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Category: Science

ADHD – Thinking Beyond the Brain

As is so often the case, Americans want to reach for pharmaceutical fixes for our various maladies, and so it is with ADHD. Right now, it is estimated that there are more than 6.5 million American children who have been given this diagnosis. Making this even worse is the fact that about two-thirds of these children are receiving powerful, mind-altering medication, the long-term consequences of which have never been studied.

I think it’s very important that we recognize that there’s a strong gut issue that relates to these children, and, for the most part, is being ignored. Apart from the fact that being born by cesarean section dramatically increases the risk for ADHD, as does frequent antibiotic exposure (both of which affect gut bacteria), a high percentage of children with ADHD have straightforward bowel abnormalities in comparison to age matched controls.

A new study evaluated 742,939 children and demonstrated that those children with ADHD had a dramatic increased prevalence of constipation almost threefold higher than those without ADHD. Fecal incontinence was sixfold higher in the ADHD group, and visits to the doctor because of bowel issues was also dramatically increased in kids with ADHD. Importantly, these findings did not differ depending on whether or not the children with ADHD were on medication.

A holistic perspective is one that looks at the entire individual. That is, embracing the notion that gut dysbiosis may play an important role in terms of how the brain works not only in ADHD, but across the spectrum of brain related disorders. Indeed, we are just beginning to understand the profound relationship between what goes on in the gut and what goes on in the brain. Moving forward, I have no doubt that understanding this relationship will open the door for some incredible ideas in terms of therapy for these conditions.

For more information, order your copy of Brain Maker today and join Dr. Perlmutter’s email list.

  • LynnG

    Couldn’t agree more. My son was diagnosed with ADHD back in September and yes – he had been passing hard, dark, pebble-like stools with a nasty, yeasty odor for years(no amount of fiber or additional water intake made a difference). We were promptly handed a free sample of Strattera. When I explained, politely, that I had no intention of giving pharmaceuticals to my
    eight-year-old son, my pediatrician was very annoyed and made his disapproval quite clear. Instead, I threw myself into research, read Grain Brain and a variety of other books, including Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride, as well as tons of online resources. We also started seeing a doctor of Integrative Medicine, who conducted a complete gut analysis. We took gluten and casein out of his diet. Started him on an anti-yeast protocol, gave him Omega-3s, a daily probiotic and a variety of homeopathic supplements. I also gave him a tiny amount of melatonin at night (less than 0.25 mg) to help with sleep as we realized that his gut was compromising his immune system’s ability to make melatonin and serotonin. We saw results within weeks. For the first time since infancy, his stools were regular, and well formed. Within months, his school announced that they no longer intended to request a 504 Plan for him as his behavior had improved so radically. Don’t get me wrong – it’s an ongoing process and his focus and impulse control are still problematic, but it has been so worth it. I want to thank Dr. Perlmutter for the support and resources that Grain Brain has provided on this path to wellness with my child.

  • Peggy Holloway

    If your child is diagnosed with ADHD or exhibiting problems with focus and staying on task, get the child off sugar, grains, refined carbs, food dyes, and additives immediately. No packaged processed foods, just whole foods high in healthy fats. I only wish I had known 20 years ago what I know now about insulin resistance and genetic carbohydrate intolerance. My poor son’s childhood and adolescence were destroyed by attempts at pharmaceutical fixes while the underlying causes of his attention issues were never considered. He has happily adopted a whole-foods, low-carb, high-fat “paleo” diet and at 26 is a productive adult, but he still carries the scars of his lost childhood. He is also still having some “gut” issues, but is experimenting with and tweaking his diet, and most of the time feels the best he has in his life.

    • keeplivinon

      Another recommendation for ADHD in children is check the nervous system, with a corrective chiropractor, take a look at Dr John Bergman’s information. Spine subluxation is a definite factor. God bless

      • LynnG

        Interesting! My son never crawled – just walked at around a year old. I’m starting a crawling technique with him, which is explained in a book by O’Dell and Cook, “Stopping ADHD” – fascinating stuff. We’re off to see a pediatric chiropractor to help ease the inevitable neck discomfort. We started this therapy last year – long before I started the diet and supplementation and he was way too moody to handle it. He is so much happier now that I think he’ll be able to manage.

