Attention Deficit
Hyperactivity Disorder

Attention deficit disorder (ADD) affects upwards of 10% of school-aged children. Over 2 million American children take methylphenidate (Ritalin). The term ADD can include 3 different forms of this syndrome:
  1. • ADD without hyperactivity
    • ADD with hyperactivity
    • ADD, residual type.

The first two disorders are seen in children. The third disorder is a residual affect of childhood ADD that manifests itself in adulthood.

For this brief descriptive outline, I’ll be using the single term attention deficit disorder (ADD).

The characteristics of this disorder are as follows:

  • • Inability to concentrate for appropriate periods of time
    • Hyperactivity
    • Emotionally challenged
    • Impulsiveness
    • Learning disabilities
    • Poor memory
    • Poor cognitive abilities
    • Hearing or speech disorders
  •  

Criteria for Diagnosing Attention Deficit Hyperactivity Disorder

From Diagnostic and Statistical Manual of Mental Disorders, 4th edition.

  1. Either 1 or 2:

1. Six or more of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

a. Often fails to give attention to details or makes careless mistakes in schoolwork, work, or other activities.

b. Often has difficulties in sustaining attention in tasks or play activities.

c. Often seems not to listen when spoken to directly.

d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.

e. Often has difficulty organizing tasks.

f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.

g. Often loses things necessary for tasks or activities.

h. Is often easily distracted by extraneous stimuli.

i. Is often forgetful in daily activities.

 

2. Six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity:

  1. Often fidgets with hands or feet or squirms in seat.
  2. Often leaves seat in classroom or in other situations in which remaining in seat is expected.
  3. Often runs about or climbs excessively in situations in which it is inappropriate.
  4. Often has difficulty playing or engaging in leisure activities quietly.
  5. Is often “on the go” or often acts as if “driven by a motor.”
  6. Often talks excessively.
  7. Often blurts out answers before questions have been completed.
  8. Often has difficulty awaiting turn.
  9. Often interrupts or intrudes on others.

    Ritalin Nation

    According to statistics, Ritalin production has increased 700 percent since 1990. The U.S. consumes 90 percent of the world’s production of Ritalin. Does anyone have a Ritalin deficiency? Why are so many children (and adults) receiving a diagnosis of ADD?

    A closer look at Ritalin and other amphetamine medications should cause parents and physicians to question whether medication’s short-term results outweigh long-term health consequences.

    Potential side-effects associated with Ritalin include, tremors, anemia, stunted growth, insomnia, anxiety, depression, joint pain, loss of appetite, nausea, dizziness, heart palpitations, chest pain, headaches, cardiac arrhythmias, weight loss, lowered immunity, and hair loss.

    Faced with the pressure applied by teachers, other parents, and school administrators, it is no wonder that some children are placed on medications (amphetamines) that are illegal when sold on the street. But who should we blame? Most parents only want the best for their children.

    I’m a pragmatist. If faced with having your child take medication or be thrown out of school, you must choose the most logical answer. However, just like oil light that appears on the cars dashboard (signaling that more oil is needed); ADD is a warning sign of underlying biochemical or emotional disturbances. Covering-up the oil light with a magic marker does eliminate the warning sign, but it does nothing to correct the problem. At some point, the cause of the oil light must be dealt with or major problems will begin to appear.

    What are some of the potential causes of ADD?

    • Nutritional deficiencies
    • Food additives
    • Food or chemical sensitivities
    • Heavy metal toxicity
    • Excess sugar
    • Poor sleep habits
    • Hypoglycemia
    • Boredom
    • True depression
    • Otitis media

    A brief overview about the list above reveals the following:

     I. Nutritional deficiencies can cause CNS dysfunction.

    Deficiencies in certain nutrients including magnesium, zinc, amino acids, essential fatty acids, and vitamins B3, B6, and C can lead to behavioral changes.

    Essential Fatty Acid Deficiencies

    The technical name for fat is lipids. Lipids are substances that can’t be dissolved in water. The lipids include fats, oils, and phospholipids (lecithin).

