by Dr. Will Cole
What’s that you said? Sorry, I wasn’t paying attention! Unfortunately, attention, concentration, and hyperactivity disorders have reached epidemic proportions. According to the Centers for Disease Control and Prevention, ADHD diagnoses jumped by 41 percent between 2003 and 2011, and in 2016, more than 9 percent of children between the ages of 2 and 17—more than 6 million children in total—were diagnosed with ADHD. Unfortunately, many of these kids don’t grow out of the problem—according to the National Institutes of Health, about 4.5% of adults have an ADHD diagnosis, and many more are probably undiagnosed, living with constant life-impacting issues like trouble concentrating, paying attention, remembering things, and staying calm.
The many symptoms of ADHD.
You probably think you know the “ADHD kid” when you see them. They are the little kid dashing wildly around the classroom unable to stay seated or listen. While that is sometimes the case, the symptoms of ADHD aren’t always so obvious. ADHD is characterized by the inability to keep focused, listen, and remember things, especially that are not of interest to the child (or adult). Other features include increased impulsivity (the child that hits without thinking of consequences first, the adult who spends money or speaks his or her mind without thinking of the consequences first), that can make school and other structured settings challenging. There are three main subtypes of attention deficit disorders: hyperactive-impulsive, inattentive, and combined hyperactive-impulsive and inattentive, all of which can contribute to symptoms such as:
- Trouble listening
- Inability to sit still
- Lack of organizational skills
- Mood swings
- Anger management problems
- Difficulty staying focused
Typically, conventional medicine’s solution to ADHD (and other brain-related problems such as anxiety) is medication. ADHD drugs are designed to help manage symptoms by targeting certain neurotransmitters in the brain. Adderall and Ritalin are two of the most common ADHD medications, and they work to dull symptoms for many people, but they also come with a variety of side effects, including trouble sleeping, depression, and mood swings, sometimes severe. A few studies have looked at the long-term effects of these medications, and suggest that they do not improve symptoms significantly. What’s worse, the studies also suggest that those taking ADHD medications had lower self-esteem than those who weren’t prescribed medication for their condition. That doesn’t mean that medication is not a good choice for everyone. It has certainly helped many children get through school, and has helped some children get better grades. What it does mean, however, is that it is important to know all the possible options before resorting to medicating your child (or yourself).
Natural remedies for ADHD.
As a functional medicine practitioner, I try to avoid medications and the side effects that come with them as much as possible. ADHD can be a real and legitimate problem for many people, impairing their functioning, but by clinically investigating the underlying and often overlooked factors that contribute to ADHD, we can then target and address these problems naturally (and effectively) to avoid a lifetime of ongoing and sometimes debilitating symptoms. Here’s where to start:
1. Feed the brain.
Many health problems are caused or greatly exaggerated by nutrient deficiencies, and brain disorders like ADHD are no exception. For instance, children with ADHD are more likely than children without ADHD to have magnesium deficiency with one study finding that 95 percent of diagnosed children were deficient. Supplementing with 200 milligrams of magnesium per day over six months has been shown to decrease symptoms of hyperactivity. Magnesium threonate is the best type for addressing ADHD because it can cross the blood-brain barrier.
Another common deficiency directly related to brain health is zinc, which is necessary for the metabolism of neurotransmitters, specifically dopamine (the “happy hormone”). Zinc deficiency has been linked to ADHD, and many studies suggest that zinc supplementation may help reduce symptoms, especially of hyperactivity in children. Not all people with ADHD are zinc deficient, and in these cases, zinc hasn’t been shown to help, but that’s just further proof that zinc is important for healthy brain function. Supplements may not be necessary, as you can get zinc from eating more dark leafy greens, wild-caught salmon, and legumes.
2. Compensate for genetic variations.
Genetics don’t control your health, but they can influence just about every aspect of your health. Because variations in your genes can put you at a higher risk for certain health problems, examining the implications of these variations can help you understand your individual susceptibilities so you can take action to protect yourself. Variations in the BHMT gene in particular have been directly associated with developing ADHD. Also, the COMT gene works to balance and regulate communication between neurotransmitters, so certain variations in this gene can increase your risk for ADHD as well.
3. Eat clean.
Food can either fuel our bodies and help to optimize health and well-being, or it can feed disease, dragging us down and making us feel “blah” at best. But rather than focusing on eliminating one whole food group (whether “meat” or “grains” or “fat”), it can be more beneficial to focus on the food additives, dyes, and other chemicals in packaged, processed food. Between 1950 and 2012, intake of artificial food dyes increased from 12 milligrams to 68 milligrams per day. According to studies, just 50 milligrams a day was shown to increase hyperactivity and symptoms of ADHD, and it looks like many people (kids included) are already above that limit. Some of the food dyes and additives to look out for are:
- FD&C Yellow No. 6: found in cereal, candy, and soft drinks
- FD&C Yellow No. 5: found in cereal, pickles, and granola bars
- D&C Yellow No. 1: found in juices and frozen desserts
- FD&C Red No. 40: found in candy, soft drinks, and even children’s over-the-counter medications
- FD&C Blue No. 1 and No. 2: found in candy, sports drinks, and cereals
- FD&C Green No. 3: found in candy, sports drinks, cereals, and ice cream
- Sodium benzoate: a preservative found in a huge variety of foods, from soft drinks to condiments
4. Discover food intolerances.
Although I advised in #3 above that it is best to focus on additives rather than entire food groups, there is evidence that some food categories do tend to be more likely to aggravate ADHD symptoms in some people. In general, gluten-containing grains (and other grains in the ultra-sensitive), dairy products, and anything with added sugar are common symptom triggers for those with ADHD. Research has even linked celiac disease with ADHD, with one study showing a significant improvement in ADHD symptoms after starting a gluten-free diet. But what food groups should you eliminate first? Everyone’s body is different, so each person is going to have different food sensitivities. An elimination diet is my gold standard for discovering your personal food intolerances to help you take back control of your health and reverse symptoms. Not sure where to begin? Check out my mindbodygreen Elimination Diet Class.
