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RUNNINGHEAD: ADHD CAMModalities
1
ConditionMonograph for NAT 504
CAM Modalities & ADHD
Management
By Kimmer Collison-Ris, ...
ADHD and CAMModalities
Page | 2
ADHD Management via Complimentary Medicine
Name of Condition
Attention Deficit Hyperactivi...
ADHD and CAMModalities
Page | 3
genetic and environmental influences is an observed decrease in long-chain (LC)
polyunsatu...
ADHD and CAMModalities
Page | 4
formally diagnosed, a CAM provider must refer to one of the above providers for testing an...
ADHD and CAMModalities
Page | 5
shows significant symptom improvement when consuming an AFC-free diet and reacts with
ADHD...
ADHD and CAMModalities
Page | 6
supplementation, dietary modification, detoxification, correction of intestinal dysbiosis,...
ADHD and CAMModalities
Page | 7
Vitamin B6 Adequate levels of vitamin B6 are needed for the
body to make and use brain che...
ADHD and CAMModalities
Page | 8
Roman chamomile
(Chamaemelum nobile).
Calming;
relieves allergies, inflammation, & insom
n...
ADHD and CAMModalities
Page | 9
officinalis) energy levels -can induce drowsiness
-can interact with sedative meds
Digesti...
ADHD and CAMModalities
Page | 10
attention issues. Stimulant medications prescribed for ADHD often disrupts sleeping patte...
ADHD and CAMModalities
Page | 11
Summary
Further research is needed in the area of CAM ADHD botanical and food supplement ...
ADHD and CAMModalities
Page | 12
References
Ageranioti Bélanger S and Vanasse M (n.d.).Omega-3 fatty acid treatment of chi...
ADHD and CAMModalities
Page | 13
Balch J, Stengler M, and Balch RY (2008). Prescription for Drug Alternatives. J. Wiley &
...
ADHD and CAMModalities
Page | 14
www.Feingold.com
Gottlieb, B (2000). Alternative Cures: The most effective home remedies....
ADHD and CAMModalities
Page | 15
McCarthy, J and Kartzinel, J (2009). Healing and Preventing Autism: A complete guide.
Pen...
ADHD and CAMModalities
Page | 16
Raz R and Gabis L (2009). Essential fatty acids and attention-deficit-hyperactivity disor...
ADHD and CAMModalities
Page | 17
http://www.psychologytoday.com/blog/in-the-zone/201107/adhd-inflammatory-
condition.
Sinn...
ADHD and CAMModalities
Page | 18
University of Maryland Medical (2013) Attention deficit hyperactivity disorder. Retrieved...
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CAM Modalities & ADHD Management

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Novel Condition Monograph for Complimentary Alternative Medicine (CAM) modalities proposed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Monograph created from a current literature search on treatment for ADHD, evidenced based complimentary therapies, nutrition, and dietary interventions.

