Nutritional Support for ADHD

 

The two main medications used to manage ADHD in children and adults are stimulant and antidepressant medications. However, for many parents, the thought of putting a young child on long-term medication, no matter how effective it may, is not a decision that sits easily. While there are undoubtedly benefits to ADHD medications and many children do well on them, there are also a large proportion (an estimated 30%) of children who can't tolerate the side effects or report the medication has no beneficial effect on their behaviour.

 

Given this, many parents choose to look for alternative means of supporting their children. While there is currently no known cure for ADHD, positive parenting strategies, school support, dietary interventions, exercise and counselling have been shown significantly help many children with their symptoms, with and without the use of prescribed medications. It is now well accepted that supporting a child with ADHD requires a holistic approach - utilising several different modalities to bring out the best a child.

 

Despite there being no conclusive evidence that supports the theory of nutritional deficiencies causing ADHD, there is a large body of evidence that shows people with ADHD commonly have deficiencies of certain nutrients such as zinc, magnesium and vitamin B6. Zinc, magnesium and vitamin B6 are all required to help synthesize and regulate the neurotransmitters that are affected in ADHD. Targeted nutritional supplementation has therefore been shown as a potential treatment or complementary intervention for children with ADHD.

 

It’s important to understand that a supplement is still a supplement, and diet should always be addressed as well. If you are interested in finding out how you can support your child’s ADHD through diet, read this blog post.

 

But for the times when you may need some extra support, here are four nutrients that have been most well researched with ADHD.

 

ZINC

 

  • Zinc deficiency is one of the most-recognised micronutrient deficiencies linked to ADHD symptoms as blood analysis of children with ADHD has demonstrated reduced zinc levels in children with ADHD compared to healthy children.
  • Numerous human and animal studies have suggested that zinc deficiency may be associated with hyperactivity and may also be involved in the pathophysiology of ADHD.
  • Zinc is an essential cofactor that is required for the production of dopamine and norepinephrine. Suboptimal levels of zinc disrupt the production and regulation of dopamine and norepinephrine, which is understood to be an essential part of the cause of ADHD.
  • Zinc is really important for regulating copper balance within the body. While trace amounts of copper are needed by the body, elevated levels can lead to over-excitation of the neurotransmitters and contribute to hyperactive ADHD symptoms.
  • A 2004 study showed improvements in hyperactivity, impulsivity, and social engagement in children with ADHD following zinc supplementation.
  • A 2016 study found zinc supplementation increased the effectiveness of an ADHD stimulant medication, lowering the dose and thus side effects in the children. 

 

MAGNESIUM

 

  • Magnesium is arguably one of the most important nutrients for optimal brain performance as it is involved in virtually every single enzyme reaction, nerve signal conduction and supports the function of serotonin and dopamine receptors. 
  • Magnesium is important for modulating the excitation of nerves and promoting GABA production. GABA is a neurotransmitter that is the basis of the inhibitory (calming) system in the body and also controls the action of epinephrine, norepinephrine, and dopamine which are affected in ADHD. 
  • Magnesium deficiency has been identified in almost all cases of ADHD. 
  • Magnesium has been shown to work best when taken with Vitamin B6 as B6 increases the absorption potential of magnesium. 
  • Similar to zinc, studies have found that magnesium appears to be a beneficial supplementary therapy alongside conventional ADHD drugs. One study found that magnesium supplementation taken in combination with conventional ADHD drugs reduced ADHD more than the drugs alone. 

 

 

VITAMIN B6

 

  • Vitamin B6 plays important roles in energy production and neurotransmitter synthesis and is also important for a healthy immune and nervous system, both of which may be impaired in children with ADHD.
  • Vitamin B6 works synergistically with zinc to produce serotonin which is a neurotransmitter involved in modulating cognition, reward, learning and memory.
  • Children with ADHD have been found to have a reduced ability to convert the amino acid tryptophan to serotonin, which results in greater impulsive and hyperactive behaviours. As Vitamin B6 acts as a cofactor for this pathway, reduced levels of Vitamin B6 can make this conversation even harder.
  • Studies have found that sub-optimal levels of B6 are common in adults with ADHD and low levels of B6 are more likely to be seen in those with greater severity of symptoms.
  • Deficiency of Vitamin B6 is associated with symptoms of irritability and difficulty concentrating, which are key symptoms of ADHD
  • Research has shown that Vitamin B6 supplementation is most beneficial for those with ADHD when also taken alongside magnesium and zinc.

