Improvement of ADHD Symptoms with a few supplements and dietary changes

An increasing number of people are being diagnosed with ADHD, which affects neurological development, learning, and social interactions. There is growing evidence that the brain and nervous system often lack nutrients that are necessary for several vital functions, or that they are exposed to harmful substances. A review article published in Cureus shows that supplements of vitamin D, magnesium, and fish oil can improve symptoms.

ADHD, which stands for Attention Deficit Hyperactivity Disorder, is a neuropsychiatric disorder. The symptoms, which vary widely, are divided into inattention, hyperactivity, and impulsivity. ADHD typically occurs at the age of 5-6 years, but some people are diagnosed as adults. Furthermore, over 85% of people with ADHD have at least one other mental disorder. ADHD is believed to be genetically inherited. However, there is increasing evidence that environmental factors play a significant role, as the number of ADHD diagnoses has multiplied in the Western world over the past few decades. Environmental influences include the mother’s condition during pregnancy, such as alcohol and smoking, as well as nutrient deficiencies that affect brain development. Premature birth, brain injuries, and exposure to lead and other toxins also play a role.
According to several researchers, there may be a connection between ADHD and inflammatory mechanisms, as they may affect the formation of neurotransmitters such as tryptophan and dopamine, which are involved in ADHD. ADHD is often treated with methylphenidate (Ritalin) and amphetamines. However, these medications may cause unpleasant or serious side effects, such as reduced appetite, insomnia, headaches, stomach pain, dry mouth, dizziness, anxiety, increased sweating, arrhythmia, reduced potency, and growth inhibition n in children. Therefore, alternative treatments are needed, and the new review article examines the role of diet in the development of ADHD and its various symptoms.

Methods and results

The researchers analyzed ADHD in children and dietary therapy through a systematic review of 14 relevant randomized controlled trials (RCTs) found in the databases PubMed, Web of Science, PubMed Central, and Google Scholar.
The study revealed that supplements of vitamin D and magnesium showed varying degrees of effectiveness. The researchers particularly found improvements in symptoms related to anxiety and social behavior. It is important to note that vitamin D supplements will only be effective if there is already a deficiency and if the vitamin D content in the supplement is high enough to optimize blood levels throughout the year. It is relevant to mention that vitamin D doses are often too small, and some studies are too short to produce reliable results.
Furthermore, supplements must contain organic magnesium forms with good bioavailability, and magnesium oxide should be avoided as it primarily has a laxative effect.
Fish oil supplements can also have a positive effect, and fish oil combined with saffron and methylphenidate has shown promising results in improving ADHD symptoms. Research is underway to investigate the impact of digestion and gut flora on the development and severity of the condition through the so-called brain-gut axis. Individuals may be sensitive to gluten without having celiac disease. Gluten can break down into a morphine-like substance that is absorbed into the bloodstream and affects the brain. Gluten can also trigger the inflammatory condition associated with ADHD. Therefore, a gluten-free diet combined with probiotic supplements can often have a positive effect on ADHD.
According to the researchers behind the new review article, the results underscore the importance of including a healthy diet as part of the ADHD treatment. By understanding the role of nutrients in the brain and nervous system, treatments can more easily be tailored to address individual patient deficiencies and potential harmful influences.
This new study is in line with a previous American-Canadian study showing that supplements of all essential vitamins and minerals can improve mood, concentration, and emotional disturbances in children with ADHD, while also promoting the children’s growth. This is important since ADHD medication can have a growth-inhibiting effect.
What effect do vitamin D, magnesium, and fish oils have on the brain and nervous system?

The role of vitamin D for the brain and nervous system

Vitamin D regulates a range of genes and biochemical processes throughout the body, including processes in brain neurons, support cells, and cells in the hippocampus. Vitamin D’s influence on brain development and function includes various neurotransmitters, cell signaling, stress hormones, and inhibition of unwanted inflammation.
Health authorities recommend that pregnant women and children up to four years of age take vitamin D supplements all year round. Nevertheless, vitamin D deficiency remains widespread among pregnant women and children, as they often forget to take supplements and do not get enough summer sun. The official recommendations are also quite low, and there is no guarantee that they can optimize blood levels of vitamin D. For reference, the EU's Scientific Committee on Food has set the following safe upper limits for daily vitamin D intake: 25 µg for infants (0-6 months), 50 µg for children (6 months - 10 years), and 100 µg for children aged 11 and older, and adults, pregnant women, and breastfeeding women.

The role of magnesium for the brain and nervous system

Magnesium is involved in over 300 enzymatic processes, including those in the brain and nervous system. Magnesium regulates the uptake of calcium in nerve cells, where only small quantities of calcium are needed. If there is a magnesium deficiency, nerve cells can easily be flooded with calcium, leading to overactive and stressed cells. This can contribute to inner unrest, tension, and neurological disturbances.
Magnesium can also increase the amount of the neurotransmitter GABA (gamma-aminobutyric acid), which inhibits brain activity. Therefore, GABA plays a significant role in regulating impulsivity and cognitive symptoms associated with ADHD. Magnesium affects stress responses via the pituitary production of ACTH (adrenocorticotropic hormone), which promotes the production of adrenal hormone.
Magnesium is also important for activating the form of vitamin D that we produce from sunlight or obtain from supplements. It appears that magnesium can correct several biochemical imbalances in the nervous system, thereby reducing the risk of various conditions, including anxiety, insomnia, and irritability.
Magnesium deficiency is widespread due to excessive sugar intake and refined and ultraprocessed foods. Too much calcium from supplements and dairy products can also disturb the balance between calcium and magnesium.
It is best to ensure sufficient magnesium by eating a coarse and green diet. Supplements must contain organic forms of magnesium with good bioavailability (remember that magnesium oxide primarily has a laxative effect).

Fish oil

The omega-3 fatty acids DHA and EPA are important for the development of the brain and nervous system. Omega-3 fatty acids also increase blood circulation in the brain, which is important for the ability to perform cognitively demanding tasks. DHA is involved in the synapses of nerve cells, where information is exchanged between neurons. DHA is therefore important for the formation of several neurotransmitters such as dopamine and serotonin. EPA regulates inflammation, which can be problematic in ADHD and other neurological disorders.
Fatty fish and fish oil supplements contain DHA and EPA, the biologically active omega-3 forms. When taking fish oil supplements, it takes about a month before the optimal effect can be expected. Similarly, when discontinuing supplementation, it will take about a month for the effect to diminish. For regulating inflammation, it is recommended to aim for 900–1,200 mg of EPA daily.

References:

FNU Abhishek et al. Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations. Cureus 2024.

Jeanette M. Jonhstone et al. Micronutrients for Attention-Deficit/Hyperactivity Disorder in Youths: A Placebo-Controlled Randomized Clinical Trial. Journal of the American Academy of Child & Adolescent Psychiatry. 2022

Tasneem Bhatia. GABA and ADHD: Exploring the Connection. CentreSpring MD. 2024

Lundbergh, B et al. Fish oil supplementation may improve attention, working memory, and ADHD symptoms in adults with autism spectrum disorder: A randomized crossover trial. British Journal of Nutrition. 2022

Deepa Anand et al. Attention-Deficit/Hyperactivity Disorder And Inflammation: What Does Current Knowledge Tell Us. A Systemic Review. Frontiers in Psychiatry 2029.

Helen Saul Case. Magnesium demper hyperaktivitet blant AD/HD-barn. Helsemagasinet Vitenskap og Fornuft. 2017