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CAM Modalities & ADHD Management

  1. 1. RUNNINGHEAD: ADHD CAMModalities 1 ConditionMonograph for NAT 504 CAM Modalities & ADHD Management By Kimmer Collison-Ris, MSN, FNP-C, WOCN
  2. 2. ADHD and CAMModalities Page | 2 ADHD Management via Complimentary Medicine Name of Condition Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition characterized by the inability to concentrate in a sustained manner, pay attention to tasks, and to control impulsive actions (Sorgi, Hallowell, Hutchins, and Sears 2007). The exact etiology is unknown but major multifactorial contributors include brain inflammation (Sears, 2011) adverse food additive responses, food intolerances, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins (ie. heavy metals and organohalide pollutants). Thyroid hypofunction may also be a link with toxic insults in ADHD symptomatologies (Kidd, 2000). The Huffington Post (March 26, 2013) cited a study published in The Journal of Neurology demonstrating “an association between having higher infection levels in the blood and risk of cognitive problems." Genetics is also suspected to play a role. Persons with ADHD struggle with development in emotional, educational, and social deficits; the impact of poor therapy has a negative effect on their future possibilities. Many individuals do not respond to conventional stimulant therapy alone, however, reported nutritional intervention appears to compliment conventional therapy, possibly playing a greater role in the etiology of ADHD syndrome (Starobrat-Hermelin and Kozielec 1997). Body System Affected Brain and Nervous System Pathophysiology Scientific theorists, believe ADHD is related to abnormalities in the frontostriatal brain circuitry and possible hypofunctioning of dopaminergic pathways; this is consistent with the benefits obtained in some cases with the use of psychostimulants (Kidd, 2000). Among the
  3. 3. ADHD and CAMModalities Page | 3 genetic and environmental influences is an observed decrease in long-chain (LC) polyunsaturated fatty acids (PUFAs) in children with ADHD. Proposed mechanisms for the low levels of PUFAs include insufficient dietary intake, inefficient conversion of shorter chain PUFAs to LC PUFAs or rapid metabolism of LC PUFAs (Sorgi, Hallowell, Hutchins, and Sears, 2007). Other recent evidence also suggests a deficit in cortical inhibition via the GABA-ergic system (γ-aminobutyric acid) report researchers Edden, Crocetti , Zhu, Gilbert, and Mostofsky (2012). As previously mentioned, The Journal of Neurology found a link between brain inflammation and infection and cognitive problems. Allopathic Diagnosis and Treatment Diagnosis is based upon a medical history, physical exam, and a comparison of the Connor’s Parent Teacher rating scales showing behavioral disruption in two different environments over a period of time . Laboratory data would show no evidence of other medical conditions. Allopathic providers believe the primary factor in ADHD development is related to the status of the monoamine system which impacts serotonin, dopamine, norepinephrine, and epinephrine. Pharmaceutical treatment is aimed to impact the monoamine systems with neutral sulfate salts like dextro-amphetamine and amphetamine, methylphenidate, dexmethylphenidate, atomextine, and lisdexamfetamine dimesylate. However, they are unable to increase the total number of neurotransmitter molecules in the central nervous system (Hinz, Stein, Neff, Weinberg, and Uncini, 2011). When to Refer Clinical Diagnosis of ADHD requires a licensed medical provider, psychologist, psychiatrist, or PhD educational specialist. If the client is suspected of having ADHD but has not been
  4. 4. ADHD and CAMModalities Page | 4 formally diagnosed, a CAM provider must refer to one of the above providers for testing and analysis because other conditions like nutritional deficiencies, inflammation, or allergy/sensitivities can mimic attentional and behavioral problems. Integrative Perspective of Causes The dietary intake pattern of general populations in Asian and American countries often reflects many nutrient deficiencies, especially essential vitamins, minerals, and omega-3 fatty acids. Rao, Asha, Ramesh, and Rao (2008) report, that “few people are aware of the connection between nutrition and depression while they easily understand the connection between nutritional deficiencies and physical illness. A notable feature of the diets of patients suffering from mental disorders is the severity of deficiency in these nutrients”. The Western diet is inflammatory. In sensitive individuals, an inflammatory diet may cause symptoms of