Dietary interventions, supplements may provide benefits for ADHD patients

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By Kat Black

At nine years old, the little boy Ryan Heer, ND, was treating for attention deficit hyperactivity disorder (ADHD) had seemingly run out of options.

“[His] ADHD [was] causing trouble with assignments and relationships back at home and at school, and [his parents] were concerned their kid had to be held back,” said Heer,  who practices at Crossroads Integrative Medicine in Indiana. “They tried different stimulants but never approached the natural options.”

After Heer took a full history, he ran an iron panel, a comprehensive metabolic panel, and a food panel. He found the child had a sensitivity to dairy and gluten, an elevation of candida, and deficiencies in ferritin, vitamin D, magnesium, and B-12.

“He had a bunch of different nutrient deficiencies,” said Heer. “We spent a lot of time correcting that. His allergic symptoms went away, his skin problems went away, and he was able to focus and sleep.”

By the end of the treatment, Heer said he was a “completely new kid.”  

According to the Diagnostic and Statistical Manual of Mental Disorders, ADHD is one of the most common childhood neurobehavioral disorders. In 2016, a study by the U.S. Centers for Disease Control and Prevention (CDC) concluded that 6.1 million children living in the United States had been diagnosed with ADHD.

ADHD is typically characterized by persistent difficulties with focus, hyperactivity, and impulsivity, which may be caused by a deficit of the neurotransmitters norepinephrine and dopamine. Though the prescription of stimulant medications is widely considered the gold standard for treating ADHD in traditional medicine, many providers have had success with a holistic treatment plan that complements pharmaceuticals with more integrative treatments.

Current research about the benefits of popular complementary treatments such as gingko biloba, pycnogenol, St. John’s Wort, neurofeedback, and acupuncture remains inconclusive, according to a 2019 report by the National Center for Complementary and Integrative Health. However, some studies have reported benefits from treatments such as dietary modifications and supplements.

A 2018 study found that children and adolescents with ADHD have a deficiency in omega-3 fatty acids or n-3 PUFAS. Omega-3 supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, the study reported. According to a 2019 study, omega-3 supplements have anti-inflammatory effects that may benefit the ADHD population, since ADHD has been linked to inflammation. Omega-3s also facilitate the synthesis of dopamine.

There are two primary types of omega-3s, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). John Ratey, MD, coauthor of Driven to Distraction, advised prescribing a supplement with three times the amount of EPA to DHA.

“The data seem to show that those using supplements containing higher ratios of EPA get a better response in ADHD symptoms,” he said, “including mood swings and aggression.”

However, one 2017 systematic review concluded that there is a lack of evidence for the effectiveness of fatty acids. Another found that the reactions to omega-3s were divided evenly between study participants, with half reporting improvements in their ADHD and the other half reporting negative results.

Nutrition is also an essential component to both understanding and managing ADHD symptoms. Research by Richard Wurtman, PhD, a neuroscientist at the Massachusetts Institute of Technology, concluded that protein synthesizes the neurotransmitters that activate alertness, and eating a low-fat, high-protein breakfast can also facilitate the absorption of stimulant medication.

A small minority of ADHD patients also benefit from elimination or restriction diets such as gluten-free, according to a 2014 article published by Child and Adolescent Psychiatric Clinics of North America. Janet Opila-Lehman, ND, OTL, who works with ADHD and autism spectrum patients, said in her experience, gastrointestinal (GI) issues are often at the root of behavioral issues. She cited an experience with one of her patients, a nine-year-old boy.

After running labs, Opila-Lehman found that he was sensitive to gluten and dairy. “The first thing we did was put him on a gluten-free dairy-free diet,” she said. “Within a couple weeks, it kicked in and he was already sleeping better. And that’s very common. Lots of these kids have gluten sensitivities.”  

Heer said he agrees that addressing gut health in ADHD patients is imperative.

“More research is coming out,” he said. “We produce so much serotonin in our gut and serotonin has such a relationship with neurotransmitters.”  

According to a 2017 article published in Gastrointestinal Pharmacology, 95 percent of the body’s serotonin is produced in the intestine, and research suggests that serotonin plays a part in regulating hyperactivity and impulsivity.

 “GI issues tend to correlate quite a bit with ADHD,” said Heer. “When our GI system isn’t functioning properly, we’re not producing the right amount of neurotransmitters. In severe cases, it can mask ADHD.”

About the Author

Kat Black 

Kat Black is a freelance journalist based in New York City. She has a Master’s degree in International Journalism from City, University of London and is a published essayist, fiction writer, and poet.