ADDRESSING ADHD WITHOUT MEDICATIONS
We have heard the reports that attention-deficit disorder, or ADHD is on the rise, and that many children (and adults) are being medicated. Is this unavoidable? Is this desirable?
Due to recent discoveries, I have become suspicious of most common medications. For example, if you have high cholesterol, you may be started on a statin to lower your risk for heart attacks. Unfortunately, statins raise the risk for diabetes. But then if you have diabetes, you may be started on a diabetes drug, such as Avandia, now suspected of causing cardiac deaths. So back to square one. Maybe it would be better to make sure that cholesterol is really harmful. I’m afraid medicine just isn’t making much sense these days.
How else then can we address serious issues such as ADHD?
ADHD (and autism, and autism spectrum disorders) represents the end result of a variety of possible impacts on the child's development. These disorders involve inflammation (immune system overactivation), which means that the immune system has something to do with it. They also involve genetics, as revealed by studies of family members and twins. They very much involve the environment, and are more common in populations exposed to certain pesticides, and to BPA (bisphenol-A, the plastic in receipts and the linings in cans).
ADHD involves problems with energy utilization within the brain. There are abnormalities on scans of blood flow to various parts of the brain. This does not tell us what causes these blood flow issues. There are also abnormalities in the way some parts of the brain work at the cellular level. Mitochondria seem to be affected. Neurotransmitters are most definitely affected.
ADHD involves problems with essential fatty acids. These are components of food that are assimilated by the body and used up to build cell membranes and other crucial working cell components. Certain essential fatty acids help regulate the immune system.
So, treatments that reverse ADHD have involved a variety of approaches. Each treatment may be weak on its own, but quite significant in combination with other treatments. Here's a long list, along with a little comment as to how they fit into the whole picture.
Diet plays a huge role. Some chemicals, such as artificial coloring, cause hyperactivity in "normal" children, and certainly make children with ADHD worse. Elimination diets improve symptoms in a large majority of the kids who can actually stay on the diet (and a majority of kids do stay on the diet). Beliefs on various diets have come and gone. In a study published in 2011, where the kids were fed basically lettuce, turkey, pears and rice, 80% of the children lost their ADHD symptoms. That’s a powerful approach, but what to do in the long term is the problem.
If ADHD involves significant inflammation, then it stands to reason that interventions that reduce inflammation would also reduce symptoms. Typically, there are 7 major steps to reducing inflammation:
The first is a return to a caveman (anti-inflammatory) diet: nuts, berries, fruits, vegetables, seeds and lean sources of protein. The fish should be wild-caught and the animal protein should come from grass-fed, free-ranging animals. The chickens ideally should eat an organic diet and ideally should be raised on pasture where they can find bugs to eat. Lean meats are better because pesticides accumulate even in organic animals, given their presence in the air we breathe.
Some researchers have seen success with medium doses of two amino acid precursors: 5-HTP and tyrosine. A majority of children begin to do better just days after starting on these supplements. Some of the children who don't respond at first, do finally respond when the doses of supplements are adjusted according to results of urine tests for amino acids.
There are more herbs and substances with research-proven efficacy. Of course, we don’t know the long-term side effects of any of these approaches. However, given the unpalatable set of choices, whatever is closer to being “natural” and actually has a biochemical mechanism that makes sense is worth looking into.
Due to recent discoveries, I have become suspicious of most common medications. For example, if you have high cholesterol, you may be started on a statin to lower your risk for heart attacks. Unfortunately, statins raise the risk for diabetes. But then if you have diabetes, you may be started on a diabetes drug, such as Avandia, now suspected of causing cardiac deaths. So back to square one. Maybe it would be better to make sure that cholesterol is really harmful. I’m afraid medicine just isn’t making much sense these days.
How else then can we address serious issues such as ADHD?
ADHD (and autism, and autism spectrum disorders) represents the end result of a variety of possible impacts on the child's development. These disorders involve inflammation (immune system overactivation), which means that the immune system has something to do with it. They also involve genetics, as revealed by studies of family members and twins. They very much involve the environment, and are more common in populations exposed to certain pesticides, and to BPA (bisphenol-A, the plastic in receipts and the linings in cans).