inattention, hyperactivity, aggression, irritability, and mood swings (Bube, 2013; Sears 2011; Feingold n.d.). Research is also suggestive of toxic buildup in sensitive individual’s systems which can contribute to the symptoms of ADHD. The Western diet is unable to eliminate environmental or food contaminants and likely intensifies these symptoms. Murray and Pizzorno (2010) hypothesize that dietary alterations may serve as a useful tool to detoxify individuals unable to eliminate toxic buildup. Specialized Integrative Analysis Increasing evidence demonstrates that many adolescents with behavioral problems are sensitive to >1 food components that negatively impact their behavior. Schnoll, Burshteyn, and Cea-Aravena (2003) found that individual response was an important factor for determining the proper approach to treating children with ADHD. Artificial food colors (AFCs) have not been established as the main cause of ADHD, but accumulated evidence suggests that a subgroup
  5. 5. ADHD and CAMModalities Page | 5 shows significant symptom improvement when consuming an AFC-free diet and reacts with ADHD-type symptoms on challenge with AFCs. Of children with suspected sensitivities, 65% to 89% reacted when challenged with at least 100 mg of AFC. Oligoantigenic diet studies suggested that some children in addition to being sensitive to AFCs are also sensitive to common nonsalicylate foods (milk, chocolate, soy, eggs, wheat, corn, legumes) as well as salicylate- containing grapes, tomatoes, and orange (Stevens, Kuczek, Burgess, Hurt, Arnold 2011; Feingold n.d.; Murray and Pizzorno 2010). Reactive hypoglycemia is a commonly undiagnosed problem that manifests as symptoms of ADHD, treatment includes eating protein and a complex carbohydrate about every two hours to avoid the spikes and extreme drops in blood sugars which cause irritability, agitation, restlessness, hyperactivity, poor concentration, and fatigue. Dr. Barry Sears (2011) reports inflammation of the brain cells results in increased neurological disorders, including ADHD. Integrative Support Protocols Integrative ADHD support protocols are designed to help maintain focus and concentration; as well as channel frustrations, anxiety, and energy. Whole foods diet is a key CAM Therapy in the management of ADHD and is comprised of an organic nutrient dense whole foods diet that omits food aggravators. Because nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins, omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine can ameliorate ADHD symptoms. Nutritional factors such as food additives, refined sugars, food sensitivities/allergies, and fatty acid deficiencies have all been linked to ADHD. There is increasing evidence that many children with behavioral problems are sensitive to one or more food components that can negatively impact their behavior (Schnoll, Burshteyn, and Cea-Aravena, 2000). When individually managed with
  6. 6. ADHD and CAMModalities Page | 6 supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a holistic program of management, the ADHD subject can lead a normal and productive life (Kidd, 2000). Dietary Support The following steps have been useful in decreasing ADHD symptoms in the table below. Step Rationale 1. Treat reactive hypoglycemia. Hypoglycemia can mimic ADHD 2. Consume an anti-inflammatory whole foods diet. Inflammation has been implicated in ADHD 3. Eliminate all caffeine, sodas,prepared/prepackaged foods,candy, and cookies. Food colors, preservatives,flavorings, and additives can cause behavioral issues in sensitive individuals. 4. Eat whole low-processed foods like eggs,meats, cheeses,fresh vegetables and fruits, nuts,seeds,and legumes. A whole /low processed foods diet is anti-inflammatory and decreases food sensitive triggers. 5. Avoid all white flour, refined sugars,high fructose corn syrup,artificial colors & additives. These foods are implicated in contributory to symptoms of ADHD. 6. Consume a low gluten, low casein diet. These foods have been helpful in some individuals sensitive to casein & gluten. 7. Make whole foods appealing by choosing color, variety, and textures. A varied diet may help avoid food triggers and cravings & is higher in anti-oxidants. 8. Drink large amounts of fresh filtered water, to help brain and body cells function properly and flush out body toxins. Chemical water additives have been implicated in environmental causes of ADHD; fresh water flushes out toxins. 9. Keep weight healthy and monitor it regularly. Obesity and ADHD are directly linked. 