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Attention Deficit
Hyperactivity Disorder (ADHD)
Also known as
Attention Deficit
Disorder (ADD)
Most if not almost all children with developmental disorders have at least one inflammatory bowel condition. [1][2][3]
More than half of classic Celiacs have neurologic disorders. [4][5]
However, the National Institute of Mental Health (NIMH) is reluctant to suggest food intolerance and diet therapy are very relevant to ADHD. As of 2003, NIMH states that diet restrictions only helped about 5 percent of children with ADHD, mostly young children who had food allergies.[6] But the secret of NIMH is that this statement is based on just two studies from 1982 and 1985 that did not investigate gluten or casein![7][8] Furthermore, both were just short-term studies.
Anecdotal evidence abounds for the effectiveness of diet on ADHD, autism and other Development Disorders. Several foods are mentioned, particularly casein (from milk), but more recently gliadin (from gluten). Although scientific research into the roles of food sensitivities are not attractive to venture capital, reports of studies linked at least some ADHD with food sensitivities are available.
Some Studies on the Effectiveness of Diet on ADHD:
· 40 children, 36 boys and 4 girls, aged 3-7 (average 4.8 years), who met the DSM-IV-criteria for ADHD, followed their usual diet for two weeks and thereafter for two weeks an elimination diet, based on the [gluten and casein free] few foods diet (rice, turkey, pear and lettuce). 9 children did not complete the diet. Of the 31 children that stayed with the diet for two full weeks, 25 children (80% of the 31) showed an improvement in behavior of at least 50% on both the Conners list and the ADHD Rating Scale. [9]
· Impaired social interaction, communication and imaginative skills characterize autistic syndromes. In these syndromes urinary peptide abnormalities, derived from gluten, gliadin, and casein, are reported. They reflect processes with opioid effect. The aim of this single blind study was to evaluate effect of gluten and casein-free diet for children with autistic syndromes and urinary peptide abnormalities. A randomly selected diet and control group with 10 children in each group participated. Observations and tests were done before and after a period of 1 year. The development for the group of children on diet was significantly better than for the controls. [10]
· “Dr Kozlowska, in her article "Evaluation of Mental Status of Children with Malabsorption Syndrome After Long-Term Treatment" published in “Psychiatria Polska” 25/2 Mar/Apr. 1991, identified fully 71% of the children they studied as having psychiatric disturbances”[11][12] which resolved after 12 months of gluten-free diet.[13][14]
· The following table is a beginning of summaries of a sample of studies that demonstrated favorable responses to restricted diets. More Studies are identified in the paper Diet, ADHD & Behavior (Parent’s Guide)
|
Total ADHD Cases completing the Diet |
Number of Improved Cases |
Degree of Improvement |
Duration of Diet |
CFGF |
Year |
Ref. |
|
31 |
25 (80%) |
50% |
2 weeks |
Yes |
2003 |
|
|
10 |
whole group |
significant |
1 year |
Yes |
2002 |
|
|
78 |
19 (25%) |
significant |
-- |
-- |
1993 |
|
|
24 |
10 (42%) |
50% |
4 weeks |
CF only |
1989 |
CFGF = gluten and casein free was included in the experiments
Neurologic manifestations of patients with CD and control subjects. [20]
|
Neurologic Condition |
Celiacs |
Control |
Factor |
|
|
1 or more conditions |
51.4% |
19.9% |
2.6 |
|
|
Hypotonia |
21.6% |
3.8% |
5.7 |
P<0.01 |
|
Developmental Delay |
15.5% |
3.3% |
4.7 |
P<0.01 |
|
Epileptic Disorders |
7.2% |
0.8% |
9.0 |
P<0.09 |
|
learning disabilities & ADHD |
20.7% |
10.5% |
2.0 |
P<0.01 |
|
Headache |
27.9% |
8.1% |
3.4 |
P<0.01 |
|
Ataxia |
5.4% |
0% |
>5.4 |
P<0.01 |
|
Tics |
0.9% |
2.4% |
0.4 |
P=0.67 |
Reviews/Bibliographies
The following are links to pages that contain review and or bibliographies of Autism and ADHD treatments.
Diet, ADHD & Behavior -- A Quarter-Century Review
“Denying that food ingredients can exacerbate ADHD or other behavioral effects reflects ignorance of the scientific research, and ignoring that research jeopardizes children’s well-being.”
