Understanding the causes of ADD / ADHD – can this improve treatement?

Understanding the causes of ADD /ADHD – can this help us to treat it better?

ADD/ ADHD is a common disorder affecting up to 8-12% of the worlds population, causing many people to struggle at school or at work. There is a strong genetic link (if only one parent has ADHD, then their child has a 50% chance of developing it) and certain environmental factors are accepted to play a role in developing it. The scientifically accepted factors, though, are relatively limited. Factors such as pregnancy related issues (alcohol exposure, low birth weight), maternal and childhood stress among a few others. However, the interaction between our day to day environment and our genetics (Epigenetics) i.e. foods, toxins, nutrient deficiencies, stress etc., is a growing field of research in ADHD. Epigenetics may explain a lot about the development of this disorder. Let us look further into the current theories as to why people get ADD /ADHD:

1. ADD/ ADHD has long been thought to be the result of a neurotransmitter imbalance, or an imbalance or miscommunication between the prefrontal cortex, and other parts of the brain. The fact that people with ADHD respond well to drugs that target dopamine receptors in the brain supports this, along with recent research on the areas of the brain affected by the disorder. However why this is the case is still the subject of much research.
2. The role of the immune system in the development of ADD/ ADHD is a point of great interest. There is an established link between ADD/ ADHD and higher levels of allergies, Higher IGE levels, and higher levels of numerous immune sensitizing molecules in the blood stream that may represent a state of hightened or hypersensitive immunity. Other researchers have found that ADD/ ADHD sufferers tend to have more common colds that people without the disorder.
3. People with ADD/ ADHD tend to have lower levels of certain anti-oxidants and higher markers of oxidative stress. They also have lower activity of antioxidant detoxification pathways in the body. Antioxidants protect the cells in the body from damage, and help the body to safely deal with and get rid of toxic substances. This could result in a buildup of irritating or damaging toxins or even neurotransmitters, possibly affecting the nervous system. It could also result in a hightened sensitivity of the brain or nervous system to environmental toxins.
4. The role of the gut and gut health in the development of ADD/ ADHD is being investigated. Higher levels of certain bad bacteria have been noted, and lower levels of good bacteria. The connection between our digestive systems and our nervous system is now a huge field of study and is being dubbed ‘ The gut – brain axis’. The digestive tract is closely linked with the immune system, our ability to absorb nutrients and even with the health of the nervous system.
5. Inflammation in the brain and nervous system has been described by a number of researchers (links: 1, 2, 3, 4). However, there is still some debate whether the markers seen, come from systemic immune reactions and inflammations or oxidative stress. Or whether the markers actaully represent inflammation the brain. Certainly, the now well accepted link between neuroinflammation and other disorderes such as Autism, Parkinsons and Alzheimers disease, means that it is not such a stretch to suppose that ADD/ ADHD is another neuroimflammatory disease.
6. The role of nutrition and diet in ADD/ ADHD has long been a point of discussion and argument. In the 1970’s Dr Feingold proposed that children with ADD/ ADHD had a sensitivity to artifical colourants and additives – this became the traditional (or controvertial) Feingold diet. It has taken decades of debate, but the American Acadamy of Paediatics has agreed that eliminating these from the diet is a resonable option. People with ADD/ ADHD show more nutrient deficiencies (like magnesium, zinc and omega 3). They also have an increase in food allergies or intolerances. So an elimination diet may be of great benefit. (links: a, b, c, d.)

So we can see that there are many factors that may underly the development of ADD/ ADHD. And in fact there are many others, like cognitive and learned factors, other toxins, obesity and stress. It should be mentioned that this combination is similar in a way to what we see in Autism. By that I mean that there is a proposed genetic predisposition or propensity towards ADD/ ADHD. Then on top of that we may have a gut sensitiviy, an immune sensitivity, allergies, sensitiviy to toxins (or detox issues) and resulting inflammation in the brain.

If we look at the fact that, for many people, ADD/ ADHD is a lifelong diagnosis, then many people might feel that purely relying on taking a mediciation for the rest of your life, is not an attractive idea. While cognitive training, regular exercise and stress management may play a big role in helping people to live with the disorder. I feel that a better (wholistic) understandng of the condition is crutial to better management. If we can look at each case and try to uncover and understand the factors affecting that person, and address them wholistically, I feel we will should have better long term brain health. By addressing the diet and gut health (food allergies, probiotics), by addressing toxins (exposure, antioxidants, detoxification) and by addressing deficiencies (omegas, minerals) and inflammation (curcumin) I feel that we should be able to plot a path to better balanced health for ADD/ ADHD sufferers (and, in fact, for all of us!)