    Fat is made up of fatty acids. The three major types of fatty acids are:

    1. Saturated fatty acids (SFAs) are found in butter, coconut oil, eggs, meat, and cheese. Saturated fats consist of long, straight chains of molecules packed tightly together. Saturated fats are solid at room temperature. 

    2. Monounsaturated fatty acids (MUFAs) are found in almond oil, avocados, canola oil, oats, peanut oil, and olive oil. Monosaturated oils are usually liquid at room temperature, but may become cloudy or hardened when placed in the refrigerator. MUFAs have one kink or bend in their structure and this makes them more flexible than SFAs.

    3. Polyunsaturated fatty acids (PUFAs) are found in corn oil, primrose oil, flaxseed oil, borage oil, certain fish, sesame oil, sunflower, safflower, and wheat germ oil. Vegetable oils are usually high in PUFAs. Polyunsaturated fats (PUFAs) are liquid at room temperature. PUFAs have many kinks or bends in the chains of fatty acids that make them up. These kinks or bends make PUFAs soft and flexible.

    Essential fatty acids are essential for our existence. They can not be manufactured by the body but must be obtained from the foods we eat. Essential fatty acids are made-up of polyunsaturated fatty acids (PUFAs).

    PUFAs are divided into two families of essential fatty acids (EFA).

    A. Omega 6 Linoleic Acid

    Pure vegetable oils, including sunflower, safflower, and corn oil contain the essential fatty acid (EFA) Omega 6. Some individuals are genetically unable to convert Linoleic acid into its derivative, Gamma Linolenic Acid (GLA). This can be overcome by taking primrose or borage oil; both are high in GLA.

    B. Omega 3 Linolenic Acid

    Omega 3 oils including Alpha Linolenic Acid (ALA) are found in flax seed, soybean, walnut, and chestnut oils, as well as some dark green leafy vegetables.  Eicosapentaenoic Acid (EPA) and DHA (docosahexanoic acid) are Omega 3 derivatives and are found in most cold water fish. These fish include salmon, tuna, and mackerel. Essential fatty acids make up the outer lining or membranes of each cell.  These lipid (fat) membranes determine which nutrients get into and out of the cells.  They are a major component of the endoplasmic reticular detoxification membranes, nuclear membranes, and the energy producing mitochondrial membranes.

    Obtaining these EFA’s from the foods we eat can be challenging. Most of our foods have undergone processing that changes the essential fatty acids into toxic hydrogenated oils. The hydrogenation of the natural oils (fats) changes them into toxic trans-fatty acids. 

    There are receptor sites on the membranes at which point the happy hormones (neurotransmitters, serotonin and others) attach themselves.  Trans-fatty acids block the cellular membrane receptor sites.  A blocked or hardened cellular membrane prevents nutrients from entering and exiting the cell.  The neurotransmitters (brain chemicals) are then unable to attach themselves to the cells membrane. This can lead to depression, insomnia, anxiety, fatigue, A.D.D., or any disorder that involves the brain hormones (serotonin, epinephrine, dopamine, etc.).

    Long Chain Fatty Acid Deficiencies

    LA (2 double bonds) is converted to AA (arachidonic acid) and finally to DPA (5 double bonds).

    ALA (2 double bonds) is converted to EPA (5 double bonds), and finally to the long chain fatty acid DHA (6 double bonds).

    Hunter gatherer societies had a 1:1 or 1:5 ration of Omega 6 to Omega 3. Modern eating habits have change this ratio that to 12:1 Omega 6 to Omega 3. Sixty-percent of the U.S. population is deficient in Omega 3 fatty acids.

    A University of Minnesota study by Dr. Ralph Holman showed that during pregnancy Omega 3 fats decrease in a mothers blood (when compared to non-pregnant females), and stayed decreased for six weeks after birth. Subsequent pregnancies made the deficiency even worse.

    Holman, R.T., The Slow Discovery of the Importance of Omega 3 essential fatty acid in Human Health. Jour Nutr 128 (1998) 4275-4335.

