Phyllis B. Books, DC, DACBN

Etiological factors include genetic predisposition, brain injury, chronic middle ear infection, visual or hearing disturbances, trauma, conditions that are medication-induced (such as vaccinations), allergic reactions and sensitivities, or simple lack of proper nutrient intake. But the end result is the same, impaired nutrient utilization, especially proteins needed for normal brain function and production of mood-enhancing neurotransmitters like serotonin (the tension reliever) or dopamine and norepinephrine (increase alertness).2,6,7,10 Due to the serious side effects of conventional pharmaceuticals, many practitioners are turning to natural alternatives to achieve more comprehensive and lasting results.1,3

A landmark study using a sophisticated brain scanning device (PET or positron-emission tomography) shows that hyperactive patients have detectable metabolic abnormalities and an inability to manufacture brain neurotransmitters. Overall brain metabolism was 8% lower, primarily in the premotor cortex and superior prefrontal cortex, which regulate attention and motor coordination. The result is faulty dopamine uptake in the entire neuronal system and a “traffic jam” of incoming and outgoing messages.1,2,8,12 Several recent studies have shown evidence that the core deficit in ADHD is failure to delay or inhibit behavioral responses. As all metabolic systems in the brain are directly linked to nutrient utilization, it becomes clinically apparent that targeted protocols will result in replicable improvements.6,10

A Pervasive problem

ADD/ADHD affects over 10% of American school children, more than 25% of American families and 10 times more boys than girls. Toddlers as young as 2 years old are being medicated for the inability to sit still.7,9,10,11 Symptoms can also persist into adulthood, oftentimes with advanced behavioral problems and inattentiveness that are harder to detect because they have been socially modified. Although labeled as having a learning disability, ADD children often exhibit above-average intelligence and are highly creative, but at the same time have behavioral abnormalities that can result in disturbed classroom or family relationships. Parents may also be intensely stressed and need nutritional support for themselves.1,6,10
Children in this category are more often affected by chemical preservatives, dyes, salicylates and high sugar content in foods. Salicylates (found in aspirin) are used as additives, but are also found naturally in almonds, bananas, apples, citrus and tomatoes. Statistics show that children in the U.S. consume over 5 pounds of preservatives a year. Although refined sugar is cited as having a primary influence on behavior due to blood sugar highs and lows, no formal studies have been conducted to prove that sugar has a direct link to development of learning disorders.1,5,7,10 However, excessive sugar intake is connected to stimulation of yeast infections such as Candidiasis that can result in hyperactivity and memory loss. Use of probiotics, essential fatty acids and B vitamins (build disease resistance) maintain proper intestinal flora and pH that aids in keeping yeast overgrowth under control. 1,6,9,10

Contaminants such as heavy metals and pharmaceuticals set the stage for brain interference or allergic reactions that lead to undesirable behaviors and hyperactivity. Coenzyme Q10 is an effective detoxifying agent for toxic chemicals and a recommended staple that aids in building new brain tissue, as in pycnogenol or grape seed extract that protects brain cells. Essential fatty acids are not only critical in the formation of chemical precursors that relay brain impulses, but also reduce inflammatory processes that contribute to allergies and their related behavioral problems.3,4,5,10

Determining the deficit

The officially accepted symptom profiles adopted by the American Psychiatric Association to categorize this group of learning disorders list a number of diagnostic signposts. Observing 6 out of 9 characteristics in either category is a positive indicator. As there are no substantiating lab tests, identifying these disorders is solely a subjective process of evaluating observed behaviors.6,10

