Written by Dr. George Papanicolaou, DO
Here’s How I Treat ADHD: A Functional Doctor Explains

Here’s How I Treat ADHD: A Functional Doctor Explains

“He’s so bright but he’s failing because he won’t turn in homework and tunes teachers out,” one parent began when we first met. Another said during our first consultation: “She would do better if she wasn’t constantly talking and disrupting the class.”

These understandably frustrated, worried parents bring their child into my office often because a school official expressed concern about their disruptive behavior, lack of cooperation, or inability to pay  attention. Parents, on the other hand, see their kids as too active, lazy, disorganized, easily distracted, or just “being a kid.”

These and other symptoms suggest Attention Deficit Hyperactivity Disorder (ADHD), which the National Institute of Mental Health defines as “a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

The American Psychiatric Association argues about five percent of children have ADHD, but other experts estimate higher rates. https://www.cdc.gov/ncbddd/adhd/data.html

To understand ADHD, think of your brain as having crisscrossing wires that go in many directions. For most people, a thought moves from point A to point B. For someone with ADHD, a thought starts out at point A, but before it gets to point B, points C and maybe even D capture their attention first. They become completely distracted before point B.

This isn’t lack of attention. In fact, a child with ADHD pays attention to and becomes interested in nearly everything they hear and see. They focus on one extremely interesting subject, blocking out everything else. To a parent or teacher, this looks like a child with ADHD is ignoring them.

This faulty cross-wiring creates two issues:

  1. Executive functioning – staying organized to, say, follow a project from start to finish. Oftentimes, multi-step projects become overwhelming so a child with ADHD doesn’t know where to start. (Parents can help by breaking down chores into individual steps and creating reminder systems, like putting  a backpack near the door so the child doesn’t forget it.)
  2. Self-regulation – the ability to manage impulsiveness. A child with ADHD might do something without first considering consequences. They fail to pick up on the behavior of those around them and behave similarly. Instead, they act on a random thought impulsively, oftentimes angering those around them.

Many times, children I see with ADHD have very low self-esteem and trust issues. If I can get a child to open up and put frustration and confusion into words, I have a greater chance of gaining trust, which yields more effective treatment and minimizes these issues.

I’m always clear during consultations that ADHD does not doom a child to a life of under-achievement. In fact, many of our greatest discoveries and inventions were made by people with ADHD.

Rather than put a label on a child based on symptoms or conditions, as a Functional Medicine doctor, I focus on what triggers ADHD. Most children have multiple triggers including genetics, environment, food intolerances, toxicity, and a poor diet.

While medication and behavior modification certainly help, diet also plays a role and can exacerbate symptoms. From that perspective, I’ve found these five dietary strategies can benefit nearly every child with ADHD.

  1. Incorporate anti-inflammatory foods and nutrients. Chronic inflammation underlies ADHD, and the typical American diet is highly inflammatory. Whereas studies show medications can have “severe side effects and intolerance,” researchers find omega-3 fatty acids can benefit children with ADHD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968854/ That’s because drugs used to treat ADHD can stimulate the brain’s dopamine receptors. So can omega-3 fatty acids: In therapeutic doses, these fatty acids can increase dopamine production and receptors. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml Most children don’t regularly eat wild-caught fish, so I’ll recommend other anti-inflammatory foods like walnuts as well as a professional-grade fish oil.
  2. Try an elimination diet. Gluten, dairy, and other potential food sensitivities can put your immune system in overdrive, increase inflammation, and create problems like intestinal permeability (or leaky gut). Studies show an elimination diet can benefit ADHD. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62227-1/abstractIn my practice, I’ve found eliminating these problem foods can do wonders for children with ADHD. They feel better, become more focused, and perform better in school.
  3. Focus on whole, nutrient-rich foods. Researchers find sugar – particularly the simple sugars in processed foods – can increase a child’s risk for ADHD. One study correlated higher sugar intake with a higher level of hyperactivity and ADHD-like attention deficiencies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133757/ Other research shows artificial colors and preservatives can become driving factors in ADHD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322780/ While it might feel like a challenge, moving children with ADHD into a whole, unprocessed foods diet that includes plenty of fruits, vegetables, and high-quality animal foods can create dramatic improvements in behavior and focus.
  4. Optimize nutrient intake. Many children with ADHD are deficient in crucial vitamins and minerals. Studies find significantly low levels of vitamin D in children with ADHD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4670977/ Likewise, a systematic review found magnesium could help treat ADHD. https://www.ncbi.nlm.nih.gov/pubmed/23808779 I find a good multivitamin-mineral (and sometimes extra vitamin D and magnesium) can restore nutrient status.
  5. Mind your gut. Researchers continue to learn about the gut-brain connection. Studies show diet influences gut microbiota, which plays a key role in disorders like ADHD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139398/ Probiotics, prebiotics, and other fiber-rich options feed good gut flora and crowd out the bad. Studies show probiotics can be effective among ADHD treatments. https://www.ncbi.nlm.nih.gov/pubmed/18444966 I encourage parents to focus on gut-healing foods including fermented choices like sauerkraut and fiber-rich options like nuts, seeds, and legumes.

My ultimate goal is to make life at school and at home easier for everyone, but also to show that ADHD is not a bad thing. Children with ADHD are often remarkably smart and creative. With the correct treatment, they will become future leaders, creators, artists, and scientists.

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