ADHD and Gluten Sensitivities

What could be better for you than a delicious slice of freshly ground, freshly baked whole wheat bread? "Wheat was made for man," right?

That may have been truer 150 years ago than it is now. When I was in medical school the disease I learned about called "celiac sprue" was considered fairly rare, about 1 in 2500 people, mostly found in children. However, now the estimate is 1 in 133 people. The reason it is estimated is that the experts believe that 97% of those with celiac disease are undiagnosed. They have had bowel problems their entire lives, but no one has tested for celiac disease. As they grow older they are at increased risk for chronic fatigue, neurological disorders, arthritis, heart disease, skin rashes, nutritional deficiencies, anemia, acid reflux, nausea, emotional illness, and more. Those doctors and hospitals that are testing are finding much larger numbers of celiac than suspected.

However, most doctors are not testing for wheat allergy that is not celiac disease. Celiac disease is when the villi in the intestinal tract are destroyed by antibodies made to gluten, which causes gastrointestinal symptoms and can cause major health problems. There are many people with allergies to gluten that don't have celiac disease. When my patients come in with chronic problems they tell me they have been tested for celiac and are negative. With the right testing, I am able to show them that indeed they are gluten sensitive, but no, they don't have celiac disease.

In the testing in my office (of course these are people with chronic diseases, so it can't be extrapolated to the general population), 3 out of 5 people show antibodies to gluten in their blood, including me.

So what does this mean for ADHD? Most children with developmental disorders (ADHD, Asperger's, autism and others) have gastrointestinal problems. More than half of those with celiac disease have neurological disorders. I cannot find studies on gluten allergies that are not related to celiac, however, my own experience with patients is that gluten often increases brain fog, difficulty focusing, stomach aches, acid reflux, depression, increased sugar cravings and difficulty sleeping, among other things.

There are no major long term studies that show the effect of gluten on ADHD, as there is no financial incentive to do one. However, there are smaller studies that have shown benefit in both autism and ADHD on a gluten free diet. One study showed that children with celiac disease have twice the amount of ADHD (20.7%) as their control group without celiac disease (10.5%).

Why are there so many more people with gluten sensitivities? Evidence is pointing to newer, genetically altered strains of wheat. There is even a difference of wheat in America with wheat in Europe. American wheat has a lot more gluten that most of the European wheat. Our bodies are not adjusting to the rapid changes in genetically modified grains, and our cells don't recognize the new wheat as good for us. Our immune system treats the food as enemies, making antibodies which affect our health.

I recommend if you have a child with ADHD, autism or another developmental disorder that he/she be tested for gluten allergy. If you ask your doctor to test, he'll most likely just test for celiac disease. Ask your doctor to test for both the IgG anti-gliadin antibody, and the IgA anti-gliadin antibody. The IgA antibody is related to celiac disease, so if that shows up there should be further testing. However, most doctors are not aware of the ability to test for the IgG antibody, which is what most of my patients show up with.

If you can't find a doctor that will do the test, do the following elimination trial: have your child (or even better, you and your entire family) go 30 days completely gluten free. That means no wheat, oats, rye or barley. Be careful with processed foods--most of them have wheat derivatives. If you must use processed foods, they should have the label "gluten-free." With celiac disease, even a small amount can increase antibodies, so no cheating allowed!

After one month, everyone gets to eat their favorite gluten foods all day. Then watch over the next 24 hours what symptoms arise. Watch for increased congestion, increased ADHD symptoms, increased gastrointestinal symptoms, increased joint or muscle pain, increased moodiness, increased weight, etc. It can affect all of these things. If there are no changes in symptoms, your child is probably free to eat gluten. If there are, then you will know if the symptoms are worth the increased work of the diet.

This may seem overwhelmingly hard, and with children who are picky eaters, it can be. But if your child (or you) is gluten sensitive, I believe you and they will come to see that the effort is truly worth it. I know that I feel much better on a gluten-free diet, which I have been following for two years since I discovered that I was sensitive. Besides helping the ADHD symptoms, it increases long-term health and reduces risk of serious illness, both physical and emotional.