    This study demonstrates the importance of Omega 3 fats for fetal development. EFA is so important that the mother’s brain shrinks three percent in order to provide enough of AA and DHA for fetal development. “Long chain fatty acid deficiency at any stage of fetal and/or infant development can result in irreversible failure to accomplish specific brain growth. There is good evidence today that lack of abundant, balanced DHA and AA in utero and infancy leads to lower intelligence quotient and visual acuity and in larger term contributes to clinical depression and

    attention deficit hyperactivity disorder.” Broadhurst, C., Leigh, Stephen C., Cunnane, and Michael Crawford.”Rift Valley lake fish and shell fish provided brain specific nutrition for early homo.” British Jour of Nutr 79 (1998) 3-21.mino Acids

    There are twenty two amino acids. Nine of these are known as essential amino acids. Essential amino acids can't be made by the body and must be obtained from our diet. Non-essential amino acids can be manufactured from within our own cells. Individual amino acids are joined together in sequential chains to form proteins. Protein, the body’s building material, is essential to every cell and makes-up our muscles, hair, bones, collagen, and connective tissue.  Amino acids are also needed to make enzymes. Enzymes are protein molecules that coordinate thousands of chemical reactions that take place in the body. Certain amino acids serve as the raw nutrients for forming the neurotransmitters (brain chemicals).II. There are over 5,000 food additives used by American food manufacturers.


    Food additives

    Artificial dyes and preservatives are used in most of our processed foods.  Allergic symptoms associated with these foreign chemicals include, hives, angioedema, asthma, sinusitis, headaches, anxiety, depression, and chronic fatigue.  Many of these dyes and preservatives are in both prescription and non-prescription drugs.  Asthmatics are often extremely allergic to sulfites.  Some asthma inhalant medications actually have sulfites in them as a preservative!  Benzoates, yellow dye [tartrazine], nitrites, sorbic acid, sulfites, Aspartame, monosodium glutamate, hydroxytoluene, and butylated hydroxyanisole are the most notorious culprits in causing the above mentioned illnesses.

    Look for Aspartame in diet sodas and other artificially sweetened food products.  Monosodium glutamin is often added to Chinese food, soups and stews. Pickles, jams, jellies, some sodas, and cakes contain benzoates, toluenes and butylated hydroxyanisole.  Sulfites are added to salad bars, beer, frozen French fries, dried fruit, shampoos, conditioners, and some cosmetics.  Nitrites are used to preserve luncheon meats, hot dogs and other ready-to-eat meats.

    Aspartame (NutraSweet, Equal)

    *Aspartame, commonly known as NutraSweet or Equal, is an artificial sweetener.  The body breaks it down into methanol and formaldehyde to metabolize it. Formaldehyde is grouped into the same class of drugs as cyanide and arsenic. Alzheimer’s disease is now being linked to methanol toxicity and aspartame.  When the temperature of Aspartame exceeds 86 degrees F, the wood alcohol in Aspartame is turned into formaldehyde and then into formic acid. Formic acid is the poison contained in the sting of a fire ant. It has been shown that methanol toxicity causes depression, brain fog, mood changes, insomnia, seizures and similar symptoms associated with multiple sclerosis. There are over 92 symptoms documented from using aspartame. Systemic Lupus has also been associated with methanol toxicity. The amino acid aspartic acid makes up 40 percent of Aspartame.  Aspartic Acid is an excitatory amino acid, and often times contribute to children and attention deficit disorder.  I always encourage my A.D.D. patients to get off and stay off diet colas. 

     *Excitotoxins: The Taste That Kills. Russell Blaylock, M.D. Health Pres 1.Health Tips  and ADHD


    Drink more Water

    The human body is 75 percent water. The brain is 85 percent water. Your body needs a minimum of 6-8 glasses of water. Headaches, asthma, high blood pressure, depression, fuzzy thinking, allergies, fatigue, and pain are all associated with being dehydrated.

     “Every function of the body is monitored and pegged to the efficient flow of water. Water distribution is the only way of making sure that...elements, hormones, chemical messengers, and nutrients…reach the vital organs.”

    “Your Body’s Many Cries for Water” F. Batmanghelidj, M.D.

    I recommend you drink (pure water) half your weight in ounces.

    “Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome”, R.H. Murphree , Harrison and Hampton Publishing 2003.


