Thursday, March 30, 2017
10 Ways Vitamin C helps treat ADHD Symptoms
10 Ways Vitamin C helps treat ADHD Symptoms
How Vitamin C can be an Effective Treatment Method for ADHD
We have previously discussed nutritional treatment methods for ADHD, including other "10 Ways" posts for carnitine and zinc. However, vitamin C, while often associated as being more of an immune-boosting and heart healthy antioxidant vitamin, may also play a crucial (and often underrated) role in taming the negative symptoms associated with Attention Deficit Hyperactivity Disorder, or ADHD.
Before we go any further, I must establish the appropriate context as to how we should interpret this blog post. Some of the following information on vitamin C surrounds more of the potential ways in which the vitamin can interact with the causative mechanisms of ADHD, and is more speculative than that of evidence-based controlled clinical trials. Other abilities or utilizations of the vitamin (such as vitamin Cs ability to boost iron absorption, or the vitamin C-dependence of various enzymes required to metabolize ADHD medications or parallel nutrition strategies) are well-documented and better established.
Having said that, out of these following 10 reasons for vitamin C supplementation for treating ADHD, around 3 to 4 are well-grounded on clinical evidence, about 3 to 4 are plausible arguments, but with potentially great limiting factors, and 3 to 4 are possible, but largely hypothetical at the current time. It is the intent of the blogger not to persuade or advocate the rampant consumption of megadoses of this vitamin, but rather to illustrate the complexities of our metabolic systems as to how such a basic vitamin can be tied into so many ADHD-relevant processes.
Based on the conclusions of the various research papers which I am about to highlight in this posting, it appears that high levels of vitamin C supplementation will do little to alleviate ADHD symptoms, especially when compared to efficacy other nutrients with better track records such as omega-3s, iron, magnesium and zinc. Based on (often substantially) greater piles of evidence, stronger claims can generally be made for a correlation between deficiencies of these aforementioned nutrients and ADHD severity than for the connection between ADHD and levels of vitamin C.
Instead, this post is meant more as an advocate for the maintenance of recommended (or slightly higher) levels of vitamin C and avoiding deficiencies (which can decrease the processes optimized by this vitamin). Thus, it appears to be more accurate if we view vitamin C as an auxiliary or secondary co-treatment strategy for ADHD via natural dietary methods and not as a stand-alone ADHD treatment. This is important to remember as we work through this post and see some of vitamin Cs potential (but not always decisively proven) "natural" ADHD treatment options.
We must also acknowledge that vitamin C exists in two major forms: the common (non-oxidized) form of the vitamin, also called ascorbic acid, or the oxidized form Dehydroascorbic Acid or DHA (Bloggers note: please dont confuse this vitamin-C derived "DHA" with the omega-3 fatty acid docosahexaenoic acid, which is also commonly abbreviated as DHA. They are two entirely different molecules. We have discussed the significance of this important omega-3 earlier posts).
As we will see later in this post, the two different forms of the vitamin have extremely different properties in several cases, including their methods of transport and uptake into the brain (while it may seem counterintuitive, given the fact that we often associate "oxidized" with being bad in the body, it is the oxidized DHA form of the vitamin actually has a number of advantages over the reduced form with regards to brain uptake).
Without further ado, here are 10 documented ways (as well as two "possibilities") in which this important vitamin can help with ADHD. While some of these may seem obvious, others appear to have a more obscure, but equally important role or function as an ADHD treatment method:
- Vitamin C offers protection against fatty acid oxidation, including the important omega-3s which are a popular treatment and supplement for ADHD. While omega-3 supplementation remains a popular treatment method among "natural" ADHD treatment advocates, its overall effectiveness remains questionable.
The theory behind omega-3 treatments for ADHD can be found in an earlier posting, but in a nutshell, the brain and central nervous system are comprised of cells with very high omega-3 fat content, and must be constantly supplied with either these fats themselves or chemical precursors to these fats (which can then be converted into these essential nutrients). These fats play a critical role in coating the outer layers of the "messenger" signaling portions of the brain, and the development of these protective layers (called myelination) is especially pronounced in adolescence.
High levels of overall brain development and re-wiring occurs during the adolescent stages, and in multiple cases, this process is delayed in the ADHD population. Therefore, the idea holds that we should be supplementing this process along by feeding the brain these important omega-3 rich foods and nutrients.
However, one of the fundamental problems is the fact that fatty acids (including omega-3s in particular) are especially susceptible to damage through chemical process of oxidation. We have alluded to this in earlier discussions on omega-3 oxidation and ADHD. Numerous studies have shown that dietary antioxidant intervention can greatly alleviate this problem. In this bloggers opinion, failure to recognize this important factor of antioxidant protection for omega-3 fatty acids is one of the biggest saboteurs of omega-3 intervention as an ADHD treatment.
As far as antioxidant protection strategies of fatty acids are concerned, vitamin C is often not the best choice. As a water-soluble vitamin, the interactions with the much less water soluble omega-3 fatty acids are potentially limited. However, vitamin C can "sacrifice" itself and help boost levels of other important antioxidants in the body that can have a greater impact on omega-3 fatty acid protection and cell membrane viability. Among these are vitamin E and glutathione (which will be addressed later on in this posting, when we talk about antioxidant recycling).
