Attention Deficit Hyperactivity Disorder (ADHD) affects up to 15% of children and 8% of adults each year. There are a variety of evidence-based, functional medicine approaches that can effectively reduce symptoms of ADHD, including nutrition, exercise, mindfulness, lifestyle, prescriptions, psychotherapy, and more.
In this article, we’ll review common root causes of ADHD and functional medicine approaches used to treat it.
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Signs & Symptoms of ADHD
ADHD is defined by the National Institutes of Mental Health as “an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development [characterized by] the following types of symptoms:
- Inattention: difficulty staying on task, sustaining focus, and staying organized, and these problems are not due to defiance or lack of comprehension.
- Hyperactivity: moving about constantly, including in situations when it is not appropriate, or excessively fidgets, taps, or talks. In adults, hyperactivity may mean extreme restlessness or talking too much.
- Impulsivity: acting without thinking or difficulty with self-control. Impulsivity could also include a desire for immediate rewards or the inability to delay gratification. An impulsive person may interrupt others or make important decisions without considering long-term consequences.”
ADHD symptoms can significantly impact people’s lives, including relationships, job performance, and more. Not everyone with ADHD has the same symptoms. People who struggle with the inattentive symptoms of ADHD may have trouble with time management, deadlines, deep listening, attention to detail, and the ability to complete projects once they start them.
For others, the hyperactivity symptoms associated with ADHD can make it difficult for them to stay seated, can lead to interruptions in class or work situations, and can cause behavioral difficulties that create conflict with others.
The good news is - whatever the symptoms are - there are many ways to treat ADHD and get back to living the best, most focused, and centered life. Let’s review them!
Possible Causes of ADHD
Below are some common possible causes:
Nutrient Deficiencies
People with ADHD have higher chances of being nutrient deficient than the average person.
Iron
People with ADHD are twice as likely to suffer iron-deficiency anemia compared to members of the general population.
Vitamin D
78.4% of children with ADHD are deficient in vitamin D compared to 48% of children without ADHD.
Omega 3, Omega 6, Magnesium, & Zinc
One study showed that 12 weeks of consumption of a combination of omega-3 and omega-6 fatty acids, magnesium, and zinc showed a considerable reduction in symptoms of attention deficit, emotional problems, hyperactivity, and impulsivity assessed by SNAP-IV.
Hormone Imbalances
Estrogen, testosterone, and progesterone hormone imbalances can worsen symptoms of concentration, impulsivity, and inattention in ADHD patients
In one study, boys with ADHD were far more likely to have higher sex hormone-binding globulin (SHBG) levels and lower DHEA levels than their peers.
Heavy Metals
Excessive blood levels of heavy metals like lead or mercury can interfere with neural signaling and worsen attention symptoms. Lead has been extensively researched in ADHD and can impact young children’s neural development even at low levels.
Food Allergies and Sensitivities
Since the 1970s, parents and practitioners have found that their pediatric patients with ADHD often experience an increase in symptoms after ingesting food ingredients like artificial food colorings (AFCs) and highly allergenic foods like milk, chocolate, soy, and wheat. Additionally, anti-inflammatory eating patterns like the DASH diet have been found to improve symptoms of ADHD.
Functional Medicine Labs to Find the Root Causes of ADHD
The following tests are beneficial for uncovering the root causes of ADHD:
Testing for Nutrient Deficiencies
Assessing nutrient deficiencies can be done in many ways, including at-home blood spot tests and serum blood levels. A CBC and CMP, which your doctor runs every year, can detect vitamin D and iron deficiencies.
Testing for Heavy Metals
The most common way to test for heavy metal levels is by checking hair, blood, and urine levels.
For further testing, a provocation challenge test can be done. This test requires you to take a small dose of a heavy metal chelator and then test how much you excrete into your urine.
Testing for Food Sensitivities
There are blood spot or blood draw collection kits that can be used to find food sensitivities.
One thing to be aware of is that the food needs to have been eaten in the last three days to make sure the body has produced enough immunoglobulins to identify a reaction.
Testing for Hormone Imbalances
Most functional medicine practitioners like to test hormone levels over an extended period of time. Hormones can be tested through urinalysis, saliva, and blood draws.
Functional Medicine Treatment for ADHD
Treatments for ADHD should be individualized to the root cause.
Nutrient deficiencies should be addressed with a food-as-medicine approach and supplements to increase deficiencies. A whole-food low inflammatory diet is commonly prescribed.
