Category Archives: ADHD Treatment

Are you tired of the prescription medication for ADHD? Are you concern that the medication turns your child into a lifeless zombie, and steals away his/her personality and creativity? We might just have the solution you are looking for at Natural Alternative ADHD Treatment.

Feingold Diet on and off

Feingold Diet for ADHD

Feingold Diet for ADHD

It is interesting that the Feingold Diet is the diet that is specifically targeted toward ADHD symptoms and it’s been around since the 1970’s. However, it is also the most ignored diet for ADHD getting a lot less attention than the fancier Body Ecology diet or Specific Carbohydrate diets.

But the Feingold diet waits patiently to be discovered. Besides, many of the principles of this diet is being incorporated in many more popular elimination diets today.

The diet was introduced by Dr. Benjamin Feingold in 1970’s. Dr. Feingold discovered that by eliminating certain food additives, such as food colorings, preservatives, etc many of his patient’s behaviors also improved. He noticed and improvement in hyperactivity, impulsivity, compulsive actions, attention span, cognitive and perceptual disturbances, skin problems/hives, and sleep problems.

Did I mention that Dr. Feingold is an allergist? He was not a psychiatrist. He made this discovery by accident when he was treating his patients for food sensitivities.

The Feingold diet has 2 phases. During the first phase, chemical additives in food and foods containing salicylates are eliminated. Salicylates occur naturally in many plants as a natural pesticide. Salicylates are also found in man-made chemicals used in artificial colors, artificial flavors, preservatives and aspartame. In the second phase, that’s when you’ll re-introduce food with salicylates, but not the chemicals.

Phase 1

The Feingold diet elimination list:

Artificial food colorings – Sunset yellow (E110) (FD&C; Yellow #6), Carmoisine (E122) – Red coloring in jellies, Tartrazine (E102) (FD&C; Yellow #5), Ponceau 4R (E124), Quinoline yellow (E104), and Allura red AC (E129) (FD&C; Red #40). These food colorings are banned in parts of Europe 4 years ago. Unfortunately, FDA is the United States still considered these as safe food ingredients.

Artificial flavoring – examples are imitation vanilla flavoring or “vanillin” might originate from the waste product of paper mills.

Artificial preservatives – BHA, BHT, TBHQ, sodium benzoate – made from petroleum.

Artificial sweeteners – only aspartame is eliminated.

Corn syrup, high-fructose corn syrup, and corn sugar – in soft drinks and other sweetened foods

MSG (monosodium glutamate, disodium guanylate, disodium inosinate) and HVP (hydrolyzed vegetable protein, which contains some glutamate)

Sodium benzoate, sodium nitrite and sodium nitrate (in luncheon or cured meats) – affects brain development in young children.

Calcium propionate (in baked goods)

Salicylate-containing foods: almonds, apples, apricots, berries, cherries, cloves, coffee, cucumbers, currants, grapes, nectarines, wintergreen oil, oranges, peaches, peppers (bell and chili), pickles, plums, prunes, raisins, tangerines, tea and tomatoes.

Phase II

After elimination of most of the items in Phase I for several week, AND with some noticeable improvement, you may embark on Phase II.

In phase two, foods containing salicylates may be added back one at a time. Keep a food journal to help keep track of all food and beverage intake, and any reactions to food. Children who are sensitive to salicylates response well to the elimination period with significant improvements in symptoms.

As with any ADHD treatment, there is an adjustment period. Don’t feel despair if you don’t see improvements right away. In some children, you may even see a period of regression, which means your child is responding to the treatment. So, be patient.

My Suggestion

While doing the Feingold diet, you should also add fish oil or omega-3 fatty acid in form of supplements. Start with 2,000mg and up to 4,000mg a day of fish oil. This should be enough to get in at least 500mg of DHA.

Yes, I know eating fish is a good way of adding omega-3 fatty acid. But the amount is usually not enough. And breaded fish sticks do not cut it.

Fish oil is one of those well-studies and well-researched nutrients. And obviously you’ve seen the explosion of fish oil supplements everywhere.

Recently, I am surprised by seeing many children with ADHD being “prescribed” a pharmaceutical grade fish oil manufactured by GlaxoSmithKline called Lovaza, which is an omega-3-acid ethyl ester. The reason I’m surprised is that Lovaza is approved for use to manage high blood fat level. But these psychiatrists are able to prescribe these for treating ADHD.

Parenting ADHD Children

Parenting ADHD Children




Kids with ADHD often lose track of their things, have difficulty staying on top of homework and seem generally scattered when attending to chores or assigned tasks.

The impulsivity makes them little defiant devils. They know what to do but they don’t do what they know. They can get easily overstimulated and overreact to frustration or challenges.

Poor parents are completely lose and confused as to whether to be firm or be patient, while trying to strike the delicate balance of believing in your child’s abilities and protecting him from the pitfalls of ADHD.

Kids with ADHD may have “hair-trigger, fight-or-flight reactions to stress,” which can make the already challenging task of parenting even more so. Parent ADHD children is not that much more different than regular parenting, just more patience, persistence and consistency. Fortunately, there are many effective strategies and rewards.

Here are some strategies to answer some of questions you have about parenting ADHD children:

1. Stay calm and set limits on your own behavior.

First of all, it is important that parents stay calm. You can’t put out a fire by keeping pouring fuel in it. We have the tendency to over-react to our children unexplained tantrum or nonsense outburst. Remember, these kids just get frustrated easily. You just need to be patient with them to figure their frustration. It could be some very minute issue that can be easily fixed. So pay attention to yourself if you have a tendency to over-react.

Arguing with your child won’t get you anywhere. Try to understand his/her frustration, and then guide them toward a better solution.
The key is to support and patience, and let them know you’re there for them.