However, we may be beginning to see that vitamin C could be an effective co-treatment to fatty acids in its own right, at least according to some recent studies. One study (which, unfortunately paid more attention to the fatty acid component and had vitamin C as more of an auxiliary co-treatment) suggested that vitamin C can boost the efficacy of flax oil (a popular omega-3 rich dietary choice) as an ADHD treatment measure. Clearly, this was just one study, and more research is warranted, but the significance of protecting these all-important dietary fats found at high concentrations in the brain and nervous system cannot be understated. - Vitamin C acts as a potent neuroprotective agent (important for neurological disorders including ADHD). It may sound surprising, but nerve endings in the brain have the second highest concentration of vitamin C in the body (behind only the adrenal glands, which produce adrenaline, which we will mention later in this post when discussing vitamin C and catecholamines). Current research appears to illuminate the protective role of vitamin C, specifically in its oxidized DHA form and when used in conjunction with vitamin D3, against a specific type of oxidative damage on the brain called ischemia (reduced blood supply to a particular brain region, which can be brought on, by other things, oxidative damage).
The relevance to ADHD here is that ischemia is a surprisingly common environmental cause of the disorder, especially during early (neonatal) development. It is believed by some researchers that oxidative damage which causes this ischemic reduction of blood supply may bring on ADHD symptoms by interfering with biological targets (or receptors) in the brain for the important neurotransmitting chemical dopamine. In other words, for those individuals suffering from reduced blood flow to these brain regions earlier in life, the important signaling chemical dopamine has trouble finding its mark in the brain, results in the attenuation of attention span and longer reaction timing (for more information on ADHD and reaction timing, please see the earlier post: Do ADHD Kids Use their brain regions differently?).
While the basis for ischemia treatment for ADHD via vitamin C supplementation is more hypothetical at the moment, the fact that treatment with this vitamin can counteract a major environmental cause of the disorder suggests that vitamin C may be a viable treatment method for this aspect of ADHD and related disorders. - Vitamin C helps "recycle" and maintain pools of other crucial antioxidants such as vitamin E, polyphenols (potent antioxidants found in fruits, vegetables, wines and teas), glutathione (which is manufactured in the body and is the bodys standard antioxidant of choice), and products of the antioxidant enzyme superoxide dismutase or SOD.
We have alluded to this message in point number 1 above. Several studies have found abnormally low antioxidant levels (and high "pro-oxidant" levels) in ADHD subjects. It appears that increasing dietary antioxidant intake may at least partially reduce this trend.
For example, boosting intake of a form of vitamin E called gamma-tocopherol can reduce the oxidation of important fatty acids in ADHD subjects (although it is worth mentioning that gamma-tocopherol is not the most bio-available form of vitamin E, that honor goes to another form of the vitamin called alpha-tocopherol). It is worth mentioning that vitamin C and vitamin E work extremely well together as an antioxidant tandem, and help spare the pool of the bodys antioxidant reserves from depletion. Therefore co-administration of these two vitamins is highly recommended.
Collective research appears to indicate that raising the total antioxidant levels in the body can offset some of the negative symptoms of ADHD and related disorders. Weve already mentioned the importance of preventing oxidation of the fatty acids (lipids) of the cell walls, including the membranes of brain cells (which are rich in the omega-3s).
Secondary to its role in preventing fatty acid oxidation, vitamin C can counteract the oxidation of minerals (including iron and copper) which may often be used as dietary supplements for ADHD treatments. As in the case of omega-3 fatty acid supplementation, the risk of increased oxidative damage due to these mineral supplements is an often overlooked negative side effect of this common "natural" ADHD treatment strategy.
Due, in part to its high concentration in brain tissue and susceptibility to oxidation, iron is prone to causing oxidative damage to the brain. Maintaining adequate levels of vitamin C (as well as vitamin E, polyphenols and glutathione) can offset much of this potential damage. We will see this more in point #5 below.
Finally, an often-overlooked side effect of most medications (including ADHD stimulant medications) is the potential for these medications to cause oxidative damage. For example, the common ADHD stimulant methylphenidate (Ritalin, Concerta, Daytrana) was found to cause oxidative stress in young rat brains, and highlights the possibility that long-term administration of these agents may leave key targeted "ADHD" brain regions more susceptible to oxidative damage.
This observation was more evident in younger rats undergoing development and brain maturation, which may translate into analogous effects in the developing brains of children. Thus, children may be susceptible to harmful oxidative damage in the brain via consistent use of common ADHD stimulant medication, increasing their need for higher levels of vitamin C and other antioxidants.
Of course, we should not put too much stock into just one or two studies; and that this conclusion is being drawn prematurely by ramblings of an over-anxious blogger :) but we may seriously need to investigate this often overlooked possibility of ADHD medication based oxidative brain damage in children, and the possible amelioration of these dagmages via treatment with dietary antioxidants such as vitamins C and E. - Vitamin C can potentially counteract the effects of lead on ADHD-like states: Numerous studies have linked in increase in ADHD symtpoms and behaviors with higher lead levels (although it is worth mentioning that numerous studies out there refute this association as well, so there is far from a consensus surrounding this issue). We have seen previously that iron may counteract lead and potentially alleviate some of these negative lead-based effects. When used in conjunction with other nutrients such as the mineral zinc and the amino acids taurine, methionine and glycine, vitamin C may reduce lead-derived learning and memory impairments (in the rat model), features which offer at least some semblance to common deficits in the disorder of ADHD.