Hormone treatments should focus on eliminating the barriers to normal hormone production using a combination of lifestyle changes, nutrient therapy, herbs, and even pharmaceuticals.
A guided elimination diet addresses food allergies and sensitivities. These are usually done for a period of 30 - 90 days, and then foods are slowly reintroduced one by one.
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Summary
There are many root causes of ADHD. These include nutrient deficiencies, hormonal imbalances, food allergies and sensitivities, and heavy metals. Functional Medicine can effectively reduce symptoms of ADHD by utilizing a root cause approach.
Special thanks to our naturopathic assistant, Lindsey Bevilacqua, for her help with this article.
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References
- “ADHD, Lead Exposure and Prevention: How Much Lead or How Much Evidence Is Needed?” Expert Review of Neurotherapeutics, 2014, www.tandfonline.com/doi/full/10.1586/14737175.8.4.519. Accessed 7 Feb. 2022.
- “ADHD Statistics: New ADD Facts and Research.” ADDitude, 6 Oct. 2006, www.additudemag.com/statistics-of-adhd/#:~:text=ADHD%20Prevalence%20in%20Children,Control%20and%20Prevention%20(CDC).. Accessed 29 Jan. 2022.
- Antalis, Caryl J., et al. “Omega-3 Fatty Acid Status in Attention-Deficit/Hyperactivity Disorder.” Prostaglandins, Leukotrienes and Essential Fatty Acids, vol. 75, no. 4-5, Oct. 2006, pp. 299–308, pubmed.ncbi.nlm.nih.gov/16962757/, 10.1016/j.plefa.2006.07.004. Accessed 30 Jan. 2022.
- Arnold, L. Eugene, et al. “Zinc for Attention-Deficit/Hyperactivity Disorder: Placebo-Controlled Double-Blind Pilot Trial Alone and Combined with Amphetamine.” Journal of Child and Adolescent Psychopharmacology, vol. 21, no. 1, Feb. 2011, pp. 1–19, www.ncbi.nlm.nih.gov/pmc/articles/PMC3037197/, 10.1089/cap.2010.0073. Accessed 30 Jan. 2022.
- “Attention-Deficit/Hyperactivity Disorder.” National Institute of Mental Health (NIMH), 2021, www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd. Accessed 28 Jan. 2022.
- “Attention-Deficit/Hyperactivity Disorder (ADHD).” National Institute of Mental Health (NIMH), 2014, www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd. Accessed 20 Jan. 2022.
- Avcil, Sibelnur. “Association between Altered Lipid Profiles and Attention Deficit Hyperactivity Disorder in Boys.” Nordic Journal of Psychiatry, vol. 72, no. 5, 24 Apr. 2018, pp. 361–366, pubmed.ncbi.nlm.nih.gov/29688116/, 10.1080/08039488.2018.1465591. Accessed 30 Jan. 2022.
- Bloch, Michael H., and Jilian Mulqueen. “Nutritional Supplements for the Treatment of ADHD.” Child and Adolescent Psychiatric Clinics of North America, vol. 23, no. 4, Oct. 2014, pp. 883–897, www.ncbi.nlm.nih.gov/pmc/articles/PMC4170184/, 10.1016/j.chc.2014.05.002. Accessed 7 Feb. 2022.
- Bos, Dienke J, et al. “Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder.” Neuropsychopharmacology, vol. 40, no. 10, 19 Mar. 2015, pp. 2298–2306, www.ncbi.nlm.nih.gov/pmc/articles/PMC4538345/, 10.1038/npp.2015.73. Accessed 22 Jan. 2022.
- Bosch, Annick, et al. “A Two Arm Randomized Controlled Trial Comparing the Short and Long Term Effects of an Elimination Diet and a Healthy Diet in Children with ADHD (TRACE Study). Rationale, Study Design and Methods.” BMC Psychiatry, vol. 20, no. 1, 27 May 2020, pubmed.ncbi.nlm.nih.gov/32460725/, 10.1186/s12888-020-02576-2. Accessed 9 Feb. 2022.
- Calarge, Chadi, et al. “Serum Ferritin and Amphetamine Response in Youth with Attention-Deficit/Hyperactivity Disorder.” Journal of Child and Adolescent Psychopharmacology, vol. 20, no. 6, Dec. 2010, pp. 495–502, www.ncbi.nlm.nih.gov/pmc/articles/PMC3003494/, 10.1089/cap.2010.0053. Accessed 22 Jan. 2022.
