Supplements & Attention

It is true that certain vitamin and mineral deficiencies can reduce your ability to sustain attention and can contribute to mood problems. Some of these deficiencies can be taken care of through food intake, others cannot.

The first step in deciding whether or not to use a vitamin or mineral supplement is getting tested to see if you have a deficiency in the first place. We’ve seen many, many patients at our clinic who take dozens of supplements on a daily basis, without any idea if they actually need them or are benefiting from them. At our clinic, we evaluate the many causes of our patient’s attention problems, including vitamin and mineral deficiencies.

Over the years we have found that about 5% of our patients (1 in 20) will have Vitamin B, zinc, magnesium or iron deficiencies. Although each of these vitamins or minerals can be introduced into the body through foods that we eat or drink, a good starting place before beginning treatment for ADHD, is to make sure that one of these deficiencies is not contributing to your problems. Here’s a chart that gives you an estimate of how much of these vitamins and minerals you should be consuming in a daily basis in addition to protein intake.

Group Age (yrs.) Protein (g) Magnesium (mg) Iron (mg) Zinc (mg)
Children 4-6 24/day 120/day 10/day 10/day
Children 7-10 28/day 170/day 10/day 10/day
Males 11-14 45/day 2700/day 12/day 15/day
Males 15-18 59/day 400/day 12/day 15/day
Males 19+ 58/day 350/day 10/day 15/day
Females 11-14 46/day 280/day 15/day 12/day
Females 15-18 44/day 300/day 15/day 12/day
Females 19+ 46/day 280/day 15/day 12/day

Vitamin D Deficiency

A far more common cause of our patient’s attention problems is Vitamin D deficiency. Vitamin D is a substance that binds with calcium and brings it to brain cells. It is the entry of calcium into the brain cell that triggers the release of neurotransmitters. Patients with Vitamin D deficiencies will have significant attention and mood problems and about 33% of our patients have Vitamin D deficiencies or insufficiencies. Unfortunately, Vitamin D is not found in high concentrations in the foods that we eat.

My child eats yogurt and drinks milk with Vitamin D. Isn’t that enough?

While many dairy products will be Vitamin D enriched, the amount found in most foods “pales in comparison” with the amount that is produced by 30 minutes of skin exposure to sunlight (about 10,000 iu’s). Although Vitamin D deficiency is more of an issue in regions where children and adults spend little time in the sun during the academic year (or are clothed from head to toe when they are outside), it is still wise to make sure that Vitamin D deficiency is not part of your attention and mood problem.


How much Vitamin D is needed?

If a supplemental Vitamin D is needed, you’ll need to be mindful that absorption of the Vitamin increases by about 50% if you take the Vitamin with a meal containing dietary fat. Dose of supplement will vary depending on the blood levels of Vitamin D. Insufficiencies (i.e. blood levels of 20-30 ng/nL) will typically respond to 2000 to 3000 iu’s of Vitamin D when you take them with a meal containing fat.

For deficiencies of Vitamin D (<20 ng/mL) dosages of at least 5,000 iu’s are commonly needed. It is important for you to realize that if you test positive for a Vitamin D deficiency, this will be a lifelong problem (unless you move to a sunnier region). Consequently, if you or your child has a Vitamin D deficiency this fall or winter, you’ll need to supplement every year. We typically recommend that supplementation continue from mid-October until May. We also advise that your physician re-evaluate Vitamin D levels in late January to make sure your dose is right for you.

Omega-3 Essential Fatty Acids

Believe it or not, people actually do need to eat fat. Well not just any kind of fat, but Omega-3 Essential Fatty Acids. There are three types of Omega-3’s: alpha-linolenic acid (ALA), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Our bodies seem to be able to use DHA and EPA more easily than ALA, so DHA and EPA are typically recommended. The primary role of DHA and EPA is to help develop and maintain the myelin sheath that covers brain cells and makes rapid communication between brain cells possible.

Consumption of Omega-3’s is important at any age, but is critical in infancy and childhood. The development of the myelin sheath is important for the emergence of all of the “developmental milestones” that parents track. Because neurological development continues until well into our 20’s, it is important that children, adolescents and young adults consume enough Omega-3’s to help their brains develop. As we age, eating Omega-3’s begin to take on a protective function, guarding our brain cells from the damage that can occur with the aging process.

At our clinic, we examine the dietary habits of our patients to make sure that they are eating enough Omega-3’s. At minimum you should be eating at least 500-1000 mg of DHA and EPA per day (4,000 mg of DHA, EPA, and ALA combined). Here’s a chart that can give you an idea of how much Omega-3’s are found in foods like wild caught fish, nuts, seeds, egg yolks and grass fed beef.

Food Type Omega 3's
Alaskan Salmon (wild) 1,716 mg in 3 ounces
Sardines 1,363 mg in 3.75 ounces
Atlantic Mackerel 6,982 mg in 8 ounces
Walnuts 2,664 mg in 2 ounces
Flaxseeds (ground) 1,597 mg in 1 tablespoon
Albacore Tuna 1,414 mg in 3 ounces
White Fish 1,363 mg in 3 ounces
Egg yolks 240 mg in 4 ounces
Grass fed beef 80 mg in 3.5 ounces

Omega-3 Deficiencies and Attention Disorders

Even though it makes sense to consume Omega-3’s, there is a tendency for clinicians to minimize the importance of this type of food in patients with attention problems. Over the past decade there has been increased interest in studying the connection between Omega-3 deficiencies and attention and mood problems. One company investigated this problem extensively (Vaya Pharma) and demonstrated that use of an Omega-3 supplement (Vayarin) significantly reduced symptoms of inattention, impulsivity, restlessness and improved mood in studies of children, adolescents and adults. The degree of improvement noted in a double blind, placebo controlled clinical trial was sufficient for the FDA to indicate Vayarin for use in the treatment of ADHD. For children, teens and adults who do not eat sufficient Omega-3’s, use of Vayarin would be worth considering.

Food Allergies and ADHD

There has been a lot of conflicting reports about the importance of screening children for common food allergies before diagnosing them with ADHD. From our perspective, it is true that a relatively small percentage of our patients (about 3-5%) will have symptoms of inattention, impulsivity or hyperactivity that are caused by food allergies. That translates to about 1 in 25 children. While such a small number may not be a “significant” number statistically, at the FPI Attention Disorders Clinic, we want to make sure that we are treating the specific medical causes of our patient’s problems, and not simply beginning with medication for ADHD and seeing how that works first. At our clinic, we conduct blood screening for the following food allergies: corn, wheat, gluten, dairy, eggs, cocoa, nuts, and food dyes. When we discover a significant food allergy, we work with children and their parents to come up with a way to still enjoy eating, even though a child’s favorite food may be eliminated from their diet.

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