- Vitamin C can boost absorption of key minerals which are often deficient in the ADHD population. One possible explanation for the ability of vitamin C to counteract the effects of lead may be the role of vitamin C in boosting iron absorption, especially in iron deficient states. Some studies strongly recommend the co-administration of these two nutrients.
As an aside, please note that there is a healthy debate surrounding the possibility of vitamin C/iron combinations acting as potentially destructive pro-oxidants. Based on current trends in the literature, however, it appears that most of these negative effects are seen more in vitro, or in cell cultures, but not in vivo, or in the body. Interestingly, this potential double-edged sword of ascorbic acid form of vitamin C (as either a pro-oxidant or antioxidant) may be strongly tied to the concentration or levels of the vitamin, in that vitamin C is reported to act more like a pro-oxidant at lower levels and an antioxidant at higher levels. This may explain some of the discrepancy surrounding the pro vs. anti-oxidant effects of vitamin C when coupled with iron or other minerals.
We have discussed the prominence of iron deficiencies in the ADHD population and the role of this critical nutrient for treating the disorder, such as the role of iron in the synthesis of neurotransmitters such as dopamine.
Additionally, common disorders common to ADHD such as Restless legs Syndrome and sleep disorders may be attributed to deficiencies in iron levels. Therefore, vitamin C may serve as a secondary protection strategy against iron deficiencies and subsequent worsening of ADHD symptoms.
I realize that it can be difficult to make sense of and keep separate the various iron/vitamin C interactions, so to summarize some of the main points of these associations:
1) Vitamin C can aid in the bodys absorption of iron.
2) Vitamin C can interact with iron and keep the iron from being oxidized, but...
3) This process can cause an oxidized form of vitamin C itself. This oxidized vitamin C species can potentially cause damage in its own right if unchecked (but can be recycled back to the antioxidant form of the vitamin by other antioxidants in the body).
4) In general, lower levels of vitamin C tend to have more of a "pro-oxidant" effect, while the antioxidant effects of vitamin C often predominate at higher levels of the vitamin. - Higher vitamin C levels have been tied to improvements in visuo-spatial abilities as well as non-verbal intelligence (both of which are often deficient in the ADHD population). As a reference, non-verbal intelligence includes skills such as being able to read or pick up on non-verbal social cues such as reading facial expressions and associating them with another persons mood, as well as distinguishing differences and inflections in tone of voice. It is important to note that non-verbal learning disabilities often accompany ADHD symptoms, and are often seen across the autistic spectrum (which mirrors ADHD symptoms in a number of ways).
The correlation between vitamin C and non-verbal abilities is more strained than some of the other associations mentioned in this piece, but this blogger has found a few documented studies pointing out this possible affiliation. The whole vitamin C association with non-verbal deficits might be part of a bigger picture, in that deficits in non-verbal IQ scores seems to be correlated with low total overall antioxidant levels.
On the flipside, the correlation between non-verbal deficits and the vitamin C antioxidant in particular appears to be more prominent in boys (compare this to a later section of this post where we will see that ADHD symptoms may be more tied to abnormalities in blood glucose levels in girls). In other words, the effects of vitamin C supplementation may have different levels of effectiveness with regards to gender and comorbid conditions (but please note that much more additional study must be done to validate this general claim). - Beyond the physical anti-aging benefits commonly associated with the vitamin, vitamin C has shown to exhibit potent intellectual anti-aging benefits (making it a good candidate for adult ADHD cases). While the publication cited above is given in the context of the neurodegenerative disorder Alzheimers Disease, we should take note that there is a significant overlap between ADHD and Alzheimers (beyond just the attentional deficits).
For example, genes (and the enzymes they code for) we have previously mentioned as being associated with ADHD are also believed to be affiliated with Alzheimers. These include "ADHD" genes and enzymes such as COMT and the Serotonin Transporter gene. Given the fact that the two disorders share a significant genetic and enzyme system overlap, as well as similarities between the features of the two disorders (as well as some anecdotal evidence for higher rates of neurodegenerative disease susceptibility in the ADHD population), this blogger suggests that the two disorders may also share effective treatment strategies utilizing vitamin C. - Vitamin Cs important role as a cofactor in important enzymes relevant to ADHD and related disorders: This is one of the less obvious (but extremely important) ways in which vitamin C treatment could benefit the individual with ADHD. Typically when we think of "cofactors" (agents which help the enzymes and enzyme systems in the body operate at peak efficiency), we often think of B vitamins or trace minerals such as zinc, iron, or magnesium.
However, it is important to get out of our heads the notion that vitamin Cs mode of action as an ADHD treatment strategy is confined to its role as a "generic" antioxidant. Several enzymes whose function is linked to ADHD (often through the metabolism of other nutrients or pharmaceutical agents) require it as an essential cofactor to improve their function. One of these is the enzyme Dopamine Beta Hydroxylase, which will be discussed in more detail in the next point. - Vitamin C is important in the conversion process of dopamine to norepinephrine: This is relevant to both drug and nutritionally based treatment methods for ADHD (dopamine and norepinephrine are key neurotransmitters in the brain and nervous system and are often unbalanced in ADHD cases. Many ADHD medications (in particular the stimulants) work by regulating the production and transport of these two chemicals by targeting key enzymes and proteins made for transporting both of these agents.
As mentioned above, one such enzyme for this conversion is the enzyme Dopamine Beta Hydroxylase (or DBH). We have investigated the importance of the gene that codes for this enzyme, the Dopamine Beta Hydroxylase gene, and its significance with regards to ADHD in earlier posts.
