Thursday, February 17, 2011

ADD/ADHD: What Can Be Done About It?

"You switch off the engine of your car, so why don't you switch off the engine of your mind?" ~Remez Sasson

As a licensed health care provider, I give talks all over the country. Often, I will hear the same questions from people in the audience over and over. Particularly parents. The well-being of the younger generation weighs heavily on the minds of many. From childhood obesity to now the "secret epidemic," (as its been termed by some), ADD or ADHD (Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder), the younger generation is battling with diagnosis codes we've never seen before.

First and foremost, I should point out, that like with any topic addressed in this blog, 2 things need to be taken into consideration:

1) The subject is so vast, with new research appearing daily, that I could literally write a book on any given post.
2) You must consult your primary care physician, before implementing any suggestions I make.

With that being said, let us explore the world of ADD/ADHD. What are the contributing factors? What's to be done? Is there anything that we can do at home to help alleviate the symptoms? How does eastern medicine view it? Can it be cured?

The above questions are all ones I hear frequently in my practice, via email, and from audience members at talks I give.

I think the subject of ADD/ADHD is like a pie, with many slices that make up its whole. I don't think there's one contributing factor, but many.

First, let us address the fact there is both adult and pediatric ADD/ADHD. Yes, adults can be diagnosed with it too. There is a misnomer that it is a "pediatric disease," yet that is not so.

I have had many referrals from psychiatrists, M.D.'s, counselors and teachers for pediatric ADD/ADHD patients. 9 out of 10 times, if the parents are compliant in following through on the suggestions I give them, we can make a significant difference in the behavior of the child. I will say that the majority of adult patients I've treated have come in with a diagnosis of ADD vs. ADHD, and vice versa for the children.

First and foremost, I think the obvious should be stated. When we look at our public schools, we are constantly faced with budget cuts, which means physical education programs get axed. The average grade-school age child gets up to 3 hrs. less per day of physical activity than when I was in grade school. This alone, is enough to make any kid hyper. We've all marveled at how children are "little balls of energy." When asked to sit sedentary at a desk with less recess and P.E., we're bound to have children not pay attention in class and act up. Its been said that exercise is "the poor man's Ritalin." We know that exercise releases "feel good" neuro-transmitters in the brain that give us a feeling of contentment. When we don't get a steady stream of these chemicals (i.e. endorphins) throughout our day, we feel jittery, unsettled and cranky. This is across the board, from children to adults. However, as we mature through life we become more desensitized to it. It doesn't mean we don't need those endorphins any less. It just means we're able to "numb out" more if we don't get them. In other words, we're able to "deal" or cope if we don't.

Another issue, which I think needs addressing is school lunches. What are kids eating today? There are so many things that affect this topic: economics, demographic, location, accessibility. It is a vast issue to conquer. Yet, it must be addressed. To create a "double whammy" we've produced a cultural "cocktail" of less exercise in the schools, bigger portion sizes and/or "All You Can Eat" buffets, and accessibility to vending machines and lunches packed with known allergens: wheat, dairy, soy and sugar. Just sitting with the above two issues is enough to see why anyone would not pay attention and be more hyper.

For little ones to have eaten a breakfast of sugary, grain-based cereal with milk, go to school, get less exercise throughout their day, eat a school cafeteria lunch with more sugar, trans-fats and refined carbohydrates, yes, no wonder we have an epidemic on our hands.

My advice to parents is, first and foremost, become more proactive in their children's nutrition, and in their accessiblity to more exercise (outdoors is even better for the vit. D, which we will see is crucial).

I had a mother once bring her daughter in due to her child's teacher stating she has "ADHD." The mother said "What can I do? She's climbing the walls at school!" I knew that she meant this as a figure of speech. I looked at her and said "So, why don't you let her climb some walls?" The mother's jaw dropped. "Are you suggesting I let her act up at school?" "On the contrary," I replied. "I'm suggesting you get her in a children's climbing club at her local rock gym after school." The mother said "Go on. I'm listening." "Do you know how much exercise your daughter gets a day, Mrs. Robinson?" I asked. "Uhhhh...I think she gets a total of an hour of recess a day, but I'm not sure." "I would suggest you find out, and take note of how much exercise she gets a day. One hour is simply not enough," I stated. I continued, "How many hours a day did you get as a kid, Mrs. Robinson?" "Well, she said thinking, I did chores on the farm before and after school. I grew up in Arkansas. That doesn't include recess at school." "Were you picking up buckets on the farm, running, gathering straw, lifting, pushing, pulling things?" I inquired. "Yes, I suppose I was," she said softly. "I guarantee you probably got at least 50% more exercise than your daughter is currently getting. Its time to change that," I said.

Her daughter (we'll call her "Amy") is now one of the top climbers in her age-division in the country. She competes all over the U.S., Mexico and Canada. I suspect I'll see her on the cover of a climbing magazine one day..."The little girl who couldn't sit still," as her teacher firmly stated. Since finding a physical outlet that appealed to her, Amy's grades have soared, her temper tantrums have stopped, she sleeps soundly, is attentive in class, and asks her mother for salads and meat "because I'm training for my next comp., mom. I need to eat healthy now."

