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What Causes ADHD?: Using Lab Testing and An Integrative Approach to Understand the Root Cause

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What Causes ADHD?: Using Lab Testing and An Integrative Approach to Understand the Root Cause

Picture this: Your mind is buzzing, you can't sit still, and focusing on just one thing feels almost impossible. Sounds familiar? Then you might relate to what life is like with attention deficit hyperactivity disorder, or ADHD for short. It's a condition that makes it hard to pay attention, stay still, and control impulses. And it's not just you; more kids are being diagnosed with ADHD now than ever before. In fact, the number of children diagnosed went up by 42% between 2003 and 2011.

So, why is this happening? What causes ADHD, and what can we do about it? In this article, we will talk about the root causes of ADHD and how to better manage the condition through lab testing and lifestyle changes. We’ll also discuss complementary therapies, including supplementation, to help mitigate symptomatology. 


ADHD Symptoms and Challenges

Attention-deficit/hyperactivity disorder, commonly known as ADHD, is a neurodevelopmental condition that can manifest in various ways and at different life stages. One of the most identifiable symptoms is a persistent pattern of inattention, where an individual may find it difficult to focus on tasks, often overlooking details and failing to complete activities. Hyperactivity and impulsivity are also frequently observed, manifesting as restlessness, an inability to sit still, and often acting without considering the consequences. Although these symptoms are most commonly recognized in children, it's important to note that ADHD can also affect adolescents and adults. These symptoms can significantly disrupt daily functioning, including academic performance, occupational success, and interpersonal relationships.

Managing ADHD is often a multi-faceted approach that involves medication, behavioral therapies, and lifestyle adjustments. Medication, usually stimulants like methylphenidate or amphetamines, can be highly effective in regulating attention and activity levels. However, medication alone is generally not sufficient for optimal management. Behavioral therapies, often including cognitive behavioral therapy, provide skills to cope with inattention and impulsivity. Lifestyle changes, such as improved sleep patterns, regular exercise, and dietary modifications, can also contribute to better symptom management (3,14). 

ADHD Root Causes: Genetic Factors, Environmental Influences

ADHD's etiology is multifactorial, comprising genetic predispositions, neurochemical variations, environmental exposures, and nutritional considerations:

Genetic Factors

Genetic predispositions appear to be a significant element in the occurrence of ADHD. Studies have consistently shown that the condition often runs in families, indicating a heritable component. Siblings of those with ADHD are at a higher risk of having the disorder compared to the general population. This seems to be supported by greater concordance rates in monozygotic (identical) twins compared to dizygotic (fraternal) twins (3,14). 

Neurochemical Imbalances

Neurological differences are another significant avenue to consider. People with ADHD show altered metabolic activity in specific brain regions responsible for executive function and motivation, like the prefrontal cortex. Neuropsychological tests have also revealed differences in the response to reinforcement, which might explain the symptoms of ADHD. In terms of neurochemistry, there is evidence pointing to decreased dopaminergic receptors in the frontal lobes, as well as a role for noradrenergic receptor involvement (3,14). 

Environmental Factors

Exposure to environmental toxins during prenatal development has been linked to a higher risk of ADHD. This includes heavy metals such as lead and mercury, as well as substances like alcohol and tobacco. Additionally, early life stressors or traumas, like family adversity, along with factors such as premature birth and low birth weight, can also be correlated with ADHD. It's worth mentioning that a pre-existing or subsequent brain injury could also serve as a risk factor (3,14). 

Diet and Nutrition

Nutrient deficiencies are commonly found in people with ADHD. Deficiencies in vitamin D, iron, and omega-3 fatty acids appear to be more prevalent in this population. Specific nutrients like zinc and magnesium have roles in regulating neurotransmitters and calming the brain, which could be beneficial for focus and attention. An anti-inflammatory diet seems to reduce the risk of ADHD, while a diet high in sugar and processed foods increases it. Food sensitivities and allergies are also more commonly observed in individuals with ADHD, and some studies suggest symptom improvement when allergenic foods are eliminated from the diet (3,14). 

Lab Testing For ADHD Root Causes

Functional medicine labs offer a variety of tests that can help tailor treatment to patients, allowing providers to optimize management strategies.

