If ADD/ADHD is a symptom, then what is the cause?

 

ADHD (Attention Deficit Hyperactivity Disorder) has an interesting history. It was in 1902 that ADHD was first recognized as a disorder. A disorder can be defined as an abnormal physical and mental condition.

1

Obviously, both adults and children presented with the symptoms associated to ADHD before it was recognized as a disorder.

The description of the symptoms of ADHD was laid out in 1922 and it did not take much time until a medical intervention was offered to remedy the situation.

As a matter of fact, in 1937, stimulants were used to treat children that exhibited signs of ADHD. In 1956, Ritalin was used to treat children considered to be hyperactive.

In 1960, the term Minimal Brain Dysfunction was used to describe the disorder. This was changed to Hyperkinetic Disorder of Childhood. 

Hyperkinetic = too much movement

Notice how as early as 1960, ADHD was referred to as a physical disorder.

In 1970, more symptoms were added to the disorder. They were impulsiveness, lack of focus and daydreaming.

Today, ADHD is considered to be a psychiatric disorder. For the diagnostic to be made, symptoms must begin before 7 to 12 years old and must be present for more than 6 months.

Interestingly, 30 to 50% of children diagnosed with the disorder continue to have symptoms in adulthood.

If close to half of the children diagnosed continue to have symptoms as adults, are we treating the cause of this disorder?

2 

An interesting fact is that 50% of children diagnosed with ADHD are also diagnosed with DCD (Developmental Coordination Disorder). It is a chronic neurological disorder beginning in childhood that can affect the planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body.

There remains controversy as far as what can be the cause or more so the causes of the disorder. In the context of this blog, 2 possibilities will be explored:

–          Executive function (Mat Boulé);
–          Diet (Natasha Azrak).

 

Executive function:

Executive functions refer to functions specific to human beings. Impairments include:

–          Problems with organizational skills;
–          Time keeping;
–          Excessive procrastination;
–          Concentration problems;
–          Processing speed;
–          Regulating emotions.

The prefrontal areas and the frontal lobe are necessary to carry out these functions.

The frontal lobes also are responsible for voluntary movements of specific body parts. They contain the primary motor cortex.

How interesting that the frontal lobe is both responsible for executive functions that are shown to be weak in the case of ADHD and that children diagnosed with ADHD are also diagnosed with DCD. The common denominator, anatomically, can be the frontal lobe! 

Is it possible that proper movement and cognitive performance can be associated?

 3

 

Consider the following in attempting to answer this question:

We move as well as our nervous system manages two types of information. In order to even just stand up, sit, walk or run we need to:

–          Know where we are in space;
–          Relate to our environment so we can interact with it properly.

Knowing where we are in space is termed proprioception (perception of self). It is hard to think one can relate to his environment if he cannot relate to himself. The main receptor that allows for this recognition of self is the muscle spindle.

When assessing for these disorders, never is posture assessed, and that’s a shame. Postural imbalances inform us in a glance about potential muscle inhibitions, thus proprioception deficits.

 4

These proprioception deficits literally mean that parts of our selves are difficult to recognize by our brain. How can we then utilize our body efficiently?

Don’t we express knowledge via muscular contractions?

We need our mouth to speak and our hand to write, don’t we?

If posture even shows these deficits in the first place, it is because our strategy to stand upright is deficient. This is mostly due to poor sensory information from the body parts that position the body against gravity. These two body parts (sensors) are the:

–          Feet;
–          Eyes.

The feet contact the ground and are the lever that allows the body to actually stand upright.

Only human beings are diagnosed with ADHD. Only human beings stand upright. Is this just a coincidence? 

The eyes allow an individual to look straight ahead to further stabilize the body against gravity, this time at a 90-degree angle.

When there is a lack of coordination in the eye muscles, since they orient the behavior of the entire body, there is a lack of coordination of the entire body.

Could it be that DCD is related to poor eye tracking?

Would it make sense that poor eye tracking could lead to a poor ability to focus? 

Do you think assessment of posture and eye tracking is a component of the diagnostic of ADHD? 

Do you think we are then addressing the symptoms or the causes of ADHD?

It is via our senses that we can relate to ourselves and that we experience the world. If they are working sub par, it will affect the projections of the frontal cortex since the frontal cortex derives its information from the senses.

5

By addressing the behavior component of ADHD, we are addressing the symptom. By assessing and treating the sensory information the brain can work with, we are managing causative factors. It’s a choice. That choice is Posturology and Brain Exercises in the context of the LPP – Learning Potential Program. For more information, visit www.thelpp.org.

Diet:

As Mat mentioned, when assessing someone with ADHD, what is usually looked at is the behavioral aspect.

But when doing that, what are we exactly looking at? Are we trying to figure out why this behavioral aspect is there in the first place or are we just looking at what is going on right now (the symptom) and what we can do to manage it?

At the clinic, when a patient complains about a behavioral problem, we don’t want to know just about that problem but about ALL of his symptoms. That’s because not only can the mind affect the body, but the body can influence the brain as well. It’s by asking our patients to tell us their story that we find the clues to their poor health.

By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, we address the whole person, not just an isolated set of symptoms. We spend time with our patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease.

Because each patient’s path to disease is unique, each treatment will be unique to the root cause of the illness.

