This section was compiled by Frank M. Painter, D.C. Make comments or suggestions to Frankp@chiro.org
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can get a definition from the Merriam Webster Medical Dictionary. If you want information about a specific disease, you can access the Merck Manual. Search PubMed for more abstracts on this topic.
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Introduction
Attention Deficit/Hyperactivity Disorder (ADD/ADHD) is the most commonly reported childhood behavioral disorder, affecting between between 3 and 7% of American children. It is characterized by poor attention span, impulsive behaviors, and hyperactivity in some children. The diagnostic criteria are strictly observational, and there are no objective laboratory tests to confirm that diagnosis. Subjective evaluations of annoying, distracting, or inattentive behavior makes the "diagnosis" of ADD/ADHD speculative at best.
The most common medical "treatment" for this controversial "disease" is prescriptions of Methylphenidate (Ritalin), a Class II controlled and addictive substance. The long–term effects of this drug on children is unknown, but the side–effects, including addiction, are becoming better understood.
What is ADD/ADHD? Although it's exact "cause" is unknown, major etiologic contributors include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins, such as heavy metals and organohalide pollutants. [
1 ]
Nutrient deficiencies are common in ADD/ADHD. Supplementation with minerals, B vitamin complex, flavonoids, and the omega-3 and omega-6 essential fatty acids have shown promising results, as are reported in the Abstracts Section section below.
A wholistic/integrative management program will include supplementation, dietary modification, detoxification, and removal of environmental toxins and toxic cleaners from the home.
This page is devoted to sharing research information about ADD/ADHD to help parents and teachers make informed decisions, and to support the children who stand to benefit from a drug–free existance. The following articles and journal abstracts discuss ADD/ADHD and a "natural treatment" program.
Articles About ADD/ADHD
Some Food Additives Raise Hyperactivity, Study Finds
New York Times Research Section ~ September 6, 2007
Common food additives and colorings can increase hyperactive behavior in a broad range of children, a study being released today found. It was the first time researchers conclusively and scientifically confirmed a link that had long been suspected by many parents. Numerous support groups for attention deficit hyperactivity disorder have for years recommended removing such ingredients from diets, although experts have continued to debate the evidence. But this new,
carefully controlled studyshows that some artificial additives increase hyperactivity and decrease attention span in a wide range of children, not just those for whom overactivity has been diagnosed as a learning problem.
Outcome-based Comparison of Ritalin versus Food-supplement Treated Children with ADHD
Alternative Medicine Review 2003 (Aug); 8 (3): 319-330 ~ FULL TEXT
Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors:
food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. The dietary supplements used were a mix of vitamins, minerals, phytonutrients, amino acids, essential fatty acids, phospholipids, and probiotics that attempted to address the AD/HD biochemical risk factors. These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment.
Attention Deficit/Hyperactivity Disorder (ADHD) in Children: Rationale for Its Integrative Management
Alternative Medicine Review 2000; 5 (5) Oct: 402–428 ~ FULL TEXT
ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but
major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.
ADHD, Ritalin, and Big Brother
Alternative Medicine Review 2000 (Oct); 5 (5): 401 ~ FULL TEXT
The year: 2000. Location: somewhere in the United States. "Doug and Marie," loving, well-intentioned parents of a school-aged child are sitting in a jail cell, awaiting a hearing in which they will be charged with child abuse and neglect. The reason? Refusing to dose their son with Ritalin. This scenario is fictitious; however, it is not far from what could happen.
Drug-free Treatment for Attention Deficit Disorders
Food, while nourishing, can also energize or subdue, comfort or agitate. A growing body of evidence implicates diet in the commonly diagnosed attention deficit disorder (ADD). Simple meal modification may eliminate the need for the frightening array of drugs being prescribed to control children. Diet can mean the difference between a normal childhood and years of difficult behavior or behavior-modifying drugs.
ADHD: A Modern Malady
ADHD is being identified as epidemic throughout the United States: the National Institutes of Health in Washington, D.C., estimates that from 3 to 5 percent of all American schoolchildren have been diagnosed with the disorder. This trend alone is reason for concern, but perhaps more troubling is that more than 6 million American children currently diagnosed with ADHD are being treated with central nervous system stimulants--usually methylphenidate (Ritalin)--when more natural approaches exist. [1] A sad commentary on the seriousness of this problem was related by a patient who recently visited his child's school and outside the nurse's office found a long line of children waiting to get their dose of Ritalin.
Polyunsaturated Fats and Neurological Disorders
For he past 50 years, major psychiatric disorders generally have been attributed to neurotransmitter system abnormalities. Neurotransmitters are biochemicals that transfer information from one neuron, or central nervous system cell, to another. While this concept is still considered valid, it has limited ability to explain the origins and guide the treatment of mental illness. Furthermore, there is a growing consensus in scientific circles that the phospholipid metabolism of the neuron cells themselves also plays a crucial role in the development of mental conditions. [1] Phospholipids are substances composed of two fatty acids linked to a phosphate group (e.g. choline, serine, inositol). This consensus has come because numerous studies have linked low brain levels of these substances to conditions such as depression, dyslexia, schizophrenia and more.