Heavy Metal Toxicity Tests

Exposure to environmental toxins like lead and mercury is linked to a higher risk of ADHD. Testing for these heavy metals in the body through hair, urine, or blood tests can uncover toxic burdens. Identifying such exposures allows for targeted treatment strategies to reduce these levels and their potential impact on mental health (3). 

Nutritional Deficiency Tests

Nutritional imbalances, including deficiencies in vitamin D, iron, and omega-3 fatty acids, are commonly found in individuals with ADHD. Comprehensive nutritional panels can identify these deficiencies, paving the way for dietary adjustments and supplementation to potentially improve ADHD symptoms (3). 

Food Sensitivity Tests

ADHD has been associated with an increased likelihood of food sensitivities and allergies. Food sensitivity tests can guide an elimination diet to identify potential triggers. Once these triggers are found, they can be avoided to see if ADHD symptoms improve (3). 

Inflammatory Marker Tests

Inflammation has been correlated with ADHD, making tests for inflammatory markers like C-reactive protein useful. Detecting elevated levels of such markers can inform anti-inflammatory treatment strategies, which might include dietary adjustments (3). 

Neurotransmitter Testing

Neurotransmitter imbalances are often implicated in ADHD, affecting areas like focus, executive function, and emotional regulation. Neurotransmitter testing can measure the levels of key neurotransmitters such as dopamine and norepinephrine in the body (3,14). 


Integrative Medicine for ADHD

Managing ADHD often involves more than just medication and counseling; it requires a comprehensive approach that includes lifestyle changes. In the coming sections, we'll explore the role of a balanced diet tailored for ADHD, discuss helpful natural supplements, and delve into complementary activities like meditation and exercise. This multi-layered approach provides a well-rounded strategy for managing ADHD effectively.

Nutritional Recommendations for ADHD

Managing ADHD often requires a holistic approach, and nutrition plays a key role in this comprehensive strategy. An anti-inflammatory diet rich in omega-3 fatty acids, fruits, vegetables, and whole grains can be beneficial, as inflammation has been linked to ADHD symptoms. Consuming foods that naturally elevate neurotransmitter levels is also advantageous. For example, foods rich in protein, particularly those containing the amino acid tyrosine—like chicken, turkey, and fish—can help balance neurotransmitter levels such as dopamine and norepinephrine. Foods high in antioxidants and folate, like berries and leafy greens, may further aid in neurotransmitter synthesis and general neurological health (3,14). 

Alongside this, avoiding environmental toxins like heavy metals is important for overall well-being and symptom management. Opting for organic produce and low-mercury fish options like sardines, salmon, and trout can mitigate exposure to such toxins. Additionally, if food sensitivities are suspected to contribute to ADHD symptoms, an elimination diet could be considered. This involves removing potential dietary triggers like dairy, gluten, and artificial additives for a specific period, followed by a controlled reintroduction to monitor any changes in symptoms (3). 

Supplements & Natural Remedies for ADHD

In addition to nutritional adjustments and medical treatments, certain supplements and natural remedies have been studied for their potential benefits in managing ADHD symptoms.

Omega-3 Fatty Acids

Omega-3 fatty acids, particularly EPA and DHA, are known for their anti-inflammatory properties and their role in brain function. These fatty acids are integral to cell membranes in the brain and may have a positive impact on neurotransmitter balance and neural connectivity. Some research suggests that individuals with ADHD may have lower levels of omega-3s, and supplementation can sometimes improve symptoms such as impulsivity and attention (3). 


Iron is essential for various physiological processes, including oxygen transport and neurotransmitter synthesis. Iron deficiency is more prevalent in individuals with ADHD, especially in women. Adequate iron levels can support dopamine synthesis, which is crucial for focus and attention.


Zinc is involved in regulating neurotransmitters and has an effect on learning, memory, emotion, and mood. Zinc deficiency has been observed in individuals with ADHD. Supplementing with zinc may help in neurotransmitter regulation and potentially alleviate some ADHD symptoms.