Diet And Its Possible Role In Developmental Disorders
From: IX. SUMMARY RE HYPOTHESES
“… It appears that some children diagnosed as ADHD are sensitive to particular foods or food additives and that this sensitivity can affect their learning and behavior. Moreover, when offending substances are removed from the diet of such children, positive changes are reported in behavior and mental processing (i.e., Hypothesis D). Although the number of children so affected seems to be small, the benefit of identifying such children and removing offending food substances from their diet appears worth the effort of finding them and attempting dietary intervention. …”
“Research has identified ADHD in 66-70% of children with untreated celiac disease, which resolves on a gluten-free diet, and returns with a gluten challenge.”
Bibliography Of Treatment Recommendations For Autism Spectrum Disorders
From “GI/Immune Research”:
“Current research shows that 98% of children on the [autistic] spectrum have [gastrointestinal] and immune irregularities. 48% of these kids show marked improvement in concentration, speech, reduction of perseverative behaviors, among others, when they implement the DAN! Protocol. DAN is a group of pediatricians that specialize in ASD kids, and do research collectively.”
“This document suggests that current practices which lead to the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) may obscure underlying pathologies which can have dangerous consequences when undiagnosed. While stimulant therapies are sometimes an effective tool for the short-term management of ADHD symptoms, they offer little long-term hope to the afflicted child, perhaps placing that person’s health in serious jeopardy. Teacher involvement in this diagnostic and treatment process may aid in perpetuating this problem. An alternative understanding of ADHD, informed by the exorphin hypothesis, offers a safe, powerful tool for dealing with the underlying condition in many cases of ADHD, and an effective treatment for ADHD. A large and growing body of evidence supports the application of the exorphin hypothesis to ADHD, and points to some specific research needs in this area. Such research requires a shift away from the pharmacological paradigm, in recognition of distinctions between pharmaceutical and dietary interventions.”
Collections of Abstracts
Here are collections of Abstracts on Studies demonstrating food sensitivity’s role in ADHD:
Allergies and ADHD - BrainTalk Communities* - Neurology Support ...
ADD/ADHD and Gluten - BrainTalk Communities*
*Massachusetts General Hospital
Articles
The Celiac Disease of Mental Illness
At the end of this article is a
list of educational benefits that treated Celiacs have reported.
“Children Once Thought of as Having “Untreatable” Developmental or Behavioral Disorders in Reality Have a Medical Disease.” … “By treating these (ADHD) and other diseases as neuro-immune dysfunctions syndromes (NIDS) and looking upon then as medical rather than developmental disorders, Michael Goldberg M.D., F.A.A.P. and his colleagues at the Neuro-Immune Dysfunctions Syndromes Research Institute (NIDS-RI) have seen dramatic improvement and normalization in children previously deemed medically untreatable.”
Review
Article : The concept of entero-colonic encephalopathy, autism and
opioid receptor ligands
“There is growing awareness that primary gastrointestinal pathology may play an important role in the inception and clinical expression of some childhood developmental disorders, including autism. In addition to frequent gastrointestinal symptoms, children with autism often manifest complex biochemical and immunological abnormalities. The gut-brain axis is central to certain encephalopathies of extra-cranial origin, hepatic encephalopathy being the best characterized.”
Collection of Ron Hoggan Articles
Controversy on Medication
For your consideration: Some web sites provide opinion and evidence critical of blanket medication of children. A small sampling:
Death
From Ritalin The Truth Behind ADHD
Attention Deficit Hyperactivity Disorder
(Exposing the Fraud of ADD and ADHD)
Shrinking
to Excess : I’ll be damned if I let a psychiatrist near my son
“Letter to Tunku Varadarajan” by Fred A Baughman, Jr, MD
Miscellany
The following is a collection of related links I haven’t yet organized:
Intestinal Pathophysiology in Autism
Aetna’s Clinical Policy Bulletins
Attention Deficit/Hyperactivity Disorder
This opinion paper of the European Food Safety Authority on food allergies uses the word “gliadin” 59 times:
Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S,
Graham PJ, Taylor E (1993). Effects of a few food diet in attention deficit
disorder. Arch Dis Childh 69: 564-568.
Taylor E (1999). Developmental neuropsychopathology of attention deficit and impulsiveness. Dev Psychopathol 11: 607-628.
“Heinz Handbook Of Nutrition, Ninth Edition”, Distributed By Heinz Corporate Research Center, H.J. Heinz Company, Edited By David L. Yeung, Ph.D. General Manager - Global Nutrition, H.J. Heinz Company And Idamarie Laquatra, Ph.D., R.D. Nutrition Consultant, 2003
Glossary of Aminoacids
Glutamic Acid plays an important role in
the metabolism of ammonia and in the formation of the neurotransmitter
gammaaminobutyric acid (GABA) in the nervous system. It is a component of the
vitamin folate. Glutamic acid is the predominant amino acid in wheat protein
(gliadin). As monosodium glutamate (MSG), it is a powerful flavor enhancer.
plays an
important role in the metabolism of ammonia and in the formation of the
neurotransmitter gammaaminobutyric acid (GABA) in the nervous system. It is a
component of the vitamin folate. Glutamic acid is the predominant amino acid in
wheat protein (gliadin). As monosodium glutamate (MSG), it is a powerful flavor
enhancer.