2. Create structure and routine, set limitations, and be patience.

Create structure. Use star charts for young children, calendars and planners for older ones, and set clear rules and routines. Structured routine helps the child to feel safe and he/she would know exactly what to expect, instead of fearing loss of control or the unknown.

Create a schedule for homework and playtime. Help your child understand and follow the schedule. Same for bed time routine – you take a bath, brush your teeth, use the potty the last time before bed, bedtime story, then lights out.

Set your time limit for bedtime story. I have a family where the parents told me they would spend over an hour reading bedtime story to their daughter at night, and they would both ended up falling asleep before their daughter falls asleep.

3. Help your kids to make wise choices and focus on his/her strengths.

Provide many opportunities for your child to respond and make decisions. Give your child two predetermined choices that steer him/her in the right direction. Basically, you already made the choices for them. But to your child, they feel they’re making the choice, and are more likely to go with the result.

For example, “Do you want to do your math or your science assignment next?” or “Before we can go, your room needs to be picked up. Do you want to start with the clothes on the bed or clear the top of your desk?”

Focus on your child’s resourcefulness, creativity and individuality. The same self-determination and stubborness that are driving us nuts today will serve your child right tomorrow. Picture him as a tireless entrepreneur, attorney, or doing any work he feels passionate about.

In my opinion, some children diagnosed with ADHD because they’re different. It’s not really because there’s something wrong with them mentally. Children with ADHD children are very creativity and intelligent children who learns and perceive the world differently, and we should honor and respect that difference.

It’s the parents’ responsibility to provide a nurturing environment to help your children thrive and succeed in his/her strengths and talents.

Think of yourself as a coach. Your job is to coach your child to successful socially, emotionally and academically. My only advice for your to patience, and a lot of love. Don’t get discouraged if you have to repeat yourself over and over again.

Sometimes I feel like pulling my hair out. But, at the same time, I’m glad that she has a strong personality, which will serve her well in the future.

Forget about the competition, and don’t compare your child to other children. ADHD children are sensitive to tension from competition. Encourage them to compete against themselves from yesterday.

4. Use reasonable consequences for rule-breaking. Tackle one issue at a time.

First of all, rules should be clear and understandable. Always write is down and all parties involved should agree to the rule.
I tape my daughter’s house rules and chores list to her bathroom mirror, so she sees it everyday, and if there’s argument later, we can always go back to the list.

Create and consistently enforce positive consequences for positive behaviors and negative consequences for negative behaviors.
Ask your child what should the reward/consequence be. This creates commitment from your child, and if they do break the rules, they’ll more likely abide by THEIR chosen consequences. On the same token, they’ll get exactly what they want if they demonstrated the desired behaviors.

Remember, not everything has to be fixed or perfect. You need to choose the best batter to fight. Some battles are just not worth the energy to deal with when you have other more important issues at hand. Don’t stress the small stuff.

5. Expect rule-breaking, and realize that your child isn’t misbehaving on purpose.

Children are programmed to break rules, with or without ADHD. That’s kids. Maybe it’s meant to be no rules?

When your child misbehave or break a rule, correct him/her right away the same way a police officer gives you a ticket. He doesn’t take it personally or groan or yell, “I can’t believe you did that again! Why do you do this to me?” Like the officer, be respectful, consistent, and matter-of-fact.

Parents in general subconsciously assume their children is misbehaving to get attention or to get the parents upset. In reality, children are very goal-oriented and do what they do with the hope of obtaining an outcome they seek, which may not necessarily be the same outcome that we wanted, such as avoiding homework, chores and bedtime.

Every time your child refuses to do what you asked them to do, ask them for a reason. Honor their independent thinking and consider what part of it you can compromise, but insist that your child respect your rules while respect her independent thinking and logic.

You’ll need more trials and exposure to consistent consequences with children with ADHD in order for them to learn. It’s not that they didn’t learn from the last time, but they’re constantly challenging you and hoping that you’ll give in to their demands. You have to be consistent and persistent with your discipline.

6. Advocate for your child when appropriate and avoid muting a headstrong child.

Certain accommodations might be necessary for your child because of his or her ADHD. However, you still want to encourage kids to cultivate their abilities.

Palladino gives an example of finding this tricky balance: “… stand up for his right for an accommodation like talking books, but encourage and expect him to learn to read fluently, giving him time, attention, a tutor, and most especially, your belief that he can.”

One of the mistakes parents can make is trying to turn a spirited, willful child into one that never questions authority and accepts all that is said ‘just because I said so’ as a parent.

Instead, he suggests that parents accept that some children will protest and talk back, and parents must set a limit that on the one hand realizes that children need at least some way to express their frustration, while still enforcing reasonable standards and rules.

7. Educate yourself about ADHD and attention.

Knowing how ADHD symptoms affect your child is essential. You might think that your child is being stubborn or behaving a certain way on purpose, but these actions may be symptoms of ADHD.

Kapalka suggests parents also educate themselves about ADHD’s causes and child development. (You can refer to books on ADHD or talk to a therapist who specializes in ADHD.)

The other important part is educating yourself about attention and learning when your child is at his or her peak of productivity. Knowing when your child can concentrate best helps you chunk assignments into manageable steps, allow breaks to decrease tension, alternate interesting and boring tasks, and keep his adrenaline-based brain chemicals pumping with a steady stream of just the right amount of stimulation.

8. Help your child adjust to change.

Children with ADHD have difficulty transitioning to a new task, or any new changes, especially if they’re hyper-focused on the present activity or are used to a certain routine.

It’s important for parents to understand this and give your child enough time to mentally process the upcoming changes. Help your child to identify the emotion and let them know it’s okay to feel that way. Kids behave badly when they are upset, sad or afraid.

