This past week, a study was released in the prestigious Journal of the American Medical Association, which documented that St. John’s Wort has no benefit in ADHD or ADD.

You can access the original article here.

While I’m glad to see a natural treatment receive such rigorous research, and publication in such a leading journal, the question is: who cares?

The main concern that I have with this study is: Who even thought that St. John’s Wort worked for ADHD?

In the introduction of the research paper, the authors assert that St. John’s Wort is one of the top 3 botanical/herbal remedies used for ADHD. This statistic is referenced from a survey published in 2003 (you can read the abstract of this study here). There is a problem with taking this as a conclusion from this survey. This study surveyed pediatric patients treated for depression and ADHD, and reported on the most common herbal treatments used in the past year. The top 3 herbal preparations used included: gingko biloba, echinacea, and St. John’s Wort. However, the authors did not correlate the herbal medicine’s use with the condition - in other words, if an ADHD patient had taken echinacea, this study does not tell us that he/she took it for ADHD or for the common cold. In other words, the St. John’s Wort could have been taken for the depression (which was also tracked in the study) and not for the ADHD. Furthermore, there were very few patients who had taken herbal preparations in the past year (i.e. 18), bringing into question if this study was representative of the wider use of herbal preparations in ADHD.

As a physician in the field of ADHD - talking to my patients who try alternatives, and reading about it as well - I have never heard of using St. John’s Wort for ADHD. Referencing the book:ADHD Alternatives: A Natural Approach To Treating ADHD, By: Aviva Romm and Tracy Romm - they document that St. John’s Wort is effective for depression, but they do not even consider it a treatment for ADHD.

The American Herbal Products Association (AHPA) responded to the study, documenting two main concerns:

• That the survey documenting that St. John’s Wort’s use for ADHD was flawed
• That the strength of the St. John’s Wort in this clinical trial was degraded by the end of the study. They document that the authors even admit this.

Click here to read the AHPA’s response to this study.

In summary, I like seeing a major clinical trial on an alternative treatment for ADHD. I believe that we need a lot more of those. In future, my hope is that the researchers will choose compounds which are both widely used and considered to be effective before running the whole trial.

Please share your comments below - and if you do have any experience with St. John’s Wort - or more importantly - an herbal treatment which actually worked for ADHD - please share it below (in the comments).

All the best,

Dr. Kenny

p.s. to read more on St. John’s Wort - here is the wikipedia article.

Technorati Tags: St. John’s Wort, ADHD, Herbal Medicine, ADD

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The link between food additives (i.e. preservatives and food coloring) and Attention Deficit Hyperactivity Disorder (ADD or ADHD) has been speculated for a very long time. There has been research for decades on this. The Feingold Diet has been in existence for many years, and postulates that when you eliminate food additives, ADD or ADHD will improve.

The issue has been that mainstream medical treatment for ADD/ ADHD has generally discounted the role of food additives and diet in the role of treating ADHD.

The interesting fact is that estimates are that up to two thirds of people try some form of alternative treatments for ADD/ADHD - with diet modification as one of the main treatments.

In September 2007, The Lancet published an article about food additives causing hyperactivity. This was a very well designed study, which documented that food additives increased hyperactivity in children who did not have ADD/ADHD. This was irrefutable evidence regarding the connection between food additives and symptoms of ADD and ADHD.

In February 2008, the American Academy of Pediatrics published an article which reviewed the issue and recommends that “a trial of preservative free, food coloring free diet is a reasonable intervention”. You can read more details of this here.

This week, an editorial was published in the British Medical Journal by Dr. Kemp, which suggests that removal of food additives from the diet should be a standard first approach when treating children with ADD/ADHD. This is based on his review of the research.

It seems that the pendulum is starting to swing.

Eliminating food additives and food coloring is on the brink of becoming a mainstream recommendation for the initial treatment of ADD and ADHD.

What Do I Suggest?

I suggest that you review all treatment options with your doctor.
In so far as diet modification, I am all for it as part of the treatment plan for ADD and ADHD. As far as treatments go - there is almost no risk or side effects to this treatment (apart from more time and possibly money to find food alternatives which are preservative free).
I suggest learning more about it - and giving it a try.

The one caution that I have is that elimination diets can be part of the treatment plan, but they may not be the whole answer. Research shows us that in general, treatment of ADD/ADHD needs a comprehensive, multimodal approach (i.e. including behavioral strategies, academic/occupational strategies, medication, therapy etc.). So while I encourage trying elimination diets, I don’t suggest that you then disregard all of the other treatment options which may be helpful.

Please share your thoughts and experiences in the comments below.

Dr. Kenny

Technorati Tags: ADD, ADHD, Food Additives, Elimination Diets, Feingold Diet, BMJ

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A new study has come out of Europe which has demonstrated that Pycnogenol has helped to reduce the symptoms of ADD and ADHD in children.

