ADHD Treatment with Amino Acids and Diet: Two Recent Studies

Amino Acids and Diet: Two Recent ADHD Studies

We have long held the opinion that the symptoms of ADHD could be lessened, and perhaps fully treated, by the use of amino acids and the help of specific ADD diets. Now two studies, one from Italy and the other from Norway, give more support for our position that prescription medications, particularly stimulants, are not the only effective ADHD treatments available.

The study from Italy looked at the effectiveness of just one amino acid in a population of ADHD children are well known as poor responders to stimulant treatment – children with Fragile X syndrome and ADHD.

Fragile X syndrome is the most common hereditary form of mental retardation, and many children with the condition also have ADHD, or at least the symptom inventory of ADHD. Over the years stimulants such as Ritalin have been used to treat these ADHD symptoms with these children, but with mixed or poor response. Stimulants often caused the children to be more irritable, to be less verbal, and often more withdrawn, so the researchers explored the possibility that the amino acid L-Acetyle Carnitine (LAC) might be helpful in reducing the ADHD symptoms, but without the side-effects.

The research team from the Università Cattolica in Rome studied 51 boys, ages 6 to 12, diagnosed with both Fragile X syndrome and ADHD. It was a double-blind study, so the boys were divided into two groups, one to get the amino acid treatment and the other a placebo. They study lasted for one year, with the boys evaluated at the beginning (baseline), at six months, and after a year.

The boys treated with the L-Acetyle Carnitine showed significant improvements. They were less hyperactive and had improved attention and focus, and without any of the side-effects that would be expected in this population from treatment with stimulants. In fact, there were no adverse side-effects reported by the amino acid group at all. The boys were also given intelligence tests, but there were no significant gains made on the IQ testing.

"We propose that LAC be recommended as a treatment of ADHD in FXS children," the authors state, "since it effectively reduces hyperactive behavior and improves social abilities without adverse side effects." They also suggest that these results may be applicable to children with autism, who also do not easily tolerate stimulants.

We have personally studies and observed the positive results from treatment with a combination of amino acids, lipid complexes, and homeopathic medicines in Attend with ADHD children. And we recommend that parents and physicians take a closer look at this alternative treatment.

SOURCE: American Journal of Medical Genetics. Part A published online Feb. 19, 2008. Part B will be published in April, 2008.

ADHD and Diet: Restrict Milk

The second study had to do with diet as a treatment intervention for ADHD. It seems that at least a small group of children with ADHD, perhaps ten percent or so, have a particular type of protein imbalance that may be contributing to a child’s ADHD symptoms, or may be causing that child’s ADHD problem entirely.

Back in 1996 a group of researchers in Norway began to study 23 children with ADHD. They placed the children on a milk free diet and have followed the children since. The researchers wanted to see if the ADHD symptoms in the children, particularly hyperactivity and impulsivity, would improve by avoiding milk, or more specifically the casein in the milk.

Since a one of our ADHD diet recommendations has been to stop drinking cow’s milk for two weeks, then add it back in to the diet and see if there is any adverse reaction to it, we were very interested in the observations from this study.

Milk is one of the most common food allergens in children. Studies in several countries around the world show a prevalence of milk allergy in children around 2% to 5%. Some estimates are much higher, as the researchers in this study propose. Cow's milk contains at least 20 protein components that may cause allergic responses. The milk proteins, casein and whey are the main problems. Caseins give milk its "milky" appearance and is the protein in milk that makes it possible to make cheese. Whey makes up the remainder of the milk substance.

The group was working under the theory that a metabolic disorder making it difficult to break down certain proteins, including could cause mental problems ranging from Autism to Schizophrenia to Attention Deficit Hyperactivity Disorder (ADHD).

All twenty-three children in the long-term study, who were between four and 11 years old when the project started, had symptoms of ADHD and had been shown to have abnormal levels of peptides in their urine. All of the children followed a strict casein-free diet the first year, and the results were overwhelmingly positive. Twenty-two of the twenty-three children had “clear improvements” in their behavior and attention span.

One of the researchers noted, "One of the kids I worked with started on the diet on Wednesday and by the weekend his parents said they saw a huge positive change in his behavior.

A number of the children have since stopped following the diet for different reasons and some were put on medication, but after eight years six were still strictly avoiding all milk products and several had also cut out gluten, which is found in wheat, rye, barley and to some extent oats.

"We see a clear difference between those who stopped and those who stayed on the diet," said another researcher.

"It's incredible. We've seen intelligence tests that had gone steadily down suddenly turn around and go back up" after a change of diet, reported a third member of the team.

