I have been wanting to write on this topic since I started this blog.

 

I have SO much to say and the topic is very vast, that every time I sat down to start, I couldn’t seem to get through to the end. There is also SO much research on this topic, which I feel is valuable to include, but then I’d just end up down the rabbit hole of the world wide web!

 

Attention Deficit Hyperactivity Disorder (ADHD) and Autism are two of the main reasons I went back to school to become a holistic nutritionist. I saw too many families struggling with traditional therapies and not having anywhere to turn. I KNEW deep in my heart that there was another way.

 

What is ADHD?

Allopathic medicine defines ADHD as a behavior disorder. If you want to read all the criteria needed for a diagnosis, you can read about it here. Back in 2016, 6.1 million children were diagnosed with ADHD. Since then, the numbers have continued to increase. The most traditional approach to treatment is that once the diagnosis is made, a prescription for medication is written.

 

But treating ADHD is more complicated than that. From the standpoint of functional medicine and nutrition, ADHD is more of a neurophysiological disorder that involves the brain and the gut. A simple prescription isn’t necessarily going to solve the issue. It’s a bandaid.

 

A study in the Journal of Psychiatry found that there is bidirectional communication between the gut and the brain. Anyone who has experienced nervous diarrhea understands this. To go one step further, we can recognize that cognitive or behavioral challenges actually may stem from, or are exacerbated by, a poorly functioning gut.

 

There are several proposed etiologies for ADHD from a functional nutrition standpoint. The prominent theories propose that gut dysbiosis, inflammation, food allergy, and nutrient deficiency could be the driver, or root cause, of ADHD.

 

There’s probably not one “cause”

As humans, we want to blame something or someone when things go wrong. However, in the case of ADHD, it’s more likely that there are several culprits simultaneously overloading a child’s brain (adults can have ADHD as well, but today I’m focusing on kids).

 

I often talk about the idea of “threshold” with my clients. Our bodies are designed to handle a certain amount of toxic load and stress, but once we fill that cup too high, our body starts to send out emergency flares. This can look like frequent illness, autoimmune disease, eczema, etc. Our bodies are trying to process the burden placed on them, but it has become too much. Everyone’s threshold is different, and finding yours is the key to long-term health.

 

Ok, but back to ADHD.

 

Our kids today are exposed to more toxins before they are born than most of us 80s babies were by the time we were 10 years old. Glyphosate, heavy metals, processed food, dyes, MSG, I could go on and on. These wreak havoc on our children’s neurological and immune systems so early in life, when they are trying to grow and mature rapidly in the first few years of life.

 

The microbiome (your gut) matures around 2 years old and is a product of what it is exposed to. If by 2, a child has been fed primarily processed foods, limited fresh fruits and vegetables, poor quality meat, and poor quality dairy, we find that the biome of that child is already in dysbiosis. This means that there is an imbalance in the beneficial and pathogenic bacteria and fungi that live in our gastrointestinal tract. This has been shown to lead to obesity, asthma, and allergies later in life. If a child has been breastfed and been exposed to a higher variety of foods, we’ll find an excellent variety of microbes and fungi in their gut.

 

This can affect a child for their lifetime. I know this seems super alarmist, which I try to stay away from, but it really is that important.

 

Not all is lost for the kiddo with dysbiosis at 2 years old. We just need a calculated and intentional approach to get him or her back on track.

 

 

Now let’s talk specifics about ADHD.

Zonulin is the most important modulator of intracellular tight junctions in your gut. Increases in zonulin levels, which is also a marker for inflammation, are linked to leaky gut.

 

Leaky gut is defined as intestinal permeability from inflammation due to toxic waste created in the body. This “waste” leaks through tiny holes in the gut wall lining and into the bloodstream, where it doesn’t belong. Needless to say, the immune system does not like this.

 

When out of balance, zonulin can be responsible for this leaky gut. It is increased by gliadin, which is in all gluten-containing foods. So it could be reasonably concluded that a gluten-free diet may help reduce ADHD symptoms.

 

The research on this is mixed because going “gluten-free” is not synonymous with health (it also doesn’t generate money for research). Processed and packaged gluten-free food can be just as inflammatory as gluten-loaded food. Perhaps adopting a paleo diet may be more helpful. Again, no real research specific to ADHD, however, the Paleo Diet has been shown to decrease systemic inflammation and improve a number of clinical markers including heart disease.

 

And this is why there are so many factors at play for ADHD.

 

The study mentioned in the beginning of this post from the Journal of Psychiatry did in fact find that zonulin might be a decent clinical biomarker for hyperactivity and impulsive symptoms in ADHD. They also found that serum zonulin is related to social dysfunctions in ADHD.

 

So, increased Zonulin = increased leaky gut/alterations to intestinal function = behavioral and social impairment.

 

(Zonulin is also associated with social impairment in children with autism spectrum disorder.)

 

Ok, so gluten is implicated. And since a leaky gut has been shown to increase behaviors associated with ADHD, we can make some educated assumptions.

 

Gluten can also cause inflammation in the body, which could theoretically also result in hyperactivity or difficulties with concentration.

 

But there’s more.

 

If a leaky gut is happening for our kids with ADHD, there is also an increased likelihood of nutrient deficiencies, although we aren’t sure which came first. Research has focused on Vitamin D, Iron, Magnesium, Omega 3 Fatty Acids, and Zinc. These nutrients are essential for maintaining healthy levels of inflammation and energy availability. Supplementing with these may be a good idea, but please work with a practitioner. Not all supplements are created equal and some may cause more harm than good, especially iron. And often for kiddos with ADHD and autism, the dosing levels are critical. So working with someone who can help you figure out how much your child needs can be really helpful.

