If you subscribe to my newsletter, you’ve already received my free guide “6 steps to selecting the perfect supplement”. In it, I discuss the importance of choosing a quality brand, due to the unregulated market and suspect ingredients in many common store brands. Additionally, I think it’s crucial to work with a practitioner who can guide you through baseline lab work and direct you to the best supplements to meet your body’s needs. Lastly, I would treat “supplements” as a “supplement” to other lifestyle changes. There’s no supplementing your way out of a poor diet, sleep habits, stress or lack of exercise. Here are the Top 7 nutrient deficiencies seen in ADHD:
As I mentioned in a recent podcast, there is an incredibly strong link to gut and brain health1. Probiotics remain a powerhouse in repairing overall gut health.
Food sources: I always recommend food sources first, including kefir, kombucha, raw sauerkraut, and low-sugar,grass-fed full fat yogurt. Homemade or local sources can be especially helpful in providing a wide diversity of bacterial strains.
How to select a supplement: In addition to food, most people need a little more help in restoring the gut in the form of a probiotic supplement. Look for a product with a high Colony Forming Unit (CFU) count of 10-40 billion CFUs. Additionally, you’ll want your brand to have a different bacteria, aiming for 10-30 different strands, including bificobacterium bidifum, bacillus coagulans, saccharomyces boulardii, bacillus subtilis, lactobacillus rhamnosus. When you start a new probiotic, remember to go “low and slow”. Probiotics work differently in everyone, so it may take some trial and error to find the right product.
Dosing: Start with a quarter to a half of the recommended dose and work your way up slowly over the course of a week or two. Gas, diarrhea and cramping can occur if started to quickly. Most probiotics are taken twice daily on an empty stomach 2 hours away from food or at bedtime.
Reputable brands include: Garden of Life Raw, Metagenics, Prescript Assist, Dr. Ohira
Omega 3 fatty acids
This powerhouse source of omega-3 fatty acids has been extensively studied in ADHD2. The two fatty acids that are found in fish oils include docosahexaenoic acid (DHA), which supports brain health and eicosapentaenoic acid (EPA), which helps with inflammation.
Food sources: My favorite food sources include fatty fish like salmon and sardines. There’s also plant based sources like flaxseed and hemp, but they are not nearly as absorbable as the animal sources (meaning, you need to take a lot more of them compared to an animal source).
What to look for: When selecting a supplement, consider finding one that is pure, made in an oxygen-free setting (less oxidation leads to less rancidity). Additionally, check to make sure your brand has undergone third party testing to ensure quality. Most fish oils on the market today have a 1:1 ratio of EPA to DHA, but look for one with a ratio of 7:1 or higher. Follow package instructions, which will vary by product.
Reputable brands include: Nordic Naturals, OmegaBrite, Designs for Health
In my opinion, krill oil could be the new fish oil! Recent studies have shown the benefit of krill oil in improving ADHD and a host of mental health disorders3. Though it’s not as well studied as fish oil, it has some properties that make it more appealing. Since it’s bound in a phospholipid structure (vs. triglyceride for fish oil), it’s more bioavailable to the body. That means it’s better absorbed and a lower dose can be given. It also contains the powerful antioxidant astaxanthin, which also prevents oxidation and rancidity.
How to take it: Dosing hasn’t been fully established yet. Dosing ranges from 320mg/day for children to 500mg/day for adults. Refer to dosing on package instructions.
Reputable brands: Dr. Mercola, Source Naturals, Thorne Research
Though there are 8 B vitamins in total, two play a particularly important role in ADHD. Vitamin B6 (pyridoxine) is critical in making the neurotransmitter serotonin4. Additionally vitamin B 12 (methy B-12) helps to regenerate neurons as well as the myelin protective sheath.5-6
Food sources: Organic, grass-fed poultry and beef, seafood, bananas, leafy green vegetables such as spinach, potatoes
How to take it: Take a B-Complex as directed on the package instructions, preferably in the morning, as it can have a stimulating effect. If you’re seeing a practitioner, he or she can recommend individual b-vitamins and suggest dosing.
Reputable brands: MegaFood
According to Carolyn Dean, M.D., up to 80% of Americans could be deficient in magnesium.8 It is essential for over 300 critical enzyme processes in the body.9 Magnesium promotes cardiovascular health, has a calming effect on the bowels and can aid in anxiety. Most children who take prescription stimulants are especially susceptible to magnesium depletion, which affects neurotransmitters controlling emotion, hyperactivity and attention. Magnesium is synergistic (or works well) with vitamin B-6 (pyridoxine).
Food sources: leafy greens, cacao, nuts, oysters, mackerel, beans, avocado, banana.
Dosage forms: Fun fact: our bodies like to absorb magnesium in different ways. Try taking a hot bath and dissolve 1-2 cups of Epsom salts, which area great source of magnesium. Or consider spraying magnesium oil on the bottom of the feet at bedtime. I also like an oral formulation called Natural Calm, which is an oral powder dissolved in water. Start with a quarter or half the normal dose with this product too. If you experience diarrhea, decrease your dose.
