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Research suggests that probably all children should receive a standard daily multivitamin with minerals. However, the amounts of some vitamins in the standard multivitamin are may be inadequate. In addition to vitamins and minerals, research with adults suggests that all children should either eat fish at least once a week or take 1-2 capsules of fish oil per day. To read my standard recommendations for children and adults, see my Recommendations for Healthy Living. Vitamins, Minerals, Diets, and Supplements in ADHD Treatment A modest amount of research with vitamins, minerals, diets, and supplements suggests that attention to these should be made when treating anyone with ADHD. Although almost all of the ADHD supplement and diet research is done with children, its findings probably apply to adult ADHD as well. For children with ADHD, there are now two studies finding that a zinc supplement (15 mg/day in one and 45 mg/day in the other) was of modest benefit. I have used 25 mg/day in addition to the multivitamin with minerals (this adds up to 40 mg/day) in my own practice. Even though there is no research on folate, I also add an extra 800-1000 mcg of folic acid since folic acid has so many good effects on the nervous system, is very safe, and is very inexpensive. Omega-3, herbals, and vitamins/minerals have been tried to help ADHD and each is covered below in that order. The herbal research is almost non-existent while the studies with omega-3 and omega-6 fatty acids is far from conclusive although suggestive of benefits. The only research with vitamins is older megavitamin research that did not use any of the vitamins and minerals currently found of use in treating nervous system disorders. Magnesium has one favorable double-blind ADHD study. While the study was not very well written, magnesium is a very good supplement for overall health. Treatment with magnesium seems premature, although magnesium is good for preventing diabetes and ADHD children tend to be overweight, a risk factor for diabetes. Testing for iron stores and correcting any iron deficiency might be worthwhile. There are a growing number of studies showing that multi-vitamin and mineral supplements combined with fish oil do help some aggressive and anti-social behaviors as well as non-verbal learning. Whether they help ADHD is unknown, but I think the research is good enough to urge every child to take a reasonable broad-spectrum multi-vitamin and mineral supplement and an omega-3 supplement with the least expensive with fish oil. All of these recommended supplements can be purchased for as little as $6 per month. They are good for normal children, not just for ADHD children. And yes, I give them to my own two very healthy children, although not the added zinc, since my kids are not hyperactive. A carnitine might be worth a try for ADHD someday. If it works, carnitine powder form can be purchased costing only $17 per month if one kilo is ordered, an 8-month supply (www.dextersportscience.com). Actually, I think the study probably used more than necessary (4 g/day) when I look at the many other studies for human illness done with the carnitines. Two grams a day is probably enough. Omega-3 Fatty Acids Fish Oil and Omega-3 fatty acid research with ADHD is very limited and not impressive. It does suggest a mild benefit. In view of evidence that omega-3 fatty acids help Alzheimer's Disease and depression in adults, as well as heart disease and strokes, it is a good idea to have everyone, as soon as they are old enough to take capsules, to consume an adequate amount of omega-3 fatty acids. Fish oil is very inexpensive. While the standard capsules are quite large, half-sized, concentrated capsules are available for about 12 cents each. I recommend at least one capsule every day for children with hyperactivity. DHA capsules from micro-algae are also available at a cost of about 50 cents a capsule. These are acceptable to vegans. Every liquid fish oil preparation