One subject in the study, who is now seventeen years old, reported that if he cheats on the diet he knows it will hurt his school performance right away. "I can tell right away when I've eaten something I shouldn't. It's really hard to concentrate. I'm always careful before tests," he says, taking a big bite of gluten and milk-free carrot cake.

Hundreds of other Norwegian children with ADHD have in recent years been put on milk-free diets to help deal with their condition, but Fosse complains many doctors don't inform parents of the option. "We want to get the word out that this can be an alternative. Parents have to do a lot of searching before they get this information," said one mother whose child has improved.

Not drinking cow’s milk is certainly a simple and safe intervention to try. And, as we like to say, if what you are doing works, don’t mess with it. But if it doesn’t work, try something else.

ADHD and Caffeine?

ADHD and Caffeine: a Treatment Option?

For many years our ADHD diet has promoted the use of moderate amounts of caffeine in the morning, along with a protein drink supplement and the nutraceutical medicine Attend, as a part of the program. Parents have reported success using the program, both with their ADHD children as well as in their own lives.

Caffeine is a mild CNS stimulant that can be used with ADHD children, teens, and adults, if used purposefully and in moderation. All stimulants are vaso-dilators, meaning that they allow the blood vessels to increase in size and increase the blood flow in the brain. One of the primary physiological problems causing ADHD seems to be a lack of blood flow to certain regions of the brain, and stimulants help to improve blood flow and reduce symptoms caused by this problem, at least temporarily.

It is estimated that 100 mg of caffeine is equivalent to 5 mg of Ritalin, which is the lowest therapeutic dose, and the usual starting dose for children. It is similar to Ritalin in that caffeine is absorbed and begins working in about 45 minutes, and the benefits wear off after about three to four hours. And, of course, caffeine can have the same kinds of side effects as other stimulants.

There may be times when it would be advantageous to have caffeine available for someone with ADHD who is successfully using stimulant medication, such as to avoid the “rebound” or “trough” effects of the stimulants, or on weekend outings, etc.

Also, if 5 mg of Ritalin is a successful therapeutic dose, parents and physicians should at least talk about using caffeine instead.

Caffeine is the most commonly used psychoactive drug in the world, with about 80% of the world’s population drinking down caffeine every day. The average daily consumption of caffeine among American adults and teens is about 260 to 300 mg per day, but about one person in four consumes more than 600 mg each day. And yes, caffeine in large amounts, over a long period of time, is addictive.

How does America get its caffeine? Here’s a pretty good list:

• Coffee, 8 oz cup has 135 mg
• Instant coffee, 8 oz cup has 95 mg
• Expresso, 1 oz shot has 50 mg
• Tea, 8 oz cup has 60 mg
• Green Tea, 8 oz cup has 30-40 mg
• Coca-cola, 12 oz has 35 mg
• Diet Coke, 12 oz has 45 mg
• Dr Pepper, 12 oz has 40 mg
• Mountain Dew, 12 oz has 55 mg
• Pepsi cola, 12 oz has 37 mg
• Sunkist Orange, 12 oz has 40 mg
• Red Bull, 8.5 oz has 80 mg
• Full Throttle, 8.0 oz has 70 mg
• SoBe No Fear, bottle has 160 mg
• Pain Relievers such as Excedrin, Bayer max strength, Midol have 60-65 mg

Drinking sodas, coffee, “energy drinks,” and other beverages with caffeine, should never replace drinking water. The human body, and specifically the brain, needs an adequate supply of water ever day in order to function optimally. Drinking a diet Pepsi is not a substitute for water. So make sure that your ADHD child or ADHD teenager is still drinking 4 to 8 glasses of water per day, depending on their body size, how hot it is outside, how active they are during the day, and so on.

Of course, whenever possible we would recommend using our ADHD diet recommendations, our specific treatment strategies for ADHD, including Attend, and other alternative treatments for ADHD, in lieu of Ritalin or stimulant medications.

ADHD Diet : Summer's the Time to Try It!

Thoughts for This Summer

School is almost out and summer vacation is nearly upon us. How will you spend the time wisely to prepare your child for success in the next school year? How will you use the time to improve your child’s ADHD symptoms?

We have several suggestions for you, and here is merely the first. ADHD Diet : Summer's the Time to Try It!

Since summer usually brings a bit more flexibility it is a good time to give an ADHD Diet a serious try. We have our own eating program for ADHD here, and there are other good programs available online to consider. Any good eating program will take about four weeks to assess whether or not any positive changes are coming from using it.

In our program we recommend NOT eating certain foods for two weeks, then adding them back into the diet to see if there are any food sensitivities contributing to the ADHD symptoms. If so, then appropriate changes can be made through the next school year. We also recommend avoiding sugars and carbohydrates paired together in foods, such as in breakfast cereals, doughnuts, and many snack foods.

