ADD and ADHD: Alternatives to Medication
The diagnoses of ADD and ADHD have skyrocketed over the past forty years. The good news is these conditions are simply a conglomeration of symptoms (aggressiveness, inattentiveness, meltdowns, lack of concentration, etc.) that have a root cause(s). Some patients are pushed towards using pharmaceuticals right off the bat, but in my practice that is an absolute last resort, if a resort at all. The truth is that medications do not address the actual cause of the symptoms and can come with short and long term side effects. Thus, I opt for a root-cause approach.
Short & Long Term Effects of Stimulant Medications
Stimulant medications have both short- and long-term effects on kids. In the short-term you may notice:
- Appetite loss and weight loss; which indicates they are not getting the nutrients they need for a growing body and brain
- Headaches
- Change in personality
- Sleep issues; which can affect learning and memory
- Elevated blood pressure and heart rate
- GI issues
- Rebound irritability
In the long-term, we see even more serious side-effects:
- Increased risk of obesity as an adult
- Stunted growth
- Increased cardiovascular risks
- Delayed onset of puberty
- Increased risk of anxiety and depression as a late teen or adult
- Increased risk of drug abuse
The Potential Root Causes of ADD & ADHD
The good news is, there are a lot of supported causes, mediators, and triggers for behavioral issues and symptoms of ADD and ADHD that can be addressed at home. Each child’s condition is unique; they may have one particular cause or many different causes. It’s worth taking the time to strategically address their environment in order to find out exactly what may be impacting their health. Some of the most common causes to consider include:
A Poor Diet and an Unhealthy Gastrointestinal Tract
A diet high in processed foods (especially those containing high fructose corn syrup, bad fats, food dyes, and food additives), fruit juice, caffeine, GMO foods (high glyphosate content), and sugary snacks and drinks can be a large contributor to behavioral issues in children. I see it all the time. What you eat has a HUGE impact on GI function and the very important GI microbiome. That in turn impacts the production of neurotransmitters, like histamine, dopamine and serotonin. A diet high in processed and sugary foods increases the production of histamine in the gut, leading to anxiety, dark circles under the eyes, allergies, runny nose, etc. In fact, 95% of your serotonin and dopamine is made within the GI tract, not your brain.
Also, these inflammatory diets can lead to unhealthy, imbalanced GI microbiomes, with yeast overgrowth becoming more and more prevalent in children. Yikes! Your GI tract is a major component of your immune system. 80% of a person’s immune cells reside in or near the GI tract. What you put into your mouth impacts your immune system. Your GI tract is much more than a “food tube.” In fact, research has shown that almost 90% of all chronic health issues can be traced back in some way to the GI tract and microbiome. Many of the foods we are feeding our children are creating an environment within their GI tracts that is contributing to gut permeability, or “leaky gut.” This is not a good scenario, as it contributes to systemic inflammation and “leaky brain.”
Food Intolerances, Sensitivities & Testing
Children with ADHD are 7x more likely to have food allergies and intolerances, and wheat is at the top of the list. Some children may have undiagnosed celiac disease (an autoimmune response to gluten), while others may simply have a wheat or gluten intolerance. The most common foods to which people have intolerances are: wheat, dairy, corn, soy, eggs, and nuts. However, it’s important to note that a child can have an intolerance to ANY food. I happen to have intolerances to wheat, eggs, whey, cantaloupe, and honey. My mother shares some of these same intolerances.
There are several ways to test for celiac disease and gluten sensitivity, but the gold standard in our practice is utilizing an elimination and reintroduction diet to identify any and all food intolerances. This invaluable diagnostic tool MUST be done correctly to get good data. Beware! There are many variations of an elimination and reintroduction diet out there on the internet, and many of them are inadequate or downright wrong in their approach.
Genetic Predisposition Plays a Small Role
It’s true, genetics influence the health issues each individual experiences, but only by about 5-10%. Genes are not static and can be “turned on and off” depending on the environment. Diet, lifestyle, stress, toxin exposures, etc. can all influence how genes are expressed. These influences can be positive or negative. So, although a genetic predisposition may explain why one child develops ADD and another doesn’t, there are many non-genetic lifestyle factors that can support the child experiencing ADD symptoms. In fact, ~90% of health problems are a result of one’s environment and lifestyle.