ADD without hyperactivity is distinguished by sloppiness, forgetfulness (loses things), absentmindedness, brain chatter, carelessness, inability to finish tasks, sleep disturbances, procrastination, emotional instability and mood swings. Extended into adulthood, these characteristics translate into failed relationships and chronic lack of career achievement. ADHD on the other hand is identified by temper tantrums, self-destructive tendencies, impatience (especially with waiting), impulsiveness, clumsiness, interrupting others, excessive talking and poor performance in school (despite high intelligence and ability to successfully complete tasks). Adults afflicted with uncorrected ADHD as a child are those who get things done rapidly, but get easily frustrated and lose their tempers. They also have a higher risk of alcoholism. A combined disorder of ADD with ADHD often results in a child with low self-esteem (resulting from shame and confusion), inability to follow rules, poor social skills and a characteristic belief that they are always right.1,4,.6,10

To calm the tendency toward excessive motion and constant brain activity, calcium and magnesium at bedtime aid in reducing agitation, as does the protein supplement GABA (gamma-amino-butyric-acid). Studies have shown that the amino acid GABA reduces hyperactivity, tendencies toward learning disabilities, violent behaviors, epilepsy and mental retardation. For inducing sleep, parents report good results combining GABA with Valerian (a gentle calming herb used as a natural relaxant). Chamomile and wild oats have calming effects on the nervous system, as does skullcap, lavender, rosemary and sage (used by Native American Indians as relaxants).1,6,7,10

Brainier kids

Of the 400,000 children now diagnosed with ADD/ADHD, many of the emotional manifestations such as sullenness, uncontrollable crying, temper tantrums, anxiety attacks, depression, lack of concentration, restlessness and aggressiveness can be improved or even reversed with targeted protocols designed for nutritional support.6,7,10

Indications show that protein deficiency is a major contributor. DMAE or dimethyl amino ethanol is a high-powered neurotransmitter that improves behavior and mental concentration within 6 weeks. (Results are so effective one teacher thought the child was taking Ritalin when he was actually on DMAE!). Amino acids act as natural mental stimulants that increase energy production in the brain, improve cognitive function, reduce hyperactivity, improve learning mechanisms, alleviate sleep disorders and reduce mental fatigue. Children, and teenagers especially, who are among the growing number of vegetarians need to pay special attention to protein intake and should consult with a knowledgeable health care professional about their nutritional balance.1,4,7,10
Temper tantrums and sleep disorders are directly related to omega-3 fatty acid deficiencies (common with today’s fast foods).7,9,20 DHA or docosahexonoic acid as an omega-3 from fish oil is vital for learning and visual coordination. Other good sources are evening primrose oil and flax seed. Suspect zinc deficiency if a child is irritable, tearful, sullen, resentful and unable to be soothed by body contact. Low levels of zinc cause hyperactivity or low serotonin, and are common in ADHD cases.1,10 SRRI drugs (selective serotonin reuptake inhibitors) like Zoloft, Paxil and Prozac impact zinc levels and create a vicious cycle of emotional instability.1,3,6 Another basic that can improve mind function is the anti-stress antioxidant, vitamin C. Studies have shown that a dosage increase of 50% raises IQ scores by 3.6 points.10 A well-rounded multivitamin should form the foundation of every child’s daily nutrition and a high potency B Complex, essential for normal nerve and brain function. Low B is linked to bad behavior, which improves when deficiencies are corrected. B12 aids moodiness and memory. Inositol fights depression, compulsive disorders and panic. Niacin or B3 treats psychiatric conditions like Schizophrenia and aids memory retention. Deficits of B3 lead to poor school performance, hyperactivity and inability to form relationships. According to psychiatric studies, B6 is more effective than Ritalin and deficiencies have been linked to autism.2,4,8,10

The Up Side of Depressions

One of the most serious threats to the well-being of American youth is the rise in teenage and childhood depression. According to estimates by the American Academy of Child and Adolescent Psychiatry, 3.4 million children and teens (about 5% of the child population) have significant bouts with clinical depression and even exhibit suicidal tendencies. Over half a million are taking antidepressants like Zoloft, Prozac and Paxil in spite of the fact that no formal testing has been done to show these medications safe for growing children. Thus, the long-term consequences of using brain-altering drugs for children are not known.1,3,10 What is known is that psychoactive drugs cover the underlying cause and add nothing to the child’s recovery process. Low self-esteem, hostility, refusal to attend school, sleep changes, irritability, eating disorders and lethargy signal a characteristic complex that also fits the diagnosis of ADHD, which can be greatly benefited by a therapeutic nutritional program.4,6,10