This is important, unless you don’t mind dealing with a crying and whining child on supposedly fun family vacation, visit from guests or a new babysitter. Even small changes, such as transitioning to a new task or activity, can turn into an ordeal easily.

9. Cut yourself some slack and celebrate being a parent.

Raising a child who is impulsive and defiant is one of the most challenging tasks any person will ever attempt. Accept your child’s uniqueness and live with it. Celebrate that your child is special and talented in his/her own way.

Trust me, every family has there issue. Our’s maybe a difficult child. But do you really want to trade your special child for other people’s nastier issues?
We all love our children, and that’s all it counts. Let your child be him/herself. Make sure they’re well fed, have a safe and nurturing environment to thrive. Spend some time each day with your child with your full attention. Look them in the eyes, touch them lovingly and listen closely to what they have to tell you.

Among all those frustrations of parenting, don’t forget to celebrate being a parent. Many couples out there struggle to have their own child. And we’re all blessed here with our unique bundle of joy.

Every child is special…embrace their individuality.




melatonin

Melatonin and ADHD




NATURAL BODY HORMONE

Our body naturally produces the hormone, melatonin, in the pineal gland located in the brain base. It regulates the circadian rhythm – our body’s biological clock that controls daily wakefulness and sleep cycle. Secretion increases with darkness to calm and induce sleepiness. Production dwindles as daylight emerges and cortisol, the waking hormone, takes over.

Children generally have higher levels of melatonin than adult at night times. However, levels dwindle as we age. Thus, we see older adults needing less and less number of hours of sleep as they age.

SLEEP DISORDERS and ADHD

Sleep disorders are common in children with ADHD. Initially, it was thought to be the side effects of ADHD medication. Studies later conclude that 30-40 percent of children with ADHD have sleep disorders regardless of whether they are taking medication or not.

It is suggested that children with ADHD has an abnormal metabolism in which their bodies do not produce enough melatonin at night. Chronic stress can also affect production and secretion of the hormone.

HOW DOES IT WORK?

Melatonin calms and induces sleepiness, helping to fall asleep faster, increasing the length of time staying asleep and increasing daytime alertness.

My 10-year-old daughter seems to be tired all the time. She is always falling asleep in short car rides (5-10 minutes). She can sleep for over 10 hours if she is given the time and allow to do so. I suspected that she must be not sleeping well. She always wakes up still tired even after 10-12 hours of sleep.

One night I decided to let her try melatonin. She fell asleep a lot quicker than usual, without the usual tossing and turning and wanting to play more. We tried this for about a week. Some days, she can actually wake up on her own in the morning, which is unusual. Besides, she is able to verbalize that with the supplement she can “organize” her thoughts better during the day. My reaction was “Wow”, that was quite some interpretation and observation.

My daughter used to move around a lot in the bed when she sleeps. But recently she told me that she notices that she is “staying in the same spot” when she sleeps now.

SUPPLEMENTATION

Because there is no established guideline or recommendation, it is generally prudent to start low and slow. For young children, start with a dose as low as 0.3 mg/day or less, and increase slowly until you see some positive results.

In adults, 3 mg is usually considered a safe place to start. Although research shows that a dose of up to 10mg is safe, it is best to proceed with the same caution.

Take the supplement 30-60 minutes before going to bed. I usually have my daughter takes hers while she is brushing her teeth before bed. I give her 1.5mg (one half of a 3-mg pill) at night several times a week, not every night.

Other side effects that have been reported are vivid dreams and nightmares. If your child experiences any of these consider decreasing the dose or discontinuing the use.

Some people may also experience stomach cramps, headaches, irritability, and dizziness.

POTENTIAL DRUG INTERACTION

If you are taking any of the following medications, please consult your physician and/or pharmacist before you start taking melatonin.

• Antidepressant

• Antipsychotic

• Anticonvulsant

• Blood pressure

• Beta blocker

• Anticoagulant

• Interleukin-2

• Steroids

• Immunosuppressant




Carnosine and ADHD

Carnosine and ADHD




Carnosine is a dipeptide molecule composed of the amino acids, histidine and alanine. It is found in high concentrations in the skeletal muscle, heart muscle, skin, stomach, nerve tissue and brain. It is produced by the body naturally by the enzyme carnosine-synthetase.

How does it work?

As an antioxidant, it protects neurons (nerve cells) from free radical damages, especially ideal for autism, ADHD, seizures and Alzheimer’s disease. It also acts as neurotransmitter, chemical messenger in the nervous system.

Carnosine may be used to mitigate excessive activities and/or stimulation of the N-methyl D-aspartate (NMDA) receptors caused by excitotoxins such as aspartate in artificial sweeteners, and glutamate in monosodium glutamate (MSG) and its derivatives.

It is also a good chelating agent of heavy metals, which potentially cause toxicity resulting in behaviors seen in children with ADHD and/or autism. It is able to chelate copper, zinc and other heavy metals by binding to them, then removing them from the body.

Carnosine is well-known for its anti-aging property and is considered to be a longevity nutrient. It protects body cells against free radical damage as an antioxidant, inhibits glycation and reverses the damages.

Glycation or non-enzymatic glycosylation is the reaction between glucose molecules and protein or fat molecules, resulting in advanced glycating end-products (AGEs). Oxidative stresses, frequently seen in children with special needs, accelerate the production of AGEs.

AGEs interfere with molecular and cellular functions throughout the body, facilitating the aging process, resulting in an array of chronic diseases and conditions, such as cardiovascular disease, Alzheimer’s disease, cancers, peripheral neuropathy, cataract formation and hearing loss.

Carnosine helps protect body cells from radiation damages, such as during cancer treatment and accidental radiation exposures by reversing the oxidative damages.