    Reduce Sugar Consumption

    It’s estimated that America's consumption of sugar in 1996 and 1997 will have risen to 9.8 million short tons, raw value, which is an increase of over 0.2 million tons from the previous year. Sugar depletes the body of B vitamins, calcium, and magnesium.

    Sugar and other simple carbohydrates.  Three ounces of sugar in any form, sucrose, honey, or fruit juice results in a 50% reduction in white blood cell activity for up to 5 hours. The average American consumes over 150 ounces of sugar a day. A can of Coke has 9-10 teaspoons of sugar. Diets high in refined sugar can promote obesity, kidney stones, osteoporosis, heart disease, dental cavities, depression, ADD, ADHD, hypoglycemia, anxiety, and criminal behavior.
    Dr. Joseph Pizzorno, in his book “Total Wellness Improve Your Health By Understanding The Body’s Healing Systems”

    American Health Association.

    Journal of Abnormal Child Psychology, 12/86, Vol.14, No.4L567-577).

    Reduce Consumption of Sodas - The American Academy of Pediatrics has urged all school districts to restrict the sale of sodas.


    Philadelphia Schools ban sale of sodas

    From Reuters Health

    Philadelphia officials have banned the sale of sodas throughout the public school system. New York City schools banned soda sales (as well as candy and sweet snacks from vending machines) in 2003.London, England.

    Children who drink soft drinks are at a higher risk of becoming over weight (obese). “We found that for every additional serving per day of a soft drink …increased the risk of obesity by 50 percent.”

    The Lancet (British Medical Journal)


    Consuming Sodas Leads To Osteoporosis

    Studies show that teenage girls who drank soft drinks were more 2 times more likely to have a bone fracture. Physically active girls were shown to be more than 5 times more likely to have a broken bone.

    Between 40-60 percent of peak bone mass is built during teenage years. Consumption of soft drinks affects both boys and girls. The acidic nature of phosphoric acid in the drinks causes the body to pull calcium out of the bones to acts as a buffer.

    Dr. Joseph Pizzorno, in his book “Total Wellness Improve Your Health By Understanding The Body’s Healing Systems”


    Reduce the Consumption of Aspartame

    The three by-products of aspartame are methanol, formaldehyde, and formate. Formaldehyde is grouped into the same class of drugs as cyanide and arsenic. It has been shown that methanol toxicity causes depression, brain fog, mood changes, insomnia, seizures and similar symptoms associated with multiple sclerosis. There are over 92 unwanted symptoms documented from using aspartame. Aspartic Acid is an excitatory amino acid, and often times contribute to children and hyperactivity disorder. NutraSweet has had more complaints (by those suffering from adverse reactions) to the FDA, than any other food product since the start of the agencies creation.

    “Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome”, R.H. Murphree , Harrison and Hampton Publ.2003.

    *Excitotoxins: The Taste That Kills. Russell Blaylock, M.D. Health Pres 1-800-643-2665.

    *Defense Against Alzheimer’s. Dr. H. J. Roberts, 1-800-814-9800.

    According to Benjamin Feingold, M.D., forty to fifty percent of hyperactive children are sensitive to the 13-15g of artificial additives (especially food colors) that make-up the average daily American diet. Feingold recommends children and adolescents avoid all artificial colorings, flavoring, sweeteners, and preservatives (BHA, BHT, and BHP). He also recommends avoiding these foods; apples, nectarines, oranges, apricots, currants, grapes, raisins, pickles, cucumbers, peaches, peppers, plums, tangerines, and tomatoes. No tea, coffee or aspirin.

    In 1999 the Center for Science in the Public Interest released findings that showed 17 of 23 double blind, placebo studies demonstrated that artificial colors or certain foods such as milk and wheat, worsened the symptoms of ADHD.

    A study released in 1988 by Ralph Nader’s Center for Study of Responsive Law in Washington, D.C., shows that much of the nation’s drinking water is unsafe.  “Tests in 38 states found more than 2,000 toxic chemicals in drinking water since 1974.  Nearly 200 of these chemicals are either known or suspected causes of cancer, cell mutations, nervous system disorders, and birth defects.  At least 1,900 to 2,100 contaminants have never been tested as to their safety.   Industrial and agricultural contaminants routinely find their way into municipal water and private well supplies.