I have tried has been too distasteful for my children. Nursing mothers should consume fish, fish oil, DHA or high levels of flax seeds to get omega-3 to their children. Flax oil is acceptable but less desirable than fish oil or DHA and is somewhat more expensive. Omega-3, Vitamin E, and Omega-6 Supplement Mild Benefit in DB: 50 children with ADHD who also had thirst and skin problems suggesting a possible omega-3 deficiency were studied in a 4-month DB PC program with half taking a daily dose of 480 mg DHA, 80 mg EPA, 40 mg arachidonic acid (AA), 96 mg GLA, and 24 mg alpha-tocopheryl acetate and half on placebo. On only two of 16 measures was there a significant advantage to the supplemented group: conduct problems rated by parents (-42.7 vs. -9.9%, P = 0.05), and attention symptoms rated by teachers (14.8 vs. +3.4%, P = 0.03). A greater number of participants also showed improvement in oppositional defiant behavior (8 out of 12 vs. 3 out of 11, P = 0.02). Purdue. EFA supplementation in children with inattention, hyperactivity, and other disruptive behaviors. Stevens L, Zhang W, Peck L, Kuczek T, Grevstad N, Mahon A, Zentall SS, Arnold LE, Burgess JR. Lipids. 2003 Oct;38(10):1007-21 Fish Oil May Have Lowered Impulsivity and Aggression in Grade School Girls: In a DB PC study of 166 children ages 9-12, fish oil group took fish oil-fortified foods (bread, sausage and spaghetti) equivalent to 2 capsules of fish oil per day for 3 months. Physical aggression in girls increased significantly (median: 13 to 15) in the control group and did not change (13 to 13) in the fish oil group (P=.008). No significant changes in physical aggression occurred in boys. Impulsivity of girls assessed by parents/guardians using the diagnostic criteria for attention deficit/hyperactivity disorder of DSM-IV was reduced in the fish oil group (1 to 0) with a significant (P=.008) intergroup difference from the control group (1 to 1). The effect of fish oil on physical aggression in schoolchildren - a randomized, double-blind, placebo-controlled trial. Itomura M, Hamazaki K, et al. Toyama Medical University, Japan. J Nutr Biochem. 2005 Mar;16(3):163-71. Highly Unsaturated Fatty Acids Helped ADHD with Dyslexia in DB: Small study of 41 8-12yos 12 week DB PC. Significant benefit over placebo measured on 3 of 14 scales. A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties. Richardson AJ, Puri BK. Prog Neuropsychopharmacol Biol Psychiatry 2002 Feb;26(2):233-9 No Benefit Fish Oil in DB: Small study of 63 ADHD 6-12yos Rx 4 months 345mg/d or placebo. DHA blood level 100% higher but no behavioral or subjective difference. Mayo. Voigt RG, Llorente AM, Jensen CL, et al. A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. J Pediatr. 2001;139:189196. Fish Oil With GLA Helped in DB: Richardson AJ, McDaid AM, Calvin CM, et al. Reduced behavioral and learning problems in children with specific learning difficulties after supplementation with highly unsaturated fatty acids: a randomized double-blind placebo-controlled trial. Presented at: 2nd Forum of European Neuroscience Societies; July 2428, 2000; Brighton, United Kingdom. Probably same study as below. Flax Oil with Vitamin C Said to Help in Small, Preliminary Study: In a sketchy pilot, an alpha linolenic acid (ALA)-rich flax oil and vitamin C emulsion significantly improved ADHD hyperactivity scores of ADHD children. Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). Joshi K, et al. University of Pune, India. Prostaglandins Leukot Essent Fatty Acids 2005 Nov 25. No Benefit in Small DB: A poorly designed 40-child 2-month Japanese DB PC study of 32 children with ADHD and 8 with "suspected" ADHD had half the children eat food with 3.6 g of DHA baked into it each week. Effect of docosahexaenoic acid-containing food administration on symptoms of attention-deficit/hyperactivity disorder - a placebo-controlled double-blind study. Hirayama S, Hamazaki T, Terasawa K. Eur J Clin Nutr. 2004 Mar;58(3):467-73. Ed: Japanese have the world's high per capita intake of seafood. Even if the children are no fish at all during the study, the DHA and EPA consumed before the study would already be incorporated into the nervous system. However, it appears that children were allowed to continue to consume their usual intake of seafood during the study. DHA Protects Rats from Hyperactivity Caused by in Utero Exposure to Alcohol: (DHA) ameliorated hyperactivity induced by in utero ethanol exposure in rat pups. Nihon Arukoru Yakubutsu Igakkai Zasshi. 