Is ADHD Caused By Nutrient Deficiencies?
The short answer is, “could be, but maybe not”.
I’m pretty sure that’s not the answer you wanted to hear, especially if your child has ADHD and you’re looking to take a drug-free approach, so let’s dig into why it’s not so simple by looking at a recent review article in the journal Molecules called: Magnesium, Iron, Zinc, Copper and Selenium Status in Attention-Deficit/Hyperactivity Disorder.
(You can read the study here).
Review studies are helpful because they compile a bunch of studies on a subject and compare them for us, saving us some leg work. But we always have to be careful to read beyond headlines; review studies are not always thorough, and in some cases authors come to conclusions that don’t reflect the complexity of an issue.
So let’s look at this one.
The Influence of Magnesium, Iron, Zinc, Copper and Selenium on ADHD... Inconclusive Evidence?
This particular review looked at literature published between 2010-2020 looking at how these particular micro nutrients may or may not contribute to ADHD (not ADD) in children (not adults).
The authors write,
The observed associations between concentration levels of the elements Mg, Fe, Zn, Cu and Se and ADHD symptoms are contradictory. This is partly due to the heterogeneity and complexity of the disorder.
Now, if you’re familiar with my work at all you'll know that I'm working towards a time when the very first thing to be considered when a child starts to struggle with mood, learning or behavior is whether the building blocks their body needs to function are present.
Nutrients are one major category of building block worth taking a look at because they drive every function in the body (including focus, energy, memory).
I have seen many cases in which nutritional deficiencies were contributing to ADHD symptoms.
(Related post: What’s Really Going On With Our Amazing Kids)
Magnesium, Iron, Zinc, Copper and Selenium (the ones looked at in this study) contribute to a whole host of functions including:
- energy production,
- transport and function of serotonin and dopamine,
- thyroid function
Breakdown in any one of those functions can affect mood, behavior and ability to learn and focus, so adding these nutrients could improve function and ease ADHD symptoms in some kids.
But according to the studies reviewed, it doesn't always.
So Do Nutrients Matter? Or Don't They?
Study results about the impact of these and other nutrients on ADHD have been contradictory, which leaves us parents scratching our heads.
That last sentence in the quote above though, explains the inconclusive results: "this is partly due to the heterogeneity and complexity of the disorder".
Looking for a one-shot-solution is, I think, why too many parents and doctors throw up their hands and stop considering nutritional intervention as a viable option for ADHD when in fact it is.
They tried taking out gluten. It didn't help.
They tried adding zinc. They didn't notice a difference.
They tried cutting additives. It didn't work.
And then they look to the research and see no definitive answers there either.
I’m not surprised though, because the heterogeneity and complexity of the disorder needs to be considered when taking a nutrition-based approach.
When parents try something and don’t see the effect they had hoped for, they mistakenly start to think "diet doesn't matter".
But it does matter, even if ADHD is a genetic issue in your family. You just might need to broaden your strategy.
(Related post: Can Changing A Child's Diet Help ADHD? )
What Is ADHD, Actually?
When parents want to take a nutrition-based approach to ADHD, here's how I encourage them to think about it...
ADHD is a label given to a person when they exhibit a certain set of symptoms. The label tells us nothing about what is causing those symptoms, merely that those symptoms are there.
Parents often find comfort in a diagnosis; it can help them access educational resources or explain behavior to teachers and friends or even to their child themselves.
But the next question I hope they’ll ask is, 'ok so what’s contributing to those symptoms?'
And then, the even deeper question is, 'what can I do to ease the contributors to the symptoms?'
That’s the level I work at with the families when they follow our Resilience Roadmap; we look for stressors that are interfering with function and we use various strategies (including extra nutrients) to relieve that stress and bring the body back into a balanced state so it can function well.
Symptom resolution might not come from just one thing (though sometimes families do find one thing that moves the needle more significantly than any other, and sometimes that thing is nutrient supplementation).
More often than not, achieving their health goals requires a multi-pronged nutrition strategy.
(Sounds complex but don't worry... read the related post: The Pillars Of Resilient Health to learn about the approach we take).