- CDC. “Data and Statistics about ADHD.” Centers for Disease Control and Prevention, 16 Nov. 2020, www.cdc.gov/ncbddd/adhd/data.html. Accessed 20 Jan. 2022.
- Centers for Disease Control and Prevention, et al. CDC’s Second Nutrition Report: A Comprehensive Biochemical Assessment of the Nutrition Status of the U.S.
Population Report Measures 58 Indicators of Diet and Nutrition New Report Uses NHANES Results. 2012.
- Colter, Ashley L, et al. “Fatty Acid Status and Behavioural Symptoms of Attention Deficit Hyperactivity Disorder in Adolescents: A Case-Control Study.” Nutrition Journal, vol. 7, no. 1, 14 Feb. 2008, pubmed.ncbi.nlm.nih.gov/18275609/, 10.1186/1475-2891-7-8. Accessed 30 Jan. 2022.
- Demirci, Kadir, et al. “The Investigation of Symptoms and Diagnoses of Adult-Attention Deficit/ Hyperactivity Disorder in Women with Iron Deficiency Anemia.” Noro Psikiyatri Arsivi, vol. 54, no. 1, 8 May 2017, pp. 72–77, www.ncbi.nlm.nih.gov/pmc/articles/PMC5439476/, 10.5152/npa.2016.12464. Accessed 11 Mar. 2021.
- Dodig-Curković K;Dovhanj J;Curković M;Dodig-Radić J;Degmecić D. “[the Role of Zinc in the Treatment of Hyperactivity Disorder in Children].” Acta Medica Croatica : Casopis Hravatske Akademije Medicinskih Znanosti, vol. 63, no. 4, 2012, pubmed.ncbi.nlm.nih.gov/20034331/. Accessed 11 Mar. 2021.
- “Effects of Iron Supplementation Twice a Week on Attention Score and Haematologic Measures in Female High School Students | SMJ.” Smj.org.sg, 2014, www.smj.org.sg/article/effects-iron-supplementation-twice-week-attention-score-and-haematologic-measures-female. Accessed 10 Feb. 2022.
- “Feed Your Child’s Focus: ADHD Foods, Dyes & Attention.” ADDitude, 23 Nov. 2007, www.additudemag.com/feed-your-childs-focus-adhd-food-nutrition/#:~:text=It%20found%20that%20both%20hyperactive,a%20general%20public%20health%20concern.&text=However%2C%20the%20FDA%20did%20admit,react%20adversely%20to%20these%20dyes.. Accessed 7 Feb. 2022.
- Glenn, Jordan M., et al. “Dietary Protein and Amino Acid Intake: Links to the Maintenance of Cognitive Health.” Nutrients, vol. 11, no. 6, 12 June 2019, p. 1315, www.ncbi.nlm.nih.gov/pmc/articles/PMC6627761/, 10.3390/nu11061315. Accessed 28 Oct. 2021.
- Gow, Rachel V., et al. “Total Red Blood Cell Concentrations of ω-3 Fatty Acids Are Associated with Emotion-Elicited Neural Activity in Adolescent Boys with Attention-Deficit Hyperactivity Disorder.” Prostaglandins, Leukotrienes and Essential Fatty Acids, vol. 80, no. 2-3, Feb. 2009, pp. 151–156, pubmed.ncbi.nlm.nih.gov/19230637/, 10.1016/j.plefa.2008.12.007. Accessed 30 Jan. 2022.
- Haimov-Kochman, Ronit, and Itai Berger. “Cognitive Functions of Regularly Cycling Women May Differ throughout the Month, Depending on Sex Hormone Status; a Possible Explanation to Conflicting Results of Studies of ADHD in Females.” Frontiers in Human Neuroscience, vol. 8, 1 Apr. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3978296/, 10.3389/fnhum.2014.00191. Accessed 7 Feb. 2022.
- https://www.facebook.com/verywell. “Why Many Women with ADHD Remain Undiagnosed.” Verywell Mind, 2021, www.verywellmind.com/add-symptoms-in-women-20394. Accessed 7 Feb. 2022.