2002 Oct;37(5):513-22 Two DB Found GLA Not Help: Aman MG, Mitchell EA, Turbott SH. The effects of essential fatty acid supplementation by Efamol in hyperactive children. J Abnorm Child Psychol. 1987;15:7590. Arnold LE, Kleykamp D, Votolato NA, et al. Gamma-linolenic acid for attention-deficit hyperactivity disorder: placebo-controlled comparison to D-amphetamine. Biol Psychiatry. 1989;25:222228. Fish Oil May Help Dyslexia, Dyspraxia, & ADHD: Failing to catch balls best predictor dyslexia. (Dyspraxia=clumsy child syndrome). Fish oil increased reading scores in dyslexia 29% 2 mo & 89% in 5 mo (Swede study). Rx ADHD with fish oil with good results (Brit study). ADHD kids may sometimes lack ability convert fatty acids to LCPs-lg chain polyunsaturated fatty acids. Jackie Stordy. U Surrey, Lancet. AAPN Newsfeed. May Help Dyspraxia: Children with dyspraxia, problems with coordination, often have dyslexia and visual difficulties. Four month open trial of 15 children with fish oil, primrose, and thyme oil showed improvement. Am J Clin Nutr 1/00 (Ed: Open trials are very untrustworthy). Also in dyslexic adults, dark adaptation a common problem. In five, dark adaptation improved after one month DHA vs. controls. Less Incorporation n-3s: There is evidence of less incorporation of DHA and AA into cell membranes in ADHD. Horrobin, Nova Scotia, Med Hypotheses 12/95;45:605 Low Omega-3 in ADHD: 53 6-12-year-old boys with ADHD vs. 43 without. Boys with ADHD had lower AA, EPA & DHA in blood. ADHD boys also had more frequent symptoms of essential fatty acid (EFA) deficiency: thirst (16% vs. 45%), freq urination (7% vs. 34%), dry hair (0% vs. 13%), dandruff (0% vs. 8%) and dry skin (5% vs. 11%), as well as more asthma and ear infections. A higher percentage of controls had been breast fed and breast fed longer (p<.0001). 21 of ADHD with EFA deficiency symptoms had even lower AA and DHA than those without. Boys with low Omega-6 have more colds but not more behavior problems. . Laura Stevens, Purdue, Dept Food Sciences, Am J Clin Nutr 10/95;62:761-8. John Burgess Dept Food and Nutrition, Stone Hall, W Lafayette 47907-1264 Herbals and Supplements 5-HTP Causes Hyperactivity in Mice But Mice Adapt to Chronic 5-HTP: With chronic doses of 400 mg/kg, mice were able to adapt to the hyperactivity that is caused in mice by acute doses. At twice the level, the hyperactivity persisted. Tolerance to the increased locomotor activity produced by L-5-hydroxytryptophan following peripheral decarboxylase inhibition in mice. Magyar RL, Gillin JC, Wyatt RJ. Psychopharmacology (Berl). 1978 Apr 11;56(3):343-50. Ed: I have heard of a physician giving a 4-year-old child 5-HTP for hyperactivity. I have been unable to find any published study of its use on humans with hyperactivity, but this mouse study suggests that 5-HTP is not likely be an effective treatment, since 5-HTP tends to cause hyperactivity in mice, not decrease it. For more on this issue, see Adv Biochem Psychopharmacol. 1974;10:213-7 and J Neural Transm. 