ADHD Weekly 2017-07-20

Join the discussion.

Question: I saw an advertisement for a micronutrient pill to treat ADHD. I’m looking for options to treat my child’s ADHD symptoms.  Could adding micronutrients have an effect on his ADHD symptoms?

Answer: Recent research implies some people might benefit from including micronutrient supplements as part of their treatment plans, but the research doesn’t point towards using supplements in place of recommended treatment.

Supplementing with micronutrients, such as elemental micronutrients (including zinc, iron and magnesium) and vitamins (often Vitamin B and Vitamin D) is an open area of exploration. Some researchers and health care providers suspect ADHD symptoms could be worse if there are deficiencies in certain micronutrients available to a person’s brain. If this is so, could supplementing with micronutrients make a difference in ADHD symptoms? There have been some studies on micronutrients for ADHD but the evidence is inconclusive at this point.

Exploring micronutrients as a complementary approach

Julia Rucklidge, PhD, clinical psychology professor at University of Canterbury in Christchurch, New Zealand, and her colleagues published their research on micronutrient supplements as a possible treatment for ADHD in the British Journal of Psychiatry. The study included 80 adults diagnosed with ADHD. Half the participants received a proprietary broad-based micronutrient preparation as a dietary supplement, while the other half received a placebo preparation. 

The study participants who received the broad-based micronutrient preparation had enough of an improvement in their symptoms, when compared to those who received the placebo, for Dr. Rucklidge to conclude that the study provides preliminary evidence for micronutrients to be used as part of treatment. However, the study was not conclusive and needs to be replicated by additional researchers before micronutrient supplementations based on broad-based micronutrient preparations could be recommended.

"This could open up treatment options for people with ADHD who may not tolerate medications or do not respond to first-line treatments," says Dr. Rucklidge in Medscape Medical News. 

Micronutrients for ADHD

CHADD Professional Advisory Board member Mary Solanto, PhD, says she can understand parents and adults being interested in micronutrients and the use of food as a treatment approach for ADHD. Dr. Solanto is an associate professor of Psychiatry and director of the ADHD Center in the Division of Child and Adolescent Psychiatry at Mount Sinai School of Medicine in New York City. A deficiency in a micronutrient would be a tempting “quick and easy” explanation for the cause of ADHD symptoms, she says.

“I think it reflects the understandable desire of parents to find an answer that they can implement quickly and easily,” Dr. Solanto says. “I think, in part, it does relate to the issue of wanting to avoid medication, because I think the dangers of medication have been overstated.”

In addition to Dr. Rucklidge’s study, there have been additional studies and meta-analyses, which are reviews of multiple studies, on supplementing with various elemental nutrients and omega-3 fatty acids, Dr. Solanto says. (Read Fishy or Not? Omega-3s and the ADHD Brain for more on supplementing with omega-3 fatty acids.)  Frequently, the elements zinc, magnesium, and iron are studied in relationship to ADHD.

Dr. Solanto says that before a parent, or an adult affected by ADHD, adds a micronutrient supplement, either as a single nutrient or vitamin-mineral combination, it’s important to find out if there is an actual deficiency that needs to be addressed, and if it could be addressed through diet first rather than supplements.

“The thing with those elements is they shouldn’t be taken in large doses or by people who don’t have a deficiency. That could lead to other health problems,” Dr. Solanto says. “One should treat a deficiency but not depend on these substances to correct ADHD.”

Supplementing with elemental micronutrients, just because they are available over-the-counter, is not necessarily a safe or wise option for a complementary approach for ADHD treatment, she says.  A concern about some commercially available preparations is related to their proprietary blends – the ingredients and amounts are not necessarily listed on the labels. The consumer may not be aware of how much of each micronutrient is present, and health care providers may not be able to determine which ingredient is effective in the preparation.

The other concern, Dr. Solanto says, is that if parents pursue a micronutrient approach first, effective treatment supported by research can be delayed. During that delay, the child continues to experience ADHD symptoms, along with academic and social difficulties related to the symptoms.

“They’re kind of basing their hope on something that’s not realistic,” she says. “In the meantime, the child is experiencing a negative impact [from ADHD].”

Considering a micronutrient approach? Talk with your doctor first

A medical test can reveal if there are deficiencies in micronutrient and vitamin levels. If there are, a doctor can prescribe therapeutic doses to correct the deficiency or a dietician can help you to plan meals that include sufficient amounts of needed micronutrients through food. 

Dr. Solanto emphasizes that having lower levels of elemental micronutrients and vitamins doesn’t necessarily mean the deficiency caused the ADHD.

• Discuss your concerns with the doctor. A blood test may be necessary to evaluate levels for certain elemental micronutrients and vitamins.
• Seek out high-quality supplements that list ingredients and amounts present. Your doctor may be able to recommend or prescribe an appropriate supplement if one is needed.
• Consider supplements as a complementary approach; research does not support their use as a primary treatment for ADHD.

For more information:

• Treatment of ADHD
• Complementary and Other Interventions
• Fish Oil Supplements and ADHD
• Using Dietary Supplements Wisely

Have you explored supplements as a complementary approach for ADHD?