    So what’s in the Water?

    Arsenic - a known carcinogen and poison.

    Asbestos - a known carcinogen

    Cadmium - causes arteriosclerosis, kidney damage and cancer

    Lead - learning disabilities in children

    Mercury - nervous system and kidney damage

    Nitrites - possible carcinogen and interferes with body’s oxygen metabolism

    Viruses and bacteria

    Toxic Chemicals

    1,1,1-Trichloroethane - causes liver damage, depression

    1,1-Dichlorethylene - depressed central nervous system and cancer

    Benzene - chromosomal damage in humans.  Causes anemia, blood disorders and leukemia

    Chloroform - causes cancer

    Dioxin -extremely toxic carcinogen

    Ethylene Dibromide - causes male sterility and cancer

    Polychlorinated Biphyls [PCBs] - liver damage, skin disorders; GI problems, and highly suspected of causing cancer


    Food Sensitivities

    III. Several studies have linked behavioral disturbances with food allergy sensitivity.

    Conservative estimates show twenty percent of young children in industrialized countries have food allergies. 

    *J. Bland, PhD.  Applying New Essentials in Nutritional Medicine, Healthcomm Seminars, p. 3, 1995.

    The most common food triggers were citrus, dairy, wheat, and corn.


    Elimination Diet

    Eliminate the above foods for two weeks. After two weeks re- introduce one food every three days note any symptoms or changes in behavior. If a food causes a negative reaction have the child avoid for three months, then attempt to re-introduce every fourth day.


    Coca Pulse Testing

    While sitting quietly take your pulse. Then challenge by chewing a small amount of food (don’t swallow) for a full minute.  Food supplements should also be challenged in same way. Liquids should be held and swished around in the mouth.  After one minute, the pulse is counted for a full minute.  At the end of this time, the substance may be expelled, and the mouth rinsed with pure water, which should also be expelled.  If the

    pulse returns to the resting value, the process may then be repeated with another substance.

    A positive reaction food or supplement will elevate the pulse above 6 points. Avoid all substances that elicit a positive reaction for 2-3 months.   For someone who has been on a strict elimination diet for weeks, a rise of only one point may be significant. If other symptoms occur after testing, such as headache, sore throat, or fuzzy thinking, this is also a positive test, and the food should be avoided for a period of 3 -6 months. Severe reaction foods should be avoided for minimum of 3 and up to 6 months.

     VI. Otitis media (ear infections) are associated with food allergies. Resultant hearing loss may impair speech and language development. This is also related to allergies.

     V. Heavy metal toxicity has been linked to learning and behavioral problems.


    TOXIC METALS

    Heavy metal toxicity is quite common in today's environment. Many of our every day activities and products contribute to heavy metal exposure and toxicity. Many of these metals have been implicated in causing or contributing to such conditions as Alzheimer’s, Attention Deficit Disorder, depression, headache, hypertension, kidney failure, loss of hearing, FMS, CFS, and tingling in the extremities.

    Aluminum

    Aluminum toxicity has been linked to Alzheimer's disease and mental dementia.

    *Knoll, O., Et Al; Consequences from EEG Findings and Aluminum Encephalopathy. Trace Element Med., 8-s 18-s 20, 1991. Rifat, S. L; Aluminum Hypothesis Lives. Lancet 343; 3-4, 1994. Aluminum is found in some antacids, baking flours, processed cheeses, toothpastes, shampoos and conditioners, prescription and non-prescription drugs, aluminum drink cans, pots and pans.

    Lead

     The effects of lead toxicity are numerous and include neurological disorders in children, chronic anemia, learning disturbances, and fatigue.

    *Sargent, J. D., Meveres, A., and Weitzman, M., "Environemental Exposure to Lead and Cognitive Deficits in Children", Letter, New. England Journal of Medicine, 320(9), 595 (1989).

    Common sources of lead in the environment are lead-based paints, drinking water, industrial contaminants, airborne emissions, and occupations involving metal work and printing. Lead absorption is higher when calcium intake is deficient.  