1973;34(2):101-9 ADHD: L-Carnitine Helped ADHD, Aggression in Very Small DB: In 13 of 24 ADHD boys receiving carnitine 100 mg/kg/day up to 4 g/day, home behavior improved as assessed with the CBCL total score (P < 0.02), i.e., 54% improved vs. 13% for placebo. School behavior improved as assessed with the Conners teacher-rating score (P < 0.05). At baseline and after carnitine treatment, responders showed higher levels of plasma-free carnitine (P < 0.03) and acetylcarnitine (P < 0.05). One boy developed an undesirable odor from the carnitine. The odor reportedly can be prevented by riboflavin, i.e., vitamin B-2. Netherlands. Efficacy of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Van Oudheusden LJ, Scholte HR. Prostaglandins Leukot Essent Fatty Acids 2002 Jul;67(1):33-8 ADHD: Acetyl- l-Carnitine Reduced Impulsive Behavior in Adolescent Rats: Chronic ALC helped an animal model of human hyperactivity and has no stimulant effect. Methylphenidate was also successful in the same study. The authors conclude it may help ADHD children. Adriani W, et al, Rome, Italy. Psychopharmacology (Berl). 2004 Nov;176(3-4):296-304. Epub 2004 May Ginseng-Ginkgo Concoction Claimed to Help ADHD: Ginseng is promoted for insomnia, stress, sexual potency, and depression. A very poorly described, unpublished study posted at oceansidemedicine.com says 25 ADHD children were treated in a DB study with American ginseng or American ginseng plus gingko. It states that 79% and 91% showed improvement on at least 3 of 7 measures. I have been unable to find the publication of such a study, but I did find an open trial of 36 children lasting only four weeks and giving the children, including children as young as 3 years old, a concoction of American ginseng, ginkgo, and Panax quinquefolium (American ginseng extract (Panax quinquefolium) (200 mg) and Ginkgo biloba extract (50 mg) called AD-FX from CV Technologies, Edmonton, Alta.) twice a day on an empty stomach. The authors, which include the CEO of the manufacturer of the concoction, claim that 74% of the children had a 10 point decrease in ADHD symptoms on the Connor scale, including improvements in hyperactivity, cognition, and oppositionality. Fourteen of the children were also on methylphenidate or dextroamphetamine or clonidine. Lyon, Cline Oceanside Functional Medicine Research Institute, Nanaimo, BC; Totosy de Zepetnek, Jie Shan, Pang CV Technologies, Edmonton, Alta.; Jie Shan, Pang, Benishin Department of Physiology, University of Alberta, Edmonton, Alta. Effect of the herbal extract combination Panax quinquefolium and Ginkgo biloba on attention-deficit hyperactivity disorder: a pilot study. Lyon MR, Cline JC, Totosy de Zepetnek J, Shan JJ, Pang P, Benishin C. J Psychiatry Neurosci. 2001 May;26(3):221-8. Ed: If it looks too good to be true, it probably is. With so much money involved, it is amazing to me that the CEO of the manufacturer was one of the authors and that the University of Alberta went along with this arrangement. Open trials are notoriously unreliable. I consider it unethical that this report was even published. Shame on the University of Alberta and the Journal of Psychiatry and Neuroscience. The manufacturer should fund a proper double-blind study by a totally independent research team whose results are made known no matter whether they are good or bad. The product is available on-line for $20 per month. The same company makes Cold-FX for colds, Pressure-FX to block parathyroid hypertensive hormone (Shark cartilage plus another ingredient)(I could not find a single study on PubMed which mentions such a hormone), Remember-FX for memory, Cell-FX (Shark cartilage) for the joints and immune system, Menta-FX (ginkgo, ginseng, St. John's wort) for mood, anxiety, learning, and memory, and Nutrite-FX for alertness. The website makes an even more extravagant claim that 85% of ADHD individuals improve. CV Technologies is listed on a Canadian stock exchange. A number of Korea mice studies do find ginseng decreases in nicotine (J Ethnopharmacol. 1999 Jul;66(1):83-90), amphetamine (Gen Pharmacol. 1998 May;30(5):783-9), morphine (J Ethnopharmacol. 1998 Feb;60(1):33-42),and cocaine (Pharmacol Biochem Behav. 