What is ADHD?
Attention deficit hyperactivity disorder sometimes known as ADHD is the descriptive label given to an ever-increasing number of children with a variety of behavioural and learning problems including hyperactivity, poor attention span, lack of concentration, disruptiveness, speech problems, clumsiness, recklessness, destructiveness, defiance and irritability.
Children with ADHD have a hard time at school and at home. They perform badly, get into trouble, have difficulty making friends and are often shunted from school to school. Untreated, such children often grow up to become delinquent teenagers going off the rails with alcohol and drugs.
What causes ADHD?
The reasons behind the ADHD disaster are not clear, but potential causative factors include smoking, heredity, drinking or drug abuse during pregnancy, oxygen deprivation at birth, prenatal trauma and environmental pollution.
Medical treatment for ADHD usually involves use of the drug Ritalin, which is a habit-forming amphetamine with many properties similar to cocaine. However research has found that Ritalin is ineffective in controlling the effects of ADHD – in fact in some cases it can make symptoms worse. What's more, Ritalin has a number of side-effects including increased blood pressure, heart rate, respiration and temperature, stomach pains, weight loss, growth retardation, facial tics, muscle twitching, euphoria, nervousness, irritability, agitation, insomnia, psychotic episodes, violent behaviour, paranoid delusions, hallucinations, bizarre behaviours, heart arrhythmias and palpitations, psychological dependence and even death.
The good news is that more often than not, children with ADHD have one or more nutritional imbalance that once identified and corrected can dramatically improve their energy, focus, concentration and behaviour.
How to improve ADHD Symptoms
* Correct Vitamin and Mineral Deficiencies
The effect of vitamin and mineral supplements on academic performance and children's behavioural problems is well documented and although it currently seems unlikely that ADHD is caused solely by nutrient deficiencies, addressing such deficiencies can significantly improve ADHD symptoms. Deficiency of Magnesium for example leads to excessive fidgeting, anxious restlessness, coordination problems and learning difficulties. The other key nutrients to watch out for are Zinc, Vitamin C, Vitamin B3, Vitamin B6, iron and copper, calcium, chromium and selenium. However, since we are all biochemically unique it is advisable to contact a trained nutritionist for advice on a specific supplement programme for you
* Increase Essential Fatty Acid Intake
Many children with ADHD are deficient in essential fatty acids and have associated symptoms such as excessive thirst, dry skin, eczema and asthma. In addition to inadequate dietary intake, a deficiency in essential fatty acids can occur if EFAS are either not absorbed properly or not converted into prostaglandins that help the brain communicate. EFA intake can be increased by giving children more oily fish (salmon, sardines, fresh tuna, mackerel) and seeds such as flax, hemp, sunflower and pumkin or their cold pressed oils. It may also be necessary to find replacements for wheat, dairy and foods rich in salicylates (prunes, raisins, raspberries, almonds, apricots, canned cherries, blackcurrants, oranges, strawberries, grapes, tomato sauce, plums, cucumbers and Granny Smith apples) since these can block the conversion of fatty acids to prostaglandins. In addition it is important to address any deficiencies in vitamins and minerals- vitamins B3, B6 and C, plus the minerals Biotin, Zinc and Magnesium are all needed for the enzymes that power the conversion
* Eliminate Chemical Food Additives & Check Other Potential Allergens Such as Wheat, Dairy, Chocolate, Oranges & Eggs
According to research, children with ADHD are seven times more likely to have food allergies than other children. Foods most likely to cause allergic reactions include food colourings, flavourings, synthetic additives, wheat, dairy products, corn, yeast, soya, citrus, chocolate, peanuts, eggs and foods containing salicylates. When allergy is contributing to ADHD symptoms, there are often associated issues such as nasal problems, excessive mucus, ear infections, tonsillitis, digestive problems, bad breath, eczema, asthma, headaches and bed wetting. To test if food allergy is contributing to your child's symptoms, eliminate any suspect foods for two weeks and then observe carefully as you introduce foods one by one. Alternatively you may wish to consider a proper allergy test using the IgG ELISA method (cost ranges between £150-£300 depending on the number of foods tested and the chosen laboratory).