Synthesis of other catecholamines (chemicals which are manufactured in the body from the amino acid tyrosine, which were alluded to in an earlier post on the drug modafinil for adult ADHD treatment and will be discussed further at the end of this post) such dopamine, norepinephrine and adrenaline) takes place in vitamin C rich regions of the body, including the adrenal glands as well as various brain regions.
Keep in mind that the concentrations of vitamin C required for the enzymes in these brain regions to work optimally are around 40 times higher than the typical vitamin C concentration in the blood. As a result, an effective transport system to get this higher concentration in the brain is necessary, which leads to the next function of the Blood Brain Barrier (BBB): - Vitamin C has multiple well-designed ways to get into the brain through the Blood Brain Barrier and its levels are tightly regulated: The Blood Brain Barrier is an important barrier that is designed to limit or prevent potentially harmful substances in the blood from crossing over into the brain, while allowing a controlled passage of nutrients into the brain. We have alluded to this barrier in the last post with regards to its role in the passage of metals such as selenium, zinc and mercury and the subsequent effects on ADHD.
Compounds which are water soluble, such as vitamin C, have an inherently more difficult passage through this critical barrier owing to size and solubility issues (in general, the blood brain barrier naturally favors the transport of less water soluble agents). However, there are a number of ways around this potential problem.
In biology and medicine, the term homeostasis refers to stability or resistance to uncontrolled fluctuation. The transport systems of the blood brain barrier seem to be well-suited for vitamin C, owing in part to the fact that the optimal levels of key proteins that transport the vitamin into the brain fall work at peak efficiency around the standard concentration of vitamin C in the blood (this is not the case for all nutrient transporters).
For example one of these proteins is called the Sodium-dependent Vitamin C Transporter-2 (or SVCT-2) allows vitamin C to be transported into the brain from the blood and maintain the much higher brain concentration of the vitamin. In fact, different transport methods exist (and, to some degree are even more favorable) if vitamin C is in the oxidized form (i.e. it has already fulfilled its role as an antioxidant by "sacrificing" itself to keep harmful oxidation from occuring to something else, such as an omega-3 fatty acid).
It is important to note that because of these tight regulatory mechanisms which safeguard levels of vitamin C both in and out of the brain, rampant supplementation with vitamin C will not change its levels in the brain to a high degree. In other words, our bodies are typically well-adapted at holding onto this vitamin and maintaining appropriate levels of this key nutrient in the brain. This provides argument against the merits of high levels of supplementation (not to say that higher levels are necessarily harmful, just that this will be of limited effect). Nevertheless, we still should strive to avoid shortages of this vitamin.
**Two other possible advantages of boosting vitamin C intake for ADHD: Please note that these next two suggestions are more of a personal hypothesis of the blogger and less validated by adequate research. Nevertheless, they may be at least worth a mention:
- Vitamin C may help regulate blood glucose levels in ADHD patients: Several studies seem to indicate that glucose metabolism in the brains of ADHD children is lower in multiple regions. It appears that these effects may be even more pronounced in girls and women with ADHD (although this blogger believes that the whole brain glucose metabolism differences are a bit overhyped, a number of other studies, which are simply not mentioned in most ADHD treatment books, found little to no metabolic differences. Nevertheless, I believe there is still sufficient evidence that, while smaller than what most other "ADHD experts" assert, there is still a significant difference in these metabolic patterns).
Additionally, these differences may become more pronounced with age, suggesting a potentially greater necessity for intervention among adult ADHD cases. Again, women in particular may be more affected, according to the current body of research. It is important to note that the evidence for vitamin C supplementation for improving brain glucose metabolic efficiency for ADHD patients is more hypothetical than experimental at the moment.
What we do know is that there are pronounced interactions with vitamin C and glucose regulation, such as vitamin C treatment for diabetic conditions. However, we may at the wrong end of a "chicken-or-the-egg" type of dilemna, since significant evidence points towards lower vitamin C concentrations in diabetic-like conditions. This is likely due, in part, to the oxidative stress caused on the body by the diabetic state (and the subsequent consumption or depletion of vitamin C stores).
Again, most of these studies are done on diabetic conditions in the blood outside of the nervous system, but some of these effects (at least in theory) could carry over to glucose regulation in the brain. However, this blogger readily admits that this possibility is somewhat tenuous. - Vitamin C can improve circulation, including to brain regions: Again, this is more on a theoretical note. In addition to its proposed role as a blood sugar regulating measure (see above), vitamin C may also help regulate blood pressure and subsequent circulatory capabilities to key brain regions. Again, the evidence supporting this assertion is much weaker than the original 10 points listed, above, but in this bloggers personal opinion, this may be another positive side effect of vitamin C treatment for ADHD.
It is important to realize that the body of research supporting these claims for utilizing vitamin C as an ADHD treatment strategy is all over the spectrum (from merely hypothetical ponderings to consistently verified controlled research studies).
At the moment, the strongest arguments for vitamin C treatment as a remedy to ADHD symptoms seem to be in protecting cells in the brain and nervous system from oxidative damage either directly via vitamin Cs antioxidant capabilities or secondarily via vitamin Cs ability to help regulate or "recycle" levels of other antioxidants, such as vitamin E (which much more effective at protecting the omega-3 rich regions of the brain from fatty acid oxidation) and glutathione. In other words, vitamin C is a great way to augment the ever-popular omega-3 fatty acid supplementation strategy for ADHD (and is unfortunately often overlooked by prescribing physicians).