1999 Jul;63(3):407-12) induced hyperactivity in mice. All of these studies are by the same group. Somehow, I am very skeptical. Borage Oil and Dimethylglycine Promoted: Despite lack of any studies on Pubmed, both of these were promoted for ADHD in book at GNC in 1999. Indeed, Dimethlyglycine had no human or animal studies showing any benefit on any disease state and very little of mechanisms when I last checked. Herbal Treatment Taken by 20%, Usually Without MD Asking or Knowing About It: 115 Texas children being treated for ADHD or depression were surveyed at 5 Community Mental Health Centers with questionnaire. The lifetime prevalence of herbal therapy in patients was 20% (23 patients). Eighteen patients (15%) had taken herbal medicines during the past year. Recommendations from a friend or relative resulted in the administration of herbal medicines by 61% of 23 caregivers. Herbal medicines were given most frequently for a behavioral condition, with ginkgo biloba, echinacea, and St. John's wort most prevalent. Almost 83% of caregivers gave herbal medicines alone, whereas 13% gave herbal medicines with prescription drugs. Most caregivers (78%) supervised the administration of herbal therapy in their children; the children's psychiatrists (70%), pediatricians (56%), or pharmacists (74%) typically were not aware of the use. A Survey of Herbal Use in Children With Attention-Deficit-Hyperactivity Disorder or Depression, Suzanne Cala, M. Lynn Crismon, Jennifer Baumgartner, Pharmacotherapy 23(2):222-230, 2003 Yizhi Chinese Medicine Helps and Additive to Methylphenidate: A DB PC Chinese study of 210 ADHD children found the Yizhi mixture effective in 76%, methylphenidate in 74%, and the combination in 83% and markedly effective in 44%, 46%, and 80% respectively using the Connor Rating Scale. Guangzhou. Assessment on effect of treatment for childhood hyperkinetic syndrome by combined therapy of yizhi mixture and ritalin. Ding GA, Yu GH, Chen SF. Yizhidan Chinese Medicine as Good as Methylphenidate in SB: A Zhengzhou random assignment single blind study. Clinical and experimental study on treatment of childhood hyperkinetic syndrome with yizhidan. Chen YH, Huang B, Zhao X. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001 Jan;21(1):19. (Ed: Single blind studies are definitely inferior to double-blind studies.) Vitamins and Minerals Iron Deficiency Common in ADHD: Iron deficiency causes abnormal dopaminergic neurotransmission. In a study of 53 French children with ADHD ages 4-14 and 27 controls, serum ferritin levels were lower in the children with ADHD (23 ng/mL) than in the controls (44 ng/mL; P < 0.001). Serum ferritin levels were abnormal (<30 ng/mL) in 84% of children with ADHD and 18% of controls (P < 0.001). Low serum ferritin levels were correlated with more severe general ADHD symptoms (P < 0.02) and greater cognitive deficits (P < 0.01). Iron deficiency in children with attention-deficit/hyperactivity disorder. KonofalE, LecendreuxM, et al. Archives of Pediatrics and Adolescent Medicine, 2004:158:1113-1115. Iron replacement has helped girls, who were iron deficient, do better academically. Iron Treatment Might Have Helped: Iron plays a role in the regulation of dopaminergic activity. 14 boys with ADHD) received an iron preparation (Ferrocal), 5 mg/kg/day for 30 days. There was a significant increase in serum ferritin levels (from 25.9 to 44.6 ng/ml) and a significant decrease on the parents' Connors Rating Scale scores (from 17.6 to 12.7). There were no changes in other blood parameters or in the teachers' scores on the rating scale. Iron treatment in children with attention deficit hyperactivity disorder. A preliminary report. Sever Y, Ashkenazi A, et al. Sackler School of Medicine, Tel Aviv University, Israel. Neuropsychobiology. 