Reputable brands: Natural Calm, Ancient Minerals, Dr. Teals Epsom Salts
About half of children are deficient in Vitamin D. Optimal levels are needed for bone health as well as immune function.
Food sources: salmon, mackerel, tuna, sardines, yogurt and milk, egg yolks, cheese and liver are good food sources of vitamin D.
How to get more: Get out in the sun! Just 15 minutes a day (without sunscreen (gasp!) can boost vitamin D levels. Check vitamin D status and consider supplementing to bring the vitamin D blood level to the middle of the “normal range.” After learning I am deficient myself, especially in the wintertime here in the Northeast, I like to use a source containing Vitamin D3. Children one year of age and above: 400 IUs per day, taken with a meal. Adult dosing can range from 1000-10,000IU/day depending on levels.
Reputable brands: Child Life, Natural Factors
Zinc helps in making dopamine, which can affect mood & concentration (a big helper for ADHD symptoms). Adequate levels also support production of melatonin and serotonin. Zinc also converts vitamin b6 (pyridoxine) into active form. It can also prevent oxidative damage.
Food sources: oysters, beef & lamb, spinach, pumpkin/squash seeds,cashews, cocoa powder, pork, white mushrooms
Dosing and other information. In clinical trials, there was a wide variety of dosing. Per the National Insitutes of Health, the upper limit daily dose of zinc is as follows: 4mg (infants to 6 months), 5mg (7-12 mo), 7mg (1-3yo), 12mg (4-8yo), 23mg (9-13yo), 34mg (14-18yo) and 40mg (19 and older).10 Zinc can lower copper store, which can also affect ADHD symptoms. Though this is a common deficiency, I would recommend talking to a practitioner before supplementing.
In the Archives of Pediatrics and Adolescent Medicine, it was noted that 84% of kids with ADHD are deficient in iron vs only 18% in those without the condition.11
Food sources: beef/ chicken liver, clams, mollusks, mussels, oysters, beef, sardines, turkey
Get tested: As with zinc, I suggest testing ferritin levels through a practitioner. Too much iron can block zinc, copper, and manganese, so you really want to know your levels before supplementing.
So what to do now with all of this information? Here’s my easy 5 step checklist:
1. Find a practitioner who can help guide you through the process. I list some searchable sites for Practitioners under “Resources”.
2. Consider adding in some probiotic foods, and or/ a wide-spectrum probiotic.
3. A few weeks later, after noting any side effects and maximizing doses, consider adding in and an omega-3 fatty acid supplement.
4. Get out in the sun for 15 minutes a day and enjoy some exercise while you’re at it!
5. Increase dietary fats (like coconut & olive oils, nuts/seeds, wild fish & avocado), while reducing processed/refined sugars and carbs.
Is this information helpful? What has worked for you?
Note: I have no affiliation to the above mentioned products.
1. Probiotics referenced from the Cleveland Clinic. Accessed August 18, 2015 at: http://my.clevelandclinic.org/health/healthy_living/hic_What_We_Eat_Affects_How_We_Feel/hic_Keeping_Your_Digestive_Tract_Healthy/hic-Probiotics
2. Gow RV, Hibbeln JR, et al. Current evidence and future directions for research with omega-3 fatty acids and attention deficit hyperactivity disorder. Curr Opin Clin Nutr Metab Care. 2015 Mar;18(2):133-8. Accessed August 18, 2015 at: http://www.ncbi.nlm.nih.gov/pubmed/25581035
3. Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev. 2007 Sep;12(3):207-27. Accessed on August 18, 2015 at: http://www.altmedrev.com/publications/12/3/207.pdf
4. Dolina S, Margalit D, et al. Attention-deficit hyperactivity disorder (ADHD) as a pyridoxine-dependent condition: urinary diagnostic biomarkers. Med Hypotheses. 2014 Jan;82(1):111-6. Accessed on August 18, 2015 at: http://www.ncbi.nlm.nih.gov/pubmed/24321736
5. Rucklidge JJ, Johnstone J et al. Moderators of treatment response in adults with ADHD treated with a vitamin-mineral supplement. Prog Neuropsychopharmacol Biol Psychiatry. 2014 Apr 3;50:163-71. Accessed on August 18, 2015 at: http://www.ncbi.nlm.nih.gov/pubmed/24374068
6. Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006 Nov;5(11):949-60. Accessed on August 18, 2015 at: http://www.ncbi.nlm.nih.gov/pubmed/17052662
- Dean, C. The Magnesium Miracle. New York, NY; 2003.
- Magnesium for Health Care Professionals. National Insitutes of Health . Accessed on August 19, 2015 at: https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
9. Patrick RP, Ames BN, et al. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J. 2015 Jun;29(6):2207-22. Accessed on August 18, 2015 at: http://www.ncbi.nlm.nih.gov/pubmed/25713056
10. Zinc Safety. Mayo Clinic. Accessed on August 19, 2015 at: http://www.mayoclinic.org/drugs-supplements/zinc/safety/HRB-20060638.
11. Konofal E, Lecendreux M, Arnulf I et al. Iron deficiency in children with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med. 2004 Dec;158(12):1113-5. Accessed on August 19, 2015 at: http://archpedi.jamanetwork.com/article.aspx?articleid=485884