Case Study: Tyrosine caused headaches but 5HTP was a game changer when coming off Adderall
Jacob (not his real name) is a 10-year-old boy with diagnosed ADHD whose mom agreed to let me share part of their story. I'm sharing it to show how we can understand the complexity of something like ADHD and use supplemental amino acids as a pressure valve to help.
Jacob was developing well until around the age of 2. His mom described a sudden shift at that time.
"There was a sudden change in food willingness, sleep difficulties and withholding began, and he became "a wild child", she told me.
In first grade (at age 7), Jacob was diagnosed with ADHD and was prescribed slow-release Adderall.
The Adderall helped a lot with noise sensitivity, focus, emotional outbursts, and transitions, and seemed to ease his negative & angry self-talk. But it interfered with his appetite, and he experienced mood swings and irritability in the morning and then again in the evening as the medication wore off. His mom also suspected the meds were contributing to some physical and verbal tics.
Jacob's parents wanted to know their options.
Jacob: A Creative, Loving Child with Big Emotions
His mother described Jacob as " loving but also erratic".
"He is a very emotional person who feels things deeply, thrives with creative play, has dramatic mood swings, and tries to dominate conversations.
He's a creative, loving, smart kid, and while he can hyper focus and be very stubborn, he has trouble focusing on non-preferred tasks and seeing tasks through."
He gravitated to scary and ominous stories and was showing addictive tendencies. Any shift in schedule would throw him off.
The family's goals were to:
- Reduce reliance on Adderall
- Guard against addictive tendencies (a family trend and starting to show up in him)
- Assess whether there was a "gut" contribution to the ADHD (they felt like they had explored everything but that)
- Empower Jacob to make healthier choices and improve his relationship with food
Assessing Jacob’s Needs: Initial Observations
Using questionnaires and by talking with his mom, I discovered that Jacob had traits consistent with low GABA, low serotonin, low catecholamines and low endorphins, pyrrole imbalance, and methylation imbalance.
All of these imbalances put pressure on a child's nervous system and reduce their capacity to learn, sit still, stay positive, sleep, poop, focus, and retain information.
He also had symptomatic deficiencies consistent with B1, B6, zinc, and magnesium (a list of symptomatic deficiencies is in my book).
His hyperactivity, anxiety, underachievement, ADHD, texture sensitivity, emotional meltdowns, poor concentration and focus, low dopamine activity (Adderall helped), and sleep problems made me suspect high copper.
His history of withholding and use of Miralax plus the sudden nature of the shift his mother described made me suspect factors in his gut were contributing to the behavior as inflammation in the gut can contribute significant stress to the brain. 90% of our serotonin is created in the gut as is 50% of our dopamine and much of our GABA, so symptoms relating to those neurotransmitters often stem back to stressors in the gut.
We didn't know anything for sure, but we had some clues.
Jacob’s selective eating made it highly unlikely his nutritional needs were being fully met, but we realized that before even considering diet changes we needed to calm his nervous system. Plus, he had no interest in eating once that medication was in his system.
Bringing Quick Relief With Amino Acids
We decided to invest in some functional tests to see what was going on and in the meantime turn to amino acids as a pressure valve. Amino acids are nutritional building blocks that our bodies use for essential functions.
Jacob's mom was amazing at gently bringing him into the conversation with love, curiosity, and compassion and he was getting interested in learning about his body. But it was going to be a long process.
"5HTP was a game-changer!"
5-HTP is an amino acid building block for serotonin. His dark moods and his volatile behavior made me suspect he could use some serotonin support.
His mother gave Jacob 50mg of 5-HTP in the mornings and again in the evenings and found it softened the edges around the Adderall by giving him some nervous system support.
"50mg of 5htp immediately bounces him out of volatility", she explained.
She reported he was way less grumpy in the morning, became more open to his mother's attempts at nourishing him with healthy foods, and even started learning about alternatives to gluten (which we later confirmed he was highly sensitive to!).