1997;35(4):178-80. Lead: Penicillamine Treatment for High Lead Levels Helped: In a 12-week DB PC study of 44 ADHD children with elevated lead levels averaging 28 mcg/dL, penicillamine improved Conners teacher hyperactivity scores (ES = 1.6; p<.001), parent Werry-Weiss-Peters hyperactivity scores (ES = 0.7; p<.05), and CGI (ES = 1.4; p<.01). The penicillamine group did nonsignificantly better than the methylphenidate group. David OJ, Hoffman SP, et al. The relationship of hyperactivity to moderately elevated lead levels. Arch Environ Health 1983;38:341-6. Magnesium-B-6 Associated With Apparent Improvement: In a poor quality, French study, 40 children with ADHD were followed during a magnesium-vitamin B6 (Mg-B6) regimen (6 mg/kg/d Mg, 0.6 mg/kg/d vit-B6) for at least 8 weeks. Children from the ADHD group showed significantly lower intraerythrocyte Mg2+ (Erc-Mg) values than control children (n = 36). In almost all cases of ADHD, Mg-B6 regimen for at least two months significantly modified the clinical symptoms of the disease: namely, hyperactivity and hyperemotivity/aggressiveness were reduced, school attention was improved. In parallel, the Mg-B6 regimen led to a significant increase in Erc-Mg values. When the Mg-B6 treatment was stopped, clinical symptoms of the disease reappeared in few weeks together with a decrease in Erc-Mg values. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Mousain-Bosc M, et al. Centre Hospitalier Universitaire Caremeau, Nimes, France. Mag Res 2006 Mar;19(1):46-52. Magnesium Said to Help ADHD: In an apparently randomized but open Polish study of magnesium supplementation for hyperactivity of a group of 75 children ages 7-12 with ADHD jointly with magnesium deficiency, 50 children in addition to standard treatment received magnesium 200 mg/day for 6 months. There was a significant increase of magnesium, zinc, and calcium and a decrease of hyperactivity in the group of children treated with magnesium. Among the 30 children given standard treatment without magnesium, hyperactivity had intensified. The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Starobrat-Hermelin B, Kozielec T. Magnes Res. 1997 Jun;10(2):149-56; The same group reports that magnesium deficiency was found in 95% of those examined, most frequently in hair (78%), in red blood cells (59%) and in blood serum (34%) of children with ADHD. Magnes Res. 1997 Jun;10(2):143-8; Ed: This research in not very impressive in its write-up, but magnesium is an excellent supplement for many conditions and appears quite safe. I would think that it is worth giving, but more research is definitely needed. Magnesium also reduces blood lead levels. ADHD: Magnesium Used in Russian Report: In a Russian study of 51 ADHD children, ages 6-11, magnesium levels were found to be moderately decreased in plasma and erythrocytes. Mg2+ -ATPase activity was also reduced. No changes of calcium or sodium homeostasis were detected in cells. A MAGNE-B6 drug, when used in the complex therapy of ADHS, normalized the magnesium homeostasis, enhanced the large and small motility, attention, psychic stability and EEG parameters, and reduced anxiety. Diagnostic value of examination of the magnesium homeostasis in children with attention deficit hyperactive syndrome. Klin Lab Diagn. 2005 May;(5):17-9. Ed: This was apparently not a controlled study, so should be given little consideration other than to show doctors in yet another country are using magnesium for ADHD. ADHD: Magnesium Used in French Report: Magnesium depletion causes hyperexcitability with convulsive seizures in rodents, reversible by magnesium (Mg) treatment. In an extremely poor quality open study of 52 hyperexcitable children erthrocyte Mg(2+) levels were reported low in 30. Combined Mg(2+)/vitamin B6 supplementation (100 mg/day) for 3 to 24 weeks restored normal ERC-Mg values. The authors claim that in all patients, symptoms of hyperexcitability (physical aggressivity, instability, scholar attention, hypertony, spasm, myoclony) were reduced after 1 to 6 months treatment. Other family members shared similar symptoms, had low ERC-Mg values, and also responded clinically to increased Mg(2+)/vitamin B6 intakes. Magnesium VitB6 intake reduces central nervous system hyperexcitability in children. Mousain-Bosc M, Roche M, et al. Nimes, France. J Am Coll Nutr. 2004 Oct;23(5):545S-548S. Ed: The claims of dramatic cause-effect benefit in such a loosely designed study are embarassing. This French study makes me think better of Poland, the country of my ancestors. Megavitamin C, B-6, Niacin, and Pantothenate No Value in 2 DB: Two BD PC studies totaling 73 ADHD children found no benefit from 3 g vitamin C, 3 g niacin (B-3), 1.2 g calcium pantothenate (B-5), and 0.6 g pyrodoxine (B-6). One study found an increase in liver enzymes while on the megavitamins. Effects of megavitamin therapy on children with attention deficit disorders. Haslam RH, Dalby JT, Rademaker AW. Pediatrics. 