ATTENTION DEFICIT DISORDER
REJECTING THE MEDICATED LIFE
By Gina Geslewitz
In high schools and middle schools across the nation, anti-drug and alcohol classes are an accepted part of the curriculum. Kids are taught the dangers of drugs and how to avoid them. Yet at the same time, many of these same children have been placed on amphetamines or "speed" by their own parents!
Millions of children are taking Ritalin, Cylert, Dexedrine, Xanax and other drugs in an effort to control a condition called Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).
This condition is North America's number one childhood psychiatric disorder. Despite this, the status of ADD as a medical disorder has not yet been established and diagnostic criteria are vague.
According to statistics, 3 to 10 percent of the U.S. populations have ADHD symptoms, which include inattentiveness, hyperactivity, impulsiveness, tantrums, aggressiveness, moodiness, migraines, bedwetting, distractibility and insomnia. It is estimated that at least four million children in the United States were taking stimulant medication during 1996 for attention deficit behaviors. That number is four times higher than in 1988. Based on these statistics, Ritalin use among children is doubled every two years.
Yet worries persist about the safety and effectiveness of these drugs. The medicines cannot cure ADD, but can moderate its effects. Many children exhibit a short-term increase in attention, control, concentration and goal directed efforts while on these drugs.
However, there are side effects and no evidence for long-term effectiveness. Among the side effects are irritability, stunted growth, insomnia, skin rashes, joint pain and drowsiness.
Because of these concerns, more and more parents of ADD children, as well as adults suffering from ADD, are looking for gentler and less drastic alternatives. Storeowners throughout the nation are reporting an increase in inquiries on better ways to deal with this intractable problem.
"It's become epidemic," states Jan McBarren, MD, who, with her husband Duke Liberatore, runs Peachtree Natural Foods, a nine-store chain based in Columbus, GA. "It's a major health concern for pediatricians, teachers, parents and children. People are coming to me because they don't want Ritalin." McBarren believes the growing number of children diagnosed with ADD is a reflection of our culture and lifestyle, as well as our eating habits.
"We're seeing a generation of children on diets of preservatives and additives since birth and it's taking it's toll. Per capital sugar consumption is at an all time high, there is an increase in single parent households and there's more stress," she said.
So according to this doctor, what is the answer? Well it's certainly not drugs, she asserted. Her prescription instead: looking at your whole lifestyle, feeding your children more fruits and vegetables and less fast food, spending more time with your children, encouraging children to spend more time playing outdoors and eating more home cooked meals.
There is a role for the health food store as well. "Kids need a good multi-vitamin and Flintstones is not it. I suggest a multi that has no preservatives or coloring or artificial flavorings and that contains all the minerals," she advises.
Dr. McBarren also said that the amino acid taurine is good for the hyperactive and those essential fatty acids such as flaxseed oil, and DHA are important.
She did note that her way is a lot more difficult than it sounds. "It's a heck of a lot easier to pop a pill. That's why Ritalin sales are up."
Dr. James Greenblatt of Newton, MA, a board certified child and psychiatrist whose practice is devoted almost exclusively to treating ADD, agrees that has been too much emphasis on drugs.
"Clearly there has been an incredible over-emphasis on drugs, but there are some kids who really need it," Greenblatt said. "There are ties when medication is the only thing that can normalize a child's behavior and it can be a life saver."
Greenblatt, who lectures throughout the United States on Natural Therapies for ADHD, said Ritalin's defense that of all the psychotropic drugs, stimulants such as Ritalin, are by far the safest. "I don't push medicines, but sometimes I find I have to defend their use," he explained, adding that the big negatives associated with the use of drugs are that they only treat the symptoms, not the underlying causes, and once the individual stops taking the medicine the behavior comes back. Also, a side effect of Ritalin is that is decreases the appetite and most ADD children already are nutrient deficient.
"Nutrition can get at the cause of some of the behavior," he said. "The most exciting thing I'm working on now is diet because that can have a long lasting effect. Medicines are the band-aid approach."
Diet is Primary
Those who promote non-drug methods of dealing with ADD almost always include diet in their treatment.
In her book, Natural Treatments for ADD and Hyperactivity, Skye Weintraub, ND, states "Awareness of the food we eat, the use of organic foods and careful attention to food allergies can all help doctors and parents to change a child's behavior."
Weintraub advises elimination of candy, cookies, sugared cereals, soft drinks, food additives and preservatives.
Instead, she recommends that both children and adults with ADD eat a wide variety of foods including fresh fruits and vegetables, seeds, cereals and whole grains.
Ironically, both Ritalin and Cylert, the most commonly prescribed medications for hyperactivity, contain artificial colorings. (ADD: It doesn't Add UP! By Susan Stockton).