He also started having more regular bowel movements which mom said made a noticeable difference in his overall stress level.
An Experiment with Tyrosine
While we were waiting for lab results I got a message from the family telling me there was a shortage of Adderall where they lived and they wanted to try using 75mg of Tyrosine to balance out the lower dose of the medication.
Tyrosine is an amino acid building block for dopamine. When there are clear signs of low dopamine like with Jacob, we can wonder, "could we help him create more dopamine by offering more building blocks?"
I'm often hesitant to start with Tyrosine when there is anger and hyperactivity in the mix as Tyrosine can be too stimulating for some kids. Plus, since the Adderall worsened tics I worried that Tyrosine would push up norepinephrine too much and do the same.
But they had their prescribing doctor's go-ahead and we had some calming support in place with the 5HTP so I told them what to look out for.
The Tyrosine didn't go very well.
The tics did subside as they reduced the Adderall dose, but the Tyrosine gave him headaches and the moodiness returned.
They went back to the full dose of Adderall, using the 5HTP support in the mornings and evenings.
Ah-Ha Moments From Jacob’s Lab Results
When we got Jacob's labs back we found some clear leverage points.
Zinc and Copper: His copper was sky-high and his zinc was low.
According to the research of Dr William Walsh, this kind of zinc-copper ratio accounts for about 60% of ADHD cases as excessive copper can lead to low dopamine, and either normal or high norepinephrine and epinephrine depending on how the body uses those.
This helped us theorize why the Adderall helped (recycling dopamine), and why the higher dose was potentially adding to the tics (high norepinephrine).
Zinc is critical for just about everything connected with the nervous and digestive systems. We need zinc to create dopamine, serotonin, and GABA; zinc is needed for our digestive enzymes, influences how foods taste and smell, contributes to protein digestion, and is crucial for detoxification. Zinc has been shown to help stimulant medication work better and balance out excessive copper.
Balancing copper and zinc was going to be important for Jacob.
Genetic Predisposition
Jacob had some genetic variants that made him predisposed to ADHD but also to low zinc, folate, vitamin D, and B12 - nutrients needed by his nervous system. Genetics don't confirm nutrient deficiencies, but low levels would make his ADHD worse so they needed to be checked.
We found genetic variants relating to the clearance of the norepinephrine and the use of serotonin which shed some light on the tics, the predisposition to addiction and anger, and why the 5HTP helped.
Gut Problems: Infections and Poor Digestion
He had two active infections in his gut, poor fat digestion, and a lack of beneficial bacteria, some of which are vital for creating GABA - our most abundant calming neurotransmitter.
His gut was not working as his ally; factors there were making his ADHD worse.
Moving Forward with a Holistic Plan
We had some leverage points to help the family achieve their goals.
We benched the Tyrosine, thinking it might still be a tool to reduce the reliance on Adderall but not before the copper and zinc were normalized.
We needed to support methylation so he could better clear the high norepinephrine and use serotonin and we needed to address the imbalances in his gut.
We needed patience, but we had a plan.
We were all - including him - starting to understand that he wasn't bad, broken, or disordered. He was under stress.
Working as a team—parents, practitioner, and most importantly, Jacob himself—we were finding a deeper understanding of his unique needs and creating a roadmap toward a healthier, more balanced life.
Related posts:
https://www.jesssherman.com/blog/do-gluten-and-sugar-impact-a-child-behaviour
https://www.jesssherman.com/blog/neurotransmitter-testing-for-kids
https://www.jesssherman.com/blog/is-adhd-a-methylation-problem
https://www.jesssherman.com/blog/genetic-testing-kids-anxiety-adhd-mood-swings
https://www.jesssherman.com/blog/amino-acids-for-mental-wellness-in-kids
https://www.jesssherman.com/blog/is-adhd-caused-by-nutritional-deficiencies
Zinc and ADHD https://pubmed.ncbi.nlm.nih.gov/21309695/