1984 Jul;74(1):103-11; Megavitamins for minimal brain dysfunction. A placebo-controlled study. Arnold LE, Christopher J, Huestis RD, Smeltzer DJ. JAMA. 1978 Dec 8;240(24):2642-3 Megavitamins Dont Help ADHD: In a study of megavitamin therapy, 41 ADHD children were given 3 months of 3 g of niacinamide and ascorbic acid, 1.2 g of calcium pantothenate, and 0.6 g of pyridoxine per day. Stage 2 consisted of four, 6-week, DB repeated crossover periods. In the first 3 months, only 29% improved. These children were used in the double-blind crossover. There was no difference (P >.05) in most behavior scores between megavitamins and placebo during stage 2. Children were 25% more disruptive in class when treated with vitamins vs. placebo (P less than .01). Transaminase levels were elevated in 42% after receiving vitamins, a sign of potential hepatotoxicity. Effects of megavitamin therapy on children with attention deficit disorders. Haslam RH, Dalby JT, Rademaker AW. Pediatrics. 1984 Jul;74(1):103-11. Vitamins-Omega-3-Mineral Supplement Helps Prisoners: A University of Oxford 4 month DB study found a 35% decrease in infractions with 37% decrease in violent ones with the supplement. British Journal of Psychiatry (2002) 181: 22-28. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behavior of young adult prisoners. Randomized, placebo-controlled trial. C. Bernard Gesch, CQSW Vitamin/Mineral Supplement Help Kid Nonverbal Intelligence: Ten of 13 DB studies to date have such a findings. U Wales Swansea. Micro-nutrient supplementation and the intelligence of children. Benton D. Neurosci Biobehav Rev 2001 Jun;25(4):297-309 Vitamin/Mineral Supplement Helped Kids Nonverbal Intelligence: In a DB 8 month study of 12-13-year-olds in England totaling 90 children, those on vitamin/mineral supplement once a day did better. Lancet 1988 Jan 23;1(8578):140-3 Vitamin/Mineral Supplement Help Junior High Nonverbal Intelligence: 600 8-10th graders in California on placebo, half, standard, or double strength multivit & mineral. Standard strength did best. Schoenthaler, Pers & Indiv Differences 12:335-41, 1991 Vitamin/Mineral Supplement Helped School Kids Non-verbal IQ 2.5 points: DB PC 243 Hispanic students at half-dose. Says other 12 studies show average of 3.2 point gain. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind placebo-controlled trial. Schoenthaler SJ, Bier ID, Young K, Nichols D, Jansenns S. J Altern Complement Med 2000 Feb;6(1):19-29 Vitamin/Mineral Supplement Decreased Kids Anti-Social School Behavior: DB PC 463 Hispanic students age 6-12 at half-dose. 47% less in vitamin-mineral tabs. Lasted entire school year and teacher gave pills. The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: a randomized, double-blind placebo-controlled trial. Schoenthaler SJ, Bier ID. J Altern Complement Med 2000 Feb;6(1):7-17 Zinc Helped ADHD Hyperactivity Somewhat: A large Turkish 12-week DB PC of 400 ADHD children with half given zinc sulfate 150 mg/day (45 mg elemental zinc) found the zinc group to do better in hyperactivity, impulsivity, and but not in inattention. Older children and those with high BMIs, low zinc, and low free fatty acids were especially helped. However, full recovery occurred in only 28% of zinc vs. 21% of placebo. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Bilici M, Yildirim F, Kandil S, Bekaroglu M, Yildirmis S, Deger O, Ulgen M, Yildiran A, Aksu H. Prog Neuropsychopharmacol Biol Psychiatry. 