 

 

While these nutrients are readily available to the general public and hold great potential for those managing ADHD, it’s important to remember that managing supplements and other integrative treatments requires expertise and should never be done without the care and approval of your health care practitioner.

 

 

References

 

Arnold, L. E., Disilvestro, R. A., Bozzolo, D., Bozzolo, H., Crowl, L., Fernandez, S., … Joseph, E. (2011). Zinc for attention-deficit/hyperactivity disorder: placebo-controlled double-blind pilot trial alone and combined with amphetamine. Journal of child and adolescent psychopharmacology21(1), 1–19. doi:10.1089/cap.2010.0073

El Baza et al. (2016). Magnesium supplementation in children with attention deficit hyperactivity disorder. Egyptian Journal of Medical Human Genetics, 17(1), 63-70.

Esparham, A., Evans, R. G., Wagner, L. E., & Drisko, J. A. (2014). Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD). Children (Basel, Switzerland)1(2), 186–207. doi:10.3390/children1020186

Greenblatt, J. (2017). Finally Focused: Mineral Imbalances & ADHD (Part 1: Zinc Deficiency and Copper Excess. Retrieved from http://blog.zrtlab.com/mineral-imbalance-adhd-zinc-copper

Greenblatt, J. (2017). Finally Focused: Mineral Imbalances & ADHD (Part 2: Magnesium Deficiency. Retrieved from http://blog.zrtlab.com/mineral-imbalance-adhd-magnesium

Ho, C., Quay, T., Devlin, A., & Lamers, Y. (2016). Prevalence and Predictors of Low Vitamin B6 Status in Healthy Young Adult Women in Metro Vancouver. Nutrients, 8(9), 538. http://doi.org/10.3390/nu8090538

International Society for Orthomolecular Medicine (IOSM). (n.d.). Micronutrient Deficiencies in ADHD: A Global Research Consensus. Retrieved November 11, 2019, from https://isom.ca/article/micronutrient-deficiencies-adhd-global-research-consensus/

 

Landaas, E. T., Aarsland, T. I. M., Ulvik, A., Halmoy, A., Ueland, P. M., & Haavik, J. (2016). Vitamin levels in adults with ADHD. BJPsych Open, 2(6), 377–384. http://doi.org/10.1192/bjpo.bp.116.003491

Moshfegh, A., Goldman, J., Ahuja, J., Rhodes, D., & LaComb, R. (2009). What we eat in America, NHANES 2005–2006: usual nutrient intakes from food and water compared to 1997 dietary reference intakes for vitamin D, calcium, phosphorus, and magnesium.

Mousain-Bosc, M., Roche, M., Polge, A., Pradal-Prat, D., Rapin, J., Bali, J. P. (2006). Improvement of neurobehavioral disorders in children supplement with magnesium vitamin B6. Magnesium Research, 19(1), 53–62.

Rucklidge, J. J., Frampton, C. M., Gorman, B., & Boggis, A. (2017). Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. The British Journal of Psychiatry, 204(4), 306–315. http://doi.org/10.1192/bjp.bp.113.132126

Rucklidge, J., Taylor, M., & Whitehead, K. (2011). Effect of micronutrients on behavior and mood in adults With ADHD: evidence from an 8-week open label trial with natural extension. Journal of Attention Disorders, 15(1), 79–91. http://doi.org/10.1177/1087054709356173

Starobrat-Hermelin, B., & Kozielec, T. (1997). The effects of magnesium supplementation on hyperactivity in children with attention deficit disorder (ADHD). Positive response to magnesium oral loading test. Magnesium Research, 10(2), 149–156.

Viktorinova, A., Ursinyova, M., Trebaticka, J., Uhnakova, I., Durackova, Z., & Masanova, V. (2016). Changed Plasma Levels of Zinc and Copper to Zinc Ratio and Their Possible Associations with Parent- and Teacher-Rated Symptoms in Children with Attention-Deficit Hyperactivity Disorder. Biological Trace Element Research, 169(1), 1–7. http://doi.org/10.1007/s12011-015-0395-3

Yorbik, O., Ozdag, M. F., Olgun, A., Senol, M. G., Bek, S., & Akman, S. (2008). Potential effects of zinc on information processing in boys with attention deficit hyperactivity disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 32(3), 662–667. http://doi.org/10.1016/j.pnpbp.2007.11.009

Brittany Darling