  • Gail Finke

    I find this intriguing for many reasons, but it’s not true that the long-term effects of ADHD medication haven’t been studied — at least for Ritalin type compounds, which have been in use for decades. Your writing this makes me question whether I should bother with the book — is it just sensational claims, or is it science? As a parent of a child with ADHD, I am bombarded by pseudoscientific theories and “miracle diets.”

    • Lynn Dell

      The book Grain Brain does not delve deeply into gut and ADD issues. It is primarily a book promoting a way of eating, exercising, and sleeping to decrease runaway inflammation in the body and to enhance good genetic expression for health. Also discussed were the toxic effects of gluten on the brain, among many other things. The article above is only focused on the research that shows there is a strong correlation between children with ADD and constipation, whether they are on medication, or not.

      It is a strong correlation worth noting. There is a lot yet to be learned. There was no causation linked to this correlation. No touting of miracle cures. However, it seems prudent to me to consider probiotics in addition to a good DHA supplement for children, in addition to going on a higher fat diet, lower carb diet, in general.

      • Lynn Dell

        One of ours deals with add, btw. It drove me nuts at the time, but I refused to go to a practice that would prescribe medication as a first priority. She went into cognitive retraining for well over a year, and made significant progress. I like cognitive training, because it can be done on a life long basis, into adulthood. They recommend medication only after cognitive training and counseling strategies do not raise people to a baseline that is considered good for functioning. Fortunately, and after a lot of frustration on her part because the exercises are tiring and taxing, we saw our daughter make enough progress with these intense focus exercises that medication was not recommended .We also have/had her in cross country, swimming, track, and summer running activities. And I TRY to get her to eat well and take supplements, but sometimes that is a losing battle. I’m glad she has a strong will. I really am, Yes, I am. 😉

        • Chara Armon

          Can you please tell me about the cognitive training? How do I find that where I live? If you would be willing to email me at chara.armon@gmail.com, I would be grateful!

    • LynnG

      Gail. I know what you mean and agree that Ritalin has been studied extensively, but even so, it does have some harsh potential side effects that are best avoided, if possible. Unfortunately, many of the other drugs currently prescribed for ADHD are quite new and haven’t been around long enough to develop any substantial studies – I shudder when I think of what’s happened with Risperdal. While I don’t want to dispute the benefits of prescription medications for the treatment of ADHD, I would like to express how, like you, I know just how hard it is to be faced with the choice of administering any form of “mind-altering” drug to a child. We all love our children and want to do the right thing. The beauty of implementing diet changes and informed supplementation is that, while time consuming and a little challenging, the results can be remarkable. Some children may still require medication to function at optimum levels, but can get by with much smaller doses. The protocol I described in my post isn’t difficult to implement and we really did see a huge improvement. No matter which path you pursue, I hope you’re able to find a treatment that works well for your child and your family. Best of luck.:)

      • Gail Finke

        Thank you for this reply! I know all about giving medications to a child, my son has been on many. I would love so much for all or even some of his problems to be because of diet, but I have seen waaaaay too many people caught up in diet fads that they have followed stricltly, all the while depriving their kids of real help. I really am interested in diet but I am very leery because there are a lot of diet quacks and pseudo-science can sound very convincing. It is so hard to evaluate, and running down a rabbit hole when it comes to a child’s health and well-being is very frightening to me.

        • Beth M

          I have a long term illness (16 years) that has included issues such as short-term memory loss, depression, hyperactivity, inability to concentrate, inability to learn new things, rage, as well as a multitude of symptoms affecting most systems in my body. I have “managed” all my issues through diet for the last 10 years (no dairy, wheat (gluten), or processed sugar, which follows I also can’t eat at restaurants, fast food, junk and most processed edibles. I MUST have 100% compliance to keep all the symptoms at bay so I MUST know every single ingredient in everything I eat. I know fairly quickly if I have ingested even the smallest amount (i.e. 1 gram) of something that is harming my body. I also know that the symptoms will pass once the “toxin” has worked its way through my system (1 gram=3-7 days of illness).This diet is difficult to follow in our society because very little available is what I consider food. It becomes easy to follow when you buy real food and cook it at home. It is worth a try, give it a couple of months at least, and, unlike drugs, it does not cause harm.

