Finding Balance with Attention Deficit Hyperactivity Disorder (ADHD)

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioural disorder that impacts around 8% of children in Australia. Boys are more likely to be diagnosed than girls, however, this may be due to the symptom picture being more evident in boys and therefore, more diagnosed. It is the most common childhood neurobehavioural disorder. The development of ADHD is thought to be influenced by both genetic and environmental factors. Some of these environmental factors include exposure to toxic substances such as lead, mercury, cadmium, aluminium and high levels of copper. ADHD impacts the executive functioning of the brain with the symptoms including developmentally impaired levels of attention, hyperactivity and impulse control.

How is ADHD diagnosed?

In Australia, ADHD in children, is diagnosed by either a child psychologist or paediatrician and in adults, psychiatrists generally diagnose ADHD. For a diagnosis, there are a number of subjective diagnostic criteria that must be met. Children are generally not diagnosed before the age of six, unless the symptoms are excessive due to the executive functioning of the brain not being fully developed until this age. The diagnostic criteria for ADHD are based on the symptoms of inattention and/or hyperactivity/impulsivity and:

·      The symptoms need to be developmentally inappropriate for the person’s age.

·      The symptoms need to be present before the age of 12 years old.

·      The symptoms must have been present for longer than six months.

·      The symptoms must be evident in multiple settings.

The three subtypes of ADHD

ADHD has been subdivided into three subtypes: predominantly inattentive, predominantly hyperactive/impulsive and a combination of the two. Predominantly inattentive children/adults get distracted easily, show poor levels of concentration and have lower than expected organisational skills. The predominantly hyperactive/impulsive subtype have difficulty slowing down, may constantly talk or fidget, have difficulty sticking to a task and may frequently interrupt or take risks. The combination type is the most common, followed by predominantly inattentive and finally hyperactive/impulsive. The hyperactive/impulsive subtype has been shown to have the lowest outcomes for quality of life.

ADHD comorbidities

Around 80% of people diagnosed with ADHD are also diagnosed with another neurological/behavioural disorder over their lifetime. The most common disorders include learning disabilities, anxiety, depression, sensory processing disorder and oppositional defiant disorder. People diagnosed with ADHD frequently also experience muscle tics, seizures and/or (as adults) substance abuse. Many of these symptoms are also related to a magnesium deficiency. Therefore, balancing the mineral levels of people diagnosed with ADHD as early as possible is paramount.

ADHD and heavy metals

Children are more likely to be impacted by the exposure of heavy metals due to their smaller size, their immature detoxification abilities and their sensory interaction with their environment such as placing objects in their mouths. In addition, if an individual has a mineral imbalance, they are more likely to absorb a toxic metal on exposure. The underlying reason for this is that many toxic substances displace a similar mineral required by the body when that mineral is deficient. For example, where a person has a zinc deficiency, on exposure to cadmium, the body will utilise the cadmium as a replacement for zinc. The toxic metal, however, is a poor substitute for the required nutrient and can lead to lower functioning of the body, decreased energy levels and increased oxidative stress and inflammation. Remembering that zinc plays a role in the development of children’s brains and a zinc deficiency is associated with learning difficulties, memory deficits and depression.

The Two stages of ADHD

The Hair Tissue Mineral Analysis (HTMA) results for people with ADHD can be divided into two stages. The first is a fast metaboliser (low calcium and magnesium with high sodium and potassium and low copper) and are often presenting with hyperactivity/impulsivity or a combination subtype. This pattern creates an over-stimulated picture as calcium and magnesium are sedating and sodium and potassium are stimulating. In addition, there is an inverse relationship between magnesium and stress. The high stress picture induces a magnesium and zinc loss. Over time, this pattern produces excessive cortisol production (anti-stress hormone) leading to adrenal insufficiency. There may also be a breakdown of muscle mass, therefore, these children are usually quite thin and unable to put on weight.

In the short-term, stimulants can alleviate these symptoms by pushing the adrenal glands to work harder. However, over the long term, the adrenals may be overworked and therefore, supplementing with magnesium and calcium/vitamin D (vitamin D is a calcium modulator) would be more beneficial, along with adrenal support. To confirm this, a 2020 study on ADHD children found supplementing with both magnesium and vitamin D was effective at improving conduct, social issues and anxiety/shyness, however, did not significantly improve psychosomatic problem scores. Just to note clinical trials use a standard dosage for everyone in the trial, as opposed to HTMA where the mineral imbalance can be identified and treated on an individual basis.

The second ADHD picture is a slow metaboliser (high calcium and magnesium and low sodium and potassium levels with high copper). They often present as the subtype predominantly inattentive and may have memory and learning difficulties. These children respond better to a low-dose stimulants that may be in the form of sodium and potassium supplementation, adrenal support and to detoxing copper. 

You may recall that copper can also be a toxic metal in higher concentrations and antagonises zinc. Therefore, in children, where they have been exposed to or inherited excess copper, they have a relative zinc deficiency that can impact the development of the brain. Excess copper has been associated with lower concentration levels, nervous system imbalances and mental health disorders. HTMA studies have also found that tissue copper is higher in children with learning disorders such as dyslexia.

ADHD recommendations

If you or your child have a diagnosis or you suspect ADHD, then mineral balancing and heavy metal detoxing is highly recommended via hair tissue mineral analysis (HTMA). As a naturopath, the holistic assessment of your/your child’s dietary habits and lifestyle also comes into play in ADHD. Where appropriate, herbs may also be recommended to support you in your naturopathic journey. 

Childhood developmental disorders and hair tissue mineral analysis (HTMA) are my specialty and if you would like to learn more, then please book in a complimentary discovery call.