Woody McGinnis' notes on ADHD and nutrients. Includes suggested supplements

Physical Health Profile in ADHD

1. Gastrointestinal Abnormality

• Colicky Infants and Older Children Diarrhea-Prone (V Colquhoun HACSG, Sussex UK 1987)
• Severe Stomach Aches (Am J Clin Nutr 1995; 62:761-8)
• Elevated Stool Creosols (Lancet 7.12.85)
• Ileal Lymphoid Nodular Hyperplasia (Lancet, July 18, 1998)
• Urinary Peptide Elevations-P. Shattock and A. Broughton
• Urinary Organic Acids Elevations- W. Shaw
• IAG Elevations-A. Broughton
• Parasitosis 67%-M. Lyon and J. Cline

2. Compromised Immunity

• More Infections and Antibiotics (Am J Clin Nutr 1995; 62: 761-8)
• Low Complement C4B (J Am Acad Child Adolesc Psych 1995; 34(8): 1009-14)

3. Detoxification Weakness

• Low-Level Lead Exposure Induces Hyperactivity in Rats (Science 182(116): 1022-1024
• Marked Improvement in 7 of 13 Chelated for "Non-Toxic" Lead Levels (A J Psych 1976 133(10): 1155-1158)
• Neonatal and Maternal Hair Lead Predict LD at Age 6 (Lancet 2:285 1987)
• Hair Lead Levels Correlate with Teacher-Rated and Physician-Diagnosed ADHD (Arch Environ Hlth 1996; 51(3): 214-20)
• Striking Chelation Results in 50 Vancouver Children (Turning Lead into Gold, paperback, Nancy Hallaway and Ziggert Strauts 1996)

4. Abnormal Nutritional Profile In ADHD

• Zinc Deficiency
  • Lower urinary, serum, nail and hair zinc than controls plus quick drop in serum and salivary zinc with double-blind tartrazine. United Kingdom. (J Nutr Med 1:51-57, 1990)
  • Plasma, erthrocytes, urine and hair lower than controls. Poland (Psychiatr Pol 28(3):345-53 1994)
  • Zinc deficiency in attention-deficit hyperactivity disorder. Israel. (Biol Psychiatry 40(12):1308-10 1996)
  • Serum zinc--and free fatty acids--lower. Turkey. (J Child Psychol Psychiatry 37(2):225-7 1996)
  • In vitro study demonstrates decreased loss of fatty acids from mesenteric phospholipids with perfusion of physiological zinc. Canada. (Can J Physiol Pharmacol 68(7): 903-907 1990)

• Fatty Acid Deficiency
  • Lower serum DHA, DGLA and AA in hyperactives than controls. (Clin Pediatr 26(8):406-411 1987)
  • Double-blind administration of evening primrose oil to a subgroup of prior study was associated with improved parent ratings for Attention and Excess Motor Activity compared to placebo. (J Abn Child Psychol 15(1): 75-9 1987)
  • Evening Primrose oil (GLA) 1 gram/day improved 53 of 79 hyperactive children selected as a subgroup on the basis of mood swings. The most striking improvement was noted in children with sleep disorders, crying spells and family history of alcohol or bipolar. (Muriel Blackburn, Crawley Hospital, Sussex , U.K.)
  • Lower plasma DHA, EPA and AA, and lower RBC AA in ADHD than controls (Am J Clin Nutr 62: 761-8 1995)
  • (Same group above correlated greater tendency to behavioral problems with lower total plasma Omega-3, more colds and antibiotics with lower total Omega-6. Physiology and Behavior Vol 59, Nos. 4/5 915-920 1996)
  • Zinc and Evening Primrose Oil the mainstay for thousands of successes claimed by the HACSG, Sussex England (Personal Communication, Vicky Colquhoun 1997)

• Magnesium Deficiency
  • Magnesium deficiency measured in 95% of 116 Polish children with ADHD: 78% low hair, 59% low RBC's, 34% low serum. (Magnesium Research 10(2): 143-148 1997)
  • Double-blind adminstration of 200 mg elemental magnesium per day to 25 of the above group produced measurable decrease in hyperactivity over 6 months compared to control. (Magnesium Research 10(2): 149-156 1997)

• Iron Deficiency
  • Preliminary study showed improved behavior in nonanemic hyper-actives given 5 mg/kg/day of Iron for 30 days, with significant increase in serum ferritin. (Neuropsychobiology 1997; 35(4):178-80)
  • Lower Iron plasma, RBC, Urine and Hair levels in 50 Hyperactives (Psychiatr Pol 1994; 28(3): 343-53)

• Calcium Deficiency
  • Plasma, RBC, urine and hair Calcium in 50 hyperactive Polish children lower than controls. (Psychiatry Pol 1994; 28(3):

• B6 in ADHD
  • B6 to hyperactives with low serotonin levels resulted in normal serotonin levels and behavior. (Pediatrics 55: 437-41, 1975)
  • B6 to 6 hyperactives with low serotonin levels increased serotonin and reduced hyperactivity better than Ritalin in double blind cross-over. Benefit carried over into the following placebo period, but not with Ritalin. (Biol Psychiatry 14(5):741-51 1979)
  • Significant subgroup of patients with ADHD (and Autism) found to have pyrroluria by Bill Walsh (Pfeiffer Treatment Center, Napperville, IL) and Hugh Riordan (BioCenter, Wichita KS). Good clinical track record for response to generous B6 and Zinc in thousands of pyrroluric patients. (Walsh also finds Biotin very useful in "slender malabsorber group")

• B12 in ADHD
  • Elevated urinary methylmalonic acid and early reports of response to oral B12 from John Linnell, research director at The Children's Medical Charity, U.K. Some reports of response to B12 shots.

Emerging Possibilities

• VITAMIN A HYPOTHESIS- M Megson
• CALCIUM DYSREGULATION HYPOTHESIS-W McGinnis

Interventional Strategies for Behavioral Children

1. OPTIMIZE NUTRITION

• Low Glycemic
• Big Breakfast, Protein First, Frequent Meals
• Good Fats
• No Excitotoxins
• Organic as Possible
• Plenty of Fiber
• Careful with the Copper

• Baseline CBC, UA, Thyroid
• Urinary pyrrole
• RBC Fatty Acid Analysis
• Hair Mineral Analysis/Other Mineral Studies
• (PHF)

Start with these incrementally, continue until proven otherwise:

• Zinc with Manganese
• B6 (and/or P-5-P) with Magnesium
• Calcium
• Vitamins C and E

Then Address Fatty Acids

• Evening Primrose for GLA (Careful Seizures or Asthma)
• Cod Liver Oil (Provides Vit A and D plus EPA/DHA)
• Fish Oil or Neuromins for additional Omega 3

Other: B12, Biotin, Taurine, MSM, Folate, DMG, Amino Acids, Mb, Fe

2. ADDRESS OVERGROWTHS AND GUT CARE

• O&P at a bare minimum
• Urinary Organic Acids

• Nystatin/Oral Amphotericin/Diflucan/Cranberry/Grapefruit Seed

• Reconsider NSAIDS
• Fiber/FOS/Glutamine/Glucosamine
• Pentosan Polysulphate ("Elmiron")?
• Re-populate bowel with probiotics
• Creon or other digestive enzymes

3. ADDRESS FOOD INTOLERANCES

• IgG food antibody blood testing

• Urinary Peptides
• Address lactose, phenolic and high-arabinose intolerance.