Environmental Toxins Are Hormonal Disruptors
We live in a toxic world unfortunately. Per the EPA, there have been ~60K chemicals introduced into our environment over the past 50-60 years. There are over 10K different chemicals allowed in our foods and food packaging. These toxins are everywhere–our food, water, soil, air, beauty products, cleaning products, pet products, lawn care products, building materials, etc. Many of these toxins act as endocrine disruptors and can overwhelm the body’s detoxification system, producing a wide array of signs and symptoms in different people, with behavioral issues as one of the more common symptoms occurring in children.
Recently, JAMA Pediatrics published an article about a link between fluoridated water consumption during pregnancy and lower IQ in offspring. Other research has found the perinatal use of drugs and certain medications have been linked with the development of ADD and ADHD in offspring. We recommend that pregnant women be very thoughtful and inquisitive when taking both prescription and over-the-counter medications during pregnancy. We also recommend that parents clean up their environment at home and work, if possible.
Heavy Metals Act As Neurotoxins
More common than you might think, heavy metal toxicities can influence the body’s ability to detox. These heavy metals are also neurotoxins and can cause immune and mitochondrial dysfunction. Mercury and lead can be found in lead-based paints, silver amalgams, fall-out from coal plants, beauty products (especially certain make-ups), thimerosal, fuel additives, lead pipes, certain fish (tuna, shark, swordfish), to name a few sources. There are also other heavy metals to consider, such as aluminum, cadmium, tin, etc. There are specialty diagnostic tests for levels of heavy metals if there is suspicion of acute or past exposures.
Excessive Emotional, Physical and/or Psychological Stress
Stress is a normal part of life. Some stress is actually necessary to prime the body for survival. Too much stress, or inappropriate responses to stress, can be detrimental to the body. This may seem like a no-brainer, but it’s important to understand a child’s stress levels. Stress, especially chronic stress, causes sustained elevations in cortisol, noradrenaline, and adrenaline–the “fight or flight” hormones. These hormones can be quite disruptive to many physiological systems and metabolic activities, contributing to sleep disturbances, gut motility issues, dysbiosis, hormonal imbalances, immune dysfunction, and cognitive issues.
Poor Sleep Schedule or Poor Sleep Quality
Children need good sleep. Period. Quality sleep is absolutely necessary for children to experience healthy growth and healthy brains. During the deep stages of sleep the brain undergoes important processes that are vital to learning, memory, repair and overall functional. A sleep-deprived child is not a happy child. Even one night of poor sleep can disrupt the executive function control system of the brain which is responsible for attention, planning, sequencing, problem solving, working memory, cognitive flexibility, abstract thinking, rule acquisition, selecting relevant sensory information, initiation of action, self-control, emotional regulation, monitoring internal and external stimuli, initiating and inhibiting context-specific behavior, moral reasoning, and decision-making. That’s quite the list, isn’t it?
Lack of Physical Activity
It should be no surprise that children need to play. Physical activity is necessary for proper health and brain development. Different physical movements help form different neuronal connections within the brain. Physical activity is not optional. Humans were designed to move.
Here in America, recess in public schools is becoming a thing of the past, although the pendulum seems to be moving in a more positive direction, at least in my home state of Arkansas. Is it really difficult to understand why behavior is becoming an issue within the classroom? I loved school, but I really loved recess. As soon as those doors opened I was sprinting towards the monkey bars. All that pent up energy had a release, and recess allowed our teachers to keep their sanity, too. Playtime didn’t end at school either. My friends and I played outside until dinnertime. All that playtime ensured we slept well…because we were tired. Well-rested and well-exercised children are better behaved and more resilient children.
Nature & Sunshine Deficiency
Not only are children not playing and moving as much as they should, they aren’t spending enough time outside. A recently published article out of the UK stated that a majority of children are spending less than 2 hours each day outside. Prisoners spend more time outside. Think about that.
When children spend time outdoors, they soak up more sun. More sunshine exposure means higher Vitamin D levels, in addition to necessary retinal exposure to blue wavelength light. Recent research has shown that retinal exposure to blue wavelength light during the day from the sun helps regulate circadian rhythms. Vitamin D also plays a role in regulating circadian rhythms. And spending time in nature has been shown to have calming effects, along with fostering creativity. Being outside surrounded by nature also means less time spent on smartphones, iPads, and computers using apps and playing games that are designed to increase dopamine levels, thus, making children (and adults) addicted to these games and apps.