However, food allergies that are seen in infancy
generally do not persist into childhood or adult life. Most infants do outgrow
them.
Chapter 7 GENERAL NUTRITION
Infant
Feeding......................................................................203
Growth...................................................................................203
Milk Feeding
..........................................................................206
Breastmilk
.........................................................................206
Infant Formula ...................................................................210
Cow’s Milk
.........................................................................211
Complementary Feeding
.......................................................211
Vitamin Supplements ............................................................214
General
Considerations.........................................................214
Food Allergy
..........................................................................216
Gluten Sensitivity...................................................................218
Bound gliadin can be freed to Trigger T1 cells?
http://www.add.org/index.html
Lilly Announces Important Liver Safety Update to Strattera Label
Eli Lilly and Company announced that it has added a bolded warning to the product label for Strattera, an attention deficit/hyperactivity disorder (ADHD) medication. The bolded warning indicates that the medication should be discontinued in patients with jaundice (yellowing of the skin or whites of the eyes) or laboratory evidence of liver injury.
Read More adult add
http://www.add.org/articles/factsheet.html
Medication is often used to help normalize brain activity, as prescribed by a physician. Stimulant medications (Ritalin, Dexedrine, Adderall) are commonly used because they have been shown to be most effective for most people with ADHD. However, many other medications may also be used at the discretion of the physician.
Bibliography Of Treatment Recommendations For Autism Spectrum Disorders
By Ashley Morgan, Parent of 6 year old son, recovered from PDD-NOS, updated 11/11/04
GI/Immune Research
with Journal articles regarding autism and gastrointestinal abnormalities
Little reference to ADD, but several Gliadin studies.
Current research shows that 98% of children on the [autistic] spectrum have GI and Immune irregularities. 48% of these kids show marked improvement in concentration, speech, reduction of perseverative behaviors, among others,
Neurology 2003;60:1581-1585
Celiac neuropathy
R. L. Chin, MD, H. W. Sander, MD, T. H. Brannagan, MD, P. H.R. Green, MD, A. P. Hays, MD, A. Alaedini, PhD and N. Latov, MD PhD
From the Department of Neurology and Neuroscience (Drs. Chin, Sander, Brannagan, Alaedini, and Latov), Weill Medical College of Cornell University, New York, NY; Department of Neurology (Dr. Sander), New York University School of Medicine, New York, NY; Department of Neurology (Dr. Sander), New York Medical College, Valhalla, NY; and Departments of Medicine and Celiac Disease Center (Dr. Green) and Pathology (Dr. Hays), College of Physicians and Surgeons, Columbia University, New York, NY.
Background: Celiac disease (CD) is a chronic inflammatory enteropathy resulting from sensitivity to ingested gluten. Neurologic complications are estimated to occur in 10% of affected patients, with ataxia and peripheral neuropathy being the most common problems. The incidence and clinical presentation of patients with CD-associated peripheral neuropathy have not previously been investigated.
Objective: To determine the incidence of CD in patients with neuropathy and to characterize the clinical presentation.
Methods: The records of 20 patients with neuropathy and biopsy-confirmed CD were reviewed.
Results: Six of the 20 patients had neuropathic symptoms alone without gastrointestinal involvement, and neuropathic symptoms preceded other CD symptoms in another 3 patients. All patients had burning, tingling, and numbness in their hands and feet, with distal sensory loss, and nine had diffuse paresthesias involving the face, trunk, or lumbosacral region. Only two had weakness. Results of electrophysiologic studies were normal or mildly abnormal in 18 (90%) of the patients. Sural nerve biopsies, obtained from three patients, revealed mild to severe axonopathy. Using the agglutination assay, 13 (65%) of the patients were positive for ganglioside antibodies. Excluding patients who were referred with the diagnosis of celiac neuropathy, CD was seen in approximately 2.5% of all neuropathy patients and in 8% of patients with neuropathy and normal electrophysiologic studies seen at our center.
Conclusion: CD is commonly associated with sensory neuropathy and should be considered even in the absence of gastrointestinal symptoms.