Also watch out for sodas. In most cases, there is one spoon of sugar in each ounce of soda. A twelve ounce can has twelve spoons of refined sugar (more or less). This is not a good idea for anyone, especially your ADHD child or teen. Water is the answer, and summer time is the time to begin this new habit.

Our program also recommends using certain foods to help to feed the brain, beginning with a higher protein breakfast to start off the day. This may call for a new set of morning habits, like cooking a breakfast rather than just pouring it out into a bowl, but the benefits can far outweigh the costs and investment of time. Summer is a great time to begin these new habits.

Learn more about our ADHD eating program here.

Food Allergies in Children: Some Thoughts

ADHD and Food Allergies

by Anthony Kane, MD

Introduction There are a number of controversial areas in medicine when it comes to ADHD. Food allergy is certainly one of them.

The classic allergic reaction, which is classified as the type-1 hypersensitivity reaction, can be elicited by food, but this is fairly uncommon. When we discuss food sensitivities in ADHD we are discussing a different, not well-defined, mechanism. One of the main progenitors of the food allergy/ADHD connection is Dr.

Doris Rapp. Dr. Rapp was a pediatric allergist who noticed that many children in her practice had significant physical and behavioral changes when exposed to certain foods. They may have red ear lobes, dark circles under their eyes, or glazed eyes after eating certain foods. These children could have tremendous swings in behavior.

They can be calm one minute and wildly hyperactive a few minutes later. To make it more interesting, children with food allergies usually crave the food that affects them negatively. That means a child who is allergic to peanuts will demand peanut butter and jelly for lunch everyday, and for the rest of the afternoon you have to peel him off of the ceiling.

What is Food Allergy? The classic allergic reaction operates through a very specific mechanism. The reaction is caused when a specific type of antibody, called IgE, reacts with a specific provoking substance called an allergen. The result of this interaction is an allergic response and the person is deemed allergic to that allergen.

The specific type of antibody involved in classic allergy is called IgE. The proposed antibody mechanism for this type of food allergy does not involve IgE, but a different antibody called IgG. This is significant because standard allergy testing tests only for IgE antibodies. If your child has IgG mediated sensitivity, his allergy test is going to miss it.

That means that your child may have a severe allergy to a specific food, but your allergist will tell you he is not allergic to it.

Why the Controversy?

Reason 1: Diagnosis - I said this was a very controversial area of medicine and here is one of the reasons why. Food allergies are very difficult to diagnose. One reason is that the symptoms wax and wane. When a child has a classic allergy, for example to bee stings, then every time a bee stings him, he will have a reaction.

Food allergies don't work that way. There seems to be a threshold that must be exceeded before there are any symptoms. In addition, this threshold seems to vary from day to day. On some days a food will affect the child, and on other days it won't.

Dr. Rapp explains this phenomenon using the analogy of a barrel. We can view each allergic child as if he has a barrel. As long as the barrel is empty or only partially full, your child will have no problems. Your child won't become hyperactive until his barrel is overflowing. Various things will fill your child's barrel.

Let's say your child is sensitive to chocolate, cats, and peanut butter. Each of these things all can partially fill his barrel. As long as he only has peanut butter or only plays with the cat, his barrel is only partially full. That means that there are no symptoms and that his behavior is fine. Then, one day he has a peanut butter and jelly sandwich, has chocolate ice cream for dessert and plays with the cat all afternoon.

These things in combination make his barrel overflow, and by evening he is out of control. Your child has food allergies, but sometimes they affect him and sometimes they don't. The barrel can change sizes. If your child has a cold or is upset his barrel gets smaller. It takes less to make it overflow.

If he is happy his barrel is bigger. It takes more to make it overflow. If he isn't eating well and that day he is low on certain nutrients his barrel gets smaller. Many traditional allergists find this barrel concept ludicrous. It doesn't fit into the pattern of how other allergies work.

Reason 2: Method of Diagnosis - The next problem is the way in which you test for food allergies. Dr. Rapp describes a technique called provocation-neutralization testing. This method works as follows: Say that a child frequently has headaches after eating eggs. The practitioner will give an intradermal injection of egg extract. If this elicits the child's headache, then the child tests positive for egg allergy.

Other signs of a positive test include an increase in pulse rate of 20 points, a large skin reaction (this indicates a classic IgE reaction), a change in the child's handwriting, or some other physical or emotional complaint.