    Mercury

    Mercury toxicity can cause a wide variety of health problems. Chronic fatigue, stunted growth, mental depression, muscle and joint pain, and possibly brain damage. Mercury can suppress selenium absorption. Selenium blocks mercury absorption by binding with competing sulfur enzyme centers.

    The primary sources of chronic, low-level mercury exposure are dental amalgams and predatory fish. Mercury enters the water as a natural process of off-gassing from the earth's crust and as a result of industrial pollution. Mercury is routinely found in large predatory fish such as swordfish, shark, salmon, and tuna.  Other sources of mercury include the use of fossil fuels, fungicides, some paints, and the production of chlorine, paper and pulp. Silver/mercury amalgams or fillings contain highly absorbable form of mercury that is very reactive and vaporizes at room temperature. Mercury is poorly absorbed if taken orally, but the vapors are readily absorbed through the lungs and quickly pass the blood-brain barrier. Once inside a cell, mercury has is usually there to stay. Mercury continually accumulates in the kidneys, neurological tissue (including the brain), and the liver. High levels of mercury exposure have also been found in the heart, thyroid, and pituitary tissues of dentists.

    Animal research has shown that within 24 hours of having a mercury/silver filling placed, mercury can be detected in the spinal fluid of the animal, and within 48 hours it is implanted in the brain.

    Mercury may also modify normal bacteria so that they become pathogenic (disease causing), and blocks the function of the nerve cells in the brain and peripheral nervous system. Mercury can also trigger autoimmune responses.  Detoxifying from mercury requires oral herbs, mineral supplements, and prescription oral or intravenous medications.

    *Lorscheider Fl, Vimy MJ, Summers AO. Mercury exposure from "silver" tooth fillings: emerging evidence questions a traditional paradigm. FASEB J 1995:504-508.

    Footnotes- (Nylander M, Frieberg L, Lind B. Mercury concentrations in the brain and kidneys in relation to exposure from dental amalgam fillings. Swed Dent.J 1987;11:179-187.)

    Nickel

    Nickel is not as toxic as many of the other metals. Nevertheless, it’s associated with headaches, diarrhea, blue gums and lips, lethargy, insomnia, rapid heart rate, and shortness of breath.

    Copper

    Elevated copper levels have been implicated in learning and mental disorders and may contribute to increased systolic blood pressure.

    Rimland, B. and Larson, G. E., Learn. Disabil., 16, 1-7 (1983). Lerch, K, Copper Monoxygenases: Tyrosinase and Dopamine B-Monooxygenase, in Metal Ions in Biological Systems, Vol. 13, Sigel, H., ED., Marcel Dekker, New York, 1981.


    Processed Sugar

    VII. Several studies have linked inappropriate emotional and mental behavior to our society’s excessive consumption of processed sugar.

    Sugar depletes certain nutrients (B vitamins) needed for the production of neurotransmitters.

    Putting a Plan Together

    Conquering the ill effects of poor diet and environmental pollutants isn’t easy. However, in my past clinical experiences in working with children (and adults) with ADD, adhering to the formula below often results to incredible success stories

    1. Begin an elimination diet. If food allergies are a real issue consider Coca Pulse testing.
    2. Severely reduce or eliminate all processed sugar. Remove all additives from the diet, especially artificial sweeteners, coloring, and preservatives.
    3. Uncover and supplement for any nutritional deficiencies. Start with a good comprehensive multivitamin/mineral formula.
    4. Test for heavy metal exposure through hair or urine screening tests.
    5. Make sure the child is eating a balanced diet. Typically, most children are eating far too many processed grains and simple sugars. Make sure they are getting enough fat and protein. It is best to combine protein, fat, and carbohydrates at each meal.
    6. Supplement essential fatty acids (fish oil): a minimum of 480mg of DHA per day.
    7. Use amino acid replacement therapy for increasing appropriate neurotransmitters (brain chemicals). This is usually DL-Phenylalanine combined with L-Glutamine.
    8. Make sure the child is getting plenty of sleep.

    Check for low adrenal function. Take the child’s blood pressure while lying down and again thirty seconds later after they stand-up. Systolic blood pressure should increase by ten points. If it doesn’t increase suspect low adrenal function and address accordingly.

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