 

One thing I want to point out before moving on from the discussion around diet and children with ADHD (adults too!) is that while there’s been no conclusive evidence to support a connection between Celiac Disease and ADHD, there is good research to indicate that when children with ADHD were tested for Celiac and found to be positive, a gluten-free diet resulted in a dramatic improvement in ADHD behavior. It may be worth having your child tested for celiac if they can tolerate a blood draw.

 

Let’s talk sleep…

 

Sleep is one of the most important things we can do for our bodies. It’s when we grow, heal, consolidate learning, store memories, and participate in the detoxification of our brain and liver.

 

If kids are not getting enough sleep or not getting high-quality sleep, it’s likely that behavior challenges will follow.

 

One of my favorite books on sleep is called Sleep Wrecked, and in there the connection between poor sleep and attention deficits and hyperactivity is clearly laid out. In a 2021 study comparing children with and without ADHD they found:

Overall, children with ADHD showed longer sleep onset latency (SOL), higher IIV (intra-individual variability) in SOL, more movements during sleep, lower sleep efficiency, and a slightly larger sleep deficit on school days compared with free days. No group differences were observed for chronotype or sleep onset time.

 

Clinically, 25-50% of children with ADHD have a sleep disorder co-morbidity. A history of snoring or possible obstructive sleep apnea during childhood is associated with a twofold difference in the odds of ADHD diagnosis or symptoms, and an elevated incidence of sleep-disordered breathing is found among individuals with ADHD. While we can’t be sure if it’s causal, there sure is a strong correlation. Insomnia (75% in kids with ADHD) is also highly correlated with ADHD.

 

There has only been a handful of studies to examine how improving sleep or withholding sleep may impact a child with ADHD. When an overnight sleep extension protocol was in place, children with ADHD demonstrated a 10% improvement in their morning and nighttime inhibitory control (i.e. when they were told not to do something, they were able to listen and follow the command 13% better). Is this clinically significant? Not sure. Could that 13% be expanded to 20% with further improvements in sleep? Maybe.

 

*side note, in this same study, kiddos without ADHD ALSO had improvement in inhibitory control when sleep was extended and improved overnight*

 

I honestly could write a whole blog just on sleep and ADHD, the information is so important to get into the hands of parents. I might just need to do that soon….

 

Other contributors

Aside from gluten, potential nutrient deficiencies, and sleep, kiddos with ADHD often have a very small remaining threshold for toxicity. Several studies including this one, implicate heavy metals in ADHD. They are also implicated in cognitive delay and lowered IQ. If finances allow, I always recommend getting heavy metal levels assessed if your child has ADHD. Removing metals can be time-consuming, but it’s worth it.

 

Let’s quickly touch on glyphosate before I finally end (phew, it’s been a long one!) Glyphosate is a chelator and an antibiotic. That means that every time you consume or even breathe it in whether from food or grass, it is binding to minerals in your body and killing the bacteria, good and bad, in your gut.

 

Considering what we talked about with leaky gut and the need for a healthy biome, exposure to this toxin could be problematic. Glyphosate has also been implicated in a causal way to leaky gut. SO. Buying organic when you can is going to be ideal. Use the EWG Clean 15 and Dirty Dozen to help you prioritize what you will buy organic and what you won’t.

 

And finally, because it needs to be said, there’s no credible research to support the idea that screen time leads to or causes ADHD. However, there are some correlations between the severity of ADHD and hours of screen time. However, it is just a correlation. I have heard anecdotally that some children have an increase in challenging behaviors after screen time, which would speak to the power that technology has on the brain. Does this mean your child with ADHD should never get screen time? No. That’s not practical or realistic. But it does mean that you need to make a choice and set boundaries for your family based on how your child responds to screens.

 

Holistic Solutions

I couldn’t end without giving some strategies!

  1. Try an elimination diet, particularly focusing on gluten. Aim for 6-weeks at least and do your best to swap out gluten-containing foods for whole, unprocessed foods, not just gluten free counterparts. If your child is a picky eater, I recommend finding a nutritionist skilled in this area to support you.

  2. Increase the color profile of your child's foods. Eating lots of colors helps improve their antioxidant consumption which helps offset inflammatory markers seen in ADHD.

  3. If you are concerned about sleep, working with a functional holistic practitioner on how to improve this for your child is key. I tend to refer out to airway specialists in our area who can thoroughly assess for obstructive sleep apnea or narrow airways. I also have the children I work with evaluated for open-mouth breathing and tongue posture.

  4. Using a gentle clinoptilolite zeolite to remove toxins like mercury and lead can be a great help, and is more affordable than the full heavy metal blood panel or hair analysis. I recommend doing this for at least 3 months. I use the Advanced TRS Brand, which you can find linked on my affiliates page.

  5. Other supplements I like for ADHD include DHA/EPA (I like the Nordic Naturals Brand for capsules, for liquid I’ll use Barleans with kids), Pycnogenol, potentially L-tryptophan, and GABA. These last two should be evaluated for use by a practitioner. Pycnogenol is well supported for decreasing inflammation in the brain and body of kids with ADHD and improving glutathione production. It needs to be dosed according to body weight, so make sure to reach out to your favorite holistic professional for guidance. You can buy these via my online dispensary, linked on my affiliates page.

  6. If there are nutrient deficiencies and a leaky gut is indicated, I will also put kiddos on a high-quality probiotic such as MEGAsporebiome, which has been shown to repair the gut lining in as little as 3 weeks. Currently, this needs to be ordered through a practitioner. Reach out if you want help getting this for you or your child.

 

And there you have it! First blog back in a while and it’s a doozy! I hope you found this helpful. Please share this with someone who you think might be helped by this information.