Majarkeun

Magnesium Deficiency and Childhood ADHD

Magnesium Levels and the Connection to ADHD
In the last blog post, we talked about how an iodine deficiency in pregnant women can lead to ADHD and other cognitive dysfunctions in children. Iodine is just one of the many key nutrients that have been correlated with a worsening of ADHD-like symptoms. The effects of deficiencies for more well-known minerals such as iron and zinc are widely published. Low levels of both of these minerals have been associated with the onset of ADHD, and will be discussed in later posts. However, a lesser-known but equally important mineral relevant to ADHD and overall brain function is magnesium. There have been multiple studies linking low levels this key nutrient to an increased onset of ADHD.

Signs and Symptoms of Inadequate Magnesium Intake
Magnesium actually shares a functional overlap with iodine as far as proper bodily function is concerned. It plays a crucial role in maintaining function in a number of enzymes and other essential proteins. Additionally, like iodine, magnesium is essential for adequate bone health as well as maintaining adequate body temperature and energy levels. There are a number of signs of magnesium deficiencies which actually mask symptoms of other diseases, but some of the most distinctive signs of low magnesium levels are unexplained ulcers in the mouth area. Additionally, while allergies and asthma occur at higher levels in individuals with ADHD as comorbid disorders, the presence of ADHD, allergies, asthma and fibromyalgia (high levels of constant pain and sensitivity to touch) can be due to inadequate magnesium levels in the body.

Frequency of Magnesium Deficiencies and Recommended Daily Amounts
Like iodine, magnesium deficiencies are relatively common in industrialized countries. In children, these trends are even more ominous, with some estimates placing up to 90% of children in the magnesium deficient category. Recommended amounts typically fall within 280 to 400 mg per day, with men requiring slightly higher amounts than women. Seeds and nuts are among the best sources of this vital nutrient, with one of the best options being pumpkin and squash seeds (1 ounce provides about a third of the recommended daily amount).

**Please keep in mind that the recommended magnesium levels of 280 to 400 mg are for adults and older children. For newborns (around 30 mg/day) to children under 9 (130 mg/day), the requirements are lower. While there are no "food-based" upper limits for magnesium, there are for supplements. This is due to in part to different absorption patterns of the different magnesium forms in supplements as opposed to foods. Please click here to see some tables for recommended and upper limits of magnesium for children. Also, keep in mind that certain antacids and laxatives contain high levels of magnesium already, so please follow the upper limit max for supplements.

Treating ADHD with Magnesium Supplementation
Given the relatively low consumption of these foods by individuals in westernized countries, as well as the prevalence of nut allergies, supplementation with magnesium is another good option.
While both of the main components of ADHD (inattention and impulsivity/hyperactivity) are both associated with low levels of magesium, it appears that the hyperactivity factor is even more pronounced. The effectiveness of magnesium treatment is boosted by another key nutrient in the family of B vitamins, namely Vitamin B6. My next blog post will go into more detail about this treatment combination for ADHD.

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Magnesium Combination Treatments for ADHD

The previous 3 posts have all addressed the role of magnesium in the causes and treatment of ADHD and related disorders. Here I will address some of the guidelines as to how to boost the effectiveness of magnesium treatments in ADHD patients. This will include information on which forms are the best and which other compounds or nutrients, when used in combination with magnesium, can help the absorption and processing of this key mineral. Please keep in mind that these are recommendations and findings compiled from hundreds of medical journal articles and clinical studies. Do not take these suggestions as medical advice until you consult with your physician!

Some guidelines are listed below:

• Based on age, gender and a few other factors, recommended amounts of magnesium levels range from 80 to 420 mg/day. For a detailed breakdown on the amount recommended for you, please check out this link here. Due to the role of estrogen, which helps in the retention of magnesium, females typically require less of this nutrient than males.



• Several forms of magnesium are available. These include magnesium chloride, magnesium oxide, magnesium lactate and magnesium aspartate. A study on human absorption patterns showed that magnesium oxide had much poorer absorption than the other three forms. Other forms include magnesium sulfate, magnesium hydroxide, magnesium acetyltaurinate, magnesium citrate, and magnesium carbonate.