This article has been cited by other articles:
Peripheral Neuropathy in Celiac Disease: Evidence for an Association, Journal Watch Neurology, September 5, 2003; 2003(905): 4 - 4. [Full Text]
A. H. Cross and P. T. Golumbek, Neurologic manifestations of celiac disease: Proven, or just a gut feeling? Neurology, May 27, 2003; 60(10): 1566 - 1568. [Full Text] [PDF]
Side effects:
Amphetamine-induced chorea in attention deficit-hyperactivity disorder
http://www.purdeyenvironment.com/webref2.htm
Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA,
Lipp SR, Burgess JR. Essential fatty acid metabolism in boys with
attention-deficit hyperactivity disorder. Am J
Clin Nutr. 1995 Oct;62(4):761-8.
Boris M, Mandel FS. Foods and additives are common causes of the attention deficit hyperactive disorder in children. Ann Allergy. 1994 May;72(5):462-8. Review.
Dr. Rapp
http://www.holisticmed.com/add/rapp.html
25% 66%
> I am a clinician who is somewhat familiar with the
research supporting and not
> supporting treatments effective in addressing ADD/ADHD. When you said that
> "66%" respond to dietary changes, you captured my interest. How
did you come
> to this finding?
In subsequent work:
Crawford, S., Kaplan, B., Kinsbourne, M., (1994). Cortex. 30 (2), 281-292.
Kaplan and her co-workers report evidence of a familial association between
autoimmunity and ADHD, as well as learning disabilities. They also report a
familial association between Crohn's disease and ADHD.
> She conducted a double-blind study in which
> ADHD preschoolers with known allergies were placed on diets without additives,
> chocolate, MSG, caffiene, and other substances known to cause allergic
> reactions for the children.
But gluten and, if memory serves, some other common allergenic substances were not considered in their exclusions. If intestinal permeability is a factor in food allergies, then the failure to examine these entities impugns their results, as elevated IgA and IgG gliadin serum antibodies have been reported in from 2.5% (Catassi et al.(1994). Coeliac disease in the year 2000: exploring the iceberg. Lancet 343(8891), 200-203. )to 15% (Arnason et al.(1992)Do Adults with high gliadin antibody concentrations have subclinical gluten intolerance? Gut . 33(2), 194-197.) of random populations.
Alternative and Innovative Therapies for Development Disorders
Gliadinomorphins? casomorphine? No wonder milk helped me sleep.
Those who cannot metabolize gluten, produce a-gliadin and gliadinomorphins, compounds which bind to the opioid receptors (C and D) that are associated with mood and behavior disturbances.
Casein is a milk protein, with a molecular structure similar to gluten's. Casein (from human or cow milk) breaks down in the stomach into a peptide known as casomorphine, which has opioid activities.
Arnason, J.A., Gudjonsson, H., Freysdottir, J., Jonsdottir, I., and Valdimarsson, H. (1992). Do adults with high gliadin antibody concentrations have subclinical gluten intolerance? Gut, 33, 194-197.A
Grodzinsky, E., Franzen, L., Hed, J., and Strom, M. (1992). High prevalence of celiac disease in healthy adults revealed by antigliadin antibodies. Ann Allergy, 69, 66-70.A
Storm, W. (1990). Prevalence and diagnostic significance of gliadin antibodies in children with Down syndrome. Eur J Pediatr, 149. 833-834.A
http://www.newsrx.com/cgi-bin/issues_partial.cgi/?issuedate=2004-01-12&code=5W#A482
mmunology
Microwave energy dose affects
immunoreactivity of gliadin and wheat flour
2004 JAN 12 -- Microwave
energy dose affects immunoreactivity of gliadin and wheat flour: low doses
increase it and high doses decrease it. According to recent research from
Poland, commercial gliadins and wheat flour were exposed to microwaves at power
... (viewing 269 of 2508 characters)
Immunology
Shyness can be deadly
2004 JAN 12 -- How you
react to stress influences how easily you resist or succumb to disease,
including viruses like HIV, discovered University of California Los Angeles
(UCLA) AIDS Institute scientists. Reported in Biological Psychiatry , the
new ... (viewing 266 of 5459 characters)
http://www.adhdfraud.org/frameit.asp?src=http://www.adhdvideo.org
Paxil is prescribed to prevent suicide, however, it actually cause suicide when so prescribed.
White matter lesions are typical of Asperger's Syndrome but white matter lesions are also commonly caused by gluten intolerance. Cerebral anomalies are possibly typical of Autism but cerebral damage is also a common result of gluten intolerance.
[Webmasters
Note: I’m still reviewing these linked sites myself. The reader is advised to be aware that there are some evolving
issues: differentiating Autism and Asperger’s, the need for a “cure”, the
justification of medication, social rights, research of physical causes (there
is no psychological cause), and so forth.]
Collections of Autism Related Links:
More Links
at Yale Developmental Disabilities Clinic