5. Manage inflammation levels.
What happens in your gut affects your brain and vice versa, due to a direct connection between the two called the gut-brain axis. One example of how this can happen is that two proteins, zonulin and occludin, both contribute to blood-brain barrier permeability as well as gut-lining permeability. A lab test can determine whether you have permeability issues through the presence of antibodies, and most likely, if your gut lining is compromised, so is your blood-brain barrier (and vice versa). The result is that undigested food proteins and bacterial endotoxins leak into the bloodstream and brain where they don’t belong, triggering an immune response and increasing inflammation.
A whole area of medical research known as the cytokine model of cognitive function looks at how brain inflammation is implicated in the onset and perpetuation of brain problems such as ADHD. Backing up the chain, the first step in managing ADHD symptoms is to get tested for these scenarios. I run these labs in my functional medicine clinic to determine a patient’s status by assessing both permeability issues and inflammation levels:
- Blood-brain barrier proteins: These can determine if the blood-brain barrier has been breached.
- Zonulin and Occludin: This blood test looks to see if antibodies to these proteins are present.
- Homocysteine: This amino acid, when high, has been linked to damage of the blood-brain barrier.
- CRP: High levels of this inflammatory protein can indicate how chronic your inflammation is throughout your body.
The next step is to work backwards up the chain, healing breached barriers by addressing inflammation with anti-inflammatory food medicines, such as turmeric, green tea, and other superfoods.
6. Try EEG biofeedback.
Electroencephalographic biofeedback is a type of neurotherapy coupled with a learning strategy that gives people feedback about their brain waves to help them learn to self-regulate their brain function. This can help to control their symptoms and increase focus, and has been used successfully with many people struggling with ADHD.
7. Go play outside.
Children don’t play outside as often as they once did, but they should—especially kids with ADHD. According to research, spending just 20 minutes outside can improve concentration in children with ADHD. Research also found that taking a walk in nature or at a park is more effective than just spending time outside in a busy city. This is likely to help adults with ADHD as well.
8. Add adaptogenic herbs.
Adaptogens are plant medicines that specifically help to restore balance to the body and mind through various stress-relieving functions. Research found that children with ADHD who took Ginkgo biloba once a day for five weeks experienced an improvement in their symptoms. A similar study also looked at the effects of red ginseng and found that a daily dose of 1,000 mg for eight weeks led to a reduction in symptoms, including decreased anxiety and improved social function. Other adaptogens that have been shown to help with ADHD are pine bark extract and Bacopa monnieri. They can easily be incorporated into your favorite smoothies, beverages, or meals to help with symptoms.
9. Try CBD oil.
Never fear–CBD stands for cannabidiol, which is a cannabinoid compound in hemp and marijuana, but unlike THC (the psychoactive component of the marijuana plant), CBD does not give you the “high” that marijuana is famous for. While CBD oil can contain very small levels of THC, most don’t contain any, making CBD oil a great option for those looking for the benefits associated with hemp and marijuana without the mind-altering effects. If you are concerned, choose a brand with verified purity, as some people don’t react well to THC.
While more studies need to be done to confirm the effectiveness of CBD oil on ADHD symptoms, research suggest that it could help manage symptoms due to its ability to significantly drive down inflammation in the brain. CBD oil also helps to relieve anxiety by increasing prefrontal cortex activation and lowering activity in the amygdala areas of the brain, as well as keeping GABA and glutamate levels balanced for great calm and focus.
10. Boost serotonin.
Many people struggling with ADHD present with serotonin imbalances. Serotonin is the “feel-good neurotransmitter” and plays a role in impulse control, mood swings, and sleep patterns. To help boost serotonin, try tryptophan, an essential amino acid that occurs naturally in many foods, including (most famously) turkey (that after-Thanksgiving-dinner drowsy feeling is often attributed to tryptophan). A vitamin that could help is B6, which is also essential for the production of serotonin and has been shown to reduce symptoms of hyperactivity. Good sources of vitamin B6 inclue wild-caught salmon, grass-fed beef, sweet potatoes, hazelnuts, and turkey.
11. Sleep better.
Insomnia is a common symptom in those diagnosed with ADHD, as the hyperactive component can make it hard to settle down and rest. Behavioral sleep intervention has been shown in clinical trials to improve sleep patterns, which in turn also helped improve hyperactivity, focus, and other symptoms of ADHD, even long after the trial was completed. A doctor can recommend a good source for this kind of intervention.
12. Exercise regularly.
If you’ve ever experienced the feeling of elation after a good workout, you know the powerful effect of exercise on mood. ADHD is associated with lower levels of dopamine (and the consequent negative feelings), but regular exercise can help to compensate for this deficiency by boosting dopamine.
Since every person’s health case is unique, what works for one person won’t always work for the next. That’s why it is important to work with a qualified practitioner, to help identify any underlying health problems you or your child might have that could factor into symptoms and overall health profile. This knowledge will help you both to come up with a plan of care that works best for your (or your child’s) individual needs.
If you want to learn more about your own health case please check out our free health evaluation. We offer in person as well as phone and webcam consultations for people across the country and around the world.
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