10. Ingest appropriate levels of high dose micronutrients. Micronutrients help to correct nutritional imbalances, boost the immune system,& help detoxify the body. 11. Get 60 minutes of physical activity/exercise daily. Physical activity increases circulation; helping to detoxify the body,& channels excess energy. Food Supplement Therapy (Vitamins & Minerals) CAM providers have found food supplements help decrease ADHD symptoms (see table 2). Name Rationale Caution Vitamin C Antioxidant, anti-inflammatory, improved the behavior in persons w/ ADHD L-carnitine formed from an amino acid and helps cells in the body produce energy - A study found that 54% of a group of boys with ADHD showed behavioral improvement -no studies exist on safe use in children -may also worsen hypothyroid symptoms, interact with some medications, and lower seizure threshold persons with previous seizure history
  7. 7. ADHD and CAMModalities Page | 7 Vitamin B6 Adequate levels of vitamin B6 are needed for the body to make and use brain chemicals, including serotonin,dopamine, and norepinephrine - B6 pyridoxine was slightly more effective than Ritalin in improving behavior among hyperactive children. High doses ofVitamin B6 can be dangerous and cause nerve damage GABA Is a neurotransmitter in the brain and is the main inhibitory neurotransmitter, resulting in calming effects. Essential fatty acids from fish oil (omega-3 fatty acids) play a key role in normal brain function - Studies reveal that children with ADHD who take the oil supplements for a period of three months, showsignificant improvements in spelling, reading, and behavior. -use with caution as high doses may increase the risk of bleeding Iron - ADHD kids tend to have low ferritin levels ( iron storage protein) -Low iron alters dopamine activity & slows brain development Iron levels must be analyzed before instituting treatment. Magnesium Symptoms of magnesium deficiency include irritability, decreased attention span,and mental confusion - A study of75 magnesium-deficient children with ADHD, those who received magnesium supplements showed an improvement in behavior compared to those who did not receive the supplements Caution should be exercised as magnesium can interfere with certain medications, including antibiotics and blood pressure medications and be dangerous. Zinc regulates the activity of brain chemicals, fatty acids, & melatonin which are related to behavior; helps regulate the function of the neurotransmitter dopamine; Research shows that zinc significantly reduces hyperactivity and impulsivity; Low zinc is related to weakened intestinal integrity Adult women who are pregnant or breastfeeding should limit their intake of zinc to 40 mg per day to avoid pregnancy or infant development complications. Botanical Therapy Herbs help to strengthen and tone the body's systems; several botanical formulations for ADHD management are sold in the United States and Europe, but few scientific studies have investigated whether these herbs improve symptoms of ADHD. Herbs are formulated as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). One or more of the following botanicals may be recommended for reducing ADHD symptoms people (see table 3 below): Name Rationale Caution Bacopa (Bacopa monnie ri) aka brahmi sedative and improves anxiety &hyperacti vity; improves memory and concentration Can cause temporary hearing loss in women, interacts w/estrogen therapy
  8. 8. ADHD and CAMModalities Page | 8 Roman chamomile (Chamaemelum nobile). Calming; relieves allergies, inflammation, & insom nia -may cause an allergic reaction in people sensitive to Ragweed; -may have estrogen-like effects --use with caution in hormone-related conditions,(ie. breast, uterine, or ovarian cancers, or endometriosis). -can interact with some medications Evening Primrose Oenothera biennis (contains Omega 3 Fatty Acids, Linoleic Acid, Gamma Linoleic Acid & omega-6 fatty acids) lack of various polyunsaturated fatty acids can contribute to attention deficit hyperactivity Lowers seizure threshold in persons taking anti-epileptics, schizophrenic meds Ginkgo Biloba(Gingko biloba) -used to improve memory & mental sharpness; improves inattention & immaturity problems; increases blood flow to the brain; helps w/ADHD sx that affect intellectual functions - used with caution in diabetes,seizures, infertility, & bleeding disorders -can interact with meds (esp. blood- thinning agents) Ginseng (American or Siberian) American ginseng (Panax quinquefolium) - known for memory boosting benefits - increases brain levels of neurotransmitters dopamine and norepinephrine -- Imbalances lead to disruption in attention span,motor behavioral dysfunctions,and auditory processing delays. - One study found gingko along w/ginseng improved ADHD sx American ginseng caution