Pycnogenol is an antioxidant plant extract from the bark of the French maritime pine tree. It was used in this study of 57 children who took either a placebo, or pycnogenol. Pycnogenol was found to reduce stress hormones in the children, and this led to a reduction in ADD/ADHD symptoms.

The results of this study will be published in the journal: Nutritional Neuroscience in the coming months.

To learn more about this study, visit here.

To learn more about Pycnogenol, visit here.

Please note - while these results may be encouraging, this does not mean that Pycnogenol has been proven to work fully for ADD or ADHD. I am not encouraging you to stop medication for ADD or ADHD, and start pycnogenol. My role is to inform you of the newest research developments so that you are ‘up to date’ on ADD and ADHD. Please keep this new study in context.

Dr. Kenny

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Recently, I posted to this blog about food additives causing hyperactivity.

I know that this is an area of significant interest and concern amongst my readers on this blog.

I wanted to share another article on the topic with you - by Time magazine. I hope this helps you to further your understanding of this topic.

Dr. Kenny

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After the new and important study came out in the Lancet this past week, drawing a connection to food additives and ADD or ADHD, a number of experts are weighing in on the issue.

I just came across this interview between Newsweek and Dr. E. Arnold - and expert and researcher in ADHD. He shares some important insights, which will be helpful to you in understanding the importance of these issues. To read the full article, visit here.

Here are a few of the important issues that Dr. Arnold shared:

• There is a big difference between food coloring and preservatives. The colors just make the ‘junk food’ look better, and aren’t that important, but the preservatives play an important role in keeping foods safe - i.e. free from bacteria.
• To get the food industry to stop using food dyes, it would likely have to be forced on everyone at the same time, or a company would lose a lot of business if they were the only ones producing candy that didn’t look bright and delicious.
• Dr. Arnold also explained that although there has been an increase in food additives in the past few years, and there has been an increase in the number of people diagnosed with ADHD, you can’t necessarily draw a causal relationship between these.

To read the whole story, visit here.

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A study was just released today documenting a connection between food additives and hyperactivity. It was published in the prestigious medical journal The Lancet. Unfortunately, one has to subscribe to access the full text of the article. However, you can read a summary of it here - in the press release.

This study tested giving children aged 3 or 8/9 a drink with food additives, and monitoring their behavior. These children did not have ADD or ADHD. The findings documented clearly that certain food additives/preservatives did increase the children’s hyperactivity. These are food dyes, and preservatives which would be found in candy, sodas, and other ‘junk food’.

While this study is important, it does not conclusively show that food additives cause ADD or ADHD. It showed an approximate 10% increase in hyperactivity when children had a significant amount of these food additives.

There is a history of eliminating food dyes and preservatives from the diets of people with ADD or ADHD. The most popular diet is the Feingold diet. This was started in the 70s/80s. You can read more about it here. This diet has been studied rigorously, and at best, it yields significant improvement for ADD/ADHD in 5% of those who follow it strictly.

What is the bottom line if you or your child has ADD or ADHD?

1. Don’t stop medication or other treatments that you are on out of concern that the food dyes may be the complete cause and solution for this condition.
2. The best treatments for ADD/ADHD have been shown to be combination treatments. The ideal treatments incorporate behavioral, parenting, academic strategies as well as medication. If you want to add a diet component to that, you can, but just keep it as one of the treatments in the combination.
3. I recommend that each parent of a child with ADD or ADHD, or each adult with ADD or ADHD should consider eliminating these food additives and dyes for a short time and seeing if it makes a difference. Talk to your doctor about this, and review it as an experiment. If you are inclined to do this - go for it. If you are not - don’t. There is no imperative here, and the research data don’t show that it is a must for the treatment of ADD or ADHD.

Most of us feel that we live in a society with too many chemicals, additives and preservatives. This study shows that in children without ADD or ADHD, there is a mild increase in hyperactivity with food additives and preservatives. This does not prove that ADD or ADHD is caused by these chemicals, nor does it show that by stopping these chemicals will ADD or ADHD be treated.

This study is quite important, and hopefully more well designed studies will help to shed light on this important issue. If you want to try to use these insights to help in your treatment of ADD or ADHD, speak to your doctor or health professional.

To read Time magazine’s perspective on this issue, visit here.

Technorati Tags: ADD, ADHD, Food Additives, Hyperactivity, The Lancet, Feingold Diet

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I came across an article which summarizes research showing that evidence is building that people with ADD or ADHD should consider taking a fish oil supplement to help with their ADHD. The important point is to make sure that it contains more Omega 3 fatty acids (EPA) as our modern diet is quite deficient in this.
To read more, visit here.

Dr. Kenny

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