* Eliminate Sugar
The role of sugar in ADHD is controversial and while some studies show that hyperactive children eat more sugar than other children, other research suggests that sugar itself does not cause hyperactivity and can even have a calming effect. Interestingly, however, a study of 265 hyperactive children found that more than three quarters had abnormal glucose tolerance. It may well be then that the problems experienced by ADHD sufferers are caused by a combination of the form that sugar comes in, the absence of a well-balanced diet and abnormal glucose tolerance.
To improve glucose tolerance, remove all forms of refined sugar and foods containing refined sugar and replace them with wholefoods and complex carbohydrates (brown rice and other wholegrains,oats,lentils, beans, quinoa and vegetables). It also helps to balance carbohydrates with protein, (half as much protein as carbohydrates at every meal and snack), by for example eating nuts with fruit or fish with rice etc.
* Have a Hair Mineral Analysis Test to Determine Whether Heavy Metal Intoxification is Contributing to ADHD Symptoms
The flip side of the detrimental effects of low levels of essential nutrients on ADHD sufferers is that excess levels of anti-nutrients can also induce symptoms. One such anti-nutrient is lead which can cause aggression, poor impulse control and short attention span. Also important are high levels of copper, and aluminium and studies have found links between these toxic metals and hyperactivity symptoms. Many toxic elements deplete the body of essential nutrients such as Zinc and can therefore contribute to nutritional deficiencies. A hair mineral analysis test can be helpful in determining whether heavy metal intoxication is contributing to ADHD symptoms.
* Supplement DMAE
Some children with ADHD disturbances suffer from 'reward deficiency syndrome' characterised by a constant need for stimulation. This is thought to occur because they either don't produce enough of the motivating neurotransmitter dopamine (from which adrenalin and noradrenalin are made) or don't respond strongly enough to their own dopamine. For these children the stimulating brain nutrient DMAE is highly effective
Holford, P., Optimum Nutrition for the Mind, Piatkus 2003
ADHD – Hyperactive Children: A parents' Guide, Hyperactive Children's Support Group, 2002. To order, see www.hacsg.org.uk
Papolos, D. and M., The Bipolar Child, Broadway Books, 2000
Weintrub, S., Natural Treatments for ADD and Hyperactivity, Woodland Publishing 1997
Block, M., No More ADHD, Block Books, 2001
Holford, P. The Kid Life Crisis (feature article)
The Brain Bio Centre
The Brain Bio Centre is a London-based treatment centre, set up by the Mental Health Project, putting the optimum nutrition approach into practice for those with mental health problems, including depression, learning difficulties, dyslexia, ADHD, autism, schizophrenia, dementia and Alzheimer's. Click here to find out more
Find a Nutritionist
The Hyperactive Children's Support Group is a UK- based charity organisation that offers support and information to parents and professionals who wish to pursue a drug-free approach to treating ADHD. They help and support hyperactive children and their parents, conduct research, promote investigation into the incidence of hyperactivity in the UK, investigate its causes and treatments, and spread information concerning the condition. There are some local groups in the UK which have been started by the parents of hyperactive children. There are also contact parents who have offered to help newly joined members in their locality.
Contact Hyperactive Children's Support Group (HACSG) at 71 Whyke
Lane, Chichester, West Sussex PO19 2PD for all information, diet
booklets, articles and general requests (enclose a stamped SAE).
Or call 01243 55131301243 551313 or visit www.hacsg.org.uk
LETTERS TO THE EDITOR
- Good nutrition and eliminating what he is allergic to. The allergies were determined by tests and simple observation.
- Getting the mercury removed from my son's body. This is the "toxic brain" Doman mentioned.
- Homeschooling Ryan with the National Association for Child Development program.
Ryan is still autistic, but he can help around the house, feed and dress himself. His academic skills and speech continue to improve. He is also very well-behaved. I can take him anywhere in public.
My husband and I totally altered our lives to do what was best for our son. Drugging him would have made my life easier but would not have benefited my son. Our society is educated into "have a problem, take a pill." It is a heartbreaking situation when pharmaceutical companies and doctors care more about their profit margin than the well-being and future of a child.
