Definition
ADD/ADHD Attention-Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder characterized by persistent and developmentally inappropriate levels of overactivity, inattention, and impulsivity; a condition that can persist into adulthood.
ADD/ADHD is the most common psychiatric disorder in youth with 9.5% of school-aged children affected in Australia and New Zealand and over 10% in the United States. The disorder not only interferes with the learning ability of a child, it also creates a great deal of stress in family life and interpersonal relationships.
Behaviour is affected in ADHD and is due to imbalances of specific neurotransmitters (i.e. noradrenaline)- impacting the executive functions of the prefrontal cortex of the brain – the area of the brain involved in planning complex cognitive behaviors, personal expression, decision making and moderating social behavior. Patients may have either too little or too much of these neurotransmitters, have defective receptor function and methylation defects – that ultimately compromises the fluidity of neuronal membranes and neuronal synchronization during attention-demanding tasks.
Currently, there are no biomedical tests for ADHD, so the condition is diagnosed by the observation of behavioral symptoms. The diagnostic criteria for ADHD are 9 symptoms in two areas of mental functioning: inattention and hyperactivity/impulsivity (see symptoms below). A child only needs 6 of these 9 symptoms in either area to obtain a diagnosis. There are around 500 different possible combinations of these 9 symptoms which means a child can present in many different ways and still reach a diagnosis of ADHD. Due to the variability of symptoms, ADHD has been classified into 3 subtypes:
- Predominantly hyperactive-impulsive: the majority of symptoms are in the hyperactivity/impulsivity category
- Predominantly inattentive: the majority of symptoms are in the inattentive category
- Combined hyperactive-impulsive and inattentive: 6 or more symptoms of each type.
Several lines of evidence support a disturbance in the gut/ brain/immune (GBI) axis. The gut/brain axis is particularly affected as toxicity, and food constituents have been identified as drivers of brain dysfunction in ADHD. Family studies also reveal a strong genetic link in ADHD, where multiple genes have been identified which involve specific neurotransmitter receptors or transport. However, it is also recognized that environmental triggers, such as heavy metals are shown to induce oxidative stress, lower intracellular glutathione levels and inhibit methylation in neurons, contributing to the ADHD phenotype.
Causes/Risk factors for ADD/ADHD
Factors that are shown to be associated with ADHD are:
- Heredity: children with ADHD usually have at least one first-degree relative who also has ADHD and one-third of all fathers who had ADHD in their youth have children with ADHD.
- Gender: ADHD is more prevalent in boys; the male-to-female ratio is 4:1 in epidemiologic surveys and 9:1 in clinic samples.
- Prenatal and early postnatal health: maternal drug, alcohol, and cigarette use; in-utero exposure to toxins, including lead, dioxins and polychlorinated biphenyls (PCBs); nutrient deficiencies and imbalances.
- Abnormal thyroid responsiveness (possibly caused by exposure to pollutants during the perinatal period).
- Learning disabilities, communication disorders, and tic disorders such as Tourette’s syndrome.
- Nutritional factors: allergies or intolerances to food, food coloring, or additives.
- Environmental exposures: chronic exposure to lead, mercury and other toxic metals have been linked to a variety of neurobehavioral conditions in children.
- Infections.
- Extreme or pervasive psychosocial stressors (such as marital discord or parental psychopathology); in isolation probably not a significant cause of ADHD, but may contribute in combination with other risks.
Signs and Symptoms of ADD/ADHD
Diagnosis is based on having 6 symptoms of either or both of the following subtypes:
Inattentive:
- Fails to give close attention to details or makes careless mistakes
- Has difficulty sustaining attention in tasks or play activities
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish schoolwork, chores, or duties at work
- Has difficulty organizing tasks and activities
- Avoids dislikes or is reluctant to engage in tasks that require sustained mental effort
- Loses things necessary for tasks or activities
- Is easily distracted by extraneous stimuli
- Is forgetful in daily activities
Hyperactive:
- Fidgets with hands or feet, or squirms in seat
- Leaves seat in situations where remaining seated is expected
- Runs or climbs excessively in inappropriate situations (in adolescents or adults, may be limited to subjective feelings of restlessness)
- Has difficulty playing or engaging in leisure activities quietly
- Acts as if “driven by a motor”
- Talks excessively
- Blurts out answers before questions are completed
- Has problem awaiting their turn
- Interrupts or intrudes on others
Treatments
To obtain optimal results, the patient might consider a holistic approach that integrates several therapies to address biochemical, physiological, energetic, emotional and spiritual imbalances.
Biomedical/Functional Medicine Treatment for ADD/ADHD
Biomedical or Nutritional and Environmental doctors and practitioners use treatments that include Diet, Nutrient Therapy, Detoxification and treatment of infections.
It is recommended that a patient consult a qualified Practitioner to assess their symptoms and case history and explore their individual need to:
- Screen for food sensitivities and allergies
- Improve gastrointestinal health to support the vegas nerve and brain and immune function
- Support neurotransmitter function
- Supply fat-soluble nutrients for brain structure and function
- Reduce toxicity and heavy metal accumulation
- Eliminate germs (bacteria, yeast, virus, parasites) to reduce immune response and nutritional deficiencies that can disrupt brain development and function
- Address dietary deficiencies/Provide essential nutrients
- Regulate blood glucose and establish healthy eating habits
Where can I find a certified practitioner?
Finding a well-trained Integrative and/or Functional practitioner requires research but is a vital step in treating complex and chronic illness.
Below are links to lists of practitioners worldwide. We recommend you research the scope, expertise and experience of any practitioners you are considering.
U.S. & Global
Institute of Functional Medicine
https://ifm.org/find-a-practitioner/
Integrative Medicine for Mental Health
http://www.immh.org/find-a-practitioner/
Medical Academy of Paediatric Special Needs (MAPS)
http://www.medmaps.org/clinician-directory/
Australia & New Zealand
Mindd Foundation
https://directory.mindd.org/
The Australian College of Nutritional & Environmental Medicine (ACNEM)
https://www.acnem.org/practitioners/
UK
The British Society for Ecological Medicine
https://www.bsem.org.uk/pages/14-practitioners
Disclaimer: Mindd Foundation does not endorse any specific individuals listed and makes no representations, warranties, nor guarantees and assumes no responsibility for any services provided. Mindd Foundation expressly disclaims all liability for damages of any kind as a result of using any products or services provided by those listed.