        • doc

          Gail, I know this might seem odd to you but what sounds crazier to you: trying to improve health by a natural means like diet modifications (especially considering what is attempted to be passed off as ‘food’ these days) or taking a synthetic substance that your body has no idea what it is and wants to eliminate it as soon as possible? Not to mention most medications only treat a symptom not the cause of the issue creating the problem. Knowing what ADHD medications are I think you are crazy NOT to try all means possible before resorting to meds. I tend to not be very trusting of companies who repeatedly fabricate data and lie in order to generate revenue at the expense of other people’s health and unfortunately sometimes their lives.

          • Gail Finke

            It doesn’t sound odd. My point, as I said above, is that I know people who have been very dedicated to diets that do not work and are fads. Following these when a medication that is known to work for millions of people exists makes no sense to me. I asked what scientific proof there is for this claim. I know that much of the science when it comes to diet is bad (I’m talking about cholesterol and heart disease etc.) and that it’s expensive adn difficult to get a good study. I just wanted to know what studies, if any, there are. I am quite willing to believe that cutting all wheat and sugar will help a lot of people. It certainly helps with diet and heart disease. But will it actually “cure” ADHD? I don’t know and I would want some serious evidence for such a claim.

          • Mom2ADHDson

            I agree that medications should not be a first choice, however, there are kids who need additional help outside of natural methods. We changed my sons diet (in fact, he is still on a GF diet & an amazing probiotic) and tried supplements and though we saw minor improvements with some changes, there were other changes that did not contribute to any improvement. My son’s DR knows that I would rather he not be on meds of any kind, but I also recognize how much they have helped him. For a 5 year old to ask for his medicine because he recognizes that it helps him focus is evidence enough to me that the prescriptions were necessary for him to reach his full potential. Please be careful in how you address parents who put their kids on medicine. Not all of us do it as a first choice and not all of us look first to synthetic medications.

    • Joe Texan

      I am a child neuropsychologist and I understand your frustration with claims for treatment of ADHD, but Dr. Perlmutter is a world class genius in my opinión, and I did my internship 25 years ago a Yale Medical and was a Fulbright Scholar. What has been learned in just the past five years about nutrients and neutro-ceuticals is thrilling. In his book, Dr. Perlmutter backs up everything he says with hard science published in the leading medical journals in the world. We have moved from 20th century medicine (traditional medicine) to 21st century medicine. Functional medicine doctors now cure cáncer with neutoceuticals. It’s mind blowing.
      I also read a book by called Micro Miracles by an Enzymologist (I didn’t even know there was such a doc) and she said she routines has success treating ADHD with carbohydrates digestive enzymes and mental focus enzyme formula. Stuff extrated from weeds in China and India and catepillars in the Himilayas. Amazing stuff.

      • ADDMom

        you were a Fulbright Scholar but you can’t spell…

        • gaylep

          This comment was unnecessary to the conversation.

        • santacruzsuz

          I think you need to do a little research about dyslexia.

        • Joe Texan

          You’re an internet editor? I don’t always read over my posts because I don’t consider it real important.

        • RM

          You’re correcting others and you apparently don’t know that sentences begin with the first letter of the first word being capitalized and end with a period, not an ellipsis.

        • Toni

          Your very ignorant. I’m sure you can’t spell either or you are a doctor with the pharmasdicals in your pocket.

      • gaylep

        Hello Joe Texan, Do you have the name of this enzymologist? Have you tried her enzymes? Suggestions? Thanks!

        • Joe Texan

          The name of the primary author is Ellen Cutter and the name of the book is Micro Miracles. I don’t know why, but when I post comments using this computer it often leaves out letters or capitalizes letters and I don’t always go back to fix it. I think maybe because my software is in Spanish because I live in Bogota, Colombia.

        • Joe Texan

          Forgot to say that I haven’t tried her formulas because I don’t have any health problems I know of, but I’m planning to do blood and saliva tests to see.

          • gaylep

            Thanks for the info!

      • Toni

        Awesome read. Thank you.