Until we meet again,

Dr. Judi

ADHD: Diet and Supplements

ADHD has become epidemic in the United States. About 1 in 7 boys and one in 19 girls between the ages of 3 and 17 had been diagnosed with ADHD in 2009. No one really knows the cause--there is much speculation, but that is the topic for another blog.

Today we are going to be talking about Diet and Supplements that can help ADHD.

ADHD has been shown in many cases to be a relative deficiency of dopaminergic reward in the brain. Increasing dopamine and balancing neurotransmitters is necessary for changes in behavior to take place.

Diet-wise, a lower simple carbohydrate and higher protein diet than most kids eat actually can increase dopamine in the brain and stabilize blood sugar levels (low blood sugar makes these kids crazy). That is why sugar can make ADHD symptoms worse--it doesn't improve dopamine and it causes a blood sugar yo-yo.

It is important to have healthy snacks available, as these children probably need to eat more often. Avoid simple carbohydrates, including white bread, white rice, white potatoes, sugar, corn syrup, honey and candy. Instead choose complex carbohydrates such as vegetables, whole grains, beans and fruit. Also consider protein snacks such as nuts and seeds, cheese sticks, unprocessed lunch meats (or leftover chicken, etc.), peanut and almond butter, etc.

Most children eat only carbohydrates for breakfast. This is one of the most important times to feed protein to keep their blood sugar stable through the morning.

Many of these children are sensitive to chemicals that have been shown to affect the brain, such as food colorings and artificial sweeteners. You may want to do an elimination trial, keeping them off chemicals and eating whole, natural foods for a week, and then give them the treats they've been demanding for a day, and see how that affects their behavior and physical symptoms. They will also notice their own behavior changes, and it can be quite effective for them to witness their own lack of control when they eat this way. It will often assist them in being more determined to stay away from those foods.

Some children have other sensitivities, such as dairy and gluten. You can ask your doctor to test gluten using the IgG and IgA anti-gliadin test, and for dairy using the IgG anti-casein test. If you don't want to subject your child to a blood draw, you can do an elimination, keeping off for two weeks, then having a day eating a lot of gluten, and another day eating a lot of dairy, and watching behaviors and physical symptoms. Allergies CAN affect the brain.

These changes can seem overwhelming, as ADHD children are often picky eaters. However, there are many ideas and creative recipes online to assist parents in learning the best way to feed their children, and how to get them to eat what you want them to.

There are supplements that have also been shown to improve ADHD symptoms. A good multi-vitamin is important to provide minerals, trace minerals, B-vitamins and anti-oxidants these children need to process their neurotransmitters.

L-tyrosine is a precursor to dopamine, and can improve dopamine levels. 5-HTP and St. John's Wart improve serotonin levels. GABA and inositol have calming affects on the brain.

DMAE improves acetylcholine transmission. Octacosanol, N-Acetyl-L Carnitine, Phosphatidylserine and Gingko Biloba improve brain function. Lithium helps calm aggression.

Grape Seed Extract, Pine Bark Extract and a good multivitamin provide antioxidants and have been shown in studies to help.

I have created two new supplements, ADD Focus Boost AM, and ADD Calm Time PM which includes all of these and more. They are formulated to balance neurotransmitters, improve focus and calm at bedtime. They are finally available at http://www.springtreehealth.com/. "Like" SpringTree Health on facebook and you can use the coupon code for a 10% discount.

These supplements are designed to be used with our Children's Vitamin, which is not available yet. I currently recommend these be used with 1/2 to 1 capsule of SuperMulti Plus (adult dose is 4 capsules).

These supplements are in capsule form. If the child cannot yet swallow a pill the capsule can be opened and put in juice or applesauce or some other food (preferably not a protein, and the protein will compete with the amino acids in the supplements). The dosages are the minimum. You can go higher if necessary without harm.

Please give us feedback as to how these supplements work for your children!

www.springtreehealth.com

Until we meet again,

Dr. Judi