Dr Leila Masson's Blog

Nutrient deficiencies and environmental toxins that can be mistaken for ADHD

Nutrient deficiencies and environmental toxins that can be mistaken for ADHD

ADHD is increasing at a rapid rate – up to 10% of children in Australia are diagnosed annually. The diagnosis itself is controversial – there are many books on the market that query whether ADHD is a “real” disease or whether there is a mismatch between our evolution and our modern lifestyle and the demands put on children.

An ADHD diagnosis is based on symptoms and behaviours: a child being impulsive, not concentrating on their schoolwork, not finishing tasks, being disruptive, restless, and easily frustrated. There is no blood test or x-ray that says “yes you have ADHD”. It is a subjective diagnosis. Both the parents and the teachers have to fill out behaviour assessment forms – because the behaviour has to be a problem in different settings, not just at school or just at home. Today I want to discuss nutritional deficiencies and environmental toxins that can cause or shall we say mimic ADHD behaviours that are treatable and can help the child.

From a nutritional point of view, you need to rule out iron and zinc deficiency, because both are quite common and can affect attention span, concentration, patience, mood, and mental processing. A child who is iron deficient may not sleep well, is often hyperactive and restless, and not able to focus on school work. Children low in iron often look pale, are tired, and do not enjoy active play and sports. Iron is found in meat and green leafy vegetables. It is best absorbed when eaten with vitamin C rich foods, such as tomatoes, lemon or oranges.

A child with zinc deficiency may be impulsive and irritable, easily frustrated, and have slow mental processing. (Physical symptoms of zinc deficiency include white spots on fingernails, slow wound healing, frequent infections, stretch marks, and acne). During growth spurts, children need a lot of zinc as it is essential to building new cells.

Omega 3 deficiency, another common issue in children eating a standard Australian diet, can affect mood, learning and behaviour in ways that mimic ADHD. If your child has dry, bumpy skin on the upper arms, that feels like sandpaper, this may be an indication of low omega 3 levels in the body. Many paediatricians will trial a child with ADHD on high dose omega 3 supplements (at least 1000mg of combined EPA and DHA daily) before prescribing a stimulant medication. The membranes of our brain cells are made up of the fats we eat in our diet; if we eat plenty of omega 3 (found for example in fish, algae, flax seed) the cell membranes are fluid and function well; if we eat too much omega 6 and 9 (as in a standard Australian diet high in fried foods and hydrogenated oil in baked foods) the cell membranes become hardened and nerve impulses will not travel as easily from cell to cell.

Magnesium deficiency is common in most developed countries – mainly because we do not eat enough magnesium-rich foods – such as nuts, seeds, and vegetables. Symptoms of low magnesium include irritability, inability to sit still, muscle cramps, tics, anxiety, all symptoms that could be mistaken for ADHD. A child who lacks magnesium may also struggle to go to sleep. And good sleep is of course absolutely essential for optimal brain function. If your child sleeps even one hour less than he or she needs per night, they will accrue a sleep deficit that takes a toll on their learning.

There are some common environmental toxins that can affect behaviour and learning and can, in fact, cause or mimic ADHD. Children who are exposed to lead are at higher risk of getting a diagnosis of ADHD. Since lead was taken out of petrol and paint in the 1970s we tend to forget about it. But children are still exposed to lead – for example from old flaking paint or contaminated soil in gardens and parks. A simple blood test will rule out current exposure to lead and tell you whether you need to worry about this. One of the ways lead interferes with children’s brain function is by displacing iron and making the child in effect iron deficient.
Mercury is another toxin to be aware of. Most fish is now contaminated with it, especially large fish, such as tuna, king mackerel, marlin, orange roughy, shark, and swordfish. I have seen children with extremely high blood levels of mercury from eating fish displaying all the behaviours of ADHD. Once they stopped eating fish the behaviour calmed down and their learning improved to the point that they lost the ADHD diagnosis.
So we have a bit of a dilemma: we need omega 3 but the usual source, fish, is contaminated. The solution is to go for the actual source of omega 3: fish get their omega 3 from algae and so can we. There are many different companies who produce algae oil omega 3; it is organic and clean. Fish oil is another option, but it has to be molecularly distilled to take out all the toxins (mercury, PCBs, and many others). Also, consider that most of our oceans are going to be empty of fish in just a few decades if we continue fishing at the current rate. So if you care about leaving a healthy planet for your children, go for algae oil.
Mould exposure can also cause illness and behaviour problems. Houses that are moist, not well ventilated, and in warm climates are at high risk of having mould growing in the walls, ceilings or floors. If you are worried about mould in your home get a building biologist to check it out. Mould can cause inflammation in susceptible people and this inflammation can cause behaviour problems. I have seen children exposed to mould who were very hyperactive and calmed down nicely once the mould was remediated. As a first intervention, you can install a room air purifier in your child’s bedroom, which will suck the mould spores out of the air so your child will not breathe them in.

So what are the practical steps you can take to make sure your child with ADHD is not affected by a lack of nutrients or an exposure to toxins?

  1. A blood test for iron: ferritin which reflects iron stores should be above 40. If it is low eat more iron-rich foods (for example green leafy vegetables) and consider taking an iron supplement. Floravital is a safe and tasty liquid and if your child can swallow a capsule you can get a recommendation for a good product from your chemist or health practitioner. I like iron bisglycinate because it is easily absorbed and usually does not cause tummy upsets. The recommended dose for a child with iron deficiency is 1-3mg for each kg of body weight for 8 weeks, then stop it for 2 days and recheck the blood. You can overdose on iron, so keep this in a safe, locked place.
  2. Plasma zinc should be above 14. If it is lower you can eat zinc-rich foods – which are unfortunately not plentiful because our soils are low in zinc; one of the few truly zinc-rich foods are not most kids’ favourite: oysters (and they may be contaminated with salmonella, so not the safest option). You can get zinc supplements as drops, tablets, capsules, and transdermal creams. The dose depends on how deficient your child is and the body weight. It is safe to give 5-10mg daily for several months. Best to check with a health practitioner if you are going for a higher or longer term dose.
  3. If the skin on your child’s arms is dry and bumpy give an omega 3 supplement: for example algae oil with a total of 1000mg of EPA and DHA (in most brands this will be 1 teaspoon or 2 capsules, but read the label).
  4. If you are concerned about lead or mercury, you can do a blood test. If the result is high you need to find the source and eliminate it. You can get lead testing kits from the hardware store and check soil, paint, pottery. Do not eat large fish such as tuna, king mackerel, marlin, orange roughy, shark, and swordfish.
  5. If you think your house or your child’s classroom may be mouldy, get it checked by a building biologist.

Apart from these nutritional deficiencies and environmental toxins, there are of course also dietary and lifestyle factors that contribute to behaviours associated with ADHD. I will write about those in my next newsletters and give you practical tips on what you can do to help your child concentrate and learn optimally.

Dr Leila Masson

Sydney based paediatrician specialised in nutritional and environmental medicine. Author of the handy 'Children's Health A to Z' guide for parents. Dr Masson lectures internationally on children's health.

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