• Of potential interest is the form magnesium acetyltaurinate. This form contains both magnesium and a chemically modified version of the substance taurine. Taurine, which is often seen in energy-boosters and “memory” drinks, has been shown to aid the absorption of magnesium into cells in mammals (as do several other compounds such as vitamin B6). It is important to note that this study was done in rats as opposed to humans, but, due to the high crossover of nutrient absorption and metabolism between the two species, I feel that this finding is at least worth mentioning. Although a rarer (and often more expensive) form of the mineral, magnesium acetyltaurinate may essentially provide “two-for-one” deal, thereby making it superior to other magnesium forms. Note that this conclusion is merely hypothetical at this point and should be treated as such. Nevertheless, with the support of your physician, it may be a strategy worthy of investigation for treatment of ADHD and related disorders.

• In a recent post, we have seen how elevated levels of the compound kynurenine can lead to numerous difficulties and exacerbate the symptoms of ADHD and related disorders. A derivative of niacin (short for nicotinic acid or vitamin B3), which is called nicotinamide, has been shown to reduce the unwanted high levels of kynurenine, especially in the brain. Additionally, it has also been shown to reduce spasms in the blood vessels, thereby improving blood flow to the brain and reducing the likelihood of a brain hemorrhage and stroke. These findings are summarized in a journal article by BL Grimaldi (an abstract of the article can be found here).

• As previously mentioned, vitamin B6 (pyridoxine) can boost the absorption of magnesium. We have seen in an earlier post that zinc can be used to boost the effectiveness of methylphenidate (Ritalin, Concerta), in certain cases. Additionally, zinc is required for optimal function of certain enzymes needed to process vitamin B6 such as pyridoxal kinase. Not surprisingly, zinc deficiencies are common in individuals with ADHD and related comorbid disorders. Vitamin B6 boosts the effectiveness of magnesium, vitamin B3 helps offset the buildup of unwanted levels of kynurenine, which is often seen in magnesium deficient individuals, and zinc aids in the processing of vitamin B6. Thus were beginning to see how all of these vital nutrients do not act merely in isolation, but rather how they can work together to reduce the negative symptoms of ADHD and related disorders.

• We have seen above that vitamin B3 can offset the buildup of unwanted kynurenine, which can be induced through magnesium deficiency. However, there are other key nutrients which are often reduced through prolonged periods of inadequate magnesium intake. Depleted levels of many antioxidants are often seen and need to be replenished. Among these are vitamin C, vitamin E and glutathione.

• Glutathione, which is manufactured in the body, is among the most widespread and potent antioxidants used in the body. However, in order to stay in its "de-oxidized" functional form, it needs help from dietary antioxidants. Vitamins C and E work with each other as well as with glutathione to keep adequate "pools" of glutathione available for the bodys natural antioxidant defenses. Inadequate levels of glutathione can lead to the onset of numerous diseases, damage to the outer covering of cells and tissues, allergies, asthma, neural dysfunction and a wide array of other disorders. Magnesium deficiencies place unwanted stress on the body and reduce the bodys available levels of glutathione. Thus, vitamin C and E are needed to "repair" this damage. Recommended levels of these two vitamins can be found here for vitamin E and here for vitamin C. These levels reflect recent changes in which the recommended doses of both vitamins have been bumped up.

• ***Bloggers note: You may have read a number of references or seen a number of websites for ADHD and multiple other ailments touting the benefits of compounds such as pycnogenol (also known as French Maritime Pine Bark Extract), and grape-seed extract. As of now, I am neutral as far as using products such as these. However, it is important to note that the majority of the benefits derived from treatments such as these are due to their antioxidant effects, which are quite powerful by the way (however, other functions besides mere antioxidant effects have been suggested and are entirely possible). Additionally, these supplements can be quite costly. It is this bloggers opinion that similar effects and benefits can be seen with vitamin C and E supplementation for a cheaper price. Nonetheless, the large number of studies supporting the effectiveness of pycnogenol and grape-seed extract does warrant further investigation and potential success as an ADHD treatment option. With youre doctors permission, pycnogenol or grape seed extract may be worthy of a trial run.
  

