ADD/ADHD

By Jacob I. Mirman, MD Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are characterized by a group of symptoms, such as difficulty concentrating, hyperactivity, behavior issues, etc. This diagnosis is closely related to Oppositional Defiant Disorder, anxiety, OCD, etc. All these conditions have something to do with dysfunction of the brain cells (neurons) operating on serotonin, dopamine and norepinephrine. Synapses, or the connections neurons make with each other, somehow malfunction, which causes symptoms. Children are most commonly diagnosed with the condition, but it continues into adulthood in many people.

Various experts talk about many possible causes of ADD/ADHD, including poor nutrition, toxicity in the environment, too much screen time, stressful lifestyle, family dynamics, some medications and food/drug additives, familial tendencies, etc. In most cases the cause cannot be pinpointed and conventional medical care consists of symptomatic relief using certain medications known to be useful in these conditions.

Please read Dr. Mirman’s article Nervous System Function, Simplified, to understand the rest of this article. It discusses the function of synapses. The synapses transmit information between neurons by the use of neurotransmitters serotonin, dopamine and norepinephrine. Dopamine and norepinephrine are the more important ones in ADD/ADHD cases. Medications attempt to redirect these neurotransmitter molecules to the part of the synapse where they have the most effect. However, in the process the drugs deplete neurotransmitter stores, which makes them ineffective in the long run. This makes matters worse in many cases. Even initially, before the neurotransmitter stores are depleted, the effect of the drugs is only about 10% better than placebo, but the side effects are significant. After a few months of use the drugs don’t work well at all in many cases, but it is hard to get off them due to addiction.

Two main classes of drugs are used in ADD/ADHD: amphetamines or their analogs and reuptake inhibitors. Both classes deplete neurotransmitter stores, and both are addictive. The addiction warnings are more obvious in the amphetamine class, but experience shows that the reuptake inhibitors are similar in this respect. The examples of legal amphetamines are Ritalin, Vivance and Adderal. Some legal reuptake inhibitors are Stratera, Serzone and others. Methamphetamine is an example of an illegal amphetamine and cocaine is an illegal reuptake inhibitor. The mechanism of action of legal members of a class is essentially the same as that of the illegal members. Legality is determined by looking at some of the bad effects, which are stronger in the illegal group.

Integrative model offers more natural treatment options in order to address possible underlying causes of ADD/ADHD. By natural treatment we mean any approach that does not interfere with natural processes in the body, as compared to the effect of drugs, which is all about such interference (most drugs block this or that enzyme or receptor). This interference is not optimal because on one hand, no drugs are so selective, as to cause only the desired effect (hence, side effects), and on the other, the body has a way of adopting, which often causes the drug effect to wane. And, as discussed above, when dealing with drugs which manipulate neurotransmitters, there are also the added issues of neurotransmitter depletion and addiction.

The natural treatments of ADD/ADHD fall into several general groups. The simplest and most straightforward method from the point of view of conventional medical science is NeuroResearch Protocol, developed by Dr. Marty Hinz. It involves taking neurotransmitter precursors (building blocks) in nutritional supplement form to increase the overall amounts of neurotransmitters and allowing for much smoother operation of the nervous system and therefore amelioration of symptoms. This method can be considered natural, because it does not interfere with any systems in the body. It increases the neurotransmitter levels in the synapses and compensates for whatever pathology is causing the dysfunction. These supplements work much better than the drugs. Their effect is not subject to waning because it does not cause neurotransmitter depletion. On the contrary, it floods the synapses with much higher levels of neurotransmitters than possible by dietary manipulation alone. The drawback of this approach is that it is not curative. It works as long as the supplements are continued, and symptoms come back when the supplements are stopped.

Naturopathic approach addresses dietary insufficiencies, toxicities, allergies and sensitivities, gut health, etc. It often optimizes imbalances and allows for a better operation of body systems, including the nervous system. It is often very useful in ADD/ADHD cases by itself, and it also improves the general health to the point where other modalities have a better chance to work.

There are several methods that work by retraining the nervous system to work better from the functional perspective, without changing its biochemistry directly. This group includes biofeedback, Music Listening, Neuro Muscular Reflex Integration and some others.

Homeopathy is in the group of so called “energy” treatments. This group may be compared to operating system debugging in computer repair. Practitioners of these methods believe that the body’s control systems at the highest levels are not “material”, i.e. not chemical, electrical or mechanical. They control and allow perfect operation of the physical systems. An error in this “operating system” is thought to cause symptoms on the physical level. Consequently, debugging this error removes the physical symptoms. While science is silent on the mechanism of action of these modalities, their effect is very powerful and clearly observable in terms of remarkable improvements of health these methods often produce. Homeopathy is probably the best known of these methods. Acupuncture is another one, possibly less useful in kids due to needles being involved. See Dr. Mirman’s homeopathy information site for more information.

When considering which one or several natural treatments for ADD/ADHD to employ in a particular case, we have to pay attention to the specifics of the case, including the nature of symptoms, concomitant conditions, use of medications, etc. Dr. Mirman is an expert in integrative modalities, and it is a good idea to have an appoinment with him to consider best options. Dr. Mirman is also a part of an integrative group of providers called Integrative Team for Children with Challenges (ITCC). The team uses several complementary modalities to help children in the most efficient way. Contact Dr.Mirman for more information.