Electronics Overload & Digital Addiction
Electronic use by children is at an all-time high. This recently new phenomena is partly to blame for the drastic decrease in time children spend outdoors. Children today are spending half the amount of time outside as their parents, and spending time with electronics is partly to blame. As I stated before, electronic games and apps are designed to be addictive. Don’t take my word for it, take the words of software designers in Silicon Valley who recently came out and spoke about what was occurring behind the scenes. The dopamine that is produced in response to playing these apps and games not only fuels the addiction to these games, it also produces anxiety and agitation. Children diagnosed with ADD and ADHD often have problems with both anxiety and agitation. Could your child’s use of electronics be to blame?
Also, it’s important to note that blue wavelength light is primarily emitted from electronic screens (and energy-efficient lighting). This blue wavelength light is very energizing to the brain. Many children have replaced their favorite night time blankie with a smartphone. Children are energizing their brains with blue light at a time when their brains need to be calming down. Blue light exposure before bed will disrupt sleep. And what did I say about quality sleep?
What Can You Do?
I get lots of questions from parents about what they can do to help and support their child. It’s important to note that each child is different. There is no “one-size-fits-all” model for addressing the symptoms of ADD/ADHD, particularly because the CAUSE(S) may be different for each child. That said, here are a few starting points we have our patients consider:
Do an elimination and reintroduction diet.
This is the GOLD STANDARD approach for almost all of our patients. Food intolerances are more common than you think. And identifying any potential intolerances is paramount for short- and long-term health. Patients who have done this well (and as a family) have experienced incredible improvements in the health of the entire family. It is imperative to do this diet correctly. Otherwise, you will get bad data. You’ll want to make sure you do this right the first time. We can ensure you do it correctly.
Eliminate processed foods and simple sugars from your child’s diet.
These inflammatory foods tend to cause allergies to flare and histamine levels to rise which can contribute to anxiety and behavior issues. And these foods can contribute to “leaky guts” which then can lead to “leaky brains” and systemic inflammation.
Avoid soft drinks, fruit juices and pasteurized milk; replace with filtered, non-fluoridated water.
This is a non-negotiable. With the exception of the rare, special occasions, sugary drinks should be off limits (and that includes diet beverages – those might just be worse!). Just keep the stuff out of the house. Your children will drink water when they are thirsty. Trust me.
Increase omega-3 fats with food and/or supplementation.
Omega-3 fats are crucial for a healthy brain. Some research has shown that omega-3 fatty acids can improve the symptoms of ADHD more effectively than drugs. Excellent food sources of omega-3s include wild caught salmon (frozen or canned), sardines and pasture-raised/free range eggs. Other sources include nuts and seeds, especially walnuts. Pesto, anyone?
Minimize all processed, inflammatory fats.
Opt for quality olive oil, coconut oil and grass-fed butter, avocados and nuts and seeds. Say no to the canola oil, vegetable oil, soybean oil and fried foods. These oils are processed in a way that makes them unhealthy. Don’t be afraid of fat! Please forget the terrible information you were fed about fat.
Clean up your environment.
Clear your house of pesticides and commercial washing detergents, cleaning products and hygiene products. Opt for more natural alternatives. The Environmental Working Group is a great resource for finding non-toxic products. Purchase organic, non-GMO foods. And maybe even try growing some of your favorite fruits and vegetables organically in small containers.
Spend more time outside and off the screens.
Outdoor play is great exercise for kids and the natural light exposure helps reset their circadian rhythms. As it gets closer to bedtime, restrict blue light exposure from screens at least 2 hours before bed as that will energize the brain and negatively impact the quality of sleep.
Keep a sleep schedule and improve sleep hygiene.
Children do better with a routine. They need to go to bed and wake up at the same time, even on weekends. Their bedtime routine should be one that is calming. Get pets out of the bed, at least initially. Cover and/or turn off any lights in the room. Even when your children’s eyes are closed, their retinas can still pick up any light that is present, even the tiny red light on the bottom of the TV. Keep the room dark and cool.
Address gut health.
If you’re not sure where to begin, we can help. Start by avoiding unnecessary use of antibiotics, acetaminophen, ibuprofen, and acid-suppressing medications as each of these can have significant negative impacts on the gut flora and gut permeability/”leaky gut.” Eating real, unadulterated, organic foods is a great place to start. “Seeding” the gut with probiotics from capsules or fermented foods is important, and “feeding” the bacteria with prebiotics is also very necessary. Fiber is a great fuel source for those important bacterial residents within the GI tract.
Little Changes & Next Steps
I know the above list might be daunting to some of you, but be encouraged to start small. Little changes can make a big difference and can increase your confidence to make more changes. Even as the numbers of ADD and ADHD diagnoses rise, there is much HOPE for healing.
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