  • Carolyn

    Would you please cite the study. Thank you

  • DaB

    The first issue in some comments here is the conceptual model applied to defining what’s a ‘cure’ for systemic problems – it’s a mistake to think there’s going to be a magic bullet ‘just do this and it’ll cured’, which is Big Pharma product marketing mentality. Unfortunately, it’s become the common basis for expectations about cures and evaluations of alternatives which require a wide range of actions, each of which is necessary but not alone sufficient. This is further complicated by the fact specific necessary actions across the afflicted population varies.

    For perspective on gluten I recommend Dangerous Grains by Braly. And for specific brain-diet/nutracuticals information I recommend Daniel Amen’s 2013 revised ed. of Healing ADD.

    Needless to say, if the GI tract is compromised, it will spawn or support many types of problems that cannot effectively be addressed until proper GI functionality is restored.

  • Michelle

    I tried the diet strictly for 4 months with my 11 year old son, no dairy and no gluten and added supplements of probiotic, digestive enzymes, fish oil, vitamins and minerals. This was not easy as he is a vegan by his choice. He was looking bloated. He now looks fit. He told me he feels his reading comprehension improved. Had his blood tested by Cyrex, array 3 and 4. He was more sensitive to corn than gluten. I feel that the strict diet for 4 months allowed his gut to heal. Now, I substitute much of his diet with gluten free produces but allow some dairy and bread. I did this because I read Power Up Your Brain by Dr. Perlmutter in 2011. And books by Dr. Robert Melillo, Disconnected Kids and Reconnected Kids. My son is much improved but he still has issues with Executive function. I believe the diet improved some things but it was not the total answer. i am still searching for ways to improve his executive function.

    • David Perlmutter

      I am glad to hear that this has put him on the road to better health Michelle.

  • klp

    I have two kids with ADHD. I put them on Dr. Perlmutter’s vitamins. They take 6 weeks to work and it was like a miracle. In 6 weeks, their focus issues were so much better. My kids have thanked me many times. They are hysterical when they run out of the vitamins. They can tell such a difference. It took hours off my daughter’s homework time. We aren’t perfect about the diet although we try. But with the vitamins, they are A students. Please try it before giving a child medication. The vitamins are so good for them regardless. I have shared the vitamins with tons of people over the years and have lots of similar success stories. It’s it amazing that vitamins can make such a difference.

    • David Perlmutter

      So glad to hear you have found a treatment plan that works for your children.

      • Moe

        My son has a nonverbal learning disorder he is now 11 . He frequently has bowel incontinence. Any suggestions? Moe

    • Patty H

      Which vitamins?

    • kenjoe33

      Hello klp,
      Would you mind recommending what vitamins you give to your ADHD children? My daughter has ADHD and I am researching the best supplements and brands to give her.
      Thank you!

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  • Nick

    What about motivation & ADHD in adults? Has anyone had success with any methods? Many people have posted here about focus and attention etc, but curious specifically for motivation? Has anyone had any success with anything in helping motivation?

    • BarbaraDale

      I have had motivation problems once in a great while, and I have found that it is because I am greatly tired and fatigued and sleep deprived and also toxic. I do liver cleanses, enemas, and whatever it takes to make me sleep. Also, I have found it is because I’m depressed. Depression and lack of motivation both disappear when I correct the causes. I have autistic disorders, and that’s the root cause also.

  • Michelle

    My son has many symptoms of Sensory Integration Disorder and as he aged Non Verbal Learning Deficits became apparent. I’ve seen much improvement with gluten free and cheese free diet but he still has many NLD symptoms, lack of facial recognition, issues with “remembering” to do things (not book memory), feeling bad about himself because he doesn’t have the memory of other kids his age, he is stressed out after a day at school and needs a fair amount of time to relax before he can do his homework. I believe these symptoms are executive function issues. Any suggestions to help him with his “memory” issues?

    • Norma

      Try to avoid all forms of sugar and especially high fructose corn syrup in soft drinks.
      Try to avoid high oxalate foods such as peanuts and chocolate.
      Try to eat a low carb diet without processed foods.