• One final ingredient which is highly recommended for adding to the "pile" of nutrients for ADHD and related treatments is lecithin. The reason I personally hold in in such high regards is that it restores multiple components which may have been compromised by prolonged magnesium deficiency. Among these are essential omega 3 fatty acids (which are often found to be compromised in a wide range of diseases and disorders such as depression, heart disease, asthma, allergies, blood clotting and strokes, ADHD, multiple other neural disorders, Tourettes, chronic inflammation, and a whole slew of other ailments) such as alpha-linolenic acid, which is sometimes abbreviated as ALA.

• Additionally, lecithin provides rich levels of inositol which is a special type of sugar which is often listed as a B-vitamin (however, by definition, it is not, since inositol, unlike vitamins, can be synthesized in the body. Nevertheless, it functionally behaves in a manner similar to several other B vitamins and is therefore sometimes classified as such), as several key agents necessary for proper cellular structure and neuronal function. These agents include phosphatidylcholine (which is needed to maintain cell structure, helps regulate breakdown of fats, and is also used to help cells communicate with each other), phostphatidylinositol (which is also required for cell communication or signaling), and phosphatidyl ethanolamine (which is a fatty tissue found in high concentrations in the brain, spinal cord and throughout the nervous system). Inositol itself is also a key "messenger" by facilitating cell-cell communication.

• In addition to their utilization for cell structure and cell membrane integrity, some of these agents (namely inositol) have been shown to be effective antidepressants, having similar effectiveness and modes of action to the SSRI (selective serotonin re-uptake inhibitor) class of antidepressant medications. A summary of some of these findings can be found in a review by Grimaldi (abstract of article listed here). There is no official recommended amount for lecithin, but two tablespoons of the granular form are often administered by physicians. For good natural sources of lecithin, please click here.

• While it provides many absorption-related benefits, magnesium can reduce the absorption and effectiveness of certain antibiotics such as tetracylcine. If you are taking this antibiotic for a short period of time, you may want to consider temporarily reducing your magnesium intake/supplementation.



• Additionally, people with kidney disorders often have difficulty processing and removing magnesium from the system. It is imperative that this is discussed with a physician before deciding on magnesium supplementation.

The main idea of this post is to introduce to you the importance of including all of the pieces of the nutrient puzzle for treating ADHD and related disorders. A quick list of nutrients which must often be used in conjunction include: magnesium, vitamin B6, vitamin B3 (niacin), zinc, antioxidants (vitamin C and E, pycnogenol, grape-seed extract), and multiple components of lecithin (inositol, omega-3 fatty acids, and neuro-regulating agents and their derivatives). To summarize:

1. Magnesium deficiency is thought to be a common underlying cause to ADHD and related comorbid disorders. Increasing magnesium intake via diet or supplementation can offset some of these problems. Recommended magnesium levels and natural sources can be found here.
2. Vitamin B6 boosts the uptake of magnesium into cells. Additionally, an enzyme which helps absorb vitamin B6, called alkaline phosphatase, requires magnesium to function properly. Therefore, vitamin B6 and magnesium function in a cooperative manner, and enhance each others effectiveness. Recommended vitamin B6 levels and natural sources can be found here.
3. In addition to magnesium, several enzymes required for the processing and proper metabolism of vitamin B6 need adequate zinc levels to function properly. Recommended zinc levels and natural sources can be found here.
4. Deficiencies of magnesium can lead to a harmful buildup of kynurenine. Treatment with vitamin B3 (niacin), can offset some of these harmful effects. Recommended vitamin B3 (niacin) levels and natural sources can be found here.
5. Magnesium deficiency can cause a depletion of antioxidants (especially glutathione) in the body. Increasing the intake of antioxidants such as vitamin C and vitamin E (which complement each other and work great together in tandem), grape-seed extract or pycnogenol can replenish and restore the proper antioxidant balance to the system. Recommended levels and natural sources can be found here for vitamin C and here for vitamin E. No official levels for grape-seed extract or pycnogenol have been established, but common treatment levels and dosage information can be found here for pycnogenol and here for grape-seed extract.
6. Low magnesium levels can also result in depleted amounts of several key fats or fatty-like substances necessary for proper nerve (as well as other types of) cell structure and function, as well as proper cell-cell communication. Lecithin is a great source of many of these deficient components, and is a good replacement method of treatment. There is no official recommended daily amount for lecithin, but for more information on common dosage levels of lecithin please click here.