While these effects are perhaps the most widely known among the health field, two other factors such as vitamin Cs role in ADHD management are also well-documented and potentially on par with its role as a generalized antioxidant. Vitamin C is an important co-factor (enzyme helper) in a number of metabolic processes surrounding the disorder of ADHD, and is key to both the synthesis of important neurotransmitters such as dopamine and norepinephrine (which are often off-kilter in the ADHD population).
Thus, it may be a beneficial adjunct therapy for precursor loading (taking high levels of a nutrient which the body can then convert to the desired compound) with the amino acid tyrosine (which the body converts to dopamine and eventually norepinephrine via a series of enzyme-dependent steps, some which utilize vitamin C. In theory were giving the body more starting material to work with to increase the output of these important neuro-signaling chemicals of clinical relevance to ADHD and related disorders. Please keep in mind that the literature seems to be split at the moment about the overall effectiveness of these precursor loading methods with regards to these ADHD treatment strategies).
In conclusion, maintaining adequate levels of vitamin C (for the recommended daily amounts of vitamin C, check here) is an often overlooked treatment method for a variety of diseases and disorders beyond the common cold. While perhaps not as promising as some of the other nutritionally-based treatment strategies for ADHD which have been mentioned in the past in this blog, such as carnitine, zinc, omega-3 fatty acids, iron, or magnesium and B vitamins, this simple and relatively inexpensive treatment method may pay dividends in the long run.
Furthermore, with low risks of toxicity due to its highly water-soluble nature (overdosing on vitamin C usually results in little more than temporary bouts of diarrhea which are quickly reversible when the vitamin intake is scaled back), the pa
Available link for download
Friday, March 24, 2017
10 Ways Carnitine can help treat ADHD
10 Ways Carnitine can help treat ADHD
As a quick aside: Carnitine, like many other nutrients, can exist in different forms, one of which is acetylcarnitine. This form, actually has a number of metabolic roles, but for the sake of simplicity, I will not go into too much detail about the different forms of carnitine unless absolutely necessary.
- Potential for boosting the effectiveness of omega-3 fatty acid supplementation: We have already discussed the theory and applications of omega-3s and their possible benefits as alternative non-pharmaceutical treatment options for ADHD. Nonetheless, despite the recent surge in population of omega-3s (including the ever-popular fish oil supplements), only marginal amounts of improvements as far as behavior and symptom reductions are often seen. A big possibility for this limited effectiveness may actually stem from missing pieces of the puzzle with regards to omega-3 metabolism. This may include a deficiency in carnitine. There is even some speculation that abnormalities in fatty acid metabolism may play a role in autism, and that carnitine levels may play a role in this. Given the degree of inter-relationship between autism and ADHD, this possible connection may be at least worth mentioning. In particular, carnitine plays an important role in the synthesis of the docosahexaenoic acid (DHA), and a carnitine deficiency can result in a reduction of this key nutrient. Like several other important fatty acids, DHA deficency is often seen in ADHD individuals.
- Carnitine may be beneficial for "refractory" ADHD (unresponsive to conventional pharmaceutical treatment): This one is somewhat surprising. Typically supplementation and "natural" measures can be tried, but if they fail, the more "heavy-hitting" pharmaceutical treatment options for ADHD are often employed. However, a Dutch study done by Van Oudheusden and Scholte which investigated the efficacy of carnitine in treating children with ADHD mentioned that carnitine was found to be effective in treating ADHD in children who were previously unresponsive to methylphenidate, clonidine or behavioral therapy treatments.
Whats interesting is that this group found a strong connection between plasma carnitine levels and a reduction in behavior problems (i.e., those children who were able to build up higher levels of carnitine in the blood were more likely to show direct benefit with regards to ADHD symptoms, while those with lower blood levels exhibited more severe ADHD-like behavior). This strongly suggests the carnitine/ADHD connection and also highlights the fact that there is a relatively wide degree of variation among individuals as far as carnitine storage and metabolism is concerned. Even more interesting, this same group found that when carnitine treatment was discontinued, the negative ADHD symptoms re-appeared relatively soon (within 3-4 weeks), but upon re-administration of the previous carnitine doses, the behavioral problems quickly subsided again. - Potential for use for both inattentive and hyperactive/impulsive ADHD: The same study on carnitine treatment for ADHD noted that a decrease in aggression and conduct problems (which are often comorbid to or co-occur with the more hyperactive/impulsive side of ADHD) upon treatment with carnitine. Not to be outdone, another study found that carnitine was more useful in treating the inattentive subtype of ADHD. Interestingly, the inattentive ADHD study found that individuals with the combined subtype ADHD subtype (which includes high levels of both the inattentive and hyperactive/impulsive behaviors) actually showed a worsening of symptoms upon treatment with carnitine.