Complementary and Integrative Therapies for ADHD

Complementary therapies can provide a meaningful supplement to a comprehensive ADHD treatment plan. Techniques like meditation and deep breathing are accessible and effective ways to enhance focus and mitigate stress. They offer valuable self-regulation strategies that are beneficial not just for the individual with ADHD but for family members as well (3). 

Exercise also holds a significant place in managing ADHD symptoms effectively. Physical activities, whether traditional sports or other engaging options like swimming and hiking are particularly beneficial in using up excess energy and improving cognitive function. Exercise not only elevates mood through the release of endorphins but can also improve the quality of sleep, an area of concern for many with ADHD. Therefore, incorporating regular physical activity can have a positive impact on both children and adults coping with ADHD (3). 



In summary, ADHD is a complex neurodevelopmental disorder influenced by a variety of factors, including genetics, environmental exposures, and lifestyle choices. Effective management typically requires a comprehensive strategy that goes beyond medication to include behavioral therapies and lifestyle modifications like diet and exercise. Functional lab tests can help pinpoint individualized factors, such as nutritional deficiencies or heavy metal exposure, allowing for more targeted treatment. Integrating these elements with complementary therapies such as meditation and nutritional supplements provides a multi-faceted approach to managing ADHD symptoms for both children and adults.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
Learn More

Lab Tests in This Article

  1. 10 Signs You Should Try An Elimination Diet. (2022, August 30). Rupa Health.
  2. A Root Cause Approach To Mercury Toxicity: A Comprehensive Guide. (2023, September 6). Rupa Health.
  3. An Integrative Medicine Approach to ADHD. (2023, March 2). Rupa Health.
  4. Anti Inflammatory Diet 101: What to Eat and Avoid Plus Specialty Labs To Monitor Results. (2023, May 22). Rupa Health.
  5. Arnold, L. E., DiSilvestro, R. A., Bozzolo, D., Bozzolo, H., Crowl, L., Fernandez, S., Ramadan, Y., Thompson, S., Mo, X., Abdel-Rasoul, M., & 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 Psychopharmacology, 21(1), 1–19.
  6. Bener, A., Kamal, M., Bener, H., & Bhugra, D. (2014). Higher prevalence of iron deficiency as strong predictor of attention deficit hyperactivity disorder in children. Annals of Medical and Health Sciences Research, 4(9), 291.
  7. Biederman, J., Feinberg, L., Chan, J., Adeyemo, B. O., Woodworth, K. Y., Panis, W., McGrath, N., Bhatnagar, S., Spencer, T. J., Uchida, M., Kenworthy, T., Grossman, R., Zafonte, R., & Faraone, S. V. (2015). Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes. The Journal of Nervous and Mental Disease, 203(11), 813–819.
  8. Derbyshire, E. (2017). Do Omega-3/6 Fatty Acids Have a Therapeutic Role in Children and Young People with ADHD? Journal of Lipids, 2017, 1–9.
  9. Dichtl, S., Haschka, D., Nairz, M., Seifert, M., Volani, C., Lutz, O., & Weiss, G. (2018). Dopamine promotes cellular iron accumulation and oxidative stress responses in macrophages. Biochemical Pharmacology, 148, 193–201.
  10. How to Balance Adrenaline Levels Naturally. (2022, October 25). Rupa Health.
  11. How to Regulate Your Dopamine Levels Naturally. (2022, September 23). Rupa Health.
  12. If You Have These Symptoms, Ask Your Practitioner To Test Your Zinc Levels. (2023, January 11). Rupa Health.
  13. Integrative Nutrition’s Role in Neurological Health and Disease Prevention. (2023, June 2). Rupa Health.
  14. Magnus, W., Nazir, S., Anilkumar, A. C., & Shaban, K. (2020). Attention Deficit Hyperactivity Disorder (ADHD). PubMed; StatPearls Publishing.
  15. Miller, A. L. (2008). The methylation, neurotransmitter, and antioxidant connections between folate and depression. Alternative Medicine Review: A Journal of Clinical Therapeutic, 13(3), 216–226.
  16. National Institute of Mental Health. (2014). Attention-Deficit/Hyperactivity Disorder (ADHD).
  17. Vitamins & Supplements for ADHD. (n.d.). WebMD.
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