In cases of childhood depression, herbals prove helpful to increase stress resistance, improve metabolic function and elevate mood. Thus, targeted herbals represent a safe, long-term alternative to drugs. Herbals both nourish the nerve tissues and act as natural antidepressants.6,7,9 Quick acting and readily absorbed, Ginkgo biloba is thought to enhance neurotransmitter sites by stimulating blood flow. Numerous clinical trials have confirmed Hypericum perforatum or St. John’s Wort to be an effective antidepressant appropriate for children and without the side effects of pharmaceuticals. Flavones, hyperforin and hypericin are the active components that inhibit the MAO (monoamine oxidase) enzyme, which keeps neurotransmitters in circulation longer. The result is a stimulation of rapid nerve impulses that reduce depression. St. John’s Wort is also an effective alternative to Tricyclic antidepressants, which cause a deficiency of B2 that affects nerve fibers and the heart antioxidant CoQ10. The herbal shows results in 3-4 weeks. (Advisement should be noted that both Ginkgo and St. John’s Wort might contain small amounts of naturally occurring salicylates.)1,4,5

Children with depression should be on a nutritional regimen of high B-complex, especially B12 that regulates mood. Teens need an additional 400mcg of folic acid (brain food that generates energy) and 2000-3000mg of vitamin C per day to enhance absorption (for younger children cut dosages in half). Depression can result from a deficiency of B6, as can fatigue, irritability and learning difficulties, hearing problems and memory loss. Inadequate protein is behind cravings for sugars and fats (fast foods) and may be another precursor to depression. Sucrose from candy and snacks causes rapid highs and lows in blood sugar that adversely affect mood and lead to chronic irritability and depression, not to mention weight gain and skin problems (themselves a basis for depressed behavior). These hypoglycemic changes impact cortisol levels in the adrenals and lead to the “fight or flight” response, followed by sudden drops in circulating adrenaline which enhances exhaustion and leads to outbursts of anger or aggressiveness. Iron deficiency anemia can lead to depression due to lack of oxygenation in brain tissues, with characteristic whining, irritability, fatigue, lethargy and slow mental processes. As a rule of thumb, children under 6 years of age take 1/4 the adult dosage, ages 6 to 12 take 1/2, from 12 to 17 take 3/4 and over 18 takes the adult level.1,4,7,9,10

Assessing Autism

Often linked with ADD in the clinical setting, autism is the third most common developmental disorder in the U.S. (above Down Syndrome) according to the Autism Society of America, and also affects more boys than girls. Like ADD/ADHD, nutritional support can provide positive reinforcement for the emotional unresponsiveness and self-destructive behavior associated with autism. Thought by researchers to be a signaling problem within the brain synapses, autistic children respond to B3, B5, B6, choline and DMG (dimethylglycine) to increase brain circulation and oxygenation of brain tissues. SAMe has been successful in reducing autistic depression.2,6,7,10

The latest controversy is tied to an explosive rise in the number of cases across the country related to mercury (Hg) used as a carrier in postpartum and childhood vaccinations. Alarming statistics like the 26% jump in total U.S. cases within one year (and rising) have stirred new interest in its causes and cures. According to the FDA and American Academy of Pediatricians, children under 2 now receive Hg levels that exceed the safety standards set by FDA. As a result of California’s own higher incidence of autism (over 500% in 13 years), four fathers of autistic children founded the MIND Institute (Medical Investigation of Neurodevelopmental Disorders) at the U.C., Davis. The Institute is now funding $4 million of independent research in the neurotoxic effects of Mercury. In a society with history’s highest rate of vaccinated children and mothers, results to date show the clinical picture of Hg poisoning is strikingly similar to autism. Uncontrollable crying, a shock-like state and acute encephalopathy (any of several brain diseases) are observed with diphtheria and tetanus toxoids (DPT) injections, for example, as well as brachial neuritis and Guillain-Barre syndrome (deterioration of nerve and muscle fibers causing progressive paralysis).2,4,6,8,12