Its important to note that the Dutch study did see some improvement in inattentive symptoms as well, so it appears (at least for now), that carnitine may be more of benefit towards treating the inattentive aspects of ADHD. This may actually be in line with other studies which link carnitine treatment to increased energy (individuals with the inattentive form of ADHD are often more likely associated to be more lethargic as opposed to the bouncing-off-the-walls behavior typically exhibited by the hyperactive/impulsive or combined ADHD subtypes). - Carnitine as a memory booster: I am personally hesitant to suggest supplementation with generalized memory boosters for ADHD (multiple ADHD websites love to do this), due to the distinct nature of the disorder. Nevertheless, individuals with ADHD do typically exhibit deficiencies in working memory, and some studies on carnitine on memory improvement are of interest. There is evidence that memory improvement from carnitine treatment may be seen in certain sub-populations. For example, carnitine treatment improved visual memory and attention in Down Syndrome patients, but the same effects were not seen in non-Down Syndrome individuals. Additionally, carnitine has also been shown to be useful in Alzheimers dementia. The possibility that unique subsections of the population may be particularly receptive is intriguing, to say the least.
- Carnitine may play a role in reducing toxicity of other psychiatric medications: We have previously addressed the possible association of ADHD and epilepsy. Valproic acid, an anti-epileptic medication (which is also used in treating bipolar disorders, which often has a fair amount of overlap with ADHD itself) has risks of toxicity. However, carnitine treatment of Valproic acid toxicity has been shown in a recent study. In general, carnitine can also help the body clear toxic carboxylic acids from its cells.
- Carnitines lack of addiction potential compared to stimulant ADHD medications: One of the classic problems with many medications (including ADHD stimulant medications) is the potential for addiction. In general, addiction potential is increased by rapid uptake into and rapid clearance by the brain. Although much more rare than prescription medications, herbs and supplements may also be addiction forming. However, there is a relatively slow uptake of carnitine into the brain, which reduces its addiction potential to virtually zero. While not entirely significant (addictions of similar types of nutrients are almost non-existent), it is worth mentioning, if for no other reason than to inform those who are looking for non-prescription alternatives to ADHD some of the benefits to nutrient supplementation.
- Acetyl-carnitine may offer the brain an alternative energy source during glucose shortages: Multiple studies have found glucose deficiencies in key specific brain regions in ADHD patients. A study found that glucose can actually inhibit the uptake of acetyl-carnitine into the brain, indicating a similar metabolic pathway. This conclusion of acetyl-carnitine as an alternative energy source was reached by the authors, however, it has been backed up by a body of research from numerous other studies. This seems to indicate that carnitine and its various forms may offer a viable means of alternative energy for glucose-starved ADHD brains.
- Carnitine plays a role in acetylcholine (and possibly dopamine) synthesis: Acetylcholine is an important neuro-transmitter in the brain. While it often takes a back seat to more well-known ADHD-related neuro-signaling agents such as dopamine and norepinephrine, several stimulant drugs which alleviate ADHD symptoms may target acetylcholine-dependent pathways (interestingly, nicotine appears to have a high degree of interaction with the acetylcholine receptors, and is often a popular drug of choice in ADHD individuals, often as a means to "self-medicate").
It appears that carnitine can help offset acetylcholine deficiencies in the brain, especially with regards to neuro-degenerative diseases. These effects can be even more pronounced if carnitine is co-administered with other key nutrients such as S-Adenosylmethionine (SAMe) and N-Acetylcysteine (NAc). To do these other two nutrients justice with regards to their effects on ADHD and related disorders or illness, they will need to be covered in their own separate posts. Finally, it appears that carnitine also affects dopamine-related pathways as well, which has numerous potential implications for ADHD, given that dopamine shortages and metabolic differences in key brain regions are often associated with the disorder. - Improved circulation via administration of carnitine (and vitamin E?): There is a mounting body of evidence that supports the assertion that individuals with ADHD have reduced bloodflow to key regions of the brain necessary for maintaining focus, eliminating distractions and maintaining attention to specific tasks. Certain ADHD medications, such as methylphenidate (Ritalin, Concerta, Metadate, Daytrana), can actually alter patterns of cerebral bloodflow in ADHD patients. It appears that carnitine can also improve blood flow to brain tissue (the study refers to the term "ischemia", which is simply a reduction of blood supply via blood vessels). These effects may possibly be increased even further, when combined with vitamin E, as highlighted in the same study. Carnitine can also help reduce ischemia to the spinal cord.
- Carnitine helps maintain cell membrane integrity: Numerous diseases and disorders are the result of damages to (or "leaky") cell membranes. These membranes are comprised mainly of fats, with several different proteins interspersed among the fatty acids. Ample omega-3 fatty acids play a critical role in maintaining a structure to the cell membranes, which is one of the reasons why adequate carnitine levels are so beneficial. However, fatty acids are prone to oxidation (think of a damage similar to rusting or corrosion, but within the body), so adequate antioxidant levels are needed to maintain these key components of cell structure and overall health.
In addition to its numerous other roles, carnitine is considered to be an antioxidant. Dietary deficiencies, as well as environmental stresses can leave these membranes prone to damage, resulting in a whole slew of potential diseases and disorders, such as increased risks of viral infections, allergies, buildup of cellular toxins, impairment of blood flow (this is actually related to our previous point on carnitine and ischemia) etc. In addition, cells contain inner membranes, whose structure and function can also be dependent on carnitine.
This is a good question, which, unfortunately, does not carry a straight answer. There is no official "RDA" for carnitine at the moment. One group studying carnitine metabolism suggested a recommended daily dose of carnitine to be 200 mg/day. The Dutch study used a dose that was proportional to the patients body weight, 100 mg of carnitine/kg body weight to be precise. This corresponded to a maximum of 4 grams of carnitine (note that this study was done in children) for the study. Dosage at this level corresponded to about a doubling in plasma carnitine concentration. With regards to side effects, there were relatively few, although one individual discontinued the study due to onset of a strange odor emanating from his skin. It was believed that this may be due to a buildup of a compound known as trimethylamine, which has a characteristic fishy, ammonia-like smell.