Athletes have long used carnosine to improve their performance. It enables heart muscles to contract more efficiently through enhanced calcium receptors in heart tissues

Dosage

100-200mg before breakfast and at lunch for children with ADHD.

Caution

Excessive intake may result in irritability, hyperactivity and insomnia.

As always consult a registered dietitian and/or physician who are familiar with dietary or nutritional supplements and working with children with developmental disorders. Avoid implementing trials of any supplements on your own, especially when your child has other medical conditions and/or taking prescription medication. Even though many supplements are natural in a sense, but when taken in high doses, it has therapeutic effects as medication. Thus, supplements may sometimes interact with medications and some require close monitoring of a pair of experienced eyes.




Vitamin B6 and ADHD Brain

Vitamin B6 and ADHD




Vitamin B6 is a water-soluble vitamin and one of the vitamin B’s that make up the complex. It is found in one of three naturally occurring forms – pyridoxine, pyridoxal, pyridoxamine, and three respective 5′-phosphate esters. Pyridoxal 5′ phosphate (PLP) and pyridoxamine 5′ phosphate (PMP) are the active coenzyme forms of B6 that participate in amino acids metabolism.

Inside the body, the naturally occurring glycosylated forms of B6 in fruits and vegetables have to be converted by the liver to the active form the body needs. People with impaired liver function, celiac disease, older adults, and children with autism and/or ADHD have decreased ability in converting vitamin B6 into its active forms. Therefore, supplementing B6 in its active form is more appropriate and readily available for use by the body.

HOW DOES IT WORK?

PLP is necessary for the conversion of DOPA into dopamine, a neurotransmitter, and conversion of glutamate, an excitatory neurotransmitter, to GABA, an inhibitory neurotransmitter. It is also involved in the decarboxylation of SAM to propylamine.

ADHD is believed to be the result of decreased dopamine activity. Low dopamine level in the frontal lobes is associated with decline in cognitive functions, such as memory, attention and problem-solving skills, while deficient of dopamine in the prefrontal cortex is associated with attention deficit disorder.

Related article: ADHD Brain

Dopamine plays a major role in the brain system that is responsible for reward-driven learning, and inhibition control. Every type of reward that has been studied increases the level of dopamine transmission in the brain, and a variety of highly addictive drugs, including stimulants such as cocaine and methamphetamine, act directly on the dopamine system. This is the same mechanism that caffeine works.

The other mechanism that B6 helps with ADHD symptoms is its use in combination with magnesium. Magnesium and vitamin B6 has a co-dependent relationship. While B6 boosts absorption of magnesium into the cells, magnesium is needed for the proper functioning of alkaline phosphatase, which helps the absorption of B6 into body tissues.

Signs and symptoms of magnesium deficiency includes sensitivity to loud noises, insomnia, anxiety, hyperactivity, restlessness, panic attacks, salt craving, and both carbohydrate craving and carbohydrate intolerance. Children with ADHD are believed to have lower levels of magnesium inside their blood cells. Since B6 helps improve blood cell level of magnesium, supplementing magnesium along with B6 will help with ADHD symptoms.

SUPPLEMENTATION

A study of young children with average age 6-7 years old showed improvement in behaviors, such as inattention, aggressiveness and hyperactivity with treatment with magnesium and B6. The amounts used were 6 mg/kg/day magnesium and 0.6mg/kg/day B6 – roughly 100-200 mg of magnesium and around 10-20 mg of B6.

Children with ADHD and/or autism have lower conversion rates to PLP, the active form of vitamin B6. Therefore, supplementing with PLP is more appropriate and readily available for use by the body.




Caffeine

Caffeine as ADHD Treatment?

 

I wasn’t going to write about caffeine or coffee as an ADHD treatment. I don’t really know if it is consider natural at all, as it is also a stimulant like all other ADHD medications.

Anyway, I was in my office the other day talking to a co-worker in the afternoon when my boss walked in with a 2-liter bottle of Mountain Dew in his hand. He loves Mountain Dew and he drinks a lot of it. I don’t know how much exactly, but I always see a bottle of Mountain Dew – big or small on his desk.

Then it dawns on me that I should write about caffeine. My boss is not hyperactive or anything. He hides in his office all day looking busy, but probably having hard time focusing on task. He talks 10,000 miles per hour, and talks people’s ears off. I’m pretty sure he has undiagnosed ADHD or ADD, and using caffeine as his treatment.

I started to learn about caffeine as ADHD treatment many years ago, when Child Psychiatry started sending their ADHD patients to see me. These children with ADHD are usually underweight because of poor appetite, an extremely common side effect of ADHD medications. I came across one patient who has mild ADHD symptoms. Instead of being put on medication, his/her psychiatrist suggested the family to give couple ounces of caffeine soda everyday, and it works.

At first I thought it was odd. But it makes perfect sense. All ADHD medications such as methylpenidate and amphetamines, are stimulants, and so is caffeine, except caffeine does not need prescription and readily available in beverages.

HOW DOES IT WORK?

Attention Deficit Hyperactivity Disorder is an inability to regulate attention. Magnetic resonance imaging studies suggest a weakening of inhibitory signaling in the frontal cortex in the ADHD brain. Stimulants, such as caffeine, help stimulate the frontal cortex to wake up the area that regulates attention. And that’s how caffeine and other stimulants work. In a normal person without ADHD any stimulants will make this person wide-awake, hyper, anxious and even cause insomnia. However, in someone with ADHD, stimulants have the opposite effect. It calms the nerves, helps the brain focus and process information. It may make the person drowsy or sleepy too in some cases.

In the ADHD brain, stimulants, such as mehtylpenidate, amphetamines and even caffeine works by increasing dopamine levels and blocking the reuptake of norepinephrine in the brain.