- Huss, Michael, et al. “Supplementation of Polyunsaturated Fatty Acids, Magnesium and Zinc in Children Seeking Medical Advice for Attention-Deficit/Hyperactivity Problems - an Observational Cohort Study.” Lipids in Health and Disease, vol. 9, no. 1, 2010, p. 105, www.ncbi.nlm.nih.gov/pmc/articles/PMC2955638/, 10.1186/1476-511x-9-105. Accessed 11 Mar. 2021.
- Hwang, Wu Jeong, et al. “The Role of Estrogen Receptors and Their Signaling across Psychiatric Disorders.” International Journal of Molecular Sciences, vol. 22, no. 1, 31 Dec. 2020, p. 373, www.ncbi.nlm.nih.gov/pmc/articles/PMC7794990/, 10.3390/ijms22010373. Accessed 10 Feb. 2022.
- Islam, Kamirul, et al. “A Study on Association of Iron Deficiency with Attention Deficit Hyperactivity Disorder in a Tertiary Care Center.” Indian Journal of Psychiatry, vol. 60, no. 1, 2018, p. 131, pubmed.ncbi.nlm.nih.gov/29736076/, 10.4103/psychiatry.indianjpsychiatry_197_17. Accessed 11 Mar. 2021.
- Kamal, Madeeha, et al. “Is High Prevalence of Vitamin D Deficiency a Correlate for Attention Deficit Hyperactivity Disorder?” ADHD Attention Deficit and Hyperactivity Disorders, vol. 6, no. 2, 9 Mar. 2014, pp. 73–78, pubmed.ncbi.nlm.nih.gov/24610453/, 10.1007/s12402-014-0130-5. Accessed 30 Jan. 2022.
- Kelly, Daniel M, and T Hugh Jones. “Testosterone: A Metabolic Hormone in Health and Disease.” Journal of Endocrinology, vol. 217, no. 3, 30 Jan. 2013, pp. R25–R45, pubmed.ncbi.nlm.nih.gov/23378050/, 10.1530/joe-12-0455. Accessed 30 Jan. 2022.
- Khedr, Eman, et al. “Iron States and Cognitive Abilities in Young Adults: Neuropsychological and Neurophysiological Assessment.” European Archives of Psychiatry and Clinical Neuroscience, vol. 258, no. 8, 20 June 2008, pp. 489–496, pubmed.ncbi.nlm.nih.gov/18574611/, 10.1007/s00406-008-0822-y. Accessed 10 Feb. 2022.
- Konikowska K;Regulska-Ilow B;Rózańska D. “The Influence of Components of Diet on the Symptoms of ADHD in Children.” Roczniki Panstwowego Zakladu Higieny, vol. 63, no. 2, 2012, pubmed.ncbi.nlm.nih.gov/22928358/. Accessed 27 Oct. 2021.
- Konofal, Eric, and Samuele Cortese. “Lead and Neuroprotection by Iron in ADHD.” Environmental Health Perspectives, vol. 115, no. 8, Aug. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1940080/, 10.1289/ehp.10304. Accessed 10 Feb. 2022.
- Lepping, Peter, and Markus Huber. “Role of Zinc in the Pathogenesis of Attention-Deficit Hyperactivity Disorder.” CNS Drugs, July 2010, p. 1, pubmed.ncbi.nlm.nih.gov/20806985/, 10.2165/11537610-000000000-00000. Accessed 30 Jan. 2022.
- Lindblad, Frank, et al. “Fasting Blood Glucose and HbA1c in Children with ADHD.” Psychiatry Research, vol. 226, no. 2-3, Apr. 2015, pp. 515–516, pubmed.ncbi.nlm.nih.gov/25747679/, 10.1016/j.psychres.2015.01.028. Accessed 30 Jan. 2022.
- May, James M., et al. “Mechanisms of Ascorbic Acid Stimulation of Norepinephrine Synthesis in Neuronal Cells.” Biochemical and Biophysical Research Communications, vol. 426, no. 1, Sept. 2012, pp. 148–152, www.ncbi.nlm.nih.gov/pmc/articles/PMC3449284/, 10.1016/j.bbrc.2012.08.054. Accessed 11 Mar. 2021.
- Murray-Kolb, Laura E, and John L Beard. “Iron Treatment Normalizes Cognitive Functioning in Young Women.” The American Journal of Clinical Nutrition, vol. 85, no. 3, 1 Mar. 2007, pp. 778–787, pubmed.ncbi.nlm.nih.gov/17344500/, 10.1093/ajcn/85.3.778. Accessed 10 Feb. 2022.
