ADHD in Children – Focusing on Simplicity for Positive Change
Jaclyn Chasse, ND
Does this sound familiar? Your young patient is sitting in your office fidgeting while their parent quietly shares with you their child’s challenges. From the trouble focusing in school, the behavior, the frustration felt by all, including the child, because they aren’t achieving the goals they hoped to when they started medication or counseling.
They’ve tried everything traditionally recommended: Adderall, Stratera, Concerta, Ritalin and others. And so they are here…looking for your help today.
Unfortunately, this is a familiar scene. The US Centers for Disease Control reports that in 2011, the percentage of children with an ADHD diagnosis increased to 11.0%, with some states, like Kentucky, posting diagnosis rates of nearly 19%- one in five children!
So, what can we do?
First, make sure that you are getting a good history and comparing a child’s behavior to how children should behave — not to how adults should behave. There is likely an element of over-diagnosis contributing to this rising statistic, and setting expectations of what can be expected of children is important, as well as coaching parents to help them with the skills needed to get the best out of children.
Second, look around at the child’s environment. The data is fascinating about the role of environmental toxins on children’s neuronal development, and this starts in-utero. What is in this child’s environment that may be harming their brain function, and what things can be easily changed? Preservatives, pesticides, and additives in food may be contributors to changed behavior. Get the family eating closer to the earth, with a focus on whole, unprocessed, organic food.
Additionally, consider what therapeutics can be helpful, and start with behaviors before ANY pills (pharmaceutical or natural).
Does the child get enough fresh air and exercise? Consider a prescription of an exercise regime that also offers the chance to enhance ability to focus, such as martial arts or kids’ yoga. Meditation, neurofeedback, and other mind-body modalities have shown promise. Consider what daily routines could help a child stay on track.
Think first about what nutrients will help with healthy brain growth and development, and then consider nutrients that will help support increased blood flow to the brain for healthy cognition. For the former, some go-to therapeutics include a good multivitamin (free of colors, additives, etc) and fish oil. With fish oil, a combination product containing both EPA and DHA is preferred, and I’d shoot for a potent dose, about 1 gram daily (1,000 mg) of EPA/DHA for a child of 50-75 lbs. In 2012, the Cochrane Review published a review of polyunsaturated fatty acids (PUFAs) for ADHD, and while there was not strong evidence of efficacy, some studies showed an improvement with combined omega 3 and omega 6 supplementation.
The most current review on the subject demonstrated that PUFAs had mixed results, but more consistent benefit was observed with administration of zinc, magnesium, and iron in lowering symptoms in children with or at high risk of deficiencies in these minerals, suggesting that mineral deficiency may play at least a partial role in the etiology of ADHD in children. Mixed evidence also exists for carnitine, pycnogenol, SAM-e, tryptophan, and Gingko biloba with ginseng. To date, there is no evidence to support the use of St. John’s wort, tyrosine, or phenynalanine in the treatment of ADHD symptoms in children.
In addition to the evidence-based suggestions above, nutrients known to support healthy cognition includes ingredients like L-theanine and GABA to promote a calm mind as well as herbs like gotu kola and rhodiola. In addition to the nutrients in a multivitamin, extra B vitamins may also support a healthy, focused mind in kids, and can be dosed in an easy-to-use lozenge.
 Polanska K, Jurewicz J, HankeW. Exposure to environmental and lifestyle factors and attention-deficit/hyperactivity disorder in children- a review of epidemiological studies. Int J Occup Med Environ Health. 2012 Sep;25(4):330-55.
 Gilles D et al. Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev. 2012 Jul 11;(7).
 Lange KW, Hauser J, et al. The Role of Nutritional Supplements in the Treatment of ADHD: What the Evidence Says. Curr Psychiatry Rep. 2017 Feb;19(2):8.
 Rucklidge JJ, Johnstone J, and Kaplan BJ. Nutrient Supplementation approaches in the treatment of ADHD. Expert Rev Neurother. 2009 April;9(4):461-76.