SIDE EFFECTS Treating children with ADHD with caffeine is controversial. It may cause insomnia, nervousness, irritability and increased heart rate. And in a growing child, caffeine may also stunt growth. In my practice I always warn parents to avoid caffeine in their children’s diet. All ADHD medications have the same side effects.

Caffeine, like all other stimulants, suppresses appetite and stunts growth.

Most children take their medication in the morning with breakfast, so breakfast is usually their best meal of the day. Once the medication kicks in the appetite become non-existent. Then come evening when the medication wears off, their appetite is back.

WHAT TO DRINK? There are a lot of beverages, especially energy drinks that are loaded with caffeine. Do not try caffeine supplements or sports performance-enhancing supplements that are really loaded with caffeine. Those you have to be very careful, especially if you have any heart problem.

For children, 1-2 ounces of coffee will work. I find that coffee somehow works better than caffeinated soda. Not sure why, maybe the high fructose corn syrup in regular soda.

Again consult your doctor or your child’s pediatrician/psychiatrist before adding caffeine or caffeine-containing beverages to the daily routine.

How much caffeine?

Vitamin B12 and Your Brain

Vitamin B12 and ADHD Brain




Vitamin B12 (B12) is a water-soluble vitamin with key role in facilitating normal functioning of the brain, nervous system, and formation of blood cells. It is involves in DNA synthesis and regulation, and also fatty acid synthesis and energy production.

There are several forms of vitamin B12 – cyanocobalamin is the synthetic form, and methylcobalamin and adenosylcobalamin are the physiological or active form. Cyanocobalamin does not occur in nature. It is commonly found in supplements due to its stability and cheaper cost of manufacturing. Theoretically, cyanocobalamine is readily converted to the active forms, methylcobalamine and/or adenosylcobalamin in the body.

VITAMIN B12 AND ADHD

B12 helps with ADHD symptoms through it’s involvement in many of the brain functions, especially in the production and maintenance of the myelin sheath (the protective coating on nerve cells), essential fatty acid metabolism and energy production.

B12 is involved in the synthesis and integrity of the myelin sheath that covers all nerve cells. Think of the plastic casing on electrical wires. These myelin sheath serve the same purpose. Vitamin B12 is the cofactor for the enzymes, L-methylmalonyl-CoA mutase and methionine synthase.

L-methylmalonyl-CoA mutase needs adenosylcobalamin to convert L-methylmalonyl-CoA (MMA) to succinyl-CoA. If this reaction is not working well, too much MMA will result. Too much MMA will make the myelin sheath unstable or not effective in doing its job. The extra MMA may also be added in place of fatty acids, such as omega-3 fatty acid, into myelin sheath. This will result in fragile myelin sheath that is not able to support normal brain functions. The precise mechanism(s) are not fully undertood at this time.

B12 also affects in the myelin formation process in another way. Methylcobalamin is a cofactor of methionine synthase, which catalyzes the conversion of homocysteine to methionine. Our body can also obtain methionine through diet. Our body needs methionine to make S-adenosyl-methionine (SAMe), which is needed for methylation of myelin sheath phospholipids. Methylation is the transfer of the “methyl” group. Methycobalamin provides the methyl group for the transfer. That is how methylcobalamin is involved here. Although our body does not need B12 to make SAMe, methionine synthase helps to provide additional methionine to boost SAMe production. SAMe is also involved in the production of certain neurotransmitters and catecholamines, which help with mood.

BODY STORES

Vitamin B12 deficiency is rare because the liver can store several years’ worth of B12. However, deficiency does happen. Certain medical conditions and/or medication may interfere with absorption or increased it’s metabolism in the body. The total amount of B12 stored in body is bout 2–5 mg in adults. Around 50% of this is stored in the liver.

SYMPTOMS OF VITAMIN B12 DEFICIENCY

Deficiency is usually the result of poor intestinal absorption due to GI surgeries and/or GI disorders, or inadequate dietary intake, such as vegetarian or vegan diet, which restrict animal products. Occasionally, certain medication may increase its metabolism in the body.

Signs and symptoms include weakness or fatigue, light-headedness, rapid heartbeat and breathing, pale skin, sore tongue, easy bruising or bleeding such as bleeding gums, stomachache, weight loss, and diarrhea or constipation.

B12 deficiency may result in megaloblastic anemia, which is due to an defective red blood cell production. The resultant red blood cells are larger than normal, which make is difficult to transport nutrients due to size constraint.

Other signs and symptoms are tingling or numbness in fingers and toes, difficulty walking, mood changes or depression, memory loss, disorientation, and dementia, which are results of nerves damages from vitamin B12 deficiency.

FOOD SOURCES

Neither plants nor animals can produce B12. Only bacteria have the enzymes required for its synthesis. Animals are good sources of B12 is because of the bacteria living in the intestines, which makes the vitamin.

Vitamin B12 is found in any foods that come from animals, such as fish and shellfish, meat (especially liver, where the vitamin is stored), poultry, eggs, dairy products. The body absorbs B12 from animal sources better. Plant foods are not considered to be reliable sources of B12.

Vegans, people who do not eat any animal products including eggs and dairy, are more likely to develop B12 deficiency because of their restrictive diets. Ovo-lacto-vegetarians usually consume enough B12 through eggs and dairy products. Vegans obtain their B12 from dietary supplements and/or fortified foods, such as fortified breakfast cereals, fortified soy products, fortified energy bars, and Brewer’s yeast.

SUPPLEMENTATION

Cyanocobalamin is the most common form of B12 found in supplements. It contains about 2% of cyanide or 20 micrograms cyanide in a 1 mg cyanocobalamin tab. This amount may seem minute. However, children with ADHD, as you have read so far, have an inefficient detoxification system. Even minute amount of cyanide may accumulate over time, causing neural damages.

