News & Views, 10/1997 - Nutrition for ADD & ADHD

Attention Deficit Disorder (ADD) with Hyperactivity (ADHD) has become an epidemic problem in our society. Many children do have problems focusing attention on a task, making learning very difficult. The majority of teachers have large classrooms that become hard to control because of students disruptive behaviors. Physicians are consulted by parents and teachers who have read about ADD and ADHD in the popular press and decided that they have a child who needs treatment for this problem. The cultural orientation towards a “quick fix” has led to prescription of powerful medications for a condition which is little understood by physicians. Is there anything that can be done to help besides drugs? What’s wrong with using the drugs if they work?

RITALIN
This medication is the most commonly used treatment for ADD and ADHD. It is a strong stimulant that is very much like “speed,” or amphetamine. In fact dextroamphetamine is also used to treat ADD and ADHD. When Ritalin does not work or quits working, doctors start fishing through a grab bag of other drugs that have been less tested and often cause even worse adverse effects and even death.

The hoped for effect that drugs have on ADD and ADHD children is to help them slow down and focus better. Frequently the child will perform better in school, at least for a while. There are side-effects, however, that limit their usefulness. One problem with the medications is reduction in appetite and failure to gain weight and grow. This effect generally wears off after several months of continuous use. The effect on ultimate stature is unknown. Another problem is that the medication can cause liver damage. Though uncommon, it is not regularly checked for by doctors treating these children. The medications are stimulants and can reduce sleep, especially if taken later in the day. These drugs are psychoactive compounds by nature, and all have subtle effects on mood and personality. This is frequently overlooked for months or years as the child cycles through mild depression and euphoria daily as the drug effects wax and wane. Another question I have not seen answered is, “How well does learning carry over when achieved under the influence of medication?”

ADD & ADHD
The causes of ADD and ADHD are not known at the present time but I suspect there are several. Genetics can play a part in increasing the susceptibility. Another important possibility is toxic overload to the body and nervous system at an early age; another is allergies, particularly to foods and chemicals. Refined sugar and food additives have been shown in some studies to aggravate behavioral problems in some children. There may even be various infections that promote or trigger this problem. In particular, the overgrowth of yeast in the colon and small intestine may lead to behavioral symptoms. ADD and ADHD are thought to be life long conditions and cure or remission is not considered to be possible. Although this assumption is of questionable validity, it is the rationale for treatment of symptoms.

Diagnosis of ADD and ADHD is a serious problem. There is no diagnostic test and physical examination does not demonstrate any abnormality that is unique to this condition. History and standardized questionnaires form the basis of the diagnosis along with testing by school psychologists some of the time. Misdiagnosis is frequent because emotional and family problems masquerade as hyperactivity and failure in school. A condition known as Bipolar Affective Disorder may mimic ADHD and be mistakenly treated with stimulant drugs. This is extremely dangerous because such treatment can result in a psychotic reaction and permanent brain damage. Few clinicians consider this and I suspect few even know about the possibility of the serious harm that can be done.

NUTRITION
There has been much written about nutrition for children with hyperactivity, and there is significant controversy. It is my opinion that there are children who are at risk who develop behavioral problems for reasons related to nutrition. A very recent article in a major pediatric medical journal reports that only 1% of children eat a diet that would be considered healthy. Physical growth may not be impaired while nutrients required for neurologic development and emotional balance may very well be unavailable in the diet of the average child.

Another issue is that of food intolerance and sensitivities to additives or toxic residues such as from pesticides. Do some individuals manifest emotional and behavioral consequences from ingestion of certain foods or chemicals? From the evidence that exists, I believe the answer is yes. I recommend testing for food allergies or sensitivities, usually using an elimination approach. This is very difficult but also very worthwhile. High risk foods such as sugar, dairy products, wheat and corn products, citrus fruits and juices, caffeine, and eggs are eliminated for a period of about one to three weeks. If improvement occurs, then individual foods are reintroduced looking for symptoms. There is also a blood test for food allergy that is available.

Another exciting avenue to help with the problem of detoxification and to deal with the poor nutrition that is present in the foods we eat is nutritional supplements. Numerous scientific studies of nutritional supplementation have found them to be of significant benefit for treating various medical conditions as well as preventing disease and improving longevity.

(Dr. Leonard Cain, M.D., Family Practice and Integrative Medicine, 15975 C. R. 30, Dolores, CO, 81323, has maintained his practice in Colorado for 11 years. For further information on nutritional supplements used by Dr. Cain or any other information related to ADD and ADHD in the medical practice of Dr. Cain, please call Tom Gregory at (800) 428-8521.)