Recent clinical trials by a pediatrician in Richmond, Virginia, suggest a potential link to foreign protein in pertussis injections and depletion of vitamin A by measles vaccine (linked to chronic arthritis). Treatment regimens with therapeutic A have shown improved thyroid and pituitary function, correction of night blindness and improvement of retinoid disturbances. Other findings indicate Hg may cause a dangerous build-up of intracellular calcium by disabling pump mechanisms. Immunized mothers can also pass along live vaccines to infants during breastfeeding, and for those mothers who do not develop antibody protection after being vaccinated, there’s a higher rate of autistic offspring.2,6,9,12

It follows that one of the most plausible theories held by medical researchers is that autism can actually be classified as an auto-immune condition. Thus there is scientific substantiation for using immune boosting nutrients including vitamin C, E, and A, CoQ10, colostrum, Omega-3 fatty acids, beta-glucans (stimulates macrophages) and quercetin (prevents reactions to certain foods and allergens). Manganese is a required mineral for proper function of the immune system and works with the B Complex to maintain a feeling of well being. Manganese also controls blood sugar levels, promotes healthy nerve fibers and aids in protein metabolism, all of which are key in attention deficit and behavior. Deficiencies can result in mental confusion, ocular problems, irritability, memory loss, muscle tremors and repetitive movements such as tooth grinding. Autistic children can also be helped by melatonin if insomnia is involved.1,2,9,10

The reign of Ritalin

The most frequently prescribed of the mainstream treatments, Ritalin (methylphenadine or methylphenidate) is a class 2 narcotic derived from the Prozac family with street-drug effects like “speed”. Paradoxically, it is both a stimulant and calming agent for the nervous system, used to increase mental focus in hyperactivity. School officials favor it because children on Ritalin act less disruptive in class, and because schools in some districts may be rewarded with grant funding if they promote medication. Although the pro-Ritalin influence is still widespread in the educational setting by instructors and counselors (thus parents may feel pressured), it is actually federally prohibited for teachers to recommend medications for behavioral issues, which is also deterred by many state laws as well.4,10

Physical side effects of Ritalin such as tics and muscle cramps are common. However, even more concerning are the mental/emotional aberrations. As Ritalin is virtually the same as cocaine according to researchers, it can often result in psychotic disorders, and the long-term effects with children are unknown. Derived from a weight loss medication used 40 years ago that was recalled due to widespread abuse, Ritalin sales today top $5 billion a year with over 500,000 prescriptions. A study reported in Child and Adolescent Psychology showed 80% of the Ritalin-treated children still had symptoms 8 years later, and 60% got worse. Side effects can include insomnia, heart palpitations, weight loss, slowed growth and tearfulness or irritability during the initial period.6,7,10

Prescriptive potpourri

Perhaps the most disturbing aspect of the attention deficit pharmacopoeia is the mixing of pscyhotherapeutics. Adderall, for example, is gaining in popularity and may have fewer side effects than the common amphetamines Ritalin, Dexadrine and Cycler, but has also been cited for psychotic episodes and homicidal tendencies. Luvox, Zoloft, Prozac and Paxil are SSRI antidepressants (selective serotonin reuptake inhibitors) with label warnings not to be taken by anyone under 18. Lithium is the medication of choice for bipolar depression, but depletes inositol (a B vitamin that fights depression, compulsive behaviors and panic). Used for treating Schizophrenia, the tranquilizer Thorazin is applied for severe hyperactivity, serious behavioral problems or the manic phase of manic depression. Unfortunately, it also can cause tardive dyskinesia (involuntary muscle spasms of the face and body that may be permanent) and depletes vitamin B2 (stunted growth, nerve problems and mental slowness), CoQ10 and melatonin. Gaining in acceptance for its more convenient once-a-day dosage, Tricyclic antidepressants like Tofranil (Imapramine) or Norpramine can themselves cause sudden learning disabilities, deplete vitamin B2 and lowers the energy-producer, CoQ10. An adult anti-psychotic, Haidol or Haloperidol is also listed as a behavioral modifier for children. This can result in insomnia, depression, and a depletion of vitamin E. Popping a pill may be easy (Ritalin comes in colors so it resembles candy), but at what cost to kids, families and communities (like Columbine, Colorado)?1,3,4,7,10

