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Support for ADHD, focus, and mood
Whether it’s full-blown attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or a milder form of neurocognitive irritation, more and more of us are struggling with anxiety, inattention, hyperactivity, behavior issues, learning disabilities, and sleep disturbances. Through targeted nutritional support, however, there is hope for both adults and children hoping to turn their brains into less of a circus show and more of a Zen dojo.
Here are some strategies for creating calm amidst the chaos:
Fighting oxidative stress and protecting DNA
French maritime pine bark extract has been the topic of over 400 peer-reviewed studies and has been shown to support brain function in those with behavioral and learning challenges by improving cognitive function, attention, mental performance, and working memory.[1],[2],[3]
Given its safety profile[4] and positive outcomes in supporting the neurological health of adults,[5] French maritime pine bark extract has drawn the interest of researchers searching for safe strategies to support children with attention issues, in particular ADHD. The results of one such study show that a month of supplementation with the extract led to a significant reduction of hyperactivity, improved attention, improved visual-motor coordination, and improved concentration in children with ADHD.[6]
These benefits may be due to pine bark extract’s rich content of polyphenols, potent antioxidants that fight inflammation and protect against DNA damage.[7] Polyphenolic compounds have proven their value in the field of mental health, and have been shown to support brain plasticity, behavior, mood, depression, and cognition.[8]
Although several properties of polyphenols have been described, they are best known for their antioxidant properties. As the words “anti” and “oxidant” imply, these compounds have been shown to protect our cells against oxidative damage, therefore reducing the risk of various conditions associated with oxidative stress – conditions like ADHD.[9],[10] In fact, abnormal oxidative metabolism and the subsequent depletion of the important antioxidant glutathione is one of the understood aspects of ADHD and its progression.[11] Unfortunately, this type of oxidative damage in the brain can be a factor not only in attention, but in mood[12] and cognitive decline.[13]
Thankfully, in a randomized, double-blind, placebo-controlled (RDBPC) trial, one month of supplementation with pine bark extract was shown to significantly increase glutathione levels and enhance total antioxidant status (TAS) in children with ADHD.[14] Another RDBPC trial also showed reduced oxidative damage to DNA, normalized TAS, and improvement in attention span in children with ADHD after one month of supplementation.[15] In both of these studies, a dose of 1 mg of extract per kilogram of body weight (1mg/kg) was administered to the children, with no observed adverse effects.
A randomized, double-blind, placebo-controlled (RDBPC) trial also showed reduced oxidative damage to DNA, normalized total antioxidant status (TAS), and improvement in attention span in children with ADHD after one month of supplementation of French maritime pine bark extract.
Other proposed mechanisms of ADHD include immune system dysfunction and an abnormal inflammatory response – both of which are potentially addressed by the immunomodulatory and anti-inflammatory effects vested in the polyphenols of pine bark extract.[16] It is no wonder, then, that French maritime pine bark extract is being investigated as an alternative to medications used for this condition as well.[17]
Calming the mind
Considering that many of the neurological ailments that affect both adults and children – hyperactivity, inattention, stress, behavioral instability, and sleep disturbance – are associated with excess excitatory neurotransmitter production, the use of calming agents can be of great value.
The balance of glutamate (an excitatory neurotransmitter) and gamma-aminobutyric acid (GABA) (a calming amino acid) plays an important role in brain health.[18] Namely, children with ADHD tend to have higher than normal levels of glutamate and lower than normal levels of GABA, tipping the balance to that of an activated, excitatory state.[19] Those with ADHD have in particular been shown to have lower GABA levels in the anterior cingulate cortex, a region of the brain associated with decision-making, emotion, and impulse control.[20] Lower GABA concentrations have also been associated with poor sleep quality,[21] depression, and anxiety.[22],[23],[24]
Those with ADHD have in particular been shown to have lower GABA levels in the anterior cingulate cortex, a region of the brain associated with decision-making, emotion, and impulse control.
Fortunately, GABA supplementation has been shown to induce relaxation, mitigate anxiety,[25] and increase the alpha brain wave patterns associated with wakeful relaxation states, as in meditation.[26],[27]
Derived from green tea, the amino acid L-theanine has also been shown to be of service in reversing excitatory states by supporting relaxation, increasing alpha-wave activity, and blocking the activation of glutamate receptors in the brain.[28],[29] L-theanine has also been shown to significantly increase the levels of serotonin, dopamine, and GABA in the brain,[30],[31] as well as to increase the expression of brain-derived neurotrophic factor (BDNF) protein, thus enhancing our ability to learn new things and form memories.[32] At a dose of 200 mg twice daily, L-theanine also has been shown to safely improve aspects of sleep quality in children with ADHD.[33]
Magnesium deficiency was observed in 95% of children with ADHD.