One of the functions of B12 is methyl donation. Supplementation with cyanocobalamin would not serve this purpose. In fact it would need donation of methyl group in the body to be converted to the active form.

Sublingual and spray methylcobalamin are supposedly much easier to absorb because these routes bypass the intestines, which can be an issue for people with GI problems. Besies methylcobalamin is the active form, which means the body can put it to use right away without any further conversion. Besides, children with ADHD just seem to have very different metabolic requirements.

Methylcobalamin supplements are usually more expensive and available mainly in health food stores. Despite the cost and probably a little extra drive for some, it is still a better choice not only because it is the active, but it is also a “cleaner” form. The methylcobalamin supplement you find in health food stores usually are free of additives, preservatives, artificial colorings, artificial sweeteners, etc. So you are definitely paying for quality for your money.

DOSING

General recommendation of B12 is between 0.4 to 2.4 mcg (micro-grams) daily depending on age. Generally, for the purpose of treating ADHD, you may start with 1,000 mcg. Toxicity is rare since Vitamin B12 is water-soluble, which means our body can easily get rid of the extra.

Couple years ago, I developed tingling sensation on my hands and feet after some medication adjustment. After doing some research, I discovered that the tingling is related to B vitamins deficiency. I started with B-complex, then later added B12. The tingling disappeared, but I was not falling asleep at night. Then I realized it’s the high dose of B12 I was taking at night. That’s what keeping me up at night. And that’s also when I realized the power of B12 vitamin. It does give you an energy boost, but without the hyper feeling of caffeine.

Now I take a 2,500mcg B12 vitamin tablet in the morning. While I started taking the B12 vitamin, I also noticed that I am less irritable and anxious.

My daughter takes a 1,000mcg tablet daily before school to help her focus. She also takes 1.5mg melatonin at night to help with her sleep. Interestingly, after taking the melatonin, she told me that her brain feels clearer and she can organize her thoughts better.




PhosphatidylCholine Pathway

Phosphatidylcholine for ADHD

What is Phosphatidylcholine?

That’s a mouthful. It sounds like something fancy. But it’s not. It’s actually pretty common.

Most of us who are not vegan or vegetarian ingest about 3 to 6 grams of lecithin a day. The term lecithin and phosphatidylcholine are used interchangeably because phosphatidylcholine makes up most of lecithin. Choline is another component of lecithin. Choline is a component of phosphatidylcholine, which is a component of lecithin.

Phosphatidylcholine and Brain function

Phosphatidylcholine makes up a big part of cell membranes. In order to make phosphatidylcholine, our body also needs docosahexaenoic acid (DHA), uridine, and choline.The reason why there is such an interest in phoshpatidylcholine is because the body uses it to make acetylcholine, a brain chemical involves in memory, and phosphatidylcholine is shown to be able to increase acetylcholine level. PC is thought to benefit brain conditions, such as memory loss, Alzheimer’s disease, anxiety, manic-depressive disorders, and a movement disorder called tardive dyskinesia.

Unfortunately, the current research findings do not consistently support the role of phosphatidylcholine in helping with cognitive function, and that supplementation with PC does not seem to result in any dramatic effects on mental cognitive abilities. The benefit on brain function from taking lecithin or PC supplements is only minimal.

As mentioned earlier, a typical person consumes about 3 to 6 grams of lecithin a day, which means the risk of phosphatidylcholine deficiency is low. However, because each human being are unique genetically, there are always a few person who are difficulty biochemically in making adequate amounts of phosphatidylcholine from scratch. Certainly, these individuals would benefit from PC supplementation.

Don’t give up yet…

I have a colleague at work who swears that phosphatidylcholine works wonders on his 2 year old son, who was diagnosed with autism. I know, I know. He’s too young to be diagnosed with autism. But he does have all the signs – speech delay, SUPER intelligent. I know this boy’s developmental pediatrician. This boy knows the difference between trapezium and rhombus at a tender age of 1 year old. According to dad, he recognizes most of the alphabet (English alphabets) and sight-read a couple words.

Anyway, my colleague told me since starting PC, his son is able to communicate more and able to recognize kids of his age and interact with them. However, the oral aversion is still a problem. Did I mention this child is also on the gluten-free casein-free diet?
My point here is studies only tell you what’s most likely to happen to the general population. Until you try it out yourself, you’ll never know if you’re the responding group or the non-responding group.

Phosphatidylcholine supplementation is also recommended in the book “What’s Eating Your Child?: The Hidden Connection Between Food and Childhood Ailments” by Kelly Dorfman, MS, LND for sensory processing disorder and speech apraxia.

Supplementation

Start with getting PC from food sources first. Try eggs, soy, and meats. Vegetables, fruits and grains contain very little lecithin. If you plan to take the supplement instead, stay with a lower dose for your child, something like three grams a day or less

Other Uses of PC

Phosphatidylcholine is also used for treating hepatitis, eczema, gallbladder disease, circulation problems, high cholesterol, and premenstrual syndrome (PMS); for improving the effectiveness of kidney dialysis; for boosting the immune system; and for preventing aging.

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SAMe pathway

S-adenosylmethionine a.k.a. SAM-e





What is S-Adenosylmethionine? What Does It Do?

S-adenosylmethionine, or better known as SAMe for short, is a natural substance that our body makes naturally from the food that we eat. Our bodies make SAMe from methionine, an amino acid found in protein-rich foods.

SAMe is one of the best methyl donors that our body can have. Like other methyl donors, such as DMAE, folic acid and B12, S-adenosylmethionine is needed in the production of neurotransmitters, such as serotonin, melatonin, dopamine and adrenaline, which affect mood, energy, alertness, concentration, and visual clarity. Multiple researches and clinical trials have shown the benefit of taking SAMe on a regular basis in fighting depression, liver disease, and alleviating pain from osteoarthritis.

