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Although there is no cure for ADHD, there are several treatment options available. The most common and effective are pharmaceuticals and behavioral therapy. However, other complementary options are also available. Elimination diets, herbal treatment, and ADHD supplements are the most common natural therapy methods.
Facts on nutrition and ADHD
The known facts on ADHD and ADHD-like symptoms are:
- Symptoms are mainly behavioral.
- Behavioral therapy and medication are highly effective conventional methods to treat ADHD.
- Medication for ADHD causes side effects in 30% of cases.
- Studies on non-ADHD children show that a low concentration of nutrients in the blood impair brain function and lead to antisocial behavior.
- Nutrient supplementation corrects this imbalance and improves anti-social behavior in about 50% of non-ADHD children. (1)
- Deficiencies in Omega 3s (2, 3), Zinc (4, 5), magnesium (6) and DHA is common in ADHD patients and may affect their behavior. (7, 8).
Since nutritional deficiencies are common in people with ADHD, many scientists investigate various supplements to reduce ADHD symptoms. However, it is still unclear if using these supplements is effective.
There are also several nutrients that can counteract some of the side effects of ADHD medications, especially if a deficiency is detected. (9)
Overall, studies on ADHD treatment with supplements, show a mixture of positive and inconcltusive evidence.
In other words, supplementing ADHD patients with nutrients is not only safe (if not used in mega-doses) but potentially beneficial. However, more studies are needed.
- Children with ADHD may be deficient in some nutrients and suffer side effects from the medications.
- Supplements made up of these nutrients are safe and potentially beneficial in ADHD.
Amino Acids supplements and ADHD
People with ADHD have low levels of amino acids, including those that are used in generating serotonin and catecholamines.
Amino acids such as phenylalanine, tyrosine and tryptophan are used in the production of neurotransmitters, dopamine, serotonin and norepinephrine which, in turn, affect the behavior of people with ADHD.
Therefore, supplementation with amino acids is thought to improve the symptoms of ADHD in children.
However, studies show that supplementation with amino acids doesn’t have benefits in the long- term, as tolerance develops within two to three months.
- Older studies showed promising results, but more recent studies show amino-acid supplementation is not effective in improving the symptoms of ADHD in the long term.
Vitamins and other compound supplements and ADHD
Vitamins are not effective supplements for ADHD symptom reduction.
Vitamins B6, B9 and B12 are used in the production of neurotransmitters and in the metabolism of fatty acids. A deficiency in these vitamins impacts cognitive functions.
Vitamin C has antioxidative properties that protect fatty acids and general oxidative damage in the brain.
Carnitine is required in fatty acid transport and reduces symptoms similar to ADHD in fragile X syndrome, so it is thought that it may also improve symptoms in ADHD children.
Vitamin supplementation studies use mega-doses of specific vitamins, which are not only ineffective but also have a harmful effect on the liver. (12)
Studies on individual vitamin supplementation have not shown improvements in the symptoms of ADHD. (13)
- Supplementation with vitamins is ineffective in reducing ADHD symptoms.
- Vitamin supplementation may be used in cases of malnutrition or poor diet
- Mega-doses of vitamins can be harmful
Mineral supplements and ADHD
Magnesium, zinc and iron deficiency is known to cause cognitive impairment in children. ADHD children have lower levels of these minerals than their non-ADHD peers.
In recent decades, research has tested the potential use of these minerals as ADHD supplements.
Most studies so far have been using single mineral supplements in ADHD cases. However, recent studies started to use broad-spectrum micronutrients (vitamins and minerals).
Multi-vitamin and mineral supplements in ADHD
Very high doses of broad spectrum micronutrient supplements can be toxic, with no visible benefits, so they are not advisable. (14)
Studies with children with ADHD are even more promising.
71% of children had a 30% decrease in symptoms, and 79% were identified as much or very much improved. (17)
This study has shown improvements in overall function, inattention, emotions and aggression, although no improvement was noted in hyperactive and impulsive behavior. (18)
Zinc supplements in ADHD
Of all minerals used as ADHD supplements, zinc has shown the most positive results, especially in the case of zinc deficiency.
