Q&A - Ritalin & ADD

ASK THE DOCTOR by Dr. Chad Larson [Q&A] Ritalin & ADD
Submitted by: J. Stevenson Q: My son has been diagnosed with attention deficit disorder (ADD), and they want to put him on Ritalin. What are the natural alternatives? A: ADD and attention deficit hyperactivity disorders (ADHD) have had many different names but the basic characteristics of this disorder are as follows: Hyperactivity Perceptual motor impairment Emotional instability Coordination deficit Disorders of attention (short attention span, distractibility, lack of perseverance, failure to finish tasks, not listening, poor concentration) Impulsiveness (action before thought, abrupt shifts in activity, poor organizational skills, fidgeting in class) Disorders of memory and thinking Specific learning disabilities Disorders of speech and hearing As with many disorders of “unknown origin,” ADD and ADHD have an etiology (cause) that is multifactorial. Several of these factors have been studied extensively with consistent results and other potential factors have been deemed controversial. One thing I know for sure, is that methylphenidate (Ritalin) or any other amphetamine for that matter, is not the answer. Like many conditions treated in the pharmaceutical model, these stimulants merely mask the symptoms without getting to the underlying cause or causes of the condition. There are millions of American school age children taking these drugs but are still being feed foods and beverages they would not even give to their dogs. The ADD child is frequently seen by a general practitioner or pediatrician who does not have the time, training, or inclination to get to the root of the child’s problem.2 In a survey of 1,000 pediatricians across the United States, researchers found more than 70% used Ritalin as a diagnostic tool for attention deficit disorder.3 Not only is that misdiagnosis and inappropriate treatment, that should be grounds for malpractice. Most normal people will have improved attention and concentration with a stimulant, but that does not mean the individual has attention deficit disorder. If the goal is to change and balance biochemistry and physiology, it would make sense to first begin with things that at least exist in nature, and not something brewed in a lab. Ingredients not found in nature are difficult for our bodies to process and will eventually lead to adverse symptoms in the short term and irreversible disease in the long term. On that note, there are more than five thousand additives and preservatives in the food supply in the United States. These additives include monosodium glutamate (MSG), aspartame (Equal, NutriSweet), sulfites, calcium silicate (anti-caking agent), BHT, BHA, hydrogenated vegetable oils, nitrates, propylene glycol, hydrolyzed vegetable protein (HVP), flavorings, emulsifiers, thickeners, vegetable gums, artificial coloring and dyes, and artificial flavorings. A recent estimation found that each person in the U.S. is consuming over ten pounds of food additives a year. Synthetic colors and flavors are probably the most common causes of adverse reactions, as they affect almost every system in the body. Incidentally, they are completely void of any nutritional value. Benjamin Feingold, MD, studied this affect and hypothesized that 40-50% of hyperactive children were sensitive to artificial food colors, flavors, and preservatives and to naturally occurring salicylates and phenolic compounds.4 Even in studies that tried to challenge and disprove the “Feingold hypothesis,” 50% of those who tried the Feingold diet experienced a decrease in symptoms of hyperactivity. The diet eliminates foods containing natural salicylates, which include almonds, apples, apricots, blackberries, cherries, cloves, cucumbers and pickles, currents, gooseberries, grapes and raisins, mint flavors, nectarines, oranges, peaches, plums and prunes, raspberries, strawberries, all tea, tomatoes, oil of wintergreen, all foods that contain artificial colors and flavors, aspirin containing compounds, and medications with artificial colors and flavors. Many studies have also revealed the connection between food allergies or sensitivities and psychological symptoms associated with ADD and ADHD. For example, severely hyperactive children were treated with the oligoantigenic diet (low allergen diet) consisting of lamb, chicken, potatoes, rice, bananas, apples, and vegetables for four weeks. Eighty-two percent of the children experienced improved behavior. Consequently, other symptoms such as headaches, abdominal pains, and fits, were also relieved.5 Hypoglycemia and reactive hypoglycemia (low blood sugar) also appear to have an affect on behavior and mental performance. This imbalance is usually caused by the consumption of refined carbohydrates such as those derived from processed white flour, including breads, pastas, crackers, chips, cakes, pies, cookies, and other high sugar products. Hypoglycemia will affect mental acuity simply because the brain does not have the fuel necessary to function. Furthermore, in hypoglycemic states, adrenaline (epinephrine) is released, promoting hyperactivity. Any nutrient deficiency can potentially result in brain dysfunction. A recent study of the American Journal of Clinical Nutrition revealed that subjects with lower compositions of omega-3 fatty acids had significantly more behavioral problems, temper tantrums, and learning, health, and sleep problems than did those with higher proportions of omega-3 fatty acids.6 Many ADD and ADHD children have excessive thirst and often eczema, allergies and asthma, all of which may be alleviated by essential fatty acids, such as flax seed oil and fish oil. Many children who have behavioral problems are deficient in zinc, vitamin B6, magnesium, and/or niacin which are all needed as cofactors for the conversion of essential fatty acids to their more active form called prostaglandins. Salicylates, which are removed in the Feingold diet, are known to block the formation of prostaglandins from essential fatty acids. Iron also plays a role in behavioral and cognitive symptoms. A study published in Neuropsychobiology reported improvement in non-anemic (non-iron deficient) children with ADHD. On the flip side of nutrient deficiencies, another link to ADD is excess body storage of heavy metals. In particular, lead storage in the body has been demonstrated strongly to childhood learning disabilities. Heavy metals also showing associations to symptoms of ADD are mercury, cadmium, copper, and manganese. Hair mineral analysis is the best way to examine an individuals body burden of heavy metals. Blood test analysis is only limited to recent heavy metal exposure.8-10 A 1994 government study found that almost 1.7 million children had excessive levels of lead in their blood. These heavy metals can be found in paint chips and dust, water piping, cigarette smoke, canned foods, pottery, contaminated food and water, air pollution, and insecticides. Poor diet and nutrition will further perpetuate heavy metal toxicity and absorption into sensitive body tissues such as the brain. Experience in clinical practice helped me disclose a lesser-known contributor to ADD and ADHD, and that is gut health. The patient was a little 8-year-old boy who kept complaining of stomach pain and who was also suffering from symptoms of ADD. He got a battery of tests from his general practitioner and was told there was nothing wrong with him and that it was all in his head. After a thorough history and examination, we decided to do a comprehensive gastrointestinal stool analysis. For a little boy he had some major imbalances. He had a couple parasites (more common than you think) and he had dysbiosis with associated inflammatory indicators. Dysbiosis is a situation where the bad bacteria outgrow the good beneficial bacteria. We prescribed some agents to kill the parasites and decrease the inflammation and then we strengthened his gut with some high potency probiotics, namely, lactobacillus acidophilus, bifidobacterium, and saccromyces boulardii. And we helped repair the gut with nutrients like L-glutamine, chlorophyll and vitamin E. When he completed the protocol, which also included some dietary changes described above, he was a changed person. During the initial visit he would not sit still, his eyes would not focus on any one thing and he was irritable. After the three month long treatment he sat still, he focused on me when I would talk to him, his stomach no longer hurt, and his mom said he was doing much better in school. This particular individual had symptoms of gut imbalance, but I have seen a number of cases where there were no specific gastrointestinal symptoms, but upon analysis there were significant imbalances. An interesting connection between brain chemistry and the gut is that, 80% of the brain neurotransmitter, serotonin (a biochemical substance with calming effects) is made in the gut. Consequently, when there is an imbalance in the gut the production and metabolism of the brain neurotransmitters is altered. As you can see the answer is complex because the condition is complex. I encourage you to remove all additives and preservatives from the diet, eat low-allergenic foods, avoid processed white flour refined carbohydrate foods, remove all foods that contain partially hydrogenated oils, balance all nutrient deficiencies, especially essential fatty acids, and consider an analysis for heavy metals and gastrointestinal health.