ADHD involves problems with energy utilization within the brain. There are abnormalities on scans of blood flow to various parts of the brain. This does not tell us what causes these blood flow issues. There are also abnormalities in the way some parts of the brain work at the cellular level. Mitochondria seem to be affected. Neurotransmitters are most definitely affected.
ADHD involves problems with essential fatty acids. These are components of food that are assimilated by the body and used up to build cell membranes and other crucial working cell components. Certain essential fatty acids help regulate the immune system.
So, treatments that reverse ADHD have involved a variety of approaches. Each treatment may be weak on its own, but quite significant in combination with other treatments. Here's a long list, along with a little comment as to how they fit into the whole picture.
Diet plays a huge role. Some chemicals, such as artificial coloring, cause hyperactivity in "normal" children, and certainly make children with ADHD worse. Elimination diets improve symptoms in a large majority of the kids who can actually stay on the diet (and a majority of kids do stay on the diet). Beliefs on various diets have come and gone. In a study published in 2011, where the kids were fed basically lettuce, turkey, pears and rice, 80% of the children lost their ADHD symptoms. That’s a powerful approach, but what to do in the long term is the problem.
If ADHD involves significant inflammation, then it stands to reason that interventions that reduce inflammation would also reduce symptoms. Typically, there are 7 major steps to reducing inflammation:
The first is a return to a caveman (anti-inflammatory) diet: nuts, berries, fruits, vegetables, seeds and lean sources of protein. The fish should be wild-caught and the animal protein should come from grass-fed, free-ranging animals. The chickens ideally should eat an organic diet and ideally should be raised on pasture where they can find bugs to eat. Lean meats are better because pesticides accumulate even in organic animals, given their presence in the air we breathe.
- The vitamin D status should be checked and optimized.
- Essential fatty acids, usually in the form of high quality fish oil, are likely to work. One study reports giving more EPA than DHA, another reports giving more DHA, less EPA. It may simply depend on the child. A blood test for these could help guide treatment. This is rarely done in the research.
- Multivitamins are a good idea because the child's need for antioxidants, B vitamins, zinc, magnesium, iron, and vitamins C and E is likely to be high. These vitamins and minerals are affected by stress levels, which tend to rise when someone's behavior is constantly a source of grief. Also, the antioxidants especially help protect the fatty acid supplements from harm within the body.
- Exercise is an important component of treatment for ADHD. I think this is because exercise reduces stress and inflammation. It also helps the body make new mitochondria. Exercise affects the brain, allowing it to make new neurons, and connections between neurons.
- Probiotics may be a good idea because gut dysbiosis (the wrong bacteria) is an important component of inflammation. Getting the bacteria right could help heal the gut, which in turn would decrease potential for mischief from digestive issues. I know this is vague, but it appears that "bad" bacteria make chemicals from food in our intestines, that then enter the bloodstream and affect behavior.
- Direct stress reduction, such as the use of the HeartMath monitor, have also had some success. Meditation boosts connections in the prefrontal cortex, which is precisely one of the areas affected in ADHD.
Some researchers have seen success with medium doses of two amino acid precursors: 5-HTP and tyrosine. A majority of children begin to do better just days after starting on these supplements. Some of the children who don't respond at first, do finally respond when the doses of supplements are adjusted according to results of urine tests for amino acids.
There are more herbs and substances with research-proven efficacy. Of course, we don’t know the long-term side effects of any of these approaches. However, given the unpalatable set of choices, whatever is closer to being “natural” and actually has a biochemical mechanism that makes sense is worth looking into.
Myrto Angela Ashe MD, MPH practices functional medicine in San Rafael, CA. She offers a 6-month health transformation program for adults who are motivated to maximize their health in order to live a long and fully enjoyable life. She also sees kids and anyone trying to avoid medication, stop medication, reverse chronic illness, or optimize well-being.
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