in diabetes, hormone-sensitive conditions,insomnia, or schizophrenia -can interact (esp blood-thinning agents) Gotu Kola (Centella asiatica) improves memory, concentration & mental fatigue breast feeding women and pregnant women must avoid the use Grapeseed Extract protects from excitotoxins Hawthorn Relieves acting out & stops inflammation caused by allergies Interacts w/cardiac meds, not indicated for use in children, pregnancy,or lactation Lemon balm (Melissa officinalis) gentle, safe calming herb for anxiety & depression; relaxes nervous system, eases agitation. avoided by individuals affected by glaucoma Passionflower (Passiflora incarnata) calming sedative that causes less drowsin ess than drugs -may interact with sedative medications. Scullcap Indicated for aggressive & agitated persons; helps decrease anxiety, restlessness,crying spells, irritabi lity, &nervousness. Useful daytime sedative that works w/o drowsiness; prevents allergic reactions. -may decrease leukocyte count -use undersupervision as can damage the liver St. John’s Wort (Hypericum perforatum) nervine tonic, antidepressant, regulates mood and attention; inhibiting the reuptake of serotonin, inhibits the reupta ke of norepinephrine and dopamine w/eq ual affinity; has an affinity for GABA receptors Interacts w/other meds, esp anti- depressants Valerian (Valerian increase in concentration and abilities and -can interact with some meds
  9. 9. ADHD and CAMModalities Page | 9 officinalis) energy levels -can induce drowsiness -can interact with sedative meds Digestion/Apsorption of Nutrients Maximum absorption of key nutrients is essential for overall body health and nervous system function. Digestive enzymes can increase nutrients and supplement absorption; many persons note improvement in ADHD symptoms when taking broad-spectrum enzyme or those targeting specific compounds. Digestive Enzymes Rationale Amylase breaks down carbohydrates,starches,&sugars Cellulase breaks down cellulose, plant fiber Protease breaks down proteins (found in meats, eggs,cheese,and nuts Lipase breaks down fats (found in most dairy products,meats, oils, and nuts) Papaya digestive enzymes Important for food/nutrient breakdown & assimilation Homeopathy Homeopathic remedies address each person's constitutional type -- physical, emotional, and psychological makeup; an experienced homeopath assesses these factors when determining the most appropriate individual’s treatment. One study of 43 ADHD diagnosed children, showed significant improvement in behavior when they received an individualized homeopathic remedy compared to children who received a placebo. Homeopathic remedies found to be most effective included: Stramonium, for children who are fearful, especially at night; Cina -- for children who are irritable and dislike being touched; whose behavior is physical and aggressive; and Hyoscyamus niger -- for children who have poor impulse control, talk excessively, or act overly exuberant (Wisegeek, 2013). SleepHygiene Persons with ADHD often have disordered sleep patterns that contribute to behavior and
  10. 10. ADHD and CAMModalities Page | 10 attention issues. Stimulant medications prescribed for ADHD often disrupts sleeping patterns causing insomnia. Melatonin helps to promote sleep in persons with ADHD and may improve behavioral and attention (Wisegeek, 2013).. Experts suggest melatonin is effective when taken for 3 weeks on and one week off (Sears, 2011). Adjunctive CAM techniques Yoga, meditation, and self-calming activities, along with increased physical activity (walking, weight lifting, swimming and biking have been useful in persons with attentional issues. Massage Relaxation techniques and massage can reduce anxiety and activity levels in children adolescents, and adults with ADHD. In one study, teenage boys with ADHD who received 15 minutes of massage for 10 consecutive school days showed significant improvement in behavior and concentration compared to those who were guided in progressive muscle relaxation for the same duration of time (WiseGeek, 2013). Biofeedback Mind/body techniques such as hypnotherapy, progressive relaxation, and biofeedback may be useful in treating individuals with ADHD. Through these techniques, individuals are often able to learn coping skills they can use for the rest of their lives. These treatments allow persons to gain a sense of control and mastery, increase self esteem, and decrease stress. Biofeedback operates on the principle that individuals can be trained to modify brain activity associated with ADHD and increase brain activity associated with attention. Several studies have shown positive results (Burton, 2008).