Diet, ADHD, and Behavior
This letter, from scientists at the Center for Science in the Public Interest is directed to Donna Shalala, Secretary of the U.S. Department of Health and Human Services. It reviews studies on the effect of diet on behavior (including ADHD) and touches on side effects of the stimulant drugs that have been used to treat behavior disorders in millions of children.
What is Methylphenidate (Ritalin)
This page from the National Library of Medicine's MedlinePlus Drug Information Page is a real eye–opener!
Fish Oil Could Be an Alternative to Ritalin
Dr Basant Puri, a consultant and senior lecturer at Hammersmith Hospital in Ireland has been using sophisticated imaging techniques to study the role of fatty acids in brain function. He says he has unearthed a wealth of evidence about how supplementation with specific fatty acids can not only help those with ADD/ADHD (attention deficit/ hyperactivity disorder), but also dyslexia and dyspraxia.
ADDers Are More Likely to Have Fatty Acid Deficiencies
A Purdue University study showed that kids low in Omega–3 essential fatty acids are significantly more likely to be hyperactive, have learning disorders, and to display behavioral problems. Omega–3 deficiencies have also been tied to dyslexia, violence, depression, memory problems, weight gain, cancer, heart disease, eczema, allergies, inflammatory diseases, arthritis, diabetes, and many other conditions.
ADD/ADHD: The "Designer Disease"
Is ADD/ADHD a "real" disease, or is it a condition, invented by psychologists, to maintain their standing in the scientific community? Want to know more? Read Dr. Shea's article.
Cervical Kyphosis is a Possible Link to Attention-deficit/hyperactivity Disorder
J Manipulative Physiol Ther 2004 (Oct); 27 (8): e14 ~ FULL TEXT
A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12 degrees C2-7 kyphosis to a 32 degrees C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis.
An Evaluation of Chiropractic Manipulation as a Treatment of Hyperactivity in Children
J Manipulative Physiol Ther 1989 (Oct); 12 (5): 353–363
While the behavioral improvement taken alone can only be considered suggestive, the strong interest agreement can be taken as more impressive evidence that the majority of the children in this study did, in fact, improve under specific chiropractic care. The results of this study, then, are not conclusive, however, they do suggest that chiropractic manipulation has the potential to become an important nondrug intervention for children with hyperactivity. Further investigation in this area is certainly warranted.
A Multi–faceted Chiropractic Approach to Attention Deficit Hyperactivity Disorder: A Case Report
ICA Internat Rev Chiro 1995 (Jan): 41–43
An 11-year-old boy with medically diagnosed Attention Deficit Disorder has been a patient and student at the Kentuckian Children's Center for three years. His case shows a history of early disruptive experience, repeated ear infections, consistent temporomandibular joint dysfunction, heavy metal intoxication, food allergy, environmental sensitivity and multiple levels of biomechanical alteration. This report emphasizes the need for care of all aspects of the structural, chemical and mental triangle of health in children with Attention Deficit Hyperactivity Disorder.
Review More Abstracts on Chiropractic and ADD/ADHD
Review abstracts about chiropractic and a variety of organic and visceral disorders at the wonderful International Chiropractic Pediatric Association (ICPA) website
B) Abstracts Supporting Nutritional Intervention
Study Links Nutrition and Children’s Behaviour
Functional Foods & Nutraceuticals July 2005
The double-blind study gave the 5- to 12-year-old children, many of whom had accompanying attention deficit problems and dyslexia, either an olive oil placebo or a fish oil-derived omega-3 fatty acid supplement. Those on the supplement showed greatly increased concentration and ability to process information within three months of taking the supplement, with an average advancement in reading age of about nine months and spelling age of six months.
Here's a report on the “The Durham Dyspraxia Trial”.
Outcome-based Comparison of Ritalin versus Food-supplement Treated Children with ADHD
Alternative Medicine Review 2003 (Aug); 8 (3): 319-330 ~ FULL TEXT
Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors: food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. The dietary supplements used were a mix of vitamins, minerals, phytonutrients, amino acids, essential fatty acids, phospholipids, and probiotics that attempted to address the AD/HD biochemical risk factors. These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment.
Long–chain Polyunsaturated Fatty Acids in Children With Attention–deficit Hyperactivity Disorder
Am J Clin Nutr 2000 (Jan); 71 (1 Suppl): 327S–330S
Several previous studies indicated that some physical symptoms reported in ADHD are similar to symptoms observed in essential fatty acid (EFA) deficiency in animals and humans deprived of EFAs. In another study using contrast analysis of the plasma polar lipid data, subjects with lower compositions of total n–3 fatty acids had significantly more behavioral problems, temper tantrums, and learning, health, and sleep problems than did those with high proportions of n–3 fatty acids.
