Supplements to ADHD

By: Dr. Arlene Dubier, ND

Attention-deficit hyperactivity disorder is a common and growing concern amongst toddlers and school-aged children, with about 5% of children between ages 3-9 being diagnosed in Canada. The goal for parents, caregivers and health care practitioners should be to destigmatize ADHD and focus on reinforcing strengths that the child has to prevent difficulties with self-esteem and self-efficacy.

Defining ADHD 

This diagnosis of ADHD involves three main symptom patterns [1]:

1. Lack of focus and/or attention
2. Impulsive behaviour
3. Increased level of activity

These symptoms must present significantly in two or more environments, such as at school, at home, in extracurricular activities and must interfere with social or academic functioning. It is important to rule out other conditions before quickly diagnosing ADHD, as these symptoms could be related to under-nutrition, other mental health concerns, hyperthyroidism or heavy metal toxicity.           

Often ADHD comes along with other neuropsychiatric disorders, such as learning delays and mood disorders. Additionally, it is common for individuals with ADHD to have sleep disorders which can contribute to the concern of poor attention and hyperactivity. 

Types of Treatment Available:

General treatment for ADHD involves a multifactorial approach via pharmaceuticals, behavioural therapy as well as natural medicine. With pharmaceuticals it is important to start at a low dose because there are common side effects of certain medications which cause loss of appetite, sleep troubles, agitation, etc. Behavioural therapy is of utmost importance to help the child develop self-efficacy and enjoy a structured routine. This may involve reinforcing boundaries, setting a daily schedule and rewarding desired behaviours. 

Food as Medicine

In terms of naturopathic treatment, diet and lifestyle are key elements as children with ADHD are often lacking certain vitamins and minerals. Any child who isn’t meeting nutritional requirements, is over-stressed and not getting enough physical activity and sleep may have difficulties with attention and unwinding. Removal or reduction of simple carbohydrates such as white grains, pastas and processed sugars can be helpful [2]. Additionally, the “Feingold” diet involves complete removal of foods with artificial dyes and colourings which may be helpful in decreasing some symptoms of ADHD [2]. Aside from this, it is important to assess if a child is sensitive to certain foods such as dairy and gluten-containing products. This may start with just changing one meal a day to incorporate nutrient-rich foods, and allowing the child to be a part of the decision-making process in the grocery store.

Sleep and Stress

Sleep hygiene is also important to promote positive sleep habits and a time for adequate rest and recovery. This includes removal of devices from the bedroom and avoiding usage at least one hour before bed. Also, ensuring that the room is completely darkened (if possible) and slightly cool to prevent overheating. Relaxation techniques could include mindfulness meditation which can help mitigate stress and allow the child to connect more to the present moment.

Activity and Screen Time

For children aged 5-17, the recommendations are 60 minutes of moderate to vigorous-intensity physical activity daily, having vigorous activity at least three days a week [3]. Children with ADHD may benefit from activities where they can build on their strengths and independence. This includes the use of tools, or taking up chores in the household. 

Nutritional Supplementation           

Before beginning nutritional supplementation, it is important to speak with your healthcare practitioner to identify any nutrient deficiencies which can be done through blood-work and a dietary assessment.

• Omega-3 Fatty Acids

The importance of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been implicated in brain disorders for development and mood regulation [4]. In a meta-analysis using omega-3 fatty acids, it was determined that supplementation can improve clinical symptoms as well as cognitive function in children and adolescents with ADHD. Additionally, in retrospective studies, it was seen that young adults with ADHD have lower levels of DHA, which is the omega-3 that is important for early and neonatal development of brain tissue [4].

• Vitamin D3

Serotonin, one of our “happy” hormones is often implicated in ADHD, which is why a common pharmaceutical used for individuals with ADHD are selective serotonin reuptake inhibitors which make serotonin stick around longer in the brain before getting reabsorbed. If vitamin D3 levels are not sufficient in the body, the theory is that this can exacerbate underproduction of serotonin and delay brain development. Vitamin D3 restriction in adulthood has also been shown to cause behavioural issues such as poor attention and impulsive behaviour [5].

• Other Supplements

After a nutritional assessment is done, and depending on what the individual needs, there are other supplements which can be added. This includes iron, B-vitamins, zinc, magnesium and probiotics. Additionally, botanical medicine has been used to help reduce symptoms of inattention and hyperactivity [3]. Please speak with your healthcare practitioner to determine what would be best for your specific needs.

ADHD is a complex neuropsychological disorder which can vary in severity and requires an individualistic approach. As its prevalence continues to grow in modern society, it is important to know what options we have for support.

References: 

1. N.A. (2020). Clinical overview: attention-deficit hyperactivity disorder, Elsevier Point of Care. Retrieved from Clinical Key
2. Boris, M. & Mandel, F.S. (1994). Foods and additives are common causes of the attention deficit hyperactive disorder in children, Ann Allergy. 72(5):462-468
3. Solomonian, L. (2019). Neurologic concerns: ADHD. Naturopathic and Integrative Pediatrics. CCNM Press Inc. Toronto, ON.
4. Pei-Chen Chang, J., Su, K-P, Mondelli, V. & Pariante, C. (2018). Omega-3 polyunsaturated fatty acids in youths with attention deficit hyperactivity disorder: a systematic review and meta-analysis of clinical trials and biological studies, Neuropsychopharmacology. 43(3), 534-545. https://dx.doi.org/10.1038%2Fnpp.2017.160
5. Patrick, R. & Ames, B.N. (2015). Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia and impulsive behaviour, The FASEB Journal. 29(6), https://doi.org/10.1096/fj.14-268342