Can Essential Fatty Acids Treat ADHD?

Are fatty acid supplements the magic bullet for ADHD?

Are fatty acid supplements the magic bullet for ADHD? Judging from recent sales at vitamin counters, that’s what lots of people think.

It all started when J. Burgess, Ph.D., a Purdue University researcher, discovered that children with ADHD frequently have much lower blood levels of DHA than normal. DHA is an omega-3 fatty acid found in fish. It is also formed by the body from alpha linolenic acid, which is found in vegetable oils such as soy, canola, and flax oil.

ADHD adults and parents across the country reasoned that if DHA is lacking in the bloodstream, then adding more to the diet is bound to help. This kind of thinking may partly explain why the rush is on for omega-3 fatty acid supplements.

A Word of Warning

Why Top Experts Recommend Against Treating ADHD With Fatty Acid Supplements:

  • Supplements have not been demonstrated to work on AD/HD symptoms
  • Supplements may not increase fatty acid levels in the AD/HD brain
  • People diagnosed with AD/HD may be too old to benefit from Fatty Acid interventions
  • Supplements could cause health problems by creating a Fatty Acid imbalance

What Does Work

  • Years of consistent effort, by parents and diagnosed adults
  • For parents, unpressured quality time with your kids
  • Identifying and build on ADHD strengths
  • Teaching ADHDers to own their behavior and providing them with helpful behavioral strategies
  • Undertaking a caring and consistent positive discipline program
  • Following safe and sound accepted medical practice

Teresa Gallagher swears by it. The creator of the popular Born to Explore web site and mother of a first-grade boy whom she says may have ADD believes flax oil supplements are partly responsible for his excellent behavior and above-average reading skills, though “we’ll never know it for sure.”

“I believe the single most important thing you can do for your child’s diet is to add a tablespoon of high quality flax oil once a day,” Gallagher tells readers on her ADD site.

Gallagher is not alone. Barlean’s Flax Oil company spokesman Jerry Gillian says he constantly gets letters and email from customers who use the product to treat ADHD. But, says Gillian, “Barlean’s cannot endorse the use of flax oil to treat any medical condition based on restrictions put forth by the U.S. Food and Drug Administration.”

If flax oil helps, why does the FDA stand in the way ? Why is it still such a “secret?” Some ADHDers and conspiracy theorists alike suggest that the medical-industrial complex somehow has influenced the FDA’s approval process. After all, if flax oil really works, people with ADHD wouldn’t have much need for costly prescription drugs and psychiatrists.

But even Dr. Burgess does not recommend omega-3 dietary supplements if treating ADHD is the goal. That’s because science has yet to prove that fatty acid supplements help ADHD.

Here is what scientists do know:

No one has been able to demonstrate scientifically that omega-3 fatty acid supplements help ADHD. Every scientific study to date has shown that giving fatty acid supplements to ADHDers does not improve their symptoms. The supplement only elevates DHA in the blood to normal levels.

Increased DHA blood levels may have no bearing on DHA levels in the brain. Scientists don’t even know whether ADHD brain levels of DHA are normal or not, because there’s no safe way to measure it. In fact, the ADHD brain may not even be able to use ingested DHA; some scientists suggest that the normal brain makes its own DHA, but this theory isn’t proven either.

Children or adults diagnosed with ADHD may be too old to benefit from dietary supplements of omega-3. Our brains do most of their growing before age two, and adding supplements after that age may be of little use for anyone who has ADHD. By the time ADHD usually is diagnosed, structurally “the damage may already be done,” says one leading researcher who declined to be named in this article.

DHA supplements could actually hurt, although this theory too remains unproven. People with ADHD also have lower blood levels of arachidonic acid, an omega-6 fatty acid. The interplay between intake of this fatty acid and DHA is fragile and complex. Research suggests that intake of too much omega-3 decreases blood levels of arachidonic acid, and also that too much omega-6 decreases blood levels of DHA and other omega-3 fatty acids.

Not having enough arachidonic acid may be as bad as not having enough DHA. That’s because arachidonic acid plays an important role in blood pressure and immune response. Despite the potential risk, however, low DHA blood levels in ADHDers remain so intriguing that scientists will continue pursuing this lead. There may soon be studies on supplementing ADHD diets with both DHA and arachidonic acid, but again, the jury is still out on whether this combination will work. (When Dr. Burgess tried this approach, it didn’t work.)

One brain disorder that fatty acid supplements do seem to help is manic depressive illness, also known as bipolar disorder. A preliminary study published recently in the Archives of General Psychiatry found that omega-3 fatty acids improved bipolar symptoms markedly.

But researchers caution us not to draw any such conclusions about their use for ADHD. While symptoms of bipolar disorder and ADHD sometimes look alike, and the two occur together in many patients, they are very different disorders and so are their treatments. “In the omega-3 / bipolar disorder study we were looking at changes in the neuronal signal transduction system, (a system) which has nothing to do with ADHD,” says Lauren B. Marangell, M.D., a Baylor College of Medicine psychiatrist who was a co-principal investigator of the bipolar disorder study. “The mechanisms of action of drugs that work for bipolar disorder are not the same as those that work for ADHD. Lithium works for bipolar disorder but not ADHD. Stimulants don’t stabilize bipolar disorder.”

The take home message is this: fatty acid supplements for ADHD may be a waste of money at best, and a potential health hazard at worst. More than that we do not know. Says Craig Bushong, M.D., a Houston psychiatrist with an active ADHD clinical practice, “You have to be very careful. Before using any treatment I’d want very solid, undeniable research that supports using it.”

Approaches similar to fatty acid supplements have been tried before for ADHD. Dr. Benjamin Feingold proposed a diet free of additives; others offered diets low in sugar, or high in vitamins and minerals. However, none of these approaches has stood up to rigorous controlled clinical trials, the gold standard of medical research.

To be sure, dietary intervention has produced some success. But more than likely, researchers say, the success stories can be attributed to three factors:

1. The Placebo Effect
People who try dietary interventions believe or want to believe they will work. Belief can influence greatly both human behavior and biology. The placebo effect is such an integral part of medicine that no scientific study is complete without taking it into account.

2. Relationship Factor
For ADHD children, the time and effort needed to manage these diets ensure that parents will spend more time with their children. This increased attention can have profoundly positive effects on children’s behavior. Many experts suggest that increased parental time with and attention to ADHD children probably has more to offer than any unproven “therapeutic” diet.

3. No Blame, More Gain
In rare cases, parents of ADHD kids can blame the child for the disorder, and ADHD adults may blame themselves. If they instead focus on deficiencies in the diet, they may be less focused on deficiencies in the child or in themselves. When people focus on external causes of ADHD, they are less apt to blame the patient – either overtly or subtly – than they would otherwise. Shifting the blame away from the ADHDer can result in a better attitude and improved behavior.

In summary, the jury is still out on dietary interventions, including those involving fatty acid supplements. None have proved effective so far. Still, there are important lessons to be learned from the journey.

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