2004 Jan;28(1):181-90. Zinc Helped as an Adjunct: Involved in Melatonin Production: In a 6-week DB PC study of 44 ADHD children ages 5-11, all were given methylphenidate 1 mg/kg/d, a moderate dose. Half were also given zinc sulfate (15 mg. zinc) and half placebo. The children on zinc did significantly better, although the actual decreases in teacher (33 baseline to 16 zinc vs. 24 placebo) and parent ratings (32 baseline to 15 zinc vs. 23 placebo) with both p<.001. Overall side-effects were equal in both groups although there was somewhat more nausea and much more metallic taste (13 of 22) with zinc. Two dropouts in each group. Zinc is an essential cofactor over 100 enzymes, both metalloenzymes and metal-enzyme complexes, required in the metabolism of carbohydrates, fatty acids, proteins, and nucleic acids. Past studies have suggested that there may be a correlation of zinc deficiency and pathophysiology of ADHD. Melatonin is a hormone that plays an important role in the regulation of dopamine, thought to be a factor in ADHD. Melatonin has been proven helpful in regulating the sleep cycle of children with ADHD. Zinc is involved in the production and modulation of melatonin, Tehran Univ. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial. Shahin Akhondzadeh, Mohammad-Reza Mohammadi, Mojghan Khademi. BMC Psychiatry 4/8/2004, 4:9. http://www.biomedcentral.com/1471-244X/4/9 free access.
Zinc Low in Inattentive ADHD in Small U.S. Study: Children ages 5-10 with DISC- and clinician-diagnosed ADHD had serum zinc determinations and parent and teacher ratings of ADHD symptoms. The 48 children (37 boys, 11 girls; 33 combined type, 15 inattentive) had serum zinc levels with a median/mode in the lowest 30% range; magnesium levels were normal. Nutritional intake was unremarkable. Serum zinc correlated at r = -0.45 (p = 0.004) with parent-teacher-rated inattention, even after controlling for gender, age, income, and diagnostic subtype, but only at r = -0.20 (p = 0.22) with CPT omission errors. Correlation with parent-teacher-rated hyperactivity-impulsivity was nonsignificant in the opposite direction. Serum zinc correlates with parent- and teacher- rated inattention in children with attention-deficit/hyperactivity disorder. Arnold LE, et al. Ohio State University, Columbus, Ohio. J Child Adolesc Psychopharmacol. 2005 Aug;15(4):628-36.
Higher Zinc Predicts Better Response to Stimulant Treatment: In 18 boys with ADHD (ages 6-12) in a DB PC crossover study, parent and teacher hyperactivity rating differences between one month of dextroamphetamine and one month of placebo correlated significantly (p less than .05, 2 tailed) on Pearson's r with baseline hair zinc levels and nonsignificantly with 24-hour urinary zinc excretion. The signs of the correlations were such that a higher baseline zinc predicted a better placebo-controlled response to amphetamine. Patient baseline urinary zinc was significantly (p less than .02) lower than 7 normal controls. These findings are compatible with the possibility that some ADHD children may be mildly deficient in zinc and constitute poorer stimulant responders. Does hair zinc predict amphetamine improvement of ADD/hyperactivity? Arnold LE, et al. Ohio State University. Int J Neurosci. 1990 Jan;50(1-2):103-7. .
Zinc Lower in ADHD Children: In a study of 48 ADHD children and 45 healthy controls, the mean serum free fatty acid (FFA) level in the patient group was 0.176 mEq/L vs. 0.562 mEq/L for placebo (p < .001). The mean serum zinc level of patients was 60.6 micrograms/dl vs. 105.8 micrograms/dl for controls (p < .001). A statistically significant correlation was found between zinc and FFA levels in the ADHD group. Zinc deficiency may play a role in etiopathogenesis of ADHD. Although we observed decreased FFA levels in ADHD cases, it is necessary to determine whether this condition is a principal cause of ADHD or is secondary to zinc deficiency. Relationships between serum free fatty acids and zinc, and attention deficit hyperactivity disorder: a research note. Bekaroglu M, et al. Trabzon, Turkey. J Child Psychol Psychiatry. 1996 Feb;37(2):225-7. Thomas E. Radecki, M.D., J.D. modern-psychiatry.com Email: [email protected]
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