Lining the shelves in supermarkets, health stores and pharmacy front shops, you’ll see a large number of products for various different ailments, most of which will promise health, vitality and, quite often, few to no side effects.

These products can be as simple as the novel multivitamin or as complicated as herbal diet programmes. If you have a problem with your body, there’s probably some kind of supplement you can take for it. When your child has been diagnosed with Attention-Deficit/Hyperactivity Disorder and the horror stories about the awful things the prescribed medicines do to children’s bodies and brains start to get tossed around like confetti at a wedding, you may find yourself wondering if you should wander around the front shop instead of filling a prescription at the dispensary.

What is the rationale for using natural remedies for ADHD?

 When treating a condition, the best place to start is to identify the underlying cause of that condition and then try to act on that specific factor or pathway. In the case of ADHD there is a lack of conclusive evidence regarding its aetiology. This, combined with arguments regarding the ideal treatment of the disorder, has resulted in an ever-increasing range of therapies for ADHD management. For many parents, the use of prescription medication for ADHD has poor connotations as a result of media reports (and unsubstantiated articles scattered across the internet), while there is also an overwhelming school of thought which dictates that if something is “natural”, it is a better option than pharmaceutically manufactured drugs. This perspective, however, may be unhealthy in that the efficacy of many of these alternative treatments has not been scientifically proven.

A number of complementary and alternative therapies have been developed which target hypothesised ADHD aetiological factors. This article will focus on some of the more commonly used natural alternatives.

Essential Fatty Acids

 The effects of essential fatty acid (EFA) intake on central nervous system (CNS) functioning has become a highly researched area, with deficiencies in these fats being linked to the development of ADHD. It is thought that EFAs, particularly arachidonic acid (AA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are influential in ADHD as these have roles in structural and functional development and maintenance of neuronal mem­branes. EFAS cannot be synthesised by the body and are sourced from dietary intake, with alpha linoleic acid (ALA) (a precursor to other EFAs) being available from plants con­taining vegetable oils such as soybeans, canola and flaxseed, while fatty fish such as salmon and mackerel provide EPA and DHA. Studies in children with ADHD identified reduced EFA plasma concentrations, lead­ing to the hypothesis that EFA deficiency may be related to some of the core behavioural deficits seen in ADHD.

Studies evaluating EFA supplementation as a treatment for ADHD have, thus far, not established any benefits due to their use. EFA supplementation is not recommended for the treat­ment of ADHD in children or adults by the National Institute for Health and Clinical Excel­lence.

Vitamins, minerals and amino acids

A number of different vitamins, amino acids and minerals are reported to modulate dopamine (DA) and noradrenalin (NA) levels via different mechanisms. Amino acids like tyrosine and phenyl­alanine are precursors (a chemical which is part of a biological synthesis to form another chemical compound) to L-dopa, a precursor to DA, thus supplementation of these amino acids is thought to bolster DA levels. Folic acid, niacin and iron have roles as co-factors in the conversion of these amino acids to L-dopa, while pyridoxine is required for conversion of L-dopa to DA. Vitamin C is a co-factor for the metabolic pathway in which NA is synthesised. A study has reported that ADHD-diagnosed individuals have significantly lower levels of these amino acids, as well as tryptophan, histidine and isoleucine than controls, thus resulting in the theory that a deficiency in amino acid transport and/or absorption may influence the development of ADHD. It is thought that supplementation with these amino acids, minerals, vitamins and herbs can modulate CNS neurotransmitter levels and thereby treat the underlying cause of ADHD.

Deficiencies in magnesium and zinc due to poor dietary behaviour are also thought to play a role in ADHD development. Zinc is a co-factor in neurotransmitter, melatonin and fatty acid metabolism. Impulsive behaviours and socialisation skills were found to improve in a study examining the effect of zinc supplementation in conjunction with stimulant treatment. Some studies have shown reduced magnesium levels in the serum and red blood cells of children with ADHD and reported improvement of symptoms following supplementation of magnesium with pyridoxine. Little evidence supports the use of megavitamin doses. - Judith Regnart

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