However, some of the effects in other studies were seen at only a fraction of these doses, such as some reporting effects such as significant improvements in attention at only 25 mg carnitine/kg body weight. 50 mg/kilogram body weight was the dosage used in a study that found carnitine to be effective in combating hyperactivity. These studies are simply rough estimates for amounts needed to suppress inattentive and hyperactive/impulsive behaviors associated with ADHD. As far as safety and toxicity issues are concerned, there are few published reports about dangerously high levels of carnitine. For a one-year study on the effects of carnitine for ADHD boys, a daily dose of 1 gram per day was found to be safe. This study recommended 20-50 mg carnitine per kg of body weight, which is roughly one fifth to one half of the levels used in the Dutch study.
Regional/Geographic effects on carnitine supplementation for ADHD: A mult-site study on the effects of carnitine on ADHD by Arnold and co-workers made an interesting observation. They studied the effects of carnitine on ADHD symptoms in children in 10 different sites across the United States, and found that significantly more pronounced effects were seen in 3 sites in Ohio and northern Kentucky. All of these sites were about 150 miles northwest of the Allegheny Mountains. The other parameters (age range, demographics, ethnicity, ADHD symptom scores, doses of carnitine, etc.) were similar to the other sites, and the researchers in the study offered no explanation for the findings and suggested the difference to be merely coincidental. While this is obviously a possibility, this blogger offers a possible explanation: the potential effects of interaction between carnitine and minerals or heavy metals.
One possibility may have to do with magnesium deficiency in this particular region. Some studies note that the soil in the Allegheny region is deficient in magnesium due to erosion or poor soil management. It is possible that this magnesium depletion in the soil may result in a higher prevalance to dietary magnesium deficiency in these geographic regions. We have demonstrated the effects of magnesium deficiency in ADHD in several previous posts, such as one on Magnesium Deficiency and Childhood ADHD. However, we have also seen that magnesium can often work in conjunction with other vitamins, minerals and antioxidants in treating ADHD as well. These highlights can be found in an earlier post on magnesium combination treatments and ADHD.
Some research has found that magnesium can boost the activity of the enzyme Acetyl-CoA carboxylase, which plays a significant role in fatty acid biosynethesis. A fatty derivative of carnitine can also push this same enzyme along. It is possible, therefore, that carnitine supplementation may take over some of the roles of the depleted magnesium, thereby freeing up magnesium for some of the other ADHD-fighting fuctions as previously noted. Of course this is just a personal hypothesis, but this blogger earnestly believes that there are a number of carnitine-mineral interactions that have not been studied extensively that warrant further investigation.
Carnitine does not act in isolation:
If you get nothing else out of this post or any of the other posts in this blog dealing with nutrition strategies for ADHD, please remember this: nutrient therapies often do not work because not all the pieces are in place. In other words, the different nutrients are highly interdependent, and a missing piece or two can sabotage the whole system. I personally believe that this is why a number of ADHD supplementation strategies do not work to their full potentials, because they are often missing key ingredients. Instead, for ADHD combination treatments to be effective, it is vital that we begin to understand all of the individual steps of nutrient metabolism and their affiliation with the disorder.
Just from this post alone, we have seen that carnitine has potential interactions with:
Omega-3 fatty acids
Vitamin E and other antioxidants
S-Adenosylmethionine (SAMe)
N-Acetylcysteine (NAc)
Magnesium
Glucose
Coenzyme Q10
Valproic acid (and other medications often used to ADHD or disorders which often show up alongside of it)
The point is, is that the various ADHD medications and treatment alternatives do not exist in a vacuum. One of the goals of this blog is to further elucidate the many interactions and factors at work in the different treatment strategies for ADHD. We need to consider all possible food-food, drug-drug, food-drug, food-supplement, drug-supplement and supplement-supplement interactions in order to tailor an effective treatment method for any individual. It is my belief that only then will we be truly able to see consistently effective individual treatments for ADHD and related disorders.
Available link for download
Saturday, March 18, 2017
A Halloween Treat Giveaway That Can Help You Lose Weight!
A Halloween Treat Giveaway That Can Help You Lose Weight!


Available link for download
Saturday, February 4, 2017
A Blogaversary Treat Children of the 90s Favorite Analytics Search Terms
A Blogaversary Treat Children of the 90s Favorite Analytics Search Terms
br

Thankfully, I am the almighty arbiter in ascertaining what exactly constitutes a treat--whether you like it or not. The real question on my mind is, how do all of you get here? I didnt issue any personal handwritten invitations (at least not lately, you see, my calligraphy ink well has run dry), so many of you travel here through the magic of Google. I get about 400 daily visitors who stop by here via Google search, and through the magic of Google Analytics tracking data, Ive learned a great deal about what exactly brings people here.