Essential Fatty Acid Metabolism in Boys With Attention–deficit Hyperactivity Disorder
Am J Clin Nutr 1995 (Oct); 62 (4): 761–768
Attention–deficit hyperactivity disorder (ADHD) is the term used to describe children who are inattentive, impulsive, and hyperactive. The cause is unknown and is thought to be multifactorial. Based on the work of others, we hypothesized that some children with ADHD have altered fatty acid metabolism.
C) Side–Effects of Methylphenidate (Ritalin)
Cerebral Arteritis Following Methylphenidate Use
J Child Neurol 2000 (Apr); 15 (4): 265–267
Stroke is a well–documented complication of amphetamine abuse. Methylphenidate, chemically and pharmacologically similar to amphetamines, is widely used in the treatment of attention deficit disorder in children. The possibility of vasculitis connected to methylphenidate should not be surprising. A case is reported of stroke associated with ingestion of methylphenidate in an 8–year–old boy.
Methylphenidate, Tics and Compulsions
Encephale 2000 (Mar–Apr); 26 (2): 45–47
Obsessive compulsive (OC) symptoms following methylphenidate (MPH) administration are seldom reported and usually not even mentioned among its adverse effects. We report here a case of MPH–induced OC symptoms which began ten months after the treatment was initiated and that were exacerbated 14 months later.
Suspected Adverse Methylphenidate–imipramine Interactions in Children
J Dev Behav Pediatr 1986 (Aug); 7 (4): 265–267
Two cases are presented which illustrate the dangers inherent in utilizing a polypharmacy approach in treating children with psychotropic medication. In each case, severe adverse effects, including cognitive and mood deterioration, were experienced by the child when treated with a combination of methylphenidate and imipramine.
D) Abstracts About Reduced Exposure to Household Toxins
The Indoor Air Quality and Environmental Toxins Page
The average person spends 90% of their time indoors, surrounded by a vast array of modern chemicals –– including the glues and coatings on our furniture and walls, the plastic cases on our electronic toys, synthetic fabrics, disinfectants, soaps, perfumes, insecticides, lubricants and more. All these products "breath" out some level of pollution –– as described by the term out–gas. Learn more here!
Parallels Between Attention Deficit Hyperactivity Disorder and Behavioral Deficits Produced by Neurotoxic Exposure in Monkeys
Environ Health Perspect 2000 (Jun 3); 108 Suppl: 405–408
Both lead and PCB exposure produce deficits on discrimination reversal and spatial delayed alternation performance; treated monkeys exhibit deficits in their ability to change an already established response strategy and inhibit inappropriate responses. Monkeys exposed developmentally to lead or PCBs also perform differently from control monkeys on a fixed interval schedule of reinforcement, which requires the temporal organization of behavior using only internal cues. Whereas the etiology of ADHD is multifactorial, the possibility that neurotoxic agents in the environment contribute to the incidence of ADHD warrants attention.
Attention Deficit/Hyperactivity Disorder (ADHD) in Children: Rationale for Its Integrative Management
Alternative Medicine Review 2000 (Oct); 5 (5): 402–428 ~ FULL TEXT
An intense debate has developed around the diagnosis, etiology, and medical management of ADHD. Parent groups, consumer advocacy organizations, and progressive physicians are calling for alternatives to methylphenidate and the many other potent stimulants used to treat ADHD, while pharmaceutical interests and physicians particularly oriented to prescribing pharmaceuticals attempt to defend the status quo (currently in the United States, between 1.5 million and 3 million ADHD children are likely taking methylphenidate). This review is intended to bring the medical and scientific issues surrounding ADHD into sharper focus, to better define a wholistic/integrative strategy for its medical management.
E) Abstracts Supporting Dietary Modification
Food Additives and Hyperactive Behaviour in 3-year-old and 8/9-year-old Children in the Community: A Randomised, Double-blinded, Placebo-controlled Trial
The Lancet 2007 (Sep 6); DOI:10.1016/S0140-6736(07)61306-3
16 3-year-old children and 14 8/9-year-old children did not complete the study, for reasons unrelated to childhood behaviour. Mix A had a significantly adverse effect compared with placebo in GHA for all 3-year-old children but not mix B versus placebo. This result persisted when analysis was restricted to 3-year-old children who consumed more than 85% of juice and had no missing data. 8/9-year-old children showed a significantly adverse effect when given mix A (0·12 [0·02–0·23], p=0·023) or mix B when analysis was restricted to those children consuming at least 85% of drinks with no missing data. Artificial colours or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8/9-year-old children in the general population.You may also enjoy this
New York Times review.
Synthetic Food Colourings and "Hyperactivity": A Double-blind Crossover Study
Aust Paediatr J 1988 (Apr); 24 (2): 143–147
The findings raise the issue of whether the strict criteria for inclusion in studies concerned with 'hyperactivity' based on 'attention deficit disorder' may miss children who indicate behavioural changes associated with the ingestion of food colourings. Moreover, for further studies, the need to construct a behavioural rating instrument specifically validated for dye challenge is suggested.
![[Ritalin in our schools]](../pediatrics/DISCONTINUED/ritalin.gif)
