ADHD, SPD, LD…
Attention-Deficit Hyperactivity Disorder (ADHD) (and other neurodevelopmental issues)
Today’s children, our teachers and our society at large are becoming more familiar with the diagnosis of ADHD. There is no doubt that the percent and sheer numbers of children dealing with ADHD-related symptoms is on the rise. It is now known to be the most common pediatric neuropsychiatric disorder, affecting up to 12% of North American school-aged children. The three most notable signs and symptoms include some degree of inattention, hyperactivity and impulsivity. If you are or were inattentive, though at the same time hyperactive and also impulsive, it would be extremely difficult to function in a classroom (if you were a child or adolescent) or in a work environment (for the adults). Signs of ADHD often appear by the age of 3 and it can be a life-long disorder, affecting social, academic, cognitive and occupational function. Medically, the solution has been to treat the symptoms with medications that stimulate the brain, however, despite generally reasonable short term benefits, there are long-term risks that have not been adequately studied. In this article, I will discuss our whole-person based naturopathic approach to helping those with ADHD or other related neurodevelopmental issues.
Naturopathic Treatment of ADHD and related learning, developmental and behavioural problems
Importance of Proper Development of Milestones
There are differences in development in infants and toddlers that lead to symptoms and signs that usually show by the age of 3. In development, typically one skill is mastered before progressing to the next skill; however, in ADHD and other related learning and developmental and behavioural challenges, there may be a delay in learning a skill, or in some cases, some moments in development are skipped all-together. For instance, some kids may skip crawling and go straight into walking. Or, they may only crawl backwards, or move forwards by pulling themselves with their behind on the ground without actually crawling. Often this is brushed off as being irrelevant, however, they are clues about what was missed that delayed proper neurological development. In many cases, there is a correlation of poor integration of sensory learning (or motor learning, or emotional learning) at an early age that has an impact on learning and behaviour and socialization that shows up either in the short term (eg: ADHD, autism, non-verbal learning disorder, etc.) or in a few years (eg: dylexia, math, language, writing disorders). In our naturopathic ADHD program, we assess the level of development in the areas of sensory, motor, emotion, behaviour, academic, immune and autonomic functions. Once we find the weak areas of development, we put a program together which includes exercises that reconditions the brain to complete the learning that was missed. Regardless of whether it was due to a toxin, poor nutrition or stress or illness during pregnancy, the child still needs to master specific neurological-related skills to work properly.
Naturopathic nutrition and ADHD
There is no doubt that nutrition plays an important role in neurological/mental functions. The obvious example is blood-sugar balance – the brain requires a certain amount of glucose, without it, you risk experiencing erratic behaviour, irritability and mood swings. However, proper nutrition is much more than just glucose for the brain. Several vitamins, minerals, proteins and essential fats have specific roles in the brain and body. As an example, a study that looked at the level of important omega-3 fats found that kids with the least omega-3 fats had less nerve connections to other areas of the brain – areas responsible for attention and executive functions and several aspects of communication. This study appeared in the 2016 medical journal, Nutritional Neuroscience. Other studies on these fats are based on blood tests to determine if there are sufficient levels obtained through the diet or supplementation. Another recent study appearing in the journal Biological Trace Element Research found that children with ADHD had lower zinc levels in their blood which correlated with the level of inattention at both home and in-school settings. There is an important relationship between zinc and dopamine. It has been found that zinc enables the body to properly process the brain neurotransmitter, dopamine. Increasing dopamine is also the way that brain stimulating pharmaceutical medications are used in people with ADHD. It only makes sense to optimize the levels of zinc in the body for those who have ADHD and other related issues. Going even deeper, zinc also has a role in activating the genes that encode for the proteins that transport dopamine in and out of the nerve cells. It’s commonly known that dopamine is a key to improving focus in these children and adults and is an important factor to assess and treat from a naturopathic perspective.
Another neurotransmitter, serotonin, is important for regulating executive function and social behaviour. L-tryptophan (an amino acid component found in proteins) is required to make serotonin, however, vitamin D hormone is required to activate this process. Research conducted at the Children’s Hospital Oakland Research Institute, in Oakland, California propose that vitamin D, L-tryptophan and omega-3 fats all are important for proper serotonin activation and if these nutritional factors are deficient, possibly in the context of a genetic predisposition, then this can explain several neuropsychiatric disorders, including ADHD. As you can see, there is an interaction among genetics and nutrition (read below about environmental factors), so that’s what makes ADHD about more than just one cause. There are several other nutrients that are important for brain function. People with ADHD may be deficient in one or several, so tests must be done to figure out which are most important for any specific person with ADHD, we’re all unique and so should be the treatment.
Naturopathic herbal treatment of ADHD
Several herbs may be useful for the treatment of ADHD. Some have impacts on memory, others can benefit the mood, yet others have beneficial affects on nerve-related inflammation. Some herbs are really based on foods such as the polyphenol group of compounds, however, in several cases these are concentrated in specific herbs or extracts. For example, bacopa is a herb with 3000 years of traditional use in the Ayurvedic system of medicine. It is known to to improve memory, attention and mood and is currently being studied in children with inattention and hyperactivity.
Importance of sleep
Sleep is an important factor in cognitive function. If a child with ADHD has poor sleep or wakes unrefreshed, there is a greater likelihood of poor cognitive function and poor behaviour in the daytime. It may be a behaviour-related sleep problem, nutrition-related, medication-related, or commonly due to restless legs or periodic limb movements in the night. Addressing the cause will improve the quality of sleep as well as daytime function.
Environmental factors in ADHD
We know that early chemical exposures can have a significant impact on development. Several early chemical exposures have been correlated with the risk of developing a neurodevelopmental disorder. For instance, prenatal exposure to organophosphate pesticides have been linked to poorer cognitive abilities in children at 7 years of age.
Mercury independently has been associated with decreased levels of the neurotransmitters dopamine, serotonin, noreprenephrine and acetylcholine in the brain. Despite some research showing that prenatal fish-sourced mercury as not having a cognitive impact, other factors have been uncovered. For instance, studies have found that the use of mobile phones increases the release of dental mercury found in mothers. Similar effects have been found in studies using much stronger electromagnetic field (EMF) exposures from MRI testing devices.
Naturopathic whole-child based treatment program for ADHD
Often, parents and even naturopathic doctors feel if we can try a vitamin or herb instead of a medication, that would solve the problem. It may solve the problem of avoiding side effects, but this substitution approach just doesn’t work for many chronic illnesses. What I call a ‘whole-child’ based model is required, in the sense of putting all the pieces together of what the person needs. The program will consist of addressing several important factors in combination:
- full initial assessment (including history, physical examination)
- neurodevelopmental assessment
- tests for nutrition, hormonal state and toxicity
- diet and clinical nutrition
- food allergies/intolerances
- promoting full neuro-development through customized exercises
- removing toxicities
- behavioural support
- academic support
- herbal support
Causes and associations with ADHD
- Older, stressed, overweight, nutrition-depleted parents
- Preterm birth
- Low birth weight
- Family history of ADHD and psychiatric illnesses
- Hormonal imbalances (eg: thyroid, testosterone, cortisol)
- Medications or illness or infections during pregnancy
- Traumatic birth
- Nutritional deficiency
- Environmental pollutants
- Chronic inflammation
To have a comprehensive approach to your child’s health where we look to address the causes and provide a range of treatment options, contact the clinic to arrange an assessment – 905-597-7201.