Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
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Natural ADHD supplements with evidence to back them include melatonin, zinc, vitamin D, and Coenzyme Q10.
Supplements often help by correcting micronutrient deficiencies and impacting the production and function of neurotransmitters.
Other ways supplements, such as probiotics, can help is through improving gut health.
Stimulant medication that works on the brain is the most researched ADHD treatment but supplements, diet, and lifestyle changes in general can offer a more whole-body approach.
Other complementary ADHD approaches include improving sleep hygiene, exercising, and behavioral therapies.
If you or your child has ADHD, taking natural supplements may be something you have thought about, but choosing the right ones can be a bit of a minefield. In this article, I hope to help guide you through this maze.
The key to understanding how supplements may work is acknowledging that attention-deficit hyperactivity disorder (ADHD) isn’t just a neurological condition: it may also be impacted by parts of the body remote from the brain, including the gut microbiome .
It’s unfortunate that kids with ADHD are often labeled as “troublemakers” when it’s not their fault. ADHD is thought to arise from a combination of genes and the environment. Viral infections, poor gut health, and nutritional deficiencies that affect levels of neurotransmitters like dopamine and serotonin in the brain, are possible factors in the development and/or symptomatology of ADHD .
About 50% of children grow out of an ADHD diagnosis, especially if they are treated, but the condition still occurs in about 3–6% of adults .
If you have ADHD, or if you’re looking after a child with ADHD, it’s totally understandable that you’d want to try to tackle it in a gentle way using natural ADHD supplements. But how do they compare with medications, which may help to tackle symptoms quickly?
There are a few key supplements that may help with ADHD. And fortunately, it doesn’t have to be either/or, and coupling conventional medicine with dietary supplements for ADHD can also be a smart approach in many cases.
By additionally working on gut health improvements, exercise, and behavioral therapies, you can not only tackle ADHD symptoms in the short term, but also potentially tackle the underlying issues in the long term.
We’ll touch more on both conventional and dietary/lifestyle approaches for ADHD later on in this article, but first let’s get straight to the 5 best supplements for ADHD and the evidence behind them.
1 – Melatonin
Supplementing with melatonin, the hormone that helps regulate circadian rhythms, may help people with ADHD get more restful sleep, which can positively impact the condition.
In a meta-analysis that pooled the results of 22 clinical trials (1,758 participants in total), melatonin helped kids with ADHD fall asleep on average 28 minutes earlier and sleep an average of 33 minutes longer .
The useful dosage of melatonin varies, but more of this supplement is not necessarily better in my clinical experience, especially when it comes to use in children.
Some studies use melatonin at doses as high as 10mg within two hours of bedtime , but I’ve found that the optimum range is a 1–3 mg daily dose.
2 – Vitamin D
The effects of taking vitamin D were assessed in a small 2019 meta-analysis of kids with ADHD who were also taking methylphenidate (Ritalin). The dosage of vitamin D in the study ranged between 1000 IU/day and 50,000 IU/week for a period of 6 to 12 weeks.
Checking vitamin D levels with a simple blood test can guide what supplementary intake is best for you or your child, but if you don’t know your level, it would be safer to start at the lower end — i.e. a daily dose of1000 IU vitamin D.This analysis found that vitamin D appeared to improve ADHD symptoms overall to a small degree, with a medium beneficial effect on :
The benefits were more pronounced in kids who started out with a vitamin D deficiency.
Another meta-analysis found that higher maternal vitamin D levels may reduce the likelihood of developing ADHD in childhood. For every 25 nmol/L increase in a pregnant woman’s vitamin D level, there was an 18% lower risk of developing ADHD .
3 – Zinc
Some studies have shown that people with ADHD may have lower levels of zinc. In one meta-analysis that evaluated 6 trials and a total of 489 school children, topping up zinc levels helped to significantly improve overall ADHD symptoms, when taken alongside methylphenidate .
Per this meta-analysis, the effective zinc supplement dosage seemed to be a minimum of 20mg per day for 8 weeks. However, more data on dosage, and on how zinc deficiency affects ADHD in general, is needed.
4 – Multivitamins
Given that a shortage of several different micronutrients, including low iron and zinc, may impact mental health and cognition, there’s a case to be made for kids and adults with ADHD taking an A–Z style multivitamin and mineral.