A healthier outlook

Nutritionally speaking, small changes can lead to big results. Experts agree that correction of even subtle variances in nutrient levels exerts a substantial influence on behavior and learning capacity. The late Dr. Lendon Smith, a pediatrician who treated over 6,000 hyperactive children during his distinguished career, reported an 80% improvement rate with dietary and nutritional changes.6,4,7

Helping parents find viable alternatives provides a life-changing service that gives back to children their hope for a more normal future, and offers society a second chance to reclaim its younger generation through wholeness and wellness rather than chemical synthetics. The real drug war may not be fought on the streets. The real “deficit” in ADD/ADHD may well be a “deficit” of sound nutrition, but at least that’s a problem we can fix.

1. Stevens, Laura J., M.S. 12 Effective Ways to Help Your ADD/ADHD Child (Drug-Free Alternatives for Attention-Deficit Disorders). Penguin Putnam, Inc., New York, New York, 2000.
2. O’Mara, Peggy, Editor. Vaccination: The Issue of Our Times. Mothering Magazine, Inc., Santa Fe, New Mexico, 1997.
3. Pelton, Ross, R.Ph., and LaValle, James B., R.Ph. The Nutritional Cost of Prescription Drugs. Morton Publishing, Inc., Englewood, Colorado, 2000.
4. Hunger, Diana. The Ritalin-Free Child. Consumer Press, Ft. Lauderdale, Florida, 1995.
5. The PDR Pocket Guide to Prescription Drugs (Based on the Physician’s Desk Reference). Simon & Shuster, Inc., New York, New York, 2000.
6. Romm, Aviva, C.P.M., A.H.G. ADHD Alternatives. Schoolhouse Road, Pownal, Vermont, 2000.
7. Martin, Grant Dr. The Attention Deficit Child. Cook Communications, 1992.
8. O’Mara, Peggy, Editor. Show Us The Science. Mothering Magazine, Inc., Santa Fe, New Mexico, March/April, 2001, pages 39-55.
9. Balch, Phyllis A., C.N.C., and Balch, James F., M.D. Prescription for Nutritional Healing. Penguin Putnam, New York, New York, 2000.
10. Block, Dr. Mary Ann. No More ADHD, No More Ritalin. The Block System, Inc., Hurst, Texas, 2001.
11 Zand, Janet, O.M.D., Walton, Rachel, R.N., Rountree, Bob, M.D., Smart Medicine for a Healthier Child. Avery Publishing, Garden City, New York, 1994.
12. Autism: A Unique Type of Mercury Poisoning (Abstract). Collaborative contributors: Sallie Bernard; Albert Enayati, B.S., Ch.E., M.S.M.E; Teresa Binstock, Heidi Roger, Lynn Redwood, R.N., M.S.N., C.R.N.P.; and Woody McGinnis, M.D. Cranford, New Jersey, ARC Research, 2000.

An ADHD-specific protocol should include lecithin-derived physphatidyl serine (a phospholipid that improves cognitiveability), chromium nicotinate (mineralandinositol (B vitamin with calming effects).

Additional requirements for amino acids include L-glutamine (brain fuel), tyrosine (precursor to mood-enhancing dopamine), phenylanine (elevates mood and acids memoryretention), taurine (treats anxiety) and 5-Hydroxy Tryptophan (precursor to tryptophan and specific to hyperactivity or depression).1,6,7,9