ADD: Attention Deficit or Nutrition Deficit?

Dr. Mary Ann Block takes on the ADD "industry" -- exposing the myths and exploring the truths

If you are reading this article you may have a child or grandchild who is active or has difficulty concentrating, women have been told this by a teacher. You also may have been told that your child should be taking a drug to control the activity anc concentration. Here is some information you might want to consider:

Only a label

Attention Deficit Hyperactivity Disorder (ADHD) is a psychiarist label. According to the National Institutes of Health, there is no valid, consistent test available to diagnose it. In truth, because of the nature of the condition, behavioral scales (like the Connors Scale) are used in the diagnosis, where the child and his or her family is asked to evaluate the student based on criteria determined by the particular test. A guardian, teacher or counselor must consult a physician before medication is prescribed. Of course only a clinical diagnosis can be made because it is a psychological condition.

Nevertheless, even children taking prescribed drugs for the problems still have higher levels of behavioral problems and show little improvement in academic and social skills. Also, did you know there is no information on the effectiveness or safety of drug treatment for more than 1 year? Most studies done on the drugs were short, only up to 3 months long (NIH Consensus Development Conference Statement on ADHD, 1998). With so little information.available on the positive and negative effects of the drugs that are used to treat ADHD symptoms, it is amazing that doctors prescribe them so readily and parents give them to their children so quickly.

How young can they be?
Nothing has surprised me more than the prescribing of these drugs to preschool age children. The Journal of the American Medical Association (March 2000), reported a 200-300% increase in the prescribing of Ritalin, Prozac and Clonidine for 2-to-4-yearold children (from 1991 to 1995). No studies have ever been done on children of this age and no long-term studies have been done on any age group.

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Ritalin is an amphetamine-like drug, a controlled substance with similar pharmacological properties to cocaine. The two drugs are similar enough that they are used interchangeably in medical research .(Archives of General Psychiatry, May 1995), Clonidine is an adult "high blood pressure" drug, and Prozac is a selective serotonin reuptake inhibitor. There are many similar drugs on the market such as Zoloft, Paxil and Luvox. According to the Physician's Desk Reference, none of these drugs should be given to young children.

All drugs have side-effects
The short-term side effects of amphetamine-type drugs are well known. Lack of appetite, insomnia, irritability and the development of tics are common. The long-term side effects are less known since no long-term studies have been done. In addition to the possible physical and emotional side effects, parents should know that if their child has been taking one of these drugs after the age of 12, it can be a permanent disqualification for the military. Allowing a child to be labeled with ADHD, or one of the other psychiatric diagnoses (such as Oppositional Defiant Disorder or Conduct Disorder), seems to do nothing more than qualify the child to take a drug. It does not look for or treat the underlying cause of the problem.

Find out what's really wrong
Evaluating a child for an underlying problem takes time. Every child deserves a complete medical work-up. It should also include a nutritional evaluation, preferably done by a licensed practitioner who has had training in nutrition.

I have found that most behavioral problems have a component of low blood sugar associated with them. A child with an erratic blood sugar content cannot sit still, cannot pay attention and can exhibit aggressive behaviors. The diagnosis of this does not need any lab work. If a child gets irritable or agitated when hungry then improves after eating, the child most likely has hypoglycemia or low blood sugar. In this case, the treatment is as easy as the diagnosis: change the child's diet. Remove all refined sugars and simple carbohydrates. Use complex carbohydrates, proteins and fresh vegetables in the diet. Make sure these children don't get hungry by feeding them healthy protein snacks throughout the day.

A study published in The Journal of Pediatrics (February 1995) found that when sucrose was given to children, their adrenaline levels could be 10 times their normal level up to 5 hours after ingesting the sugar. Most of these children had difficulty concentrating, and were irritable and anxious, which are normal reactions to too much adrenaline in the bloodstream.

Allergies and hypersensitivities affect how we feel, think and act. Sensitivities to foods, and even allergens in the air have been shown to cause many of the symptoms of ADHD. Artificial colors and flavors also affect some children adversely. Dr. Ben Feingold proclaimed this for years, and founded his organization on this, the Feingold Association of the United States (FAUS).

Nutrients are vital
Vitamins, minerals and other nutrients are so vital to the way our bodies work that it continues to surprise me that nutrition is not a major part ofmedical school curriculum. In 1975, the journal, Pediatrics published a study showing that when vitamin B-6 was given to hyperactive children, their hyperactivity seemed to "dissapear." In 1979, a double-blind, crossover study in Biological Psychiatry reported that vitamin B-6 was more effective than Ritalin in treating a group of hyperactive children. Why isn't this information common knowledge? Why don't-doctors recommend vitamin B-6 instead of Ritalin? Niacin may also be helpful for hyperactivity, deteriorating school performance, perceptual changes and the ability to maintain social relationships.

My own experiences with magnesium match those published in Clinical Aspects of Chronic Magnesium Deficiency (1980). Deficiency in magnesium is characterized by excessive fidgeting, anxious restlessness, psychomotor instability and learning difficulties. One teenage patient of mine said he felt dramatically better, calmer and better able to focus on his school work when I treated him for his magnesium deficiency. The mineral, zinc, has been found to be lower in children who were diagnosed with ADHD symptoms.

Children with zinc deficiencies were also found to be irritable, tearful and sullen, not soothed by close body contact and resent disturbances. Dimethylaminoethanol (DMAE), a probable neurotransmitter precursor, appears to enhance memory and mental function. It seems to increase attention span, help alleviate behavioral problems and hyperactivity and decrease aggression.

Essential fatty acids(EFA's) are another area of nutrients that are very important. Lower levels of omega-3 fatty acids which are found in fish oils and flax seed, were discovered in children who had more temper tantrums and sleep problems.

Bright and gifted children
In some cases, children labeled as ADHD have not been diagnosed properly. Some of the children who have received the ADHD label are just too smart for the school situation in which they have been placed. A smart child will get bored easily with work already learned. Students need to be challenged in and out of the classroom. When they have completed their work, they should be given more challenging work to complete. Too often they are told to just sit still and wait for the others.

Many schools have stopped their physical education programs. Some have limited time for recess and if the child did not complete her/his work, recess is denied. Often the child who needs recess the most is not allowed to participate. Is your child expected to sit quietly in the classroom for long periods at a time? Are the children allowed to go to the restroom or get a drink of water if they want? Many adults are unable to function in the situations we expect young children to handle.

I believe that all children want to be good and want to please adults. We need to be realistic and fair about our expectations of them. Unrealistic expectations may be one reason why some children are labeled with a psychiatric diagnosis. Other times it can be due to an underlying nutritional or health problem that has manifested itself as a behavior or learning problem.

ADHD is a psychiatric label that can follow these children and limit their potential for the rest of their lives. Every child deserves the opportunity to reach his or her full potential. Every time I see a child who has been labeled ADHD, I see the real child under the label: Another Dynamic, Huggable, Delightful child!

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By Mary Ann Block, DO

Adapted by DO

Dr. Mary Ann Block is the author of the books, No More Ritalin, Treating ADHD Without Drugs and No More Antibiotics, Treating Ear and Respiratory Infections the Natural Way, is Medical Director of The Block Center, an international clinic for the treatment of chronic problems in children and adults. For more information about Dr. Block and her approach to treating ADHD, visit her web site at www.blockcenter.com

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