Kitty Young, Clearwater
A dangerous experiment
I commend Robert Farley for his article The atypical dilemma. There is a recklessness involved with the prescribing of antipsychotic drugs. They are being used for purposes and symptoms not approved by the Food and Drug Administration and it's affecting our growing children - the future of our society.
Such drugs are, in effect, being used in an experimental fashion on the general public, except that it is being done in a completely unscientific manner. This experiment doesn't even have the same controls nor has it been given the same respect that would be given to an experiment with laboratory rats. The statistics will be found in our future - good or bad.
Have we become a "pill popping" society only looking for a quick fix for our problems? Do we no longer have the time to handle our most prized possessions - our children?
Shouldn't the FDA be controlling this issue?
Tobie Greenberg, Clearwater
Drugs are not a solution
Thanks for shedding some light on medication as a disastrous solution to educational and behavioral challenges.
I was a second-year teacher in Minnesota when I saw my first drugged third-grader. His parents had put him on medication because he was "nervous." What seemed strange in 1969 had become the usual by 2000.
Instead of fixing problems that children have with their schools, homes or their bodies, the kids are medicated. It's thalidomide for the brain for all we know.
Sharon Hillestad, Clearwater
Diet makes a difference
As an educator, I read your cover feature on atypical drugs with dismay, but not surprise. Given the amount of processed junk food, sugar and caffeine consumed by a typical American child on a daily basis, it could be worthwhile to try an alternative that doesn't solely rely on dispensing dangerous drugs.
On the other hand, there's not much money to be made with that approach. Therein lies the problem.
Gary Compton, Wesley Chapel
MESSAGE FROM PROFESSOR G DUFF, CHAIRMAN, COMMISSION ON HUMAN MEDICINES.
16th February 2006 CEM/CMO/2006/
Strattera▼ (atomoxetine) – conclusions of risk:benefit review
I wrote to you in September 2005 to inform you about new evidence of an increased risk of suicidal thoughts or behaviour in association with the use of Strattera (atomoxetine). Strattera is authorised for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children of 6 years and older, and in adolescents, as part of a comprehensive treatment programme. It must be initiated by, or under the supervision of, a physician with appropriate knowledge and experience in treating ADHD.
Strattera has been marketed in the UK since July 2004 but has been available in the United States since November 2002. Worldwide exposure is estimated at 3.7 million patients as of November 2005. In light of the concern about the increased risk of suicidal thoughts and behaviour, a Europe wide review of available data on the risks and benefits of Strattera was initiated. This review has concluded that the overall balance of risks and benefits of Strattera remains positive in the treatment of ADHD in children of 6 years and older and in adolescents. However, in order to optimise the safe use of Strattera it is important that prescribers are aware of the following:
New Advice to prescribers
• Seizures are a potential risk with Strattera and therefore it should be introduced withcaution in patients with a history of seizure. Discontinuation of Strattera should be considered in any patient developing seizure or if there is an increase in seizure frequency.
• Reports of QT interval prolongation have been received in association with Strattera. Therefore, it should be used with caution in those with congenital or acquired long QT or a family history of QT prolongation. This risk may be increased if Strattera is used concomitantly with other drugs that produce QT prolongation, drugs that can cause electrolyte disturbances and those that inhibit cytochrome P450 2D6.
Reminder of previous advice
• Due to concerns about an increased risk of suicidal thoughts and behaviour, patients should be monitored for signs of depression, suicidal thoughts or suicidal behaviour and referred for appropriate treatment if necessary.
• There is a risk of rare, but sometimes severe, hepatic disorders. Strattera should be discontinued in patients with jaundice or laboratory evidence of liver injury, and should not be restarted. The Strattera product information for prescribers (the Summary of Product Characteristics) and patients (the Patient Information Leaflet) are currently being updated to include appropriate warnings about the risk of seizures and QT interval prolongation.
Please report any suspected adverse reactions to Strattera via the Yellow Card Reporting Scheme to the CHM/MHRA
For further information please call the Medicines and Healthcare products Regulatory
Agency on 020 7084 2000020 7084 2000 or visit the website (www.mhra.gov.uk).
Professor Gordon Duff
Chairman, Commission on Human Medicines