    • BarbaraDale

      Hello, Michelle. It sounds like your son is my twin. Book memory is called factual memory. Procedural memory is remembering our experiences. I, too, cannot have cheese or any fermented foods at all. It sounds like he has an adrenal problem. Try building up his adrenals by nourishing them with B vitamins, licorice root, calming herbs, such as passion flower, hops, skullcap, catnip, but not valerian root, as valerian root will worsen ADD. Make sure he gets plenty sleep at night, like ten to twelve hours. If he has an adrenal problem, he also has a thyroid problem, as those two glands are like siamese twins. When you start getting into all of this, it’s like going through a maze. But, you will get results. Life is a journey, anyway. Think of it as a mission, and you will be blessed. Also, it sounds like he needs an inhibitory neurotransmitter like GABA. Bacopa extract comes from a flower in India that make GABA. Bacopa is sold in food supplements. I am not licensed, but I have studied for a long period of time to help myself and also my sons who have inherited my disorders.

  • RM

    It’s also important to note that in addition to dietary deficiencies, there is also evidence that points to excess television and electronic stimulation. The effects of hours upon hours of television on the brain is akin to the effect of a steady lifestyle of junk food and lying on the couch. I recently gave up television and rediscovered the joy of reading books, which has been almost like a high-intensity workout for my brain. I’ve also greatly increased the time I spend exercising. I just picked up a copy of The Grain Brain and can’t wait to learn about how changing my diet can also help alleviate my ADD symptoms even further. As challenging as it is in our digital age, it’s important to get kids away from the gadgets and outside exercising as well as spending time every day developing good reading habits. I know it’s easier said than done, but please give it a try. I would give anything to go back in time 30 years and tell my parents not to have cable TV in the house, but little was known about ADD and the causes back then.

    I don’t mean to oversimplify the nature of any of your children’s problems, and I apologize if that’s how this comes across since I do not wish to judge anyone or generalize. I’m speaking from experience as someone who’s been there and has seen positive changes, despite the struggle still being present but lessened. I urge all parents of ADD/ADHD children and also adults with the condition to at least be open to trying this, in addition to a greater focus on nutrition.

  • Tammy

    My son has all the ADD symptoms but he has overactive neurotransmitters- all of them are off the charts….. he is gluten free and we are in process of fixing a leaky gut but nothing seems to be helping yet….any ideas to calm his brain…….

  • Great post; thanks. However, there seems to be a problem with sharing this post on a Facebook page that I manage. The picture doesn’t come through and just the following comes up in a box:

    The link to my Fan page is here so you can see what it looks like on my page:

    • David Perlmutter

      Thanks for pointing this out Angelo. I will have someone on my team take a look.

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  • Gil Desaulniers

    I am interested in finding more references that discuss “the fact that being born by cesarean section dramatically increases the risk for ADHD” I definitely see this to be true in my practice as a paediatric chiropractor and would love any sources of information you could share!

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  • KH

    Hello =]

    My name is Kris and I was born in 1977.

    I am stuck and firm on the idea that both my past digestive issues and my childhood diagnosis of ADHD are directly related to the flora(or perhaps lack of) in my gut.

    I write this because I have cured all my constipation and/or irregular stool

    At 39 years of age, after a pre-adult life of ADHD and prescription drugs and a mid-life learning what to eat, I believe I have learned to minimize and even remove any of the negative effects of the so-called ADHD.

    As a kid this included not doing specifically what adults wanted me to; call it expression of free will.
    As an adult this mainly includes me being able to sufficiently perform a task which I have absolutely no interest – long term; the best example is a job you don’t like.

    Now for the hard truth.

    Parents have to learn to raise children, that is a given and mistakes are part of that process. The worst mistake my parents ever made was letting doctors put Ritalin, and such, in my body. I completely forgive them without hesitation because they were simply doing what they were convinced was best.

    So to parents I say this: the drugs are just made to shut off the part of your child you don’t understand – this is the child being curious, learning, and expressing themselves. Your best long term benefits with come from encouraging the child with anything and everything you can think of to foster the curiosities that they seem to have. Accept the fact that you, and your mate, created a child that is probably biologically different than either of you; this expands your scope of family and should not cause you fear of the unknown.

    And to the people like me with the so-called ADD/ADHD: if you are still reading and want to know more about what I have done to optimize my “condition”, I can be reached at oceans2018@gmail.com

    Thanks and I hope this helped even one family or person =]

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