Children with ADHD are more likely to be deficient in the mineral magnesium than unaffected children. In fact, magnesium deficiency was observed in 95% of children with ADHD in one study,[34] and several trials have demonstrated the validity of magnesium supplementation to help both children and adults with ADHD, anxiety, stress, and other neurocognitive struggles.[35],[36],[37] In the case of ADHD, magnesium has been found to be particularly helpful in alleviating hyperactivity.[38],[39],[40] Although taking too high of a dose of magnesium at once may cause loose stools, the safety profile of magnesium supplements is excellent.[41]
Mend the gut, heal the mind
A balanced microbiome and gastrointestinal integrity also likely influence neurological health in both children and adults,[42] making probiotics potentially powerful allies in the management of ADHD, autism spectrum disorder, and their associated symptoms.
Phosopholipids such as phosphatidylcholine may also be of benefit to those in need of nervous system support, as they have been shown not only to support the mucosal barrier in the gut, but also to enhance cellular repair in the brain.[43],[44]
Detoxification for nervous system health
From pesticides and additives in our food supply, to the chemicals found in plastics and other household items, to the over-prescription of pharmaceutical medications, we are exposed to a surprising number of toxicants. This, coupled with the increasing incidence of genetic mutations that can compromise detoxification pathways, may place undue strain on the nervous systems of children – males, in particular.[45]
As mentioned above, the powerful antioxidant glutathione, as well as other nutrients that support it like French maritime pine park extract, selenium, and N-acetyl cysteine (NAC), are of particular value in supporting the liver and its detoxification pathways in both children and adults.[46],[47]
Methylated B vitamins – namely methylcobalamin (methyl B12) and folate – and magnesium may further support mood, enhance detoxification pathways, and augment nutritional status in those with ADHD and other neurocognitive challenges.[48],[49]
In short, nature has much to offer those struggling with ADHD and other neurocognitive challenges. From antioxidant support to neurotransmitter balance to gut health to detoxification, there are many paths to find the cognitive health and balance that we all (even children!) seek.
Click here to see References
[1] Trebatická J, et al. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006 Sep;15(6):329-35. [2] Dvoráková M, et al. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (Pycnogenol). Nutr Neurosci. 2007 Jun-Aug;10(3-4):151-7. [3] Dvoráková M, et al. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox Rep. 2006;11(4):163-72. [4] D’Andrea G. Pycnogenol: a blend of procyanidins with multifaceted therapeutic applications? Fitoterapia. 2010 Oct;81(7):724-36. [5] Hosoi M, et al. Pycnogenol® supplementation in minimal cognitive dysfunction. J Neurosurg Sci. 2018 Jun;62(3):279-84. [6] Trebatická J, et al. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006 Sep;15(6):329-35. [7] Bhooshan Pandey K, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009 Nov-Dec; 2(5):270-8. [8] Trebatická J, ÄŽuraÄŤková Z. Psychiatric disorders and polyphenols: can they be helpful in therapy? Oxid Med Cell Longev. 2015;2015:248529. [9] Vita JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. Am J Clin Nutr. 2005;81:292-7. [10] GarcĂa-Lafuente A, et al. Flavonoids as antiinflammatory agents: implications in cancer and cardiovascular disease. Inflamm Res. 2009;58:537-52. [11] Ceylan MF, et al. Changes in oxidative stress and cellular immunity serum markers in attention-deficit/hyperactivity disorder. Psychiatry Clin Neurosci. 2012 Apr;66(3):220-6. [12] Ozcan ME, et al. Antioxidant enzyme activities and oxidative stress in affective disorders. Int Clin Psychopharmacol. 2004 Mar;19(2):89-95. [13] Mulero J, et al. Oxidative stress, frailty and cognitive decline. J Nutr Health Aging. 2011 Nov;15(9):756-60. [14] Dvoráková M, et al. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox Rep. 2006;11(4):163-72. [15] Chovanová Z, et al. Effect of polyphenolic extract, Pycnogenol, on the level of 8-oxoguanine in children suffering from attention deficit/hyperactivity disorder. Free Radic Res. 2006 Sep;40(9):1003-10. [16] Verlaet AAJ, et al. Rationale for dietary antioxidant treatment of ADHD. Nutrients. 2018 Mar;10(4):405. [17] Verlaet AA, et al. Effect of Pycnogenol® on attention-deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial. Trials. 2017 Mar;18(1):145. [18] Petroff OA. GABA and glutamate in the human brain. Neuroscientist. 2002 Dec;8(6):562-73. [19] Gilgun, JF. The NEATS: A Child & Family Assessment. Printed by CreateSpace, 2011. [20] Ende G, et al. Impulsivity and aggression in female BPD and ADHD patients: association with ACC glutamate and GABA concentrations. Neuropsychopharmacology. 