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.
Jacob was developing well until around the age of 2 at which point his mom describes a sudden shift.
"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 (he'd only eat a handful of foods and fresh basil was the only green vegetable he'd accept), 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 it was contributing to some physical and verbal tics.
Jacob's parents wanted to know their options now that he was in a pretty good place emotionally and was better able to communicate his feelings to them.
A Loving And Highly Creative Kid
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 also gravitated to scary and ominous stories and was showing addictive tendencies (consistent with family trends). Any shift in schedule would throw him off.
The family's goals were to:
- Reduce reliance on Adderall
- Guard against addictive tendencies (ran in the family and were 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)
- Explore ways to empower Jacob to make home life healthier as a whole and improve his relationship with food specifically
My Initial Thoughts
Using questionnaires and in talking with his mom, I found out that Jacob had traits consistent with low GABA, low serotonin, low catecholamines and low endorphins, pyrrole imbalance, and methylation imbalance.
All of these imbalances can 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). And he showed signs of excessive copper -- hyperactivity, anxiety, underachievement, ADHD, texture sensitivity, emotional meltdowns, poor concentration and focus, low dopamine activity (Adderall helped), and sleep problems.
We didn't know anything for sure at this point, but we had clues for where to start.
Jacob's extreme pickiness and selectivity with food made both me and his mom quite sure there was no way his nutritional needs were being met.
We knew we'd need to expand his palette, but also knew that we wouldn't be able to do that until we brought some calm to his nervous system - a stressed body isn't hungry and will shut down digestion! Plus, he had no interest in eating once that medication was in his system.
His history of withholding and use of Miralax plus the sudden nature of the shift his mother described made me curious if there were factors in his gut contributing to the behavior. The gut and the brain are very much connected and inflammation in the gut can contribute significant stress. 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 interfering with their creation and transport. I was also wondering if some kind of infection was at play, keeping his nervous system on high alert.
How We Used Amino Acids
Jacob's mom was a superstar about 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.
So for some quick relief, we turned to Amino Acids. These are nutritional supplements that come from protein. Our bodies break long protein chains down into single amino acids and then use them as building blocks for other things.
5HTP was a game-changer!
5 HTP is an amino acid building block for serotonin and his dark moods and his volatile behavior made me suspect he could use some serotonin support.
His mother gave Jacob 50mg of 5HTP in the mornings and again in the evenings and it sufficiently tamed 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 found out he was highly sensitive to!). He also started having more regular bowel movements which mom said brought with them a noticeable difference in his overall stress level.
An Interesting Experiment
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 there were with Jacob, we can wonder, "could we simply help him create more dopamine by giving him more building blocks with which to make it?"
I'm often hesitant to start with Tyrosine (as I was here) when there is anger and hyperactivity in the mix. Tyrosine can be too stimulating for some kids, especially when there's high copper because the dopamine it turns into quickly converts to norepinephrine and epinephrine which can lead to heightened anger and anxiety in some cases.
Amino acids are pretty safe to trial though, and they had their prescribing doctor's go-ahead, so I told them what to look out for.
The Tyrosine didn't go very well.
The tics did subside with the reduced Adderall dose, but even that low dose of Tyrosine gave him headaches and the moodiness returned.
They went back to the full dose of Adderall with the 5HTP support before and after.
An Ah-ha Moment
When we got Jacob's labs back we found some clear leverage points.
We found out that 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.
Since copper is heavily involved in the conversion of dopamine to norepinephrine, excessive copper can lead to low dopamine, and either normal or high norepinephrine and epinephrine depending on how the body flushes those. In this case, Jacob's symptoms correlated to low dopamine and high norepinephrine (most common) which was showing up as lack of focus and motivation (low dopamine), along with anger, irritability, and impulsivity (high norepinephrine). It helped us understand why the Adderall was helping so much, and also why the higher dose was potentially adding to the tics (high norepinephrine).
Low zinc is a problem in its own right. Zinc is critical for just about everything connected with the nervous and digestive systems. We need zinc to create dopamine, serotonin, and GABA; zinc lends a hand to all 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.
So it was looking like improving Jacob's zinc levels and bringing down his copper were going to be a major leverage point for us.
We found genetic variants in the MAO enzyme needed to clear the norepinephrine (this also heightened his predisposition to addiction and anger), and the SCL and HTR enzymes needed to get serotonin into the brain, which helped explain why the higher dose of Adderall may have contributed to tics, and the 5HTP helped.
We found that Jacob was genetically prone to deficiencies in nutrients needed by his nervous system; specifically zinc, folate, vitamin D, and B12 so we needed to make sure to focus on foods with those nutrients as we expanded his diet.
He also had two active infections in his gut, was not digesting fat well, and was lacking in supportive beneficial bacteria, including species that create GABA.
We needed to be patient, but we had some leverage points to help the family achieve their goals and a few pressure valves to start with.
We benched the Tyrosine, thinking it might still be a tool for the future to reduce the reliance on Adderall, but first the copper and zinc needed to normalize and we needed to support methylation so he could better clear the norepinephrine. Plus, we needed to get him eating so he could get in all the nutrients his body and brain required.
We needed patience, but we had a plan. And we were all (including him) starting to understand his body.
This is a nice example of how amino acids and nutrients can support mood, behavior, learning, and development in kids.
Zinc and ADHD https://pubmed.ncbi.nlm.nih.gov/21309695/