Nutritional Deficiencies: An Overlooked Cause of ADHD (Part 1: B Vitamins)

Nutritional Deficiencies:  An Overlooked Cause of ADHD (Part 1: B Vitamins)
For decades, the medical profession has mostly dismissed any relationship between nutritional factors – like vitamins, minerals and plant-derived phytonutrients – and the symptoms of ADHD.
In fact, organizations like the American Academy of Pediatrics (AAP) have discouraged parents from giving nutritional supplements to ADHD children. Are any nutritional treatments endorsed? Well, a recent scientific paper in Pediatrics, the AAP journal, advocates “a healthy dietary pattern” for kids with ADHD as “the most promising and practical complementary or alternative treatment of ADHD.”
I’m all for feeding your kid a healthy diet, of course. (Though trying to get your ADHD child to consistently eat “healthy” can drive him – and you – crazy.) But 30 years of experience treating thousands of kids with ADHD has shown me that detecting and treating specific nutritional imbalances is often a necessary step to controlling ADHD symptoms.
For example, 9 out 10 ADHD children are low in magnesium. Supplementing the diet with the mineral can improve focus, ease anxiety, deepen sleep, and even reduce or eliminate the side effects of ADHD drugs. (More on detecting and correcting magnesium deficiency in next blog…)
I’d like to see the medical profession begin to acknowledge the crucial link between many nutrients and ADHD – which is why I was happy to read a recent scientific paper that provided more evidence about the connection between vitamin and mineral deficiencies and ADHD. Specifically, a lack of two B vitamins…
B’s and Behavior
Norwegian researchers tested blood levels of B vitamins in 133 adults who had been diagnosed with ADHD (ages 18 to 40) and 131 adults with ADHD symptoms but no diagnosis.
They found that those diagnosed with the disorder had lower levels of B2 (riboflavin), B6 (pyridoxine) and B9 (folate). And those with the most severe symptoms had the lowest levels of B2 and B9.
I was pleased by these findings, but I wasn’t surprised. Since the 1970s, researchers have been writing about B vitamins and ADHD, and using the nutrients to treat the disorder.
What’s the connection between B’s and behavior? To find out, let’s take a closer look at vitamin B6, or pyridoxine…
The Power of Pyridoxine
With too little B6 on board, the body can’t make normal levels of several neurotransmitters, the chemicals that control communication between brain cells (neurons). That includes dopamine, which is often imbalanced in ADHD; norepinephrine, a partner with dopamine; serotonin, which helps control mood; and GABA, a calming neurotransmitter. Yes, all of them depend on B6. (So does melatonin, the hormone that controls the sleep-wake cycle.)
Not only that, B6 helps magnesium work. And as I mentioned a moment ago, magnesium is a must for kids with ADHD. B6 also helps control levels of blood sugar (glucose) in the brain-and steady levels of brain glucose are a must for balanced behavior.
Not surprisingly, supplementing the diet with B6 can make a big difference, as I describe at length in my book Finally Focused, which is being published in May. In that book, I describe these and many other studies:
B6 works as well as Ritalin. 
Back in 1979, a group of researchers compared B6 to Ritalin (methylphenidate)-and found them equally effective in easing the symptoms of ADHD. They noted that B6 increased serotonin levels, but Ritalin didn’t.
Improving attention. 
In another study, researchers gave a pyridoxine-derived drug (Metadoxine) or a placebo to 36 adults with ADHD. The vitamin-based drug “significantly improved sustained and selective attention.”
Does B6 deficiency cause ADHD? Pyridoxine is so essential to the formation of neurotransmitters and the health of the brain that ADHD could be considered a “pyridoxine-dependent condition” caused by an “inborn [genetic] disorder of vitamin B6 metabolism,” wrote another team of Israeli researchers in Medical Hypotheses.
The Pyloria Problem
That’s definitely the case when a child has “pyloria”-a genetic defect in handling hemoglobin, the oxygen-carrying protein in red blood cells. People with pyloria produce too much kryptopyrrole, a compound that binds to vitamin B6 and zinc, causing a deficiency in these two nutrients.
That deficiency in turn causes a deficiency in neurotransmitters, with symptoms like an inability to handle stress, intense anxiety, frequent and explosive anger, mood swings, poor short-term memory, reading problems and depression. I test for this condition in every child I treat for ADHD-because if it’s not detected and corrected, the child won’t get better.
The Folate Defect
Similarly, I test every child for a genetic variation that slows the conversion of the B vitamin Folate into the active form L-Methylfolate. L-Methylfolate is a form of this B vitamin that crosses the blood-brain barrier and stimulates the conversion of amino acids in our diets to dopamine, norepinephrine and serotonin. Deficiencies in these neurotransmitters related to folate may contribute to the behavioral and emotional problems commonly seen in depression and ADHD.
If a child or adult has a positive test, I recommend supplementation with L-Methylfolate of at least 5 mg or because of the significant positive benefits of higher dose L-Methylfolate there are prescription forms that your doctor can prescribe called Enlyte. Enlyte has higher doses of L-Methylfolate with the cofactors necessary for neurotransmitter synthesis.
In my next blog, I’ll discuss other vitamin and minerals deficiencies and imbalances that are common in ADHD, and that are addressed in my Plus-Minus Treatment Plan in Finally Focused.
For focus and full potential,
James Greenblatt, MD

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