an important role in neurotransmitter action, and supplementation can significantly optimize cognitive functioning.
Mark Olson, M.Sc., is currently director of research and development for Chemi -Source Inc. based in Newport Beach, Calif.He has conducted published research at Harbor! UCLA and is currently active in other university clinical investigations.
Steve Holmes, a 15-year clinical nutritionist, is presently working in a multi-doctor medical office specializing in childhood behavior problems. He also is involved in research projects and provides technical support for nutritional supplement companies.