2016 Jan;41(2):410-8. [21] Gottesmann C. GABA mechanisms and sleep. Neuroscience. 2002;111(2):231-9. [22] Pehrson AL, Sanchez C. Altered Îł-aminobutyric acid neurotransmission in major depressive disorder: a critical review of the supporting evidence and the influence of serotonergic antidepressants. Drug Des Devel Ther. 2015;9:603-24. [23] Meyerhoff DJ, et al. Cortical gamma-aminobutyric acid and glutamate in posttraumatic stress disorder and their relationships to self-reported sleep quality. Sleep. 2014;37(5):893-900. [24] Rosso IM, et al. Insula and anterior cingulate GABA levels in posttraumatic stress disorder: preliminary findings using magnetic resonance spectroscopy. Depress Anxiety. 2014;31(2):115-23. [25] Abdou AM, et al. Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. Biofactors. 2006;26(3):201-8. [26] Khare KC, Nigam SK. A study of electroencephalogram in meditators. Indian J Physiol Pharmacol. 2000;44(2):173-8. [27] Yoto A, et al. Oral intake of Îł-aminobutyric acid affects mood and activities of central nervous system during stressed condition induced by mental tasks. Amino Acids. 2012;43(3):1331-7. [28] Nobre AC, et al. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr. 2008;17 Suppl 1:167-8. [29] Kakuda T, et al. Inhibition by theanine of binding of [3H]AMPA, [3H]kainate, and [3H]MDL 105,519 to glutamate receptors. Biosci Biotechnol Biochem. 2002;66(12):2683-6. [30] Yokogoshi H, et al. Effect of theanine, r-glutamylethylamide, on brain monoamines and striatal dopamine release in conscious rats. Neurochem Res. 1998;23(5):667-73. [31] Nathan PJ, et al. The neuropharmacology of L-theanine (N-ethyl-L-glutamine): a possible neuroprotective and cognitive enhancing agent. J Herb Pharmacother. 2006;6(2):21-30. [32] Wakabayashi C, et al. Behavioral and molecular evidence for psychotropic effects in L-theanine. Psychopharmacology (Berl). 2012;219(4):1099-109. [33] Lyon MR, et al. The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. Altern Med Rev. 2011;16(4):348-54. [34] Kozielec T, Starobrat-Hermelin B.. Assessment of magnesium levels in children with attention deficit hyperactivity disorder (ADHD). Magnes Res. 1997 June;10(2):143-8. [35] Boyle NM, et al. The effects of magnesium supplementation on subjective anxiety and stress – a systematic review. Nutrients. 2017 Apr 26;9(5). [36] Gröber U, et al. Magnesium in prevention and therapy. Nutrients. 2015 Sep 23;7(9):8199-226. [37] Sartori SB, et al. Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by therapeutic drug treatment. Neuropharmacology. 2012 Jan;62(1):304-12. [38] Starobrat-Hermelin B. [The effect of deficiency of selected bioelements on hyperactivity in children with certain specified mental disorders]. Ann Acad Med Stetin. 1998;44:297-314. [39] Starobrat-Hermelin B, Kozielec T.. 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;10(2):149-56. [40] Ghanizadeh A. A systematic review of magnesium therapy for treating attention deficit hyperactivity disorder. Arch Iran Med. 2013 Jul 1;16(7):412-7. [41] Mowry JB, et al. 2014 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd Annual Report. Clin Toxicol. 2015;53(10):962-1147. [42] Butel M-J, et al. The developing gut microbiota and its consequences for health. J Dev Orig Hlth Dis. 2018 Mar:1-8. [43] Stremmel W, et al. Mucosal protection by phosphatidylcholine. Dig Dis. 2012;30 Suppl 3:85-91. [44] MorĂ© MI, et al. Positive effects of soy lecithin-derived phosphatidylserine plus phosphatidic acid on memory, cognition, daily functioning, and mood in elderly patients with Alzheimer’s disease and dementia. Adv Ther. 2014 Dec;31(12):1247-62. [45] Kern JK, et al. Developmental neurotoxicants and the vulnerable male brain: a systematic review of suspected neurotoxicants that disproportionally affect males. Acta Neurobiol Exp (Wars). 2017;77(4):269-96. [46] Ziment I. Acetyl cysteine: a drug that is much more than a mucokinetic. Biomed Pharmacother 1988; 42(8):513-519. [47] Joshi D, et al. N-acetyl cysteine and selenium protects mercuric chloride-induced oxidative stress and antioxidant defense system in liver and kidney of rats: a histopathological approach. J Trace Elem Med Biol. 2014 Apr;28(2):218-26. [48] Zhang Y. Decreased brain levels of vitamin B12 in aging, autism and schizophrenia. PLoS One. 2016 Jan 22;11(1):e0146797. [49] James SJ, et al. Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism. Am J Clin Nutr. 2009 Jan;89(1):425-30.
The information provided is for educational purposes only. Consult your physician or healthcare provider if you have specific questions before instituting any changes in your daily lifestyle including changes in diet, exercise, and supplement use.
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Dr. Erica Zelfand
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