Food allergies or sensitivities can also play a role in causing the problems associated with ADD. When a child exhibits ADD-like behavior it is a good idea to determine if there are any possible allergies that may be causing the behavior," noted Weintraub.
Such renowned holistic minded physicians as Lendon Smith, William Crook, Doris J. Rapp, and James Braly, have all noted the connection between food and behavioral problems.
Dr. Braly considers hidden food allergies to be the most common undiagnosed illnesses today. Among the most common offenders are sugar, food additives, preservatives, milk, soy, corn, wheat, and eggs.
"I am convinced that our recent increase in hyperactivity and in various learning emotional and behavioral disorder is due in large part to the diet of today's young people and delayed food allergy," he writes in Dr Braly's Food Allergy and Nutrition Revolution.
While most agree that providing children with a healthier diet is essential to control ADD, that's not always an easy thing to do.
"Kids are picky eaters," notes Carol Simontacchi, a certified clinical nutritionist and owner of the seven-store Health Haus chain in Portland, OR, and Vancouver, WA.
Simontacchi, the mother of four, understands the challenges an ADD child poses to a household, but doesn't see drugs as the answer.
It is typical for kids to be deficient in key nutrients because they don't eat enough vegetables, fish and red meat, Simontacchi noted. In addition to diet and allergy testing, she recommends that parents consider supplements such as DHA or herbs to focus the mind. Kava or St. John's Wort is helpful for hyperactivity and Subligual B complex taken before school can make an enormous difference in concentration and mental acuity, she said.
Among the more frequently mentioned supplements useful in alleviating ADD symptoms are Essential Fatty Acids, Proanthocyanidins, amino acids, herbs, NADH, and homeopathy.
Essential Fatty Acids
While fats in general are being blamed for everything from causing obesity, to heart disease to cancer, the fact remains that we need certain fats for our bodies to function. Specifically, we need to get the essential fatty acids (EFAs) Omega 3 (linolenic acid) and Omega 6 (linoleic acid) from our diets, as our body cannot make them.
The Hyperactive Children's Support Group in England has researched and found a connection between ADD and the deficiency of essential fatty acids. They suspect that children with Add might have a problem converting EFAs to prostaglandins - tissue-like hormones that control all bodily functions at the cellular level.
Good sources of Omega 3 fatty acids are cold-water fish and flaxseed oil. Good sources of Omega 6 include leafy green vegetables. Because children notoriously are fussy eaters and unlikely to eat much of the above, it becomes necessary to supplement with oils such as flaxseed, evening primrose or borage oil and Omega 3 oils that include EPA and DHA, which are long chain polyunsaturated fatty acids found in fish oil, are essential for mental and visual function.
Research conducted by John R. Burgess, PhD, of Purdue University's Department of Foods and Nutrition, indicates that deficient levels of DHA are correlated with behavioral problems in children. Burgess has conducted a study on a population of children in Indiana and found that subjects with ADHD has significantly lower levels of DHA when compared to control subjects.
Proanthocyanidins
Proanthocyanidins are super powerful antioxidants with the ability to cross the blood/brain barrier. The most popular sources of Proanthocyanidins are grape seed extract and the bark of the maritime pine tree (Pycnogenol). Studies have shown that Pycnogenol is effective in decreasing symptoms and appears to improve memory.
Minerals
The minerals magnesium and zinc have been credited with helping children with hyperactivity and attention disorder. In the book, ADD The Natural Approach, Nina Anderson and Howard Peiper cite Florida pediatrician Estaban Genoa, who has had tremendous success treating ADD in children with liquid electrolyte trace minerals and extra zinc.
Zinc is a cofactor in numerous enzymatic processes and reactions, and enzymes are essential to life.
"It seems to follow that a deficiency of zinc would automatically inhibit certain enzymatic functions and that this is perhaps a very key and basic element of the clinical picture of attention deficit disorder. It may in fact be one reason why taking enzyme supplements aids in the healing of the symptoms of ADD," write Anderson and Peiper.
Magnesium is most always deficient in hyperactive of ADD children, states Dr. Billie Jay Sahley, PhD, in Control Hyperactivity ADD Naturally. "Magnesium is necessary for proper brain energy and is the first mineral depleted when anyone-child or adult-is under stress.
"Magnesium quiets the central nervous system. When it is added to the ADD/ADHD diet, calming effects are sometimes seen immediately." She concluded.
Herbs
Herbs that help relax the body and mind and those that have been found to aid in concentration and memory are also being administered to those with ADD symptoms. Among the herbs mentioned by retailers and nutritionists we spoke with were: St. John's Wort, Kava Kava, Gotu Kola, Ginkgo, Valerian and Passion Flower.