Early evidence suggests that micronutrient supplements may be able to help treat ADHD symptoms in adults more safely than medications .
In a randomized controlled trial, kids with ADHD and irritability who took nutritional supplements containing essential nutrients also had reduced symptoms according to clinicians’ assessments. Parental assessments of micronutrient supplementation showed less clear benefits, but the supplements were safe and may also have contributed slightly to height growth in the children who took them .
A good multi-micronutrient formulation should contain B vitamins, vitamin D, and antioxidants (e.g. vitamins C and E), as well as minerals, including magnesium and zinc, which can be hard to come by in the diet.
5 – Coenzyme Q10
Coenzyme Q10 could also be worth adding to an ADHD supplement regimen. This supplement has an important role in the chain of chemical reactions that generates adenosine triphosphate (ATP), the major currency of energy in our body.
One randomized controlled trial tested the safety and efficacy of coenzyme Q10 alongside a non-stimulant drug treatment (atomoxetine) for ADHD. Children in the study were either given atomoxetine plus CoQ10 or atomoxetine plus placebo for 6 months.
Those who took CoQ10 had greater improvements in learning difficulties, impulsivity, and hyperactivity than those who didn’t. They also achieved the benefits in less time and with fewer side effects .
Dosages of CoQ10 vary, but I’d generally recommend 100mg daily for the best effect.
Do Fish Oil Supplements Work for ADHD?
Omega-3 fatty acids, including EPA and DHA from fish oil used to be considered a promising supplement for reducing ADHD symptoms, but expert opinion has shifted somewhat more recently.
A 2018 meta-analysis of clinical trials and observational data concluded that kids and teens with ADHD tended to have lower omega-3 fatty acid levels than healthy controls, and that omega-3 supplements might improve :
ADHD clinical symptoms (small effect)
Some aspects of cognitive function (larger effect)
However, a larger2021 large meta-analysis found that omega-3 supplements did not have any noticeable impact on symptoms, behavior, or quality of life in children and teenagers with ADHD .
Furthermore, in a large systematic review, taking omega-3 fatty acids during pregnancy or infancy did not appear to influence the risk of a child developing ADHD .
While you can definitely find data that seems to support the use of fish oils for kids and adolescents with ADHD, the bulk of evidence isn’t that supportive for this health condition.
Gut Health and ADHD
As research uncovers more about the gut–brain connection, it’s becoming clear that a disrupted gut microbiome and ADHD are linked. We still don’t know for sure how gut dysbiosis might contribute to ADHD, but given the two often occur together, it would sense that tackling gut health might also help ADHD symptoms.
Here is what some of the studies show us:
A 2022 meta-analysis showed that kids with ADHD had higher levels of certain types of gut bacteria than healthy controls. This suggests ADHD “can no longer be conceptualized as primarily a neurocognitive disorder,” according to the researchers .
In one evidence-mapping study, people of all ages with ADHD appeared to have a distinct gut bacteria profile that overlapped with conditions like anorexia and bipolar disorder .
Taking antibiotics during pregnancy may be linked to a higher risk of ADHD in offspring, perhaps by impacting fetal development via the mother’s gut microbiome (antibiotics are disruptive to the microbiome) [15, 16].
The gut conditions celiac disease and leaky gut are associated with a higher risk of ADHD . High levels of a leaky gut biomarker called zonulin appeared to correlate with more severe ADHD symptoms in children in one study .
Probiotics and ADHD
Because of the associations between gut health and ADHD, some researchers have started to look into the effects of probiotics on ADHD symptoms and risk.
Three clinical trials so far have suggested that probiotics and synbiotics might have potential benefits for ADHD symptoms and associated inflammation (though more robust research is necessary to establish their effectiveness). The findings to date are as follows:
One RCT found that kids with ADHD who took synbiotics had less ADHD-associated inflammation, in part because the synbiotics increased short-chain fatty acid production .
Another RCT found that kids whose mothers took probiotics during pregnancy and then gave them probiotics for the first 6 months of life had a lower risk of developing ADHD than kids and their moms who took a placebo .
A small non-randomized trial showed that after kids and teens with ADHD took probiotics for 8 weeks, their clinical symptoms improved and their gut microbes changed .
What Diet Works for ADHD?