Zinc is used in the production of neurotransmitters and in over 100 enzymes. It is essential in melatonin and dopamine production.
However, the results depend on the dosages and initial level of zinc deficiency.
High dosages show good results. In one study, a high dose of 150mg/day showed a significant improvement in ADHD children’s hyperactivity and impulsivity. It didn’t report any changes in inattention. (23) However, such high dosages may cause side effects. (24)
Zinc supplementation mostly benefits children with the lowest blood concentration of zinc and essential fatty acids.
This explains why studies done in areas with higher deficiency levels, such as Iran and Turkey, had positive results, but not in the U.S,. where zinc deficiency is not as prevalent.
However, various studies using smaller doses, didn’t show improvements. (25)
Iron supplements in ADHD
Iron deficiency may be linked to restless legs syndrome and play a role in ADHD.
Iron is involved in the metabolism of essential fatty acids and regulates dopamine and noradrenaline production (26).
Iron supplementation is beneficial in children with ADHD who are anemic or with abnormally low ferritin levels, but not those with normal iron levels.
Supplementing with 80 mg/day of ferrous sulfate improves ADHD symptoms. (27) However, more studies are needed on non-anemic ADHD children.
Magnesium supplements in ADHD
Magnesium protects the membranes of neurons and modulates the release of neurotransmitters in the brain (28).
Magnesium supplementation of 200mg per day for 6 months in children with magnesium deficiency, resulted in a significant decrease in hyperactivity. (29)
Magnesium together with Vitamin B6 can be effective in increasing magnesium in plasma levels and reducing hyperactivity and inattentiveness in children with ADHD with low magnesium levels.
One study has shown that 6mg of magnesium per kg of body weight per day, together with 0.6mg of Vitamin B6 per kg of body weight per day over a period of 4 months improves attention.
A combination of 80mg/day of magnesium and omega 3 fatty acids given to ADHD children for three months decreased their inattentiveness, hyperactivity and impulsivity. (30)
More large, long-term double blind randomized control clinical trials are needed to show the effects in children with normal magnesium levels.
- Studies on multi vitamin-mineral supplementation on ADHD children and adults are promising, although require more good quality, large controlled studies for more evidence.
- Association between single mineral supplements and ADHD is not clear and requires evidence to establish the optimal doses with minimal side-effects.
- Of all micronutrient ADHD supplements, zinc is shows the most promising results.
- Zinc is one of the more promising supplements for ADHD treatment, especially in cases of zinc deficiency.
- Studies on iron supplementation have shown modest to negligible results in the treatment of ADHD symptoms. However, it is useful in cases of iron deficiency and anemia.
- Studies on magnesium supplementation found modest to negligible results in ADHD therapy. However, it is useful in the treatment of magnesium deficiency.
- The combination of magnesium with vitamin B6 or omega 3s has potential benefits but requires more studies.
People with ADHD have lower levels of omega 3s (especially DHA) in the blood.
Omega 3s have been used as ADHD supplements to improve DHA blood levels and also in the hope that the symptoms would subside.
Studies have so far found a mixture of inconclusive and positive results. However, please note that studies that show positive results are of better quality.
More, large good quality clinical trials of at least six months duration are needed to clarify, if omega 3s with or without adding omega 6 are useful in improving ADHD symptoms.
- The effects of supplementation with omega 3 are unknown, although existing studies show promising results.
- More long-term studies with a large group of participants and various combinations of essential fatty acids are needed.
The best ADHD supplements
So far there are no ADHD supplements that stands out or are effective in a large portion of the affected population.
While amino acids have shown to be ineffective as an ADHD supplement, individual and broad-spectrum vitamins and minerals may be beneficial in individuals with deficiencies.
Supplementation with DHA and EPA may have small benefits, especially in the case of deficiency or poor diet. However, more studies are needed.
- So far there is no evidence of exceptionally effective supplements for ADHD treatment.
NUTRITION FACTS VS NUTRITION MYTHS
You will find a summary of the most common nutrition myths and evidence-based nutrition facts here.