This last criterion "some other physical or emotional complaint" is problematic. It is too vague. The result is that when studies compared how several physicians evaluated the same group of patients, their results didn't agree. For each patient if there were twenty different doctors with twenty different sets of findings. None of their diagnoses matched.

Reason 3: The Mechanism - As I mentioned before, the proposed mechanism is an IgG mediated response. Some food allergists diagnose specific food allergies by measuring IgG levels. This runs counter to all of modern allergy practice.

Allergists give allergy shots to treat allergy. The way this works is they give a low level of allergen, which is not enough to elicit an IgE reaction. The dose is slowly increased until eventually the patient can tolerate a significant exposure to the allergen. This is how it works. The repeated low-level exposure to the allergen induces the body to make a different antibody to the substance. This antibody attaches to the allergen and deactivates it before IgE can cause the allergy reaction.

What is this antibody that allergists try to induce to cure their patients of their allergies? You guessed it, IgG.

So the very antibody the traditional allergists have been inducing for decades to successfully treat allergies, the food allergy people claim is the antibody guilty of causing allergies. For a traditional allergist this is nothing short of heresy. IgG has been used for decades to treat allergies successfully.

Comes along Rapp and her friends and they claim that IgG causes allergy? This is a little hard for some people to accept.

Just how strongly do allergists reject this idea? I once tried to contact an Israeli physician who was a food allergy specialist to discuss with him provocation-neutralization testing. I called the hospital where he is on staff and asked to speak with him. For some reason the operator instead put me through to the head of the Department of Allergy. I began discussing with him the theory of food allergies, provocation-neutralization testing and IgG testing. He told me that he was the head of a committee of allergists who were in the process of testifying before the Israeli Knesset to get legislation passed to make IgG testing illegal in Israel.

Can you imagine? You visit a prison in Israel. In one cell there is car thief. In the next cell there is a mass murderer. And in the next cell there is a guy who tested someone for food allergies. \Now that's pretty strong opposition!

Do Food Allergies Really Exist? The formal medical societies like the AMA claim there is no such thing as food allergies. Rapp and her friends have been screaming for decades that they do exist. So, what is the bottom line?

Does it really make sense that what a child eats can affect him so strongly that experts will diagnose him as having ADHD? We know that the brain is a highly complicated and sensitive organ. We know that many foods have a physiological effect on the body without inducing a classic allergic response. For example, people who are sensitive to monosodium glutamate can have a severe reaction to eating it. The chemicals in red wine affect certain people.

We also know that ingesting certain foods alters brain function. Diet has been proven to influence neurotransmitter function. Components of foods can also be used as drugs. For example, tryptophan, tyrosine, and choline have been used in the treatment of sleep disorders, pain, depression, mania, hypertension, shock, or dyskinesias.

The logic of Rapp's argument is so strong and there is enough circumstantial evidence, that I feel that the question is really the other way around. We know that the brain is intricate and has tremendous metabolic requirements. We know that some people have very strong reactions, including behavioral changes, to certain foods. These things are undisputed. If it turns out that foods do not elicit significant problems in sensitive children, in my opinion, we would need to explain why not!

Are we really seeing an allergy mechanism to food?

I prefer to stay out of that debate. Rather than be ostracized by the doctors who specialize in allergy, I feel it is safer to call them food sensitivities. There are no doctors who specialize in sensitivity.

Does Your Child Have Food Sensitivities? A large number of ADHD children may be having a negative response to food, and this response may be the primary cause of their ADHD.

In what type of child should you suspect food allergies? The following is a list of symptoms that resulted from food allergies in certain children:

• Hyperactivity
• Changes in mood
• Halitosis
• Sleep disturbances
• Delay in sleep onset
• Migraines
• Other headaches
• Abdominal pain
• Bedwetting
• Tantrums
• Eczema
• Asthma
• Seizures

Research shows that by treating the food allergies all of these symptoms can be relieved. If you see your child's symptoms in this list it is possible that food allergies may be contributing to his problem. If your child also has other allergic problems, such as allergy or asthma, then food allergies are almost certainly contributing to his problems.

What Should You Do? As I wrote in How to Help the Child You Love, there are a number of approaches to diagnosing food allergies. None of them are well substantiated and all of them have difficulties. Yet, many people find that these diagnostic techniques worked for them. Therefore, I'd suggest you could use them provided you have it on good authority that the person administering them has a strong record of success. In my experience, these techniques are more of an art than a science. They really depend upon the talent of the diagnostician.

As I said last time, the best approach to finding food allergies in your child is an elimination diet. It doesn't really matter which one you choose. I prefer the three that I outline in How to Help the Child You Love.

Conclusion
Researchers claim that the percentage of ADHD children whose behavioral symptoms are affected by foods ranges from 60% to 75%. This, however, is probably not an accurate number.