Some types of diet appear to reduce ADHD symptoms, while other ways of eating appear to worsen symptoms. More specifically :
Eating a “junk food’ (highly processed) or a Western diet raises the odds of having ADHD
Children who ate lots of veggies, fruits, legumes, and fish, were less likely to have ADHD
If you or your child with ADHD has a history of gut-related issues alongside ADHD hyperactivity or inattention issues, it makes sense to eat an anti-inflammatory diet that helps promote a healthy microbiome and can help heal a leaky gut.
The Mediterranean diet is a healthy way of eating that works for all the family and is also anti-inflammatory. A randomized controlled trial found the DASH (dietary approaches to stop hypertension) diet, which is similar to a Mediterranean diet, improved ADHD symptoms in boys, compared to a control diet .
Adults with ADHD who have more complex gut issues or food sensitivities could also consider a Paleo diet or a low FODMAP diet that restricts intake of certain carbohydrates. However, it’s not a good idea to restrict food groups in growing children, unless absolutely necessary. As just one example, children with ADHD tend to have lower iron levels compared to kids without ADHD , and a restricted diet could make this worse.
If you suspect certain foods may be triggering your child’s ADHD symptoms, I’d recommend working with a pediatrician or other health professional.
Two specific dietary issues to give attention to if your child has ADHD are sugar intake and intake of synthetic colors.
One meta-analysis found a possible link between higher sugar consumption and increased ADHD symptoms in kids .
Another meta-analysis suggested synthetic food colors might slightly affect attention in kids with ADHD. Around 8% might benefit from a diet without such colors .
While you don’t need to obsess about every morsel your child eats there’s no doubt that moving away from too many processed foods is a step in the right direction.
Sleep and Exercise Benefits
Regular physical activity is another healthy practice that can significantly help improve ADHD symptoms and improve executive function (the capacity to plan ahead, meet goals, and stay focused) in kids and teens with ADHD.
A 2022 meta-analysis found that aerobic exercises that were highly consistent, stationary, and self-paced, were the best for improving hyperactivity/impulsivity and inattention .
These are activities like running on a treadmill or riding a stationary bike.
However, exercises that required dynamic reactions in activities guided by someone else had the most benefits for executive functioning (the capacity to plan ahead, meet goals, and display focus and self-control).
These are activities such as aerobics, martial arts, table tennis, yoga, swimming, and horseback riding).
Mixing it up with different types of exercise is likely best, but any physical activity is better than none, especially if it involves a child with ADHD feeling more accomplished and confident.
Employing better sleep hygiene practices can also reduce the severity of ADHD symptoms, according to one randomized clinical trial . In the study in question, the 244 children (aged 5–12) with ADHD, and their parents, received normal clinical care or were taught about better sleep hygiene practices by trained psychologists during two fortnightly consultations and a follow-up telephone call .
Those that had the sleep hygiene training not only achieved better sleep but also exhibited improved behavior, and had better daily functioning, quality of life, and working memory, even after 6 months.
Medication and Behavioral Therapies
As I laid out at the beginning of this article, medication can be effective for some with ADHD, but it isn’t right for everyone. When you’re weighing up whether to use medication, know that the evidence supports stimulant medications, more specifically methylphenidate, as a first-line treatment for kids and teens, and amphetamines as a preferred treatment in adults . However, adults have less benefit and tolerance of ADHD medication than younger people.
Non-stimulant medications are also available, but they tend not to be as effective.
Behavioral therapies (psychosocial treatments) are another option to try, either with or without medication. A comprehensive meta-analysis found that psychosocial treatments can be helpful for children with ADHD, but there’s no one-size-fits-all treatment .
Behavior therapy delivered by parents is likely most ideal, as it can effectively reduce ADHD symptoms and improve children’s conduct while boosting parental self-esteem .
For adults with ADHD, cognitive behavioral therapy (CBT) is the most effective behavioral treatment for symptoms like depression, anxiety, and emotional dysregulation [32, 33]. CBT also helps enhance adults’ quality of life and treats emotional issues in the long term .
Supplements Are Just One Piece of the ADHD Jigsaw
Natural supplements can help to fill in the nutritional gaps that might be contributing to hyperactive symptoms and brain health issues.
However, any ADHD supplements should be in addition to, not in place of, more fundamental actions, including improving gut microbiome health (which could positively impact brain function), lifestyle and behavioral modifications, and taking medication if your doctor thinks it will be of benefit.
The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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