Should Doctors Be Treating ADHD With Nutrients?
In some cases, maybe. After all, nutrients make the body and brain function.
For some kids, focusing on foods that contain nutrients like Magnesium, Iron, Zinc, Copper and Selenium and using nutritional supplements is a game changer. Getting more nutrients in is almost always where I start with my clients.
(Related post: Top Nutrients For Your Child's Brain)
But I can see why most parents don't leave the average doctor's office with a bottle of nutritional supplements. There's more to the story.
Pertaining to iron and zinc for example (two nutrients that are often considered to be contributors to ADHD), the authors of this review go on to say,
As a trend, lower ferritin and zinc levels can be observed. However, this correlation is not causative, as illustrated by placebo-controlled trials reporting conflicting evidence on the efficacy of supplementation.
Well, conflicting evidence on the efficacy of supplementation is exactly what I would expect. Why? Because no two bodies are the same.
Two kids with ADHD symptoms might have different nutritional deficiencies. They also might respond differently to supplementation due to differences in their genetics and their digestion. They might have been given a different form of the same supplement. They will even respond to supplements differently depending on the amount of stress they were under when they took them.
The uniqueness of children makes it hard to treat ADHD with nutrients if what you’re looking for is a blanket protocol that fits all kids.
So I can see why, if they don't have time or expertise to take an individualized approach, doctors don't typically use nutrients as a tool for treatment.
But that doesn't mean you can't.
No Two ADHD Kids Are The Same
Your child’s behavior might fit the same diagnostic category as their friend, but each child has a unique set of factors that drive that behavior.
The needle-mover for your child’s ADHD might be to replenish nutrients. For your neighbour’s child the game changer might be taking out foods that are causing stress and inflammation.
For the kid who lives down the road it might be more about relieving their chronic constipation, sleep problems and balancing out their gut bugs.
We have to remember the heterogeneity and complexity of the disorder.
We have to remember the heterogeneity and complexity of children.
Is This Review Study Helpful For Treating ADHD?
This study discusses the impact of Magnesium, Iron, Zinc, Copper and Selenium specifically, and each section ends with some version of "we're not sure".
I think I've explained why their conclusions are so inconclusive.
But if you're new to drug-free approaches to ADHD and are someone who likes diving down research rabbit holes, it offers some good solid paths to follow. Follow the links in the study and here on my blog to learn about the impact of:
- other nutritional deficiencies,
- oxidative stress,
- metal toxicity,
- decreased methylation of relevant genes,
- cerebral hypoperfusion,
- mitochondrial dysfunctions,
- digestive problems,
- sleep issues,
- food sensitivities
You'll also find some research and commentary on how ADHD has been resolved by using diet to modify gut microbiota and immune function, and how antioxidants and the removal of dietary triggers can help.
Essentially, following the links will help you dig underneath diagnosis and understand some of the things that can make a child hyperactive, unfocused, irritable, spacey and anxious.
If you don't want to go down the research rabit holes and instead you just want a system to follow read this. It outlines ours.
The study is not going to give you a definitive treatment solution for your child’s ADHD. So don’t look to it for that.
If you’re waiting for a study that tells you definitively that your child’s ADHD will resolve if you give them 30mg of zinc or 1000mg of fish oil or 5000IU of vitamin D, or if you’re looking for a study to confirm for you that if you take out gluten or additives your child will no longer have ADHD, you’ll be waiting a long time.
I don’t expect we’ll ever see a study like that.
There will always be “conflicting evidence” because your child's body is a complex ecosystem and because there are multiple possible drivers of the condition.
But that does not mean you can’t make some very solid progress by examining the body’s major pillars of function and adding nutrients, removing irritating foods and improving gut health to support them.
Nutrients can help ADHD. I see it all the time in the families that follow our Resilience Roadmap.
But there might be more to your solution than a simple supplement.
Related Post: Nutritional Approach To ADHD: Where Do You Start?
Care to share? What has worked for you? Tell us in the comments...
Reference: Magnesium, Iron, Zinc, Copper and Selenium Status in Attention-Deficit/Hyperactivity Disorder (ADHD)