The first three were said to be especially favored by adults.
"We've gotten good feedback from adults who've taken St. John's Wort, Kava Kava, and Gotu Kola," said David LaLuzerne, RPh, of Green Earth, a three-store chain in Madison, WI. "These three and ginseng help focus attention and aid in the function of the brain."
Ginkgo has been shown to improve blood flow to the brain and thus help in concentration. Gotu Kola and Kava Kava have a calming effect. St. John's Wort has been used effectively to treat mild to moderate depression and promotes improvement in mental outlook.
Special Formulations
A snack bar called Attention! designed for children who have trouble with concentration was recently introduced. Designed by Metabolic Response Modifiers, each 2-oz. bar contains nutrients that "may play a major role in enhancing focus and intellectual skills" an advertisement claims. Active ingredients include DHA, DMAE, phosphatidylserine, tyrosine, gymnema sylvestre extract and chromium chelate.
Herbs, Inc., has had a product out about a year called Kidalin that is marketed as a herbal alternative to Ritalin.
Daniel Gagnon, President of Herbs, Etc., in Santa Fe, NM, and a medical herbalist said Kidalin has had an incredibly good reception. "It is one of our top 20 products (out of 150)," he reported. "There are so many people with ADD and not many alternatives."
Gagnon said Kidalin has been tested in his retail store, also located in Santa Fe, and early reports indicate that it works well. "What was interesting was how many adults come into our store asking if we had something for adults" related Gagnon.
The three chief herbal ingredients in Kidalin are catnip, damiana and kola nut.
"While catnip drives cats into a frenzy, it does just the opposite with children. Catnip calms and focuses hyper kinetic children," Gagnon said.
"About half a million adults have ADD and these people have problems keeping a job, they can't finish anything. It's very difficult," he said. That's why shortly after launching Kidalin, Herbs, Etc., came out with an adult version as well.
For some reason, ginkgo appears to work in adults and adolescents, but is not as effective with children.
Dr. Greenblatt said he often uses ginkgo with college students and adults in doses that are much higher than what is recommended on bottles found in health food stores.
The psychiatrist noted that kids and adults need much different approaches. "I rarely prescribe medicines for adults. Ideally, we try to stay away from drugs."
Greenblatt said he has been using ENADA (stabilized NADH-Nicotinamide Adenine Dinucleotide) with adolescents and adults because "it acts more like a drug than a supplement and helps the individual with attention and focusing."
NADA is a naturally occurring coenzyme that is said to increase brain activity. He noted that while Ritalin will work for four to six hours, a dose of NADH will work for a couple of days. However, he added, as with all supplements, lots more research needs to be done.
Marcia Owings, of Sevananda Natural Foods Co-op, Atlanta, GA., said she herself is taking several products including Adult Kidalin. "I went to a few seminars in Florida and it opened my eyes about the way I felt growing up. The more I heard, the more convinced I was that I fell into the category of ADD. I found that the more I work with EFAs, Phosphotidylserine and herbal relaxants, the easier it is to focus on my job and stay on track. Several people on our staff also think they have it (ADD)."
Carol Simontacchi, who gives seminars on ADD, reports that 25% of people suffering from ADD are adults. However, Dr. Greenblatt noted that only about half of the adults who tell him they think they have ADD really do.
Dr. Jan McBaren noted that adults tend to respond better to diet and lifestyle changes, such as giving up caffeine. "Adults aren't being judged in school with a report card," she pointed out.
Reading Up on ADD
While there are many nutritional supplements and herbs that may help with the various symptoms of ADD, there is not a whole lot of good clinical research on them. Most people familiar with the problem, recommend a mixture of dietary and lifestyle changes along with good supplementation.
"There's not one single thing that does the job," states Simontacchi. "You need to see a naturopathic physician to test for allergies, you need to test toxic metal accumulation and nutrient deficiency."
Owings says that when people come to her store and ask about ADD, she and her staff encourage them to read about it in books and third-party literature. "We help people make sure they have the correct diagnosis. We point out that lifestyle and dietary input is very important as well as environmental stimuli."
ADD is a reflection of our culture and lifestyle," asserted Dr. McBarren. "Ritalin is the easiest way out, but not the best way out."
"It's a hot button and it's becoming an issue, a negative issue." Stated LaLuzerne, of the ADD controversy. "Our society is so prone to taking tablets and not doing anything else, even those in the natural product industry fall into this trap."
Fortunately, even the medical community is beginning to realize that they may be over prescribing.
La Luzerne reports that he's seeing a lot of people sent by their doctors and school nurses. People are rejecting the drug answer and looking for better alternatives. Hopefully by knowing more about ADD you can be mentally prepared to provide healthier answers.
Reprinted with permission from: Health Products Business