The dietary supplements below may be very helpful:


	. Attentive Child . Attentive DHA (Neuromins) . Vitamin E . Ultra-Magnesium We live in bodies where all the systems are very interrelated in a web-like balance of interactions. We cannot just listen to one instrument when addressing the human body but rather have to respect and consider the entire symphony. As usual, I would recommend a consultation for an individualized, comprehensive assessment.


References:


	1. Murray, Michael and Pizzorno, Joseph. Encyclopedia of Natural Medicine, 2nd Ed. Prima, 1998. 2. Walker, S. J Learn Disabil, June/July, 1975; 8(6): 21-25. 3. Goldman, E. Family Practice News, Nov.1, 1955; 33. 4. Feingold, N. Why your Child is Hyperactive, New York, Random House, 1975. 5. Egger, J. et al. Lancet. 1985; 540-5. 6. Burgess, JR., et al, Am J Clin Nutr, 2000:71 (Suppl): 327S-330S. 7. Sever, Y., et al. Neuropsychobiology 1997; 35 (4): 178-80. 8. Marlowe, M., et al, J Learn Disabil 17 (1977): 418-421. 9. Rimland, B, et al, J Learn Disabil 16 (1983): 219-285. 10. Bryce-Smith, D. Nutr Health 1 (1983): 179-184. 11. Gittleman, A. How to Stay Young and Healthy in a Toxic World. Los Angeles, Keats, 1999.


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