Parents who consent to have their children participate in diet studies usually believe they have observed food-induced problems in their children. Therefore, children who participate in these studies are more likely to respond to foods than the general population.

The truth is we do not know what percentage of ADHD children will respond to dietary changes, but it seems that the number is significant. Treating the food sensitivities in ADHD children has a number of advantages over using medication.

One major advantage all the current methods of treatment can be used to treat pre-school children. Most clinicians do not use medication on pre-school children.

A more significant advantage of treating food allergy is that when it works, it works all day. In contrast, Ritalin wears off in about 4 hours. All this, of course, is providing that food allergies really do exist.

The main thing to remember is that if you think your child has food allergies, then the biggest mistake you can make is to go to an allergist. They don't believe in food allergies. And whatever you do, do not go to an allergist and ask to have your child provocation-neutralization tested for food allergies. He is going to laugh at you.

Food allergy is an alternative medicine diagnosis.

Still, there are physicians who specialize in diagnosing and treating these sensitivities, but they no longer call themselves allergists. Rapp and her group were so ostracized by the formal allergy societies that they eventually broke off and formed a new field called Environmental Medicine.

Therefore, if you want a physician to treat your child you need to find an Environmental Medicine specialist. They are not so common, but they are around.

As I mentioned before, there are a number of approaches to treating food sensitivities. The one you can do yourself is to use an elimination diet. I devoted a large section of How to Help the Child You Love describing exactly how to use elimination diets to diagnose and treat food sensitivities.

In the final analysis, I feel it is fair to say that many ADHD children have sensitivities to the foods they eat. These sensitivities may exacerbate their ADHD symptoms. I won't go so far as to say that food allergies cause ADHD. That means that if your ADHD child has severe food sensitivity, treating that sensitivity may not get rid of his ADHD. However, until you treat his food allergy, nothing else you do will really help your child's ADHD, either.

Anthony Kane, MD
ADD ADHD Advances.

Anthony Kane, MD., is a physician, an international lecturer, and director of special education. He is the author of a book, numerous articles, and a number of online programs dealing with ADHD treatment, ODD, parenting issues, and education. Visit his ADD ADHD Advances website.

To sign up for the free ADD ADHD Advances online journal send a blank email to: subcribe@addadhdadvances.com

akane@addadhdadvances.com

Milk, ADHD, and Dr. Reichelt's Theories

Recent Study on Milk and ADHD

Changes in our diets can be used as a treatment intervention for ADHD. And according to a recent study from Norway, it seems that at least a sub-group of children with ADHD have a particular type of protein imbalance that may be contributing to a child’s ADHD symptoms, or may be causing that child’s ADHD problem entirely.

The study began back in 1996 as a group of researchers and educators in Norway began a study of 23 children with ADHD. They placed the children on a milk free diet and have followed the performance of the children since. The researchers wanted to see if the ADHD symptoms in the children, particularly hyperactivity and impulsivity, would improve by avoiding milk, or more specifically the casein in the milk.

Since a one of our long-held ADHD diet recommendations has been to stop drinking cow’s milk for two weeks, then add it back in to the diet and see if there is any adverse reaction to it, we were very interested in the observations from this study.

Milk is one of the most common food allergens in children. Studies in several countries around the world show a prevalence of milk allergy in children around 2% to 5%. Some estimates are much higher, as the researchers in this study propose. Cow’s milk contains at least 20 protein components that may cause allergic responses. The milk proteins casein and whey are the main problems. Caseins give milk its “milky” appearance and is the protein in milk that makes it possible to make cheese. Whey makes up the remainder of the milk substance.

We have been familiar with the theories of Dr. Kalle Reichelt and have offered Dr. Reichelt's thoughts on diet, particularly milk and gluten, and mental illness to our readers for several years on our websites. So I have always been interested in studies that have investigated these positions. This study caught my eye.

The group was working under Reichelt’s theory that a metabolic disorder making it difficult to break down certain proteins might cause mental problems including ADHD.

All twenty-three children in the long-term study had symptoms of ADHD and had been shown to have abnormal levels of peptides in their urine. The children followed a strict casein-free diet a year, and 22 of the 23 children showed “clear improvements” in their behavior and attention span.

Not drinking cow’s milk is certainly a simple and safe intervention to try. And, as we like to say, if what you are doing works, don’t mess with it. But if it doesn’t work, try something else.

Learn more about our recommended Eating Program or ADHD Diet at http://newideas.net/adhd/adhd-diet or to read more about ATTEND with amino acids for a natural but effective treatment for ADHD at http://newideas.net/attend.