  11. 11. ADHD and CAMModalities Page | 11 Summary Further research is needed in the area of CAM ADHD botanical and food supplement therapy and management; as well as the dietary and environmental influences that cause inflammation in ADHD. Children, Adolescents, and adults respond differently to ADHD treatments and need a variety of modalities available to address their unique needs beyond Allopathic prescription medications.
  12. 12. ADHD and CAMModalities Page | 12 References Ageranioti Bélanger S and Vanasse M (n.d.).Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study. Pediatrics & Childhealth. Retrieved from Pub Med via ACHS Library. Arnold LE. Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD). Ann N Y Ann N Y Acad Sci. 2001 Jun;931:310-41. Arnold LE and DiSilvestro RA. (2005). Zinc in attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmaco. 2005 Aug;15(4):619-27. Arnold LE, DiSilvestro RA, Bozzolo D, Bozzolo H, Crowl L, Fernandez S, Ramadan Y, Thompson S, Mo X, Abdel-Rasoul M, and Joseph E (2011). Zinc for Attention- Deficit/Hyperactivity Disorder: Placebo-Controlled Double-Blind Pilot Trial Alone and Combined with Amphetamine. Burton, D (2008). Attention deficit hyperactivity disorder: herbal and natural treatments. Ohlone Herbal Center. Retrieved from http://www.ohlonecenter.org/research-papers/attention%C2%ADdeficit-hyperactivity- disorder-herbal-and-natural-treatments/ Journal Child Adolesc Psychopharmacol. 2011 February; 21(1): 1–19. doi: 10.1089/cap.2010.0073 Cortese S, Angriman M, Lecendreux M, Konofal E. (2012). Iron and attention deficit/hyperactivity disorder: What is the empirical evidence so far? A systematic review of the literature. 1 Expert Rev Neurother. 2012 Oct;12(10):1227-40. doi: 10.1586/ern.12.116.
  13. 13. ADHD and CAMModalities Page | 13 Balch J, Stengler M, and Balch RY (2008). Prescription for Drug Alternatives. J. Wiley & Sons, Inc: Danvers, MA Balch P (2002). Prescription for Herbal healing: An easy to use A-to-Z reference to hundreds of common disorders and their herbal remedies. Penguin Press, Inc: New York Blum K, Chen K, and Oscar-Berman M (n.d.). Attention-deficit-hyperactivity disorder and reward deficiency syndrome. Child Pediatric Health. Retrieved from ACHS library via Pubmed. Burton, D (2008). Attention Deficit Hyperactivity Disorder: Herbal and Natural Treatments. Ohlong Herbal Center. Retrieved from http://www.ohlonecenter.org/research- papers/attention%C2%ADdeficit-hyperactivity-disorder-herbal-and-natural-treatments/ Doney R and Thome J (2010). Inflammation: good or bad for ADHD? ADHD Attention Deficit and Hyperactivity Disorders December 2010, Volume 2, Issue 4, pp 257-266 Retrieved from http://link.springer.com/article/10.1007/s12402-010-0038-7. Dvořáková M, Ježová M, Blažíček P, Trebatická J, Škodáček I, Šuba, J, Waczulíková I, Rohdewald P, and Ďuračková Z (2007). Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): Modulation by a polyphenolic extract from pine bark (Pycnogenol®) Nutritional Neuroscience, Volume 10, Numbers 3-4, June/August 2007 , pp. 151-157(7) Retrieved from http://www.ingentaconnect.com/content/maney/nns/2007/00000010/F0020003/art00007 Edden RA, Crocetti D, Zhu H, Gilbert DL, Mostofsky SH (2012). Reduced GABA concentration in attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2012 Jul;69(7):750-3. doi: 10.1001/archgenpsychiatry.2011.2280. Retrieved from ACHS library.
