Ask The Doctor: ADHD

How can I treat my son's attention deficit hyperactivity disorder (ADHD) without drugs?

Answered by: Mark Hyman, MD, is author of The UltraMind Solution (Scribner, 2009) and founder of The UltraWellness Center in Massachusetts.

When I was in school 40 years ago, there was that one troubled kid in the class. Now ADHD is rampant, affecting almost 10 percent of children between ages 8 and 15. The symptoms include inattention, impulsivity, and hyperactivity at home, school, and during play—and are beyond what is “normal” for children. More than
8 million (one in 10) children now take stimulant medications such as Ritalin or Adderall to control their behavior. The use of these medications has increased by more than 1,000 percent in the last 20 years.

Conventional medicine sees ADHD as an irreversible brain problem with no known causes, and uses cocktails of psychiatric drugs (with side effects such as headaches, weight loss, and insomnia) to control behavior. But emerging research points to a number of important environmental factors that alter brain function in children and thereby contribute to the ADHD epidemic. Our overprocessed, high-sugar, nutrient-poor, toxin-burdened diet plays a large role, as do environmental toxins, including lead and mercury. I also believe ADHD is actually a “nature deficit” disorder, resulting from children being stuck indoors and focused on computer monitors, video games, and television.

Addressing one or all of these factors can improve or resolve symptoms in many children. I have found two simple notions to be remarkably successful in treating my patients with ADHD: Take out the bad stuff, and put in the good stuff. The body takes care of the rest. In fact, the cure for brain problems often requires treating the body, not simply taking psychiatric medications that only mask the symptoms. Think of this approach as a diagnostic test. While none of the interventions below is a miracle cure, they, as a whole, can bring children who are out of balance back into more harmony—both metabolically and behaviorally—and make their lives less of a struggle and more of a joy.
Take out the bad stuff
• Start by changing your child’s diet. Eliminate sugar, food additives, pesticides, high-fructose corn syrup, trans fats, nitrates, monosodium glutamate, aspartame, and anything else that is processed. If it is grown on a plant, eat it. If it’s made in a factory, leave it on the shelf. You may see a calmer, happier, more focused child emerge.  
• After two weeks on the real-food diet, try eliminating all gluten (wheat, barley, rye, spelt, and kamut) and dairy (yogurt, milk, cheese, and ice cream). Getting rid of these potential food-sensitivity triggers can often make a significant difference. After two weeks off gluten and dairy, add gluten back in, and monitor behavior and attention. Three days later, add back dairy and monitor behavior and attention. If symptoms worsen, take gluten and dairy out of the diet for two years, then try them again. As usual, when making changes to your child’s diet, it’s best to work with an experienced nutritionist.
• Consider having your child evaluated for heavy metals, such as mercury or lead, with blood, hair, and urine testing. This can improve behavior, attention, and brain function.
• Your child may also have undiagnosed imbalances in his gut—including bacterial overgrowth, yeast, and parasites—that can alter brain function. Testing for and treating these imbalances can be helpful; consult with a physician who specializes in functional or integrative medicine or naturopathy.
• Cut down TV, computer, and other “screen” time to less than one hour a day.

Put in the good stuff
• Feed your child only fresh, whole, organic, and “real” food, including vegetables, fruits, whole gluten-free grains (brown rice, quinoa, buckwheat, millet), beans, nuts, seeds, and lean animal protein.  
• Encourage outdoor play and physical activity. Going for a walk in the woods or by a lake can be calming to the nervous system. Playing outside for an hour or two a day and going on longer ventures into nature will reduce the over-stimulatory effects of computers, TV, and video games.
• Incorporate supplements into your child’s regimen. Here are a few to try:
A good multivitamin and multimineral supplement (daily).
Fish oil with EPA and DHA to improve brain function (1 to 2 gram softgels or 1 to 2 teaspoons of purified cod liver oil per day).
Magnesium citrate or glycinate, both of which are calming (150 mg twice a day).
Zinc citrate for digestion, immunity, and detoxification (30 mg a day).
B vitamins to improve neurotransmitter function (25 to 50 mg a day of B6; 800 mcg a day of B9, or folic acid; and 1,000 mcg a day of B12, or methylcobalamin).
Probiotics to promote healthy gut bacteria (5 to 10 billion colony-forming units of lactobacillus or bifidobacteria a day; to control yeast and improve immunity use Saccharomyces boulardii).
Digestive enzymes to break down food and heal the gut (take as directed with meals). Find one made with Dipeptidyl peptidase-4 (DPP-IV), which helps break down dairy and cereal grains.