And it’s the same with the topic of ADHD. There is no one-way to treat ADHD, no magic bullet, pill or diet. It’s all about doing some detective work to figure out when, how and what happened. So in the next few paragraphs, I will talk about some of the possible causes of ADHD:

Nutrition

Insufficiencies of certain vitamins, or minerals are common among children with ADD/ADHD.

Children’s diets’ have changed dramatically since the 1970’s with the advent of food processing. The foods eaten today can be high in calories, highly processed, contain the wrong types of fats, be rich in sugar, salt, artificial colors, artificial flavors and preservatives.

6

With children having more food choices than ever and an abundant food supply, it is hard to believe that they could be lacking in essential nutrients.

Nutrient deficiencies can make ADD/ADHD symptoms worse, adding stress to the family unit as a whole.

There is solid research in the area of nutrition and ADHD diets. Recently, Professor Wendy Oddy and her team from the Centre of Child Health in Western Australia  have demonstrated that the typical western diet (highly processed) is associated with poor behaviour, aggression and depression.

Here are a few nutrients to look out for:

  1. Iron– vital to make the brain chemical dopamine, which supports concentration. Research has shown that low ferritin (iron storage) is linked to hyperactivity, poor concentration and poor behaviour. Children can exhibit  headaches, dizziness, low immunity and they can be tired  and irritable as a result of low iron levels. Once low iron levels are corrected behaviour, concentration and hyperactivity will improve. Ask your Dr for iron studies if you are concerned.
  2. Zinc- plays a key role in behaviour and in making the “feel good” brain   chemical serotonin. Children with ADHD have been found to be zinc deficient with lower levels of zinc associated with more severe symptoms.
  3. Magnesium- decreased magnesium levels are associated with increased hyperactivity and impulsivity, poor sleep, poor school attention, constipation, anxiety and depression. Magnesium deficiency occurs more frequently in children with ADHD. Studies have shown that magnesium supplementation (200mg/day) may be of great benefit in children with ADHD.
  4. Iodine- vital for healthy brain function and intellectual development. Research has linked low iodine levels with ADHD.

Fatty Acids

7

ADD/ADHD may be associated with deficient essential fatty acids like omega-3 EPA and DHA.  In a study, boys diagnosed with attention-deficit hyperactivity disorder (ADHD) had significantly lower concentrations of ALA, DGLA, AA, EPA and DHA than controls. The brain is made up of 60% fat. Omega 3 fats are vital for brain development and brain function. Research has shown omega 3 fats to be of great support for mood and behavior. Insufficient intake of omega 3 fats can result in children having difficulties with working memory, may experience poor concentration and be easily distracted. Their mood may even be negatively affected depressed/anxious/ moody.

Digestive Function

Intestinal flora imbalances (bacteria, parasites, or yeast) may lead to nutrient insufficiencies that predispose to ADD/ADHD. Children sometimes exhibit chronic digestive problems that may be linked to changes in mood and behavior. Enzyme deficiencies, malabsorption, and yeast overgrowth are common findings. A Stool Analysis provides a noninvasive assessment of microbial balance (including yeast and bacterial growth), digestive function, and absorption. This test can be used to develop individualized treatment strategies to improve function and reduce gastrointestinal symptoms.

Intestinal Permeability

8A ‘leaky gut’ predisposes to food allergies as well as the passage of behavior-altering peptides into the system.

The integrity of the intestinal lining plays a critical role in absorbing nutrients and preventing toxins, allergens and other potentially harmful molecules from penetrating into the systemic circulation.

Allergies or intolerances

Studies of children with ADHD have shown improvements in ADD/ADHD when they were placed on an allergen-free diet. Caregivers often report that certain foods appear to exacerbate symptoms. One possible mechanism may involve an immune hypersensitivity to foods. Hypersensitive foods are very hard to identify due to delayed symptoms possibly appearing 3 days after being consumed. A blood test to identify immediate (IgE) and/or delayed (IgG) sensitivities to commonly encountered food and environmental substances can be done. Results can be used to help individualize a diet plan that eliminates provoking substances

A study that was conducted in the Netherlands and Belgium with results published in the prestigious Lancet Journal in 2011 showed that the elimination diet (low alergen diet) had a significant beneficial effect on the symptoms of ADHD in 64% (32 of 50) of children.

Heavy Metal Toxicity

Exposure to toxic metals such as lead can affect the nervous system, possibly triggering hyperactivity. Exposure to environmental toxins or the inability to properly eliminate them from the body may play a role. In one study that found blood levels of toxic chemicals exceeding adult maximum tolerance, every affected child also showed impaired detoxification. The body’s ability to metabolize and eliminate specific agents from the body can be assessed, thus providing important clues about the body’s susceptibility to chemical sensitivities and toxic burden. Results can provide clinical direction for improving the body’s natural detoxifying mechanisms.

There are no clear guidelines in this article, because it depends of what your child’s situation is, what the cause of his symptoms is. All of the points mentioned above can be evaluated through functional testing to assess exactly where your child is.

I hope these points can start making you see other approaches to ADHD, and make you understand that it is not just a behavioral problem but a symptom of an or multiple underlying imbalances.

Every child with behavior problems, ADHD, or ADD is unique — and each has to find his or her own path with a trained doctor.

Both Natasha and Mat can be reached at Clinique Médicale de Santé Globale Brouillard at (450) 661-4865.

9

Tags: , , , , ,

Comments are closed.