  14. 14. ADHD and CAMModalities Page | 14 www.Feingold.com Gottlieb, B (2000). Alternative Cures: The most effective home remedies. Rodale Press, Inc: Hinz M, Stein A, Neff R, Weinberg R, and Uncini T (2011). Treatment of attention deficit hyperactivity disorder with monoamine amino acid precursors and organic cation transporter assay interpretation. Neuropsychiatr Dis Treat. 2011; 7: 31–38. Horrocks LA and Yeo (1999).Health benefits of docosahexaenoic acid (DHA). YK.Pharmacol Res. 1999 Sep;40(3):211-25 Hurt EA, Arnold LE, Lofthouse N. Dietary and nutritional treatments for attention- deficit/hyperactivity disorder: current research support and recommendations for practitioners. Curr Psychiatry Rep. 2011 Oct;13(5):323-32. doi: 10.1007/s11920-011- 0217-z. Huffington Post (March 26, 2013) Huss M, Völp A, Stauss-Grabo M. (2010).Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems - an observational cohort study. Kidd PM (2000). Attention deficit/hyperactivity disorder (ADHD) in children: rationale for its integrative management. Altern Med Rev. 2000 Oct;5(5):402-28. (LA Times, 3/2013) Lipids Health Dis. 2010 Sep 24;9:105. doi: 10.1186/1476-511X-9-105. Hyperactivity Disorders December 2010, Volume 2, Issue 4, pp 257-266 Retrieved from http://link.springer.com/article/10.1007/s12402-010-0038-7. Lyon M, and Murray M “Attention Deficit Hyperactivity Disorder” CHAPTER150 pp 1252- Textbook of Natural Medicine.
  15. 15. ADHD and CAMModalities Page | 15 McCarthy, J and Kartzinel, J (2009). Healing and Preventing Autism: A complete guide. Penguin Group, Inc. New York: New York. Mahan L.K., Escott-stump, S, and Raymond J.L. (). Krause’s Food & the Nutrition Care Process, 13th Ed. Elsevier Sunders: St. Louis, Missouri. Millichap JG and Yee MM (2012). Pediatrics. 2012 Feb;129(2):330-7. doi: 10.1542/peds.2011- 2199. Epub 2012 Jan 9. Mousain-Bosc M, Roche M, Polge A, Pradal-Prat D, Rapin J, Bali JP. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Magnes Res. 2006 Mar;19(1):46-52. Murray, M and Pizzorno, J. (1998).Encyclopedia of Natural medicine, rev 2nd ed. Prima Health: Rocklin, CA. Osman, B (1997). Learning Disabilities & ADHD: A family guide to living & learning together. J Wiley & Sons: Danvers, MA. Page, L and Abernathy, S (2011). Healthy Healing, 4th ed. Healthy Healing Enterprises, LLC. Pg. 337-338. Peters, D. and Pelletier, K.R.(2007). ADHD pp 402-405. New Medicine: Complete Family Health Guide. Dorling Kindersley Limited: London. Pizzorno J and Murray M. (2013). Textbook of Natural Medicine (ed. 4th). St. Louis, Missouri: Elsevier Churchill Livingston, 1167-1168.
