Understanding Nutrient Deficiencies in ADHD and How to Address Them

If you or a loved one is diagnosed with ADHD, this post on integrative nutrition and lifestyle strategies is for you.

Research shows that nutrition plays an important role in reducing the severity of ADHD symptoms. Also, there is no down side or negative effects when it comes to optimizing nutritional status for someone living with ADHD.

There are several nutrition related areas to discuss below. I’ve compiled a list of “stones I overturn” with patients if the goal is reducing symptoms (inattention, hyperactivity and/or impulsivity).

Addressing any or all of these only has the potential to help someone with ADHD:

• Zinc deficiency. This mineral has so many important roles in the human body; when deficient, it can exacerbate ADHD symptoms. Get screened for zinc deficiency (serum zinc). Serum zinc levels below 70 mcg/dL indicate inadequate zinc status. I often order this bloodwork and correct if abnormally low or near low as my goal is to get it to optimal. At a bare minimum if not able/unwilling to get bloodwork done, meet the dietary reference intake for zinc which varies depending upon age and gender. (Dietary reference intake just means the appropriate amount that should be consumed for age and gender).
• Iron deficiency. Full on anemia or degrees of low iron stores can exacerbate ADHD symptoms too. Other indicators besides classic ADHD symptoms that could present in a person low in iron include desire to chew ice, fatigue, feeling cold, or hair loss. Next, it is important to look into why low iron is happening as it’s not always due to poor intake. Other reasons iron can be low include: absorption issues, h. pylori overgrowth/infection, having a parasite, having celiac disease, or too much blood loss like with menstrual bleeding or a GI bleed. I perform my nutritional assessment and look at the big picture, and then I usually order and recommend a CBC, ferritin, TIBC, iron saturation, serum iron, transferrin. Bottom line: screen for low iron and at a bare minimum, ensure the dietary reference intake for age and gender is being met.
• Vitamin D deficiency. Screen for this and correct as most will end up needing supplementation due to either inadequate sun exposure, living in a specific region, or not eating enough – all which are super common. As with most deficiencies, it is almost impossible to “eat your way out of deficiency” with a balanced diet; tailored and therapeutic doses of the nutrient are needed. I generally recommend vitamin D3/K2 at 2000-5000IU per day and then recheck in 3 months.
• Omega 3 fatty acids.  Inadequate intake of this essential fatty acid is linked to worsening of ADHD symptoms. Studies with EPA doses of at least 500 mg found significant improvements in hyperactive symptoms. In the USA, we generally get way too many omega 6 fatty acids (seed oils like canola oil, soybean oil, etc. found in processed foods) which are proinflammatory and not enough omega 3 fatty acids (fish, flax seed, walnuts). This imbalanced ratio can casade to various dysfunction throughout the body. Often omega 3s need to be supplemented if not consistently meeting the dietary reference intake from food sources.
• Magnesium. Many studies show lower serum magnesium levels reported for patients with ADHD compared to healthy subjects. According to the University of Notre Dame and mutiple other sources, experts think around 75% of us do not consume enough magnesium rich foods. Given this either meeting the dietary reference intake of magnesium from an increase in magnesium rich foods or supplementing with magnesium is important but especially for those with ADHD symptoms.
• Probiotic usage: Probiotics (aka “good bacteria”) are found in small amounts in some foods and also found in supplements in therapeutic dosages; both can help those with ADHD. Bifidobacterium species & Lactobacillus rhamnosus outperform placebo for symptom improvement. Probiotics with these strains are generally safe and an option to try.

These above are general recommendations of what to explore to add to the diet to optimize nutrient intake and give the body what it needs fo function best. Click here for general dosing recommendations and access to supplements at 10% off and free shipping.

Now, what should be minimized or avoided to help someone with ADHD:

• Food dyes. This is controversial, but there is no health benefit from food dyes – all colors; best to avoid.
• Folic acid. This synthetic form of folate is not used well in those with the MTHFR gene mutation. Experts think around 50% of humans have a MTHFR gene mutation. MTHFR mutations can cause a buildup of folic acid and make mood and behavioral disorders worse. You can get tested for this, however given the high incidence, best to avoid cereals, breads, vitamins with folic acid and opt for real folate found in foods or methylated folate found in quality supplements.
  • Note pregnant women don’t really need folic acid either which is most people’s point of reference when they hear the words “folic acid;” it is better for this population to also have folate which can also reduce risk of spina bifida.
• Added sugar. These are the sugars that humans have added to food (so not fruit). Added sugars are again controversial when it comes to the conversation surrounding ADHD management. In the same breath, added sugars have no health benefits and arguably linked to many health concerns; best to minimize for multiple reasons.
• Heavy metals. Obviously no one intentionally consumes this. Heavy metals are often lurking in places: public tap water is a notorious source of lots of contaminants; many fish also contain heavy metals. If you visit www.ewg.org/tapwater you can see what contaminants are in your zip code’s water supply.
  • I HIGHLY recommend getting a quality water filter strong enough to filter out heavy metals. The Brita and your fridge filter don’t cut it. Consider the reverse osmosis system. Filtering water is a proactive approach. If heavy metals have already bioaccumulated, which I can order urine testing to see this, a reactive approach may be needed to help mobilize these toxins from your body.
• Phthalates. This group of chemicals used as plasticizers in the production of plastics is to make products more flexible and durable. Phthalates can be found in a variety of everyday products such as food containers, toys, personal care products to name a few. It is wise to buy phthalate free shampoos, body wash, hand soap, etc. Simple swaps over time add up!

A word on mold exposure

This topic is very personal to our family. Toxic indoor mold gets downplayed, but it is a common biotoxin (up to ~70% of all homes have mold experts say).

• Mycotoxins  -from mold- can exacerbate or even thought to sometimes cause ADHD symptoms, especially inattention.
• I’ve seen patients completely come off ADHD medication with mold remediation and mold detox; it begs the question if ADHD is sometimes a mislabel in the cases of mold which contributes to brain inflammation.
• I order urine mycotoxin testing to assess if mycotoxins are present in the body first is the first step to seeing if this is part of the equation.
• I also recommend an ERMI kit 1 – which is an at home dust collection kit that screens for clinically significant levels of mold. A score of 5 or higher warrants professional mold inspection and remediation.

Studies linking ADHD and Mold Exposure:

A study published in the Journal of Attention Disorders found that children exposed to mold in their homes were more likely to be diagnosed with ADHD. The study surveyed 1,911 children and found that those with higher levels of mold exposure in their homes were more likely to be diagnosed with ADHD.

Mold exposure can be associated with “brain fog,” characterized by difficulty concentrating, memory problems, and confusion. Another study published by the National Institute of Health found that individuals with mold exposure were more likely to report symptoms of difficulty remembering & concentrating. Consider looking into mold exposure being a possibility. Not sure where to begin considering taking my Healing from Mold Online Program.

I wish you well on your journey with ADHD. If you need individualized care, please schedule a consult package.

References:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025252/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025252/
• https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893446/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4883772/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437823/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946190/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8877879/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910189/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998645/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967436/

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