Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in

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Reviewed by SIAHMSR medical team

Nutritional neuroscience - Nutraceuticals for ADHD

    Nutritional neuroscience is a branch of medicine studying the impact of food and food additives on neurological and psychiatric disorders. Various nutrients or elements of food can affect the functions of brain and nervous system.

The cognitive or thinking & understanding potential, memory, emotions etc. are affected by neurotransmitters produced by brain cells. Nutrients such as vitamins , minerals and other compounds of food have crucial role in these processes. Nutritional cognitive neuroscience is an emerging interdisciplinary field of research that seeks to understand nutrition's impact on cognition and brain health in all age groups.

What is a neutraceutical?

Nutraceutical is defined as a food or part of it that provides the body with medical or health benefits, including the prevention and treatment of a disease. It is a natural way to accomplish better therapeutic results with minimal side effects compared to pharmacological or drug therapy.

Simply nutraceuticals are nutritional supplements such as vitamins, minerals and herbs which can provide some health benefit to human body.

In addition to vitamins, the term nutraceutical includes naturally occurring ingredients such as garlic, ginseng and other herbal products such as phytochemicals extracted from plants. Soluble and insoluble fibres are also included in this category.

These  substances are often available  as non prescription or over the counter drugs.

All these supplements are not effective  as the prescribed medicines are, but they have some effects  and less or minimal side effects on the body. To understand the effects of neutraceuticals more comprehensively extensive research studies are to be conducted  in future.

 Nutraceuticals can have multiple functions and impact on more than one disease state.

These supplements may affect several molecular pathways and hundreds of proteins and genes. For a comprehensive understanding of the complex interrelationships among genes and proteins that change with nutraceuticals and disease, genomic and proteomic technologies are used as the preferred bioanalytical techniques in nutraceutical research.

Nutritional supplements or nutraceuticals for ADHD

        Attention deficit hyperactivity disorder [ADHD] is a neurodevelopmental disorder affecting children predominantly. The pharmacological or medicinal therapy for ADHD is able to reduce the symptoms of ADHD ,however the side effects associated with the drugs make the parents anxious and they prefer natural  supplements more.

Are the nutriceuticals effective in managing ADHD?

·       Omega 3 fatty acid supplements for ADHD

According to a study published in 2014 on the efficacy of nutritional supplements in ADHD children, polyunsaturated [Omega 3] fatty acid supplementation has found to be effective.

The benefits provided by this polyunsaturated fatty acid seem small compared to the effect of pharmacological treatments for ADHD. However, evidence suggests that omega 3 fatty acid formulations with higher eicosapentaenoic acid content may be more effective in improving ADHD symptoms [1]

Currently the recommendation for ADHD is:

supplementation with a dose of 1–2g daily with a substantial content of  eicosapentanoic acid [EPA] within the omega-3 formulation.

·       Melatonin

Melatonin as a neutraceutical supplement seems to have some effect on sleeplessness in children with ADHD but appears to have minimal effects in reducing the core ADHD symptoms like inattention, hyperactivity, impulsivity etc.

·       Iron and zinc

 Iron and zinc supplementation may have benefit in reducing ADHD symptoms in children with deficiency of these minerals.

Iron helps for dopamine and norepinephrine neurotransmitter production in ADHD children.

Iron is a cofactor for tyrosine hydroxylase, the rate-limiting enzyme of monoamine synthesis and thus it is important for dopamine and norepinephrine neurotransmitter production. Further trials are needed to understand if iron supplementation has any effect in ADHD patients with no evidence of iron deficiency.

It is very important to understand that excessive intake of iron as a supplement without physician’s directions can do more harm as it may cause haemosiderosis   later. So supplements should be used with some caution, knowing the adverse effects that can happen beyond the recommended intake.

zinc

Zinc is a cofactor for enzymes that are important for cell membrane stabilization, and in the metabolism of neurotransmitters, melatonin and prostaglandins.

Zinc has indirect effects on dopamine metabolism and antioxidant functions also.

zinc deficiency can cause inattention, jitters and delayed cognitive development, which may resemble the symptoms of ADHD.

Zinc supplementation either as an adjunct to drugs or alone as a nutraceutical have provided conflicting evidence of efficacy.

·       Gingko biloba

Ginko biloba has been in use as a  nutraceutical supplement for dementia and memory impairment although it is not as effective as pharmacological treatment. Indiscriminate use of ginko biloba is associated with increased bleeding risk.

·       Hypericum perforatum  or St. John’s Wort

This is a natural supplement that has been demonstrated to inhibit reuptake of serotonin, norepinephrine, and dopamine neurotransmitters.

The mechanism of action of hypericum is similar to some ADHD medications, atomoxetine (a norepinephrine reuptake inhibitor) and bupriopion (a norepinephreine and dopamine reuptake inhibitor).However , studies shows that it is not an effective solution for ADHD management.

Summary

·       Omega 3 fatty acids, particularly eicosapentanoic acid is recommended as a nutraceutical or supplement with some efficacy in ADHD management.

·       Zinc and iron have reduced symptoms of ADHD but only in the zinc or iron deficient children having symptoms mimicking ADHD .

·       Nutraceutical herbs like ginko biloba and hypericum have some effects on cognitition and memory however all studies could not prove their efficacy beyond doubt. Extensive research in larger population size is needed to study the benefits as well as adverse effects of these nutraceuticals in ADHD.

Reference

1.    Nutritional Supplements for the Treatment of Attention-Deficit Hyperactivity Disorder

Dr. Michael H. Bloch, MD, MS and Ms. Jilian Mulqueen, BA

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4170184/

2.    https://pubmed.ncbi.nlm.nih.gov/9342769/

3.    https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/nutraceutical