The methyl group (CH3) that is attached to the methionine in SAMe is very chemically reactive. This allows the methyl group to be released easily and be transferred to an acceptor substrate. SAMe is involved in more than 40 metabolic reactions involving various substrates, such as nucleic acids, proteins, lipids and secondary metabolites.

When a SAMe molecule loses its methyl group, it becomes homocysteine, which becomes toxic if it builds up within cells. Generally with the help of vitamins B6, vitamin B12 and folic acid (all B vitamins), our bodies is able to convert homocysteine into glutathione (our body’s detox superstar) or back to methionine via re-methylation with the help of TMG (Trimethylglycine).

SAMe and homocysteine are essentially two versions of the same molecule—one benign and one malicious. Generally, our body maintains a low level of homocysteine with good supply of B vitamins. However, homocysteine can start building up quickly when methyl-donors, such as vitamin B6, vitamin b12 and folic acid intake is low. The build-up of homocysteine slows the production of SAMe and subsequent health problems. Elevated homocysteine level is associated with heart attack and stroke; it increases risk of spina bifida and other birth defect during pregnancy.

How does S-adenosylmethionine help in ADHD?

Depression is common in children and adults with ADHD. SAMe may enhance the mood-enhancing effects of serotonin and dopamine—either by regulating their breakdown or by speeding production of the receptor molecules they latch on to. SAMe may also make existing receptors more responsive. If the membranes get thick and sticky, due to age or other stresses, the receptors lose their ability to move and change in response to chemical signals. By methylating fats called phospholipids, SAMe keeps the membranes fluid and the receptors mobile.

Since the 1970s, researchers have published over 40 clinical studies involving roughly 1,400 patients. These maybe small studies by FDA standards, findings are remarkably consistent. In 1994 Dr. Giorgio Bressa, a psychiatrist at the University Cattolica Sacro Cuore in Rome, pooled found that “the efficacy of SAMe in treating depressive syndromes…is superior [to] that of placebo and comparable to thea of standard…antidepressants.”

SAMe is not exceptionally better than current prescription antidepressant, but it’s clearly less toxic and more tolerable. Common antidepressants, such as Prozac, Zoloft and Paxil, have known side effects ranging from headaches and diarrhea to agitation, sleeplessness, sexual dysfunction, and manic episode in people with bipolar disorder. And SAMe? Maybe a mild stomachache; and possibly manic episodes in people with bipolar disorder, just like other antidepressant.

Supplementation

You can’t really get SAMe from eating any particular food. But you can eat a high protein diet, which will supply the methionine needed for making SAMe. Otherwise, supplementation is your best option.

SAMe comes in two forms, tosylate and a more stable form called butanedisulfonate. Only Nature Made and GNC sell the new butanedisulfonate version. Choose enteric-coated SAMe as it is absorbed mainly through the intestine. The enteric coat will ensure that the S-adenosylmethionine molecule is protected from stomach acid, and reach the intestine intact for absorption.

It is best to take SAMe twice a day on an empty stomach. You may start at 400mg/day divided into two doses.

CALCULATING SUPPLEMENT DOSE FOR CHILDREN FROM ADULT DOSE

Frequently dosing of supplements are based on adults. As we all know, children have smaller body size and thus require different dosage of many vitamins and supplements, especially medications.

Here is a formula that you can use simply to estimate the dose for children:

Adult dose divided by 150, then multiply by your child’s weight in pounds. This will give you the dose for your child.

Remember, it is just an estimate. Always check with your pediatrician or registered dietitian to get the proper amount for your child.





Benefits of a Plant Based Diet





Watch Rip Esselstyn’s (author of Engine 2 Diet) TEDTalk on how the Plant Strong Diet improved the health of his fire house.

By the way, Rip Esselstyn is the son of Dr. Caldwell Esselstyn, who was trained as a surgeon at the Cleveland Clinic and at St. George’s Hospital in London. Dr. Esselstyn has been associated with the Cleveland Clinic since 1968. He was studying about how a plant-based diet can reverse chronic diseases, such as heart diseases, hypertension, diabetes, cancer, etc.

No kidding…we have cures for these common killers already?! Pharmaceutical companies are not advertising it. Doctors are not believing it, because they’re trained to prescribe medications.

Anyway, watch “Forks Over Knives” documentary in Netflix, and you’ll know who Dr. Esselstyn is and what the China Study discover.

BENEFITS OF A PLANT BASED DIET”

Lower Oxidative Stress & Inflammation

Studies show that high intake of whole plant foods, such as fruits, vegetables, whole grains, nuts, tea, coffee, red wine and olive oil, decreases levels of oxidative stress and inflammation, which are associated with the development of chronic disease. (Nutrition, 2004 and JACC, 2006)

In the Adventist Health Study II, a vegetarian diet was linked to lower CRP levels, a marker of inflammation. (Ethn Dis, 2011)

Healthy Gut/Immune System

Increasing evidence fiber-rich, plant-based diet promotes healthy gut microbiota, linked to immune support and digestive health.
EPIC study found lower rate of hospital admissions and risk of death from diverticular disease among vegetarians. (BMJ, 2011)

Brain Protection

Chronic inflammation and oxidative stress lead to development of Alzheimer’s. Adherence to Mediterranean, plant-based diet linked with lower risk of Alzheimer’s disease. (Archives Neurology, 2009)

Environmental Working Group

All meat is not created equal. Lamb, beef, pork and cheese generate the most greenhouse gases. They also tend to be high in fat and have the worst environmental impacts. Meat and dairy products requires large amount of pesticides, chemical fertilizer, fuel, feed and water and generates greenhouse gases, toxic manure and other pollutants that contaminate our air and water.

