introduction

Attention-deficit/hyperactivity disorder (ADHD) is a complex nervous disorder that is characterized by noticeably higher levels of hyperactivity, impulsivity, and inattention that affect behavioural, emotional, cognitive, academic, and social functions.[1] The characteristics of ADHD theoretically appear before your child hits 7 years of age and currently affects 5% to 9% of children in Australia.

signs & symptoms

Some of the early signs to look out for may include problems with their academic performance, relationships, and self-esteem. Other symptoms that coincide with these signs include other physical or psychological illnesses like speech or language disabilities, depression, and anxiety according to the American Academy of Paediatrics.[2] Two main types of ADHD exist that have different behavioural characteristics. See the below table for a breakdown of each type.

causes

From a naturopathic standpoint there are several factors that influence a person’s susceptibility to developing ADHD, including the below:

• Genetics and environmental factors cause imbalances to neurotransmitters like dopamine and serotonin [3]
• Increased oxidative stress and inflammation in the brain [4] 
• Dysfunction to the stress response (HPA axis) and higher cortisol levels as a result [5] 
• Paediatric Autoimmune Neuropsychiatric Disorder (PANDAS) may increase the expression of symptoms [7]

prevention

Although genetics may not necessarily be within your control, there are a lot of other angels we can use to prevent and manage ADHD symptoms, including the below:

• Genetics – children with ADHD often have at least one close relative who has ADHD [6] 
• Focus on pre and early postnatal health – limiting maternal drug, alcohol, and cigarette use; exposure to toxins and heavy metals like lead and PCBs; ensure thyroid health [8]
• Address nutritional deficiencies – vitamin B6, folate, vitamin B12, iron, vitamin D, omega-3 fatty acids [9]
• Identify and limit intolerant foods like food colours and additives [10]
• Support gut health [11]
• Improve sleep hygiene and health [12]
• Regulate and promote a healthy stress response [13]
• Support impaired methylation pathways with activated B vitamins and choline [14]
• Identify heavy metal toxicity and reduce environmental exposure [15]
• Reduce systemic inflammation [16]
• Balance blood sugar levels [17]

testing

Your health practitioner may recommend testing any of the below areas to support effective treatment of ADHD symptoms in your individual situation:

• Omega-3 – EPA and DHA
• Folate and vitamin B12
• Zinc: copper ratio
• Serum vitamin D
• Homocysteine
• Iron studies
• Blood glucose
• Microbiome insights
• Hair Tissue Mineral Analysis (HTMA)
• Methylation profile
• Cortisol Awakening Response (CAR) profile

treatment

There are a few options available to effectively support living with ADHD, such as:

• Pharmaceutical drugs – psychostimulant medications are most commonly prescribed by medical doctors, however, may also prescribe other mood stabilisers like anti-depressants or alpha-2-agonists as well
• Nutritional supplements – B vitamins, magnesium, omega-3, iron, vitamin D, and probiotics are most commonly prescribed by your naturopath/nutritionist
• Herbal medicine – Kava kava, Chamomile, Valerian, Lemon balm, Passionflower, American ginseng, Bacopa, Ginkgo, and Rosemary may be prescribed by your naturopath/herbalist
• Diet – an elimination diet is usually prescribed under the guidance of your health professional, however, may transition over to or try gluten-free, casein-free, low-FODMAP, anti-inflammatory, alkaline, or Mediterranean diet long term depending on the individual situation
• Lifestyle – regular moderate to high-intensity exercise has seen promise in managing this condition in addition to limiting recreational screen time

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