How many "Amys" are out there, who are being medicated that potentially are "hiding under a bushel" of talent? We will never know.

In addition to the two components, less exercise and poor-quality nutrition, we must consider the paramount premise of Chinese Medicine: "Its not just WHAT you eat, but IF you DIGEST it." This is KEY. You can eat all the wonderful organic, wholesome foods you want, but if you have compromised digestion, in any capacity, you're still not getting the nutrition you need. In other words, you're not getting the "bang for your buck" from the food you're taking in. For a growing child, an athlete, someone in a deficient state of health, a pregnant woman, this is crucial.

Its been said in the world of nutrition that ADD/ADHD is linked to a combination of 2 things: an inability to breakdown the milk protein called casein and either a lack of essential healthy fats, or the inability to absorb them. Once again, it tends to be a combination of these 3 things. Naturopathic physicians frequently increase an intake of essential fatty acids for a patient with either diagnosis. Symptoms decrease, parents are pleased. However, it shouldn't end there.

Proper gut flora is essential to the proper absorption of both fats and proteins. To simply increase "healthy fats" is what we call in Chinese medicine the "biao" (branch). The "ben" (root) of the issue is improper gut flora, acidic body pH & possibly poor diet. These things, plus a lack of exercise are all major contributors to ADD/ADHD.

So, where do we go from here? Give the child (or adult) some probiotic tablets, a few capsules of room-temperature flax seed oil, bought on a store shelf and call it a day? Not quite. First and foremost, it is pointless to buy any omega-3 oil at room temperature. Omega-3's are NOT heat-stable. When I was a buyer at "Down To Earth," the chain of health food stores on the Hawaiian Islands, the first thing I did was make it mandatory that every omega-3 oil be refrigerated. You're wasting your money if you buy them on the store shelf. The only way they're still therapeutically active is if they've been flushed with inert gas to make them last longer. The minute you open any of the following oils they should be refrigerated immediately: olive oil, flax seed oil, pumpkin seed oil, cod liver oil, krill oil, salmon oil. That is the way to gain true medicinal benefit.

Also, my first nutrition teacher, Donna Gates, is the foremost expert on autism and ADD/ADHD in the country. I can't highly emphasize enough to read her book "The Body Ecology Diet" and begin implementing probiotic-laden foods immediately. For more information: www.bodyecologydiet.com

I know of no one more active on the east coast, and in the south, regarding public school nutrition and this issue than Donna. The above website has a host of additional informative articles written by her on autism and ADD/ADHD. In addition, she posts wonderful tidbits, recipes, information, "YouTubes," etc. on her "Facebook" page.

Omega 3 fatty acids tend to be what's focused on when it comes to "healthy fats" and ADD/ADHD. They're often, in fact, heralded as the cure-all for it. I think it never hurts to increase omega 3's...for anyone. I will say this: I believe fat-soluable vitamins A & D to be MORE important. I want to make this pretty clear: this is ZERO VEGAN EQUIVALENT for fat-soluable vitamins. They can ONLY be found in animal products such as soft (over-easy) egg yolks, cod liver oil, and fermented dairy. I emphasize fermented, because if the child has compromised digestion, then fermentation is paramount for the dairy to be digested. Fermentation breaks down the milk protein, casein, so that its "pre-digested," & easy to absorb. An example? Kefir or yogurt, although read "The Body Ecology Diet" to find out why kefir is preferred.

Children who live above the equator need more vit. D via food. Again, this can only be found in animal products. If you live in the tropics its easier to be vegan, or get less vit. D, due to the increase in exposure to sunlight. The more far north you get, the more you need animal products. You do not see Scandanavians eat coconuts, nor do you see natives from Fiji living off of thick butter and raw cheese. Here's the equation: the more north you go, the more animal products you need. No, vit. D tablets and tanning beds don't cut it. Not even close.

Fat is said to have a "heavy" or "settling" nature, according to eastern medicine. In India, many pictures of the boy-king, Krishna, are of him dipping his hands in a jar of ghee (clarified butter). What's the "take home message?" Ghee is a powerful medicant. It is said to "calm the mind," "soothe the nerves," "promote serenity," and "deepen sleep." Ghee is very easy to make, is lactose-free, and therefore does not require refrigeration (making it great for traveling, camping, etc.). Here's a link on how to make ghee: http://www.ayurveda.com/online_resource/ghee_recipe.htm

In addition, there are "YouTube" videos on how to make ghee as well you can search. If you'd like more information about healthy fats, please see my previous blog post titled "Fats: Friend or Foe?"

For additional assistance, above and beyond what has been discussed, you may see your local naturopathic physician or licensed acupuncturist in your area. There are many herbal formulas, from mild to prescription-strength, that can be taken in addition to improving nutrition and increasing exercise (again, get that vit. D in anyway you can, so make it outside :-) These formulas can be the "frosting on the cake" to the above suggestions, and work effectively, without side-effects. Acupuncture, in and of itself, has a very calming and overall balancing effect on the body/mind complex. Specific acupuncture protocols are used for an ADD/ADHD diagnosis. Even for children, if they're open to the idea.

"After a storm comes a calm...a sense of serenity." ~Matthew Henry