You have hopefully seen how these key ingredients all work together and how a deficiency in even one of these can inhibit the effectiveness of the other nutritional agents.

Keep in mind that all of these can be obtained from natural food sources. It is not my intention to turn anyone into a "supplement popper". However, if your dietary patterns leave you prone to deficiencies in any of these nutrients, I do recommend supplementation. However, please check with your doctor before doing any of these treatment suggestions. Also, keep in mind that this list is not extensive. I will be discussing some other essential nutrients (such as iron, whose low levels are often connected to ADHD and related disorders) in future blog posts.

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Long Wave Infrared Imaging A new detection method for ADHD

Detecting ADHD using the long-wave infrared spectrum:

I always enjoy covering new breakthroughs in the diagnosis and treatment methods in the medical field. A new study just came out which may have a number of potential applications to aid in the diagnostic process of ADHD, which I believe is worth sharing. Called Long-Wave Infrared Imaging, this method utilizes the infrared spectrum to detect biological activity (namely bloodflow patterns) via the differences in radiation emitted by these activities. The study, titled Sensitivity and Specificity of Longwave Infrared Imaging for Attention-Deficit/Hyperactivity Disorder, found that this method may be a surprisingly powerful way of separating ADHD from other related disorders, aiding in the always-difficult process of differential diagnosis.

The basics of Long-Wave Infrared Imaging:

The term "long-wave" is a relative term, of course, referring to wavelengths of approximately 10 nanometers (or only one one-hundred millionth of a meter). Differential bloodflow patterns can result in temperature differences by a full degree (Celsius), making this technology useful in tracking bloodflow disorders. A recent publication in the Journal of Medical Physics by Bagathaviappan and coworkers suggests describes how this long-wave infrared imaging can detect areas in the circulatory system where bloodflow activity is sluggish or reduced. Typically, these areas appear "cooler" on the spectrum, due to the lack of a new, replenishing blood supply.

Applications for ADHD:

A number of studies have confirmed the hypothesis that individuals with ADHD have reduced bloodflow levels marking a recuction of activity to multiple key brain regions. Additionally, while several disorders have a number of overlapping symptoms (which can make the diagnostic process more complicated, especially if multiple comorbid disorders are present), differential blood flow patterns to the brain may be able to help make these distinctions. For example, blood flow patters to the brains of ADHD and OCD (Obsessive Compulsive Disorders) can show pronounced differences, which can aid the diagnostic process between these two disorders (while ADHD and OCD are often considered to be on "opposite" ends of the spectrum with regards to neuro-chemical signaling levels, these two disorders can often exhibit similar symptoms, such as a severe impairment in the response to verbal directions. This is especially true in younger children).

This technology may even be extended to measuring or predicting which medications may work for an individual diagnosed with ADHD, based on blood flow in specific localized brain regions. Cerebral blood flow patterns may help predict the response to common ADHD drugs such as methylphenidate (Ritalin, Concerta, Metadate, Daytrana). For example, a study by Cho and coworkers found increased blood flow in at least three different brain regions for individuals who showed poor response to methylphenidate treatment compared to their peers who did show improvements under the drug.

While the medication response study was done utilizing a different type of brain imaging device known as SPECT, which utilizes gamma rays and radioactive tracers to detect brain activity in 3-dimensional patterns. While SPECT has proven to be an extremely powerful and effectively safe method of detection (the radioactive isotope used in this method is relatively non-invasive and breaks down quickly, and the gamma rays are carefully controlled), concerned parents may still have an inherent fear of the terms "radioactivity" and "gamma rays" tend to shy away from this powerful detection method on their kids.

While this blogger personally has a very high opinion about the use of SPECT as a diagnostic tool for ADHD and related disorders, it is at least worth mentioning the possibility that long-wave infrared imaging methods may be a viable alternative method in at least some of these imaging cases (SPECT technology has been around for over 30 years, but the recent advances in computational power resurrected this technology in the very recent past, similar possibilities may abound by this infrared technology, which has been around even longer).

Keep in mind that the studies utilizing this range of infrared imaging technologies for detecting and differentiation disorders such as ADHD are still relatively scarce. Nevertheless, long-wave infrared imaging appears (at least in this bloggers personal opinion) to be a powerful diagnostic tool for ADHD and related disorders in the near future.

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