- “Office of Dietary Supplements - Vitamin D.” Nih.gov, 2015, ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed 20 Jan. 2022.
- Parkman, Henry P., et al. “Dietary Intake and Nutritional Deficiencies in Patients with Diabetic or Idiopathic Gastroparesis.” Gastroenterology, vol. 141, no. 2, Aug. 2011, pp. 486-498.e7, pubmed.ncbi.nlm.nih.gov/21684286/, 10.1053/j.gastro.2011.04.045. Accessed 9 Feb. 2022.
- Parletta, Natalie, et al. “Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls.” PLOS ONE, vol. 11, no. 5, 27 May 2016, p. e0156432, pubmed.ncbi.nlm.nih.gov/27232999/, 10.1371/journal.pone.0156432. Accessed 30 Jan. 2022.
- Roberts, Bethan, et al. “Reproductive Steroids and ADHD Symptoms across the Menstrual Cycle.” Psychoneuroendocrinology, vol. 88, Feb. 2018, pp. 105–114, www.ncbi.nlm.nih.gov/pmc/articles/PMC5803442/, 10.1016/j.psyneuen.2017.11.015. Accessed 10 Feb. 2022.
- Scassellati, Catia, et al. “Biomarkers and Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analyses.” Journal of the American Academy of Child & Adolescent Psychiatry, vol. 51, no. 10, Oct. 2012, pp. 1003-1019.e20, www.jaacap.org/article/S0890-8567(12)00605-3/fulltext, 10.1016/j.jaac.2012.08.015. Accessed 10 Feb. 2022.
- Sharif, Mohammad Reza, et al. “The Relationship between Serum Vitamin D Level and Attention Deficit Hyperactivity Disorder.” Iranian Journal of Child Neurology, vol. 9, no. 4, 2015, pp. 48–53, www.ncbi.nlm.nih.gov/pmc/articles/PMC4670977/#:~:text=However%2C%20there%20was%20a%20statistically,vitamin%20D%20level%20below%20normal.. Accessed 29 Jan. 2022. The remaining 78.4% children had serum vitamin D level below normal.
- Stevens, Laura J., et al. “Dietary Sensitivities and ADHD Symptoms: Thirty-Five Years of Research.” Clinical Pediatrics, vol. 50, no. 4, 2 Dec. 2010, pp. 279–293, pubmed.ncbi.nlm.nih.gov/21127082/, 10.1177/0009922810384728. Accessed 11 Mar. 2021.
- Surman, Craig, et al. “Does L-Methylfolate Supplement Methylphenidate Pharmacotherapy in Attention-Deficit/Hyperactivity Disorder?” Journal of Clinical Psychopharmacology, vol. 39, no. 1, Jan. 2019, pp. 28–38, pubmed.ncbi.nlm.nih.gov/30566416/, 10.1097/jcp.0000000000000990. Accessed 29 Jan. 2022.
- Tolppanen, Anna-Maija, et al. “The Association of 25-Hydroxyvitamin D3 and D2 with Behavioural Problems in Childhood.” PLoS ONE, vol. 7, no. 7, 10 July 2012, p. e40097, www.ncbi.nlm.nih.gov/pmc/articles/PMC3393748/, 10.1371/journal.pone.0040097. Accessed 30 Jan. 2022.
- Villagomez, Amelia, and Ujjwal Ramtekkar. “Iron, Magnesium, Vitamin D, and Zinc Deficiencies in Children Presenting with Symptoms of Attention-Deficit/Hyperactivity Disorder.” Children, vol. 1, no. 3, 29 Sept. 2014, pp. 261–279, www.ncbi.nlm.nih.gov/pmc/articles/PMC4928738/, 10.3390/children1030261. Accessed 22 Jan. 2022.
- Wang, Liang-Jen, et al. “Dehydroepiandrosterone Sulfate, Free Testosterone, and Sex Hormone-Binding Globulin on Susceptibility to Attention-Deficit/Hyperactivity Disorder.” Psychoneuroendocrinology, vol. 103, May 2019, pp. 212–218, pubmed.ncbi.nlm.nih.gov/30711898/, 10.1016/j.psyneuen.2019.01.025. Accessed 10 Feb. 2022.
- “Women, Hormones, and ADHD.” ADDitude, 25 Feb. 2009, www.additudemag.com/women-hormones-and-adhd/. Accessed 22 Jan. 2022.
