Attention-deficit / hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder that’s characterized by impulsivity, inattention and hyperactivity. While pharmacological treatment was once hailed as a panacea for many of the woes afflicting society, as confidence in medical orthodoxy slowly begins to waver more parents are turning to complementary and alternative medical (CAM) therapies in order to spare their children the undesirable side-effects associated with prolonged medication.
ADHD Pathology:
The underlying causes of ADHD can be quite diverse and many possible risk factors have been identified in the development of ADHD. Among these are conditions that cause neurological impairment such as; lead poisoning, oxygen deprivation at birth, smoking / alcohol during pregnancy and various chromosomal abnormalities. In biological terms, researchers suggest ADHD may be related to low levels of epinephrine, norepinephrine, dopamine and serotonin in certain sections of the brain, as these neurotransmitters are responsible for activating focus and concentration.
ADHD Risk Factors:
In addition to the underlying pathology, researchers have identified a number of risk factors that appear to worsen the existing symptoms of ADHD. With regard to dietary factors, poor diet deficient in zinc, magnesium, glutathione and / or Omega-3 fatty acids all appear to affect concentration, memory and learning problems in children with ADHD. There is also a link between ADHD and food additives (preservative, artificial flavours and colours) which all occur in diets high in refined carbohydrates and manufactured foods. A lack of protein may foster amino acid deficiency symptoms which are crucial for neurotransmitter production in both adults and especially in the forming brains of developing children. Moreover, when children are exposed to heavy metals, solvents, pesticides or neurotoxins through environmental exposure, they may find disrupted neurotransmitter function contributing to worsening symptoms. Finally, over-stimulation resulting from high amounts of television watching behaviour, and pre / post natal exposure to cell phone radiation and a deficiency of natural light constitute further risk factors to children.
Side Effects of Conventional Treatment:
The treatment of ADHD using traditional medications (stimulants, non-stimulants & anti-depressants) can result in both short-term and long-term side effects including:
· Loss of appetite
· Anxiety
· Insomnia
· Increased blood pressure
· Suppression of growth
· Cardiovascular effects
· Physical / psychological dependence on the drug
· Psychotic symptoms
· Increased suicidal tendencies
Complementary / Alternative Treatments:
These types of therapies focus on treating the patient holistically and individually, recognizing that each child’s symptoms may be caused by different etiologies. For the purpose of this article, I will only briefly highlight the possibilities of CAM treatments. For further information on the modalities through which these therapies operate, see the research reference at the conclusion of my post.
· Diet – Proper nutrition is necessary for EVERYONE, but especially for growing children. Regular meals / snacks are advised consisting of low-GI carbs, protein and essential fatty acids. Refined carbohydrates, sugars and processed foods are completely eliminated from the diet and when possible, organic fruits / vegetables and meats should be consumed. Using such ‘elimination diets’, studies have shown at least 50% improvement in behaviour.
· Exercise – Regular exercise that is cognitively, aerobically and socially challenging can facilitate healthy cognitive development / alleviate symptoms of ADHD.
· Supplemental Intervention – Studies have found improvements by using supplements such as Fish Oil (8-16g), Vitamin B6 (0.6mg/kg/d), Magnesium (6mg/kg/d), Iron & Zing (150mg zinc sulphate) – in children who are deficient, Calcium / Magnesium, Acetyl-L Carnitine, GABA, Glycine, L-Theanine, L-Tyrosine, Taurine, 5-HTP, SAMe, DMAE, Phosphatidyl Serine, Melatonin, Probiotics.
· Herbal Treatment – Certain herbs including Rhodiola, Chamomile, St. John’s Wort, Valerian and Bacopa have shown promise in the treatment of ADHD
The above information should once again serve to highlight that ADHD, like any condition or disorder, is a complex and heterogenous condition which appears to have multiple possible causes / risk factors. As in psychology, the bio-psycho-social model is a useful method for understanding the etiology of disease and the fact that CAM offers many alternatives to conventional medication suggests that ADHD too needs assessment and treatment on an individual / case-by-case basis. Rather than a reactive, one-pill-suits-all approach, where possible, proactive steps should be taken to ensure the prevention of such conditions.
Where preventative strategies are no longer possible, natural alternatives to the pharmaceuticals may provide a gentler approach to harsher medications. Unfortunately, while short-term use may yield little adverse effects (in most people), little longitudinal data exists assessing the safety and efficacy of these interventions on a long-term basis. As such, as allied health professionals, it is imprudent to claim complete safety with little regard for possible safer alternatives.
When discussing prevention of ADHD, the burgeoning field of ‘epigenetics’, also bears consideration. According to this principle, we are able to change our genetic structure through our lifestyle choices, diet, exercise habits, and the toxins we expose ourselves to, also bears consideration, meaning the decisions we make as individuals have profound impacts on our future offspring. As a result, basic steps such as regular exercise, proper nutrition, etc. can potentially create a healthy future for children as yet unborn. An abstract concept, I know, but one which is increasingly gaining more ground within the scientific community.
Take Away:
The ultimate aim of this post was simply to turn the spotlight on a serious and all-too common condition that seems to be prone to ‘over-diagnosis’ at times, highlight the potential side-effects of the drugs prescribed to treat it and offer ideas about possible alternatives that frequently get left by the way-side as parents look for the ‘miracle-pill’.
Reference:
Pellow, J., Solomon, E.M., & Barnard, C.N. (2011). Complementary and Alternative Medical Therapies for Children with Attention-Deficit / Hyperactivity Disoder (ADHD). Alternative Medicine Review, 16(4), 323-337.
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