Challenges of a Plant based Diet

Misperceptions, such as getting adequate protein and calcium intake.
More food preparation required.
Lack of cooking skills regarding beans, whole grains, tofu.
Unfamiliarity with new foods, such as tofu, tempeh (Indonesian fermented soy), seitan.
Meeting nutritional needs.

Developing and Planning a Plant based Eating Style

Include more whole plant foods, such as plant proteins:
Legumes (beans, lentils, and peas)
Whole Soy Foods (tofu, tempeh, soy milk)
Nuts and Nut Butters (almonds, walnuts, hazelnuts, pecans, pistachios, macadamias, Brazil nuts, peanuts)
Seeds and Seed Butters (sunflower, sesame, hemp, chia, pumpkin seeds) walnut, hemp and chia good source omega-3 FA.
Whole grains (quinoa, wheat berries, oats, brown rice) can be good protein source (up to 11 g protein per cup, i.e. Kamut)
Vegetables, such as peas, spinach, and broccoli (can contain up to 6 g protein per cup)

Plant proteins, such as legumes, nuts and seeds, are excellent “protein packages”—packed with fiber, micronutrients, phytochemicals.

Calcium

If no dairy, choose total of two servings per day of calcium-fortified foods, such as plant-based milk alternatives, tofu, or orange juice.
Choose more dark green leafy vegetables.
Calcium supplement to meet daily calcium needs.

Related article: 15 Non-Dairy Plant based Sources of Calcium that Will Surprise You

Vitamin D

Ten minutes of sunlight exposure a day.

Consume vitamin-D-fortified foods, such as soy milk and orange juice, and consider a vitamin D supplement.

Vitamin B12

Available only in animal foods: meat, fish, poultry, eggs, and dairy products.

Also available in nutritional yeasts and fortified products, such as cereal and soy milk.

Vegans should take a vitamin B12 supplement daily.

How to Start Plant Based Eating Style

Start the day right. Go veggie at breakfast or fruits and veggie smoothie.

Join the Meatless Monday bandwagon.

Shop for plants first. Instead of planning your menu around meat, plan it around plants.

If you eat meat, use it as a seasoning. Cut down on animal food intake while pushing plants by using meat as a flavoring in dishes instead of main event. Idea from indigenous diet. Great ways to reduce meat intake, but not completely giving up.

Create a plant-based pantry list. Many plant based foods like beans and whole grains are shelf-stable, convenient, and economical.

Get cooking! Plan at least one night a week to try a new vegetarian recipe. Do it with Meatless Monday night.

Keep it simple. Not every meal has to involve cookbooks and cutting boards; it can be as easy as black bean burritos, vegetarian chili, or hummus pita sandwich.

Try ethnic flair. Some cultures know how to do vegetarian meals right!

Convert your favorite dishes. Turn your favorite meat-based recipes veggie for an easy dinner solution. New family favorite.

Dust off your slow-cooker. Just throw in veggies, herbs, vegetable broth, canned tomatoes, whole grains, and dried beans; then turn the dial on.

Try plant-based dairy products. Try more plant-based alternatives for milk, yogurt, and cheese. Popular as there are many alternative choices available.

Think “yes”. Don’t dwell on what you can’t have, think about what you can have! There are thousands of choices.

Helpful tips

1. Puree, chop, or dice vegetables into smaller pieces to hide them in dishes and stuffed foods to increase taste and nutrition without the family noticing.

2. I introduce people to green smoothies… If possible, we make a smoothie together so they can see how simple it is. Hands-on or demo gives them more confidence than just getting a recipe.

3. Warn clients that not all meat free foods (especially the packaged products) are healthy just because they are meat free. Encourage them to read food labels and try to follow the 5 ingredient rule (try to stick to foods that only include 5 ingredients).

4. I recommend to my clients to eat a fruit or vegetable (or both!) at each meal and snack. That way they’ll get 5 or more servings in each day. Repeat this day after day and you have a positive healthy habit.

5. Add veggies to your traditional recipes. Try adding a can of pumpkin puree to your favorite chili recipe. You can’t taste the pumpkin at all, but it boosts the nutrient profile and gives it a fabulous texture!

6. Buy in bulk. Purchase more when there is a good deal or when something is especially delicious. Most fruits and vegetables keep well in the freezer and then you will always have them on hand.

7. Be open to adding different spices and herbs, it can really tantalize the taste buds! Every day you can have a mini food adventure trying new foods and flavors while becoming healthier.

8. On Sunday afternoons, turn on some good music and invest an hour to chop up veggies and prepare “food for the week”…This way you have “ready to go” options to get you through the week for lunches, meals and side dishes!

9. No time to slice fresh veggies for a salad? Add frozen peas or frozen mixed veggies instead. They will be defrosted by lunch and ready to top with your favorite dressing.

10. Start your grocery store trip in the produce isle. Only shop on the outside of the store. This helps eliminate most processed foods and helps your cart contain fresh foods. Fruits and vegetables should fill up the bottom of your cart.

Essential amino acids in plant-based diet:
Complement plant food. Plant protein always missing a few amino acid (x soy, spinach and quinoa). New idea is the amino acid intake throughout the day, not focus in a meal. Plant protein with lower digestibility, thus recommend increasing intake about.

Allergy to soy, nut, legumes, peanut:
Consider if true food intolerances. May introduce dairy product to meet protein needs.

Additional resources:

• China Study by Collin Campbell
• Beautiful Truth documentary video
• Forks Over Knives documentary video
• Whole: Rethinking the Science of Nutrition
• In Defense of Food by Michael Pollan