  16. 16. ADHD and CAMModalities Page | 16 Raz R and Gabis L (2009). Essential fatty acids and attention-deficit-hyperactivity disorder: a systematic review. Dev Med Child Neurol. 2009 Aug;51(8):580-92. doi: 10.1111/j.1469- 8749.2009.03351.x. Epub 2009 Jun 22. Raz R, Carasso RL, and Yehuda S (2009). The influence of short-chain essential fatty acids on children with attention-deficit/hyperactivity disorder: a double-blind placebo-controlled study. J Child Adolesc Psychopharmacol. 2009 Apr;19(2):167-77. doi: 10.1089/cap.2008.070. Rao TSS, Asha MR, Ramesh BN, and Rao KSJ (2008). Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008 Apr-Jun; 50(2): 77–82. doi: 10.4103/0019- 5545.42391 Richardson AJ (2006). Omega-3 fatty acids in ADHD and related neurodevelopmental disorders. 2006, Vol. 18, No. 2 , Pages 155-172 (doi:10.1080/09540260600583031). Retrieved from http://informahealthcare.com/doi/abs/10.1080/09540260600583031. Rucklidge JJ, Johnstone J, Kaplan BJ (2009). Nutrient supplementation approaches in the treatment of ADHD. 1 Expert Rev Neurother. 2009 Apr;9(4):461-76. doi: 10.1586/ern.09.7. Schnoll R, Burshteyn D, Cea-Aravena J.Nutrition in the treatment of attention-deficit hyperactivity disorder: a neglected but important aspect. Appl Psychophysiol Biofeedback. 2003 Mar;28(1):63-75. Sears B. "Toxic Fat." Thomas Nelson. Nashville, TN (2008) Sears B (2011). ADHD: An inflammatory condition. The link between ADHD and obesity. Published on July 20, 2011 by Barry Sears, Ph.D. in In the Zone. Retrieved from
  17. 17. ADHD and CAMModalities Page | 17 http://www.psychologytoday.com/blog/in-the-zone/201107/adhd-inflammatory- condition. Sinn N and Bryan J (2007). Effect of Supplementation with Polyunsaturated Fatty Acids and Micronutrients on Learning and Behavior Problems Associated with Child ADHD. Journal of Developmental & Behavioral Pediatrics: April 2007 - Volume 28 - Issue 2 - pp 82-91 doi: 10.1097/01.DBP.0000267558.88457.a5. Retrieved from http://journals.lww.com/jrnldbp/Abstract/2007/04000/Effect_of_Supplementation_with_ Polyunsaturated.2.aspx Sorgi PJ, Hallowell EM, Hutchins HL, and Sears B (2007). Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder Nutr J. 2007; 6: 16. Published online 2007 July 13. doi: 10.1186/1475-2891-6-16 Starobrat-Hermelin B, Kozielec T. (1997).The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test.Magnes Res. 1997 Jun;10(2):149-56. Stenninger E, Flink R, Eriksson B, and Sahlen C (1998). Long term neurological dysfunction and neonatal hypoglycaemia after diabetic pregnancy Arch Dis Child Fetal Neonatal Ed. 1998 November; 79(3): F174–F179. Stevens, Kuczek, Burgess, Hurt, Arnold, 2011 Dietary sensitivities and ADHD symptoms: thirty- five years of research. Clin Pediatr (Phila). 2011 Apr;50(4):279-93. doi: 10.1177/0009922810384728. Epub 2010 Dec 2.
  18. 18. ADHD and CAMModalities Page | 18 University of Maryland Medical (2013) Attention deficit hyperactivity disorder. Retrieved from Centerhttp://umm.edu/health/medical/altmed/condition/attention-deficit-hyperactivity- disorder#ixzz2eSuNWSv Waldo E and Connected Health Systems, LLC (2008). Treating ADHD and other diseases involving inflammation. Retrieved from http://patentscope.wipo.int/search/en/WO2008103538. Wang GX, Ma YH, Wang SF, Ren GF, Guo H (2012).Association of dopaminergic/GABAergic genes with attention deficit hyperactivity disorder in children. Mol Med Rep. 2012 Nov;6(5):1093-8. doi: 10.3892/mmr.2012.1028. Epub 2012 Aug 9 Wisegeek (2013)How do I choose the best Supplements for ADHD? Retrieved from http://www.wisegeek.com/how-do-i-choose-the-best-supplements-for-adhd.htm Zavala M, Castejón HV, Ortega PA, Castejón OJ, Marcano de Hidalgo A, Montiel N. [Imbalance of plasma amino acids in patients with autism and subjects with attention deficit/hyperactivity disorder]. Rev Neurol. 2001 Sep 1-15;33(5):401-8. [Article in Spanish] Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11727202

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