In honor of the blogaversary I totally forgot about yesterday, I thought Id share with you just a few of the many, many hilarious search terms Ive seen in the past few weeks. Apparently the answer to how some of you got here involves some truly bizarre Googling. Dont worry, though, Im not here to judge. Actually, that was a boldfaced lie. My major purpose is to judge. All in good fun, and all that, but some of these just cant go unsnarked. It would be a disservice to the public to let them go without a brief mocking. Please enjoy the following output of total and utter ridiculousness. All in the spirit of the blogaversary celebration, obviously.
compare contrast essay 90s tv show mash and fresh prince of bell air
Geez, you Googlers sure are philosophical. Whenever I spot a search term like this, Ive got to wonder about the motivation behind it. Sheer curiosity? Bizarre academic assignment? Either way, its sort of an odd pairing.
warner brothers stinky and the brain
You may need a little remedial nostalgia work. Last time I checked, no one named "Stinky" ever plotted to take over the world. I could be wrong.
is 2010 going to be like the 90s
Youve got to love these type of questions. I feel like the internet is both a blessing and a curse; its given us constantly at-our-fingertips access to all sorts of pertinent information, but we cant rely on it for everything. Just ask anyone whos ever cited Wikipedia as a source for a paper. This isnt a crystal ball here, people. What are you expecting? Results found: 1. 1st result: Yes. Happy?
what is self concept of britney spears
Im not sure, why dont you ask her? Much as Id like it, my blog has not yet advanced to the stage of setting up shop in celebrities minds. Ms. Spears has yet to approach me with hopes of sharing her innermost desires and ideals.
children of the nineties official website
Ah, music to my ears. Well, eyes. Whatever the equivalent of eye music is. You know, like visual art. Anyway, these people think Im official. Not too shabby.
is lisa frank dead?
No?
mr and mrs romero are having triplets. suppose the chance of each child being a boy is 50% and of being a girl is 50%. find each probability.
I spy a cheater. I only wish wed had the internet and could solve simple word problems by the process of Googlage. What this person thought hed find at Children of the 90s is beyond me, but I hope he got it figured out eventually.
90s catch phrases no _________ for you
Soup! Soup! Its soup. What do I win?
swallowed a whole role of bubble tape
SEEK MEDICAL ATTENTION. Or possibly psychiatric care. Decide quickly, please. Time is likely of the essence.
why did crystal pepsi failed?
Im not sure, but I think the executives disbanded to address the more pressing issue of widespread grammar abuse.
a childrens book about a skunk who makes bread from the 1980s
Why anyone would want to make bread from the 1980s is beyond me. It seems much fresher to bake more up-to-date bread. Then again, if youre a skunk freshness may not be your highest priority. Ah, the wonders of misplaced modifiers.
did carmen san diego ever existed?
I think this one must refer to Where in Time is Carmen Sandiego? How else would you explain all the jumbled tenses?
poop french toast crunch scandal
WHAT??? Ive eaten that cereal. For the life of me, I hope this is some type of misinformed urban legend.
cabbage patch kids coming to life and strangling owner
Again...Im at a loss.
whos that actor whos blond and always plays a douche from the 90s
At least youre getting straight to the point. I suppose Google could care less about your tact.
encino man drinking games
Ooh, if you know any, please share. That sounds awesome. Id be willing to take a shot every time Pauly Shore referred to "chillage". It would probably enhance the movie watching experience considerably.
how to make a slip and slide on cement
Really? What part of this seems like a viably injury-proof idea. I hope you all wore helmets.
good things about cheese handisnacks
Finding an answer in this case will probably take some pretty serious searching. Especially if youre referring to the nutritional value.
is mrs doubtfire based on a true story?
I probably shouldnt even dignify this with a response. Who saw that movie and left the theater believing it was a ripped from the headlines story? Im actually a bit concerned.
video of cats vomitting whoomp
HOW did this bring you here? Please explain. 300 words or fewer. Due Friday.
gigapet depression
Do any of you know? Is this an actual phenomenon? Im tempted to say yes, just because those things are so damn time-consuming and needy. Mine probably suffered from separation anxiety. Thank goodness I dropped it behind a bookshelf and it eventually starved to death.
are those michael jacksons biological children in space jam?
There are so many things wrong with this, I dont even know where to start.
how to remove gak from hair
What exactly were you doing? Im actually sort of curious. Id say peanut butter, but you cant quote me on that.
write an introduction on the topic saved by the bell
No. I do what I want.
Remember when aol had all the chatrooms?
Yes.
What do blue m&ms mean?
Oh, so now each of our candy color varieties needs a backstory? What kind of an answer are you seeking, exactly? Some sort of fortune telling-esque omen? They come from the factory like the rest of the colors. Thats pretty much all there is to it.
khaki wishes and cookie dreams definition/meaning
Ive gotten an inordinate amount of searches like this one. What do you mean what does it mean? Its just a Robin Leach cameo line from Troop Beverly Hills. It doesnt mean anything. I wouldnt overanalyze that movie.
at what part of the song do you start doing the macarena?
I love imagining the kind of person whos too self-conscious to just go with it. Theyve got to search the internet for answers to their outmoded potential dancing faux pas. Its sort of endearing, if not completely embarrassing.
10 things i hate about you is the one of 90s movie teeny bopper i actually enjoyed
I appreciate your willingness to share.
whats that little redheaded brat in that one 90s movie?
Oh right...her.
lisa frank backpacks children
She DOES? We should stage a boycott.
how to make an aggro crag replica
Let me know if you figure this one out. It sounds awesome. Ill totally come race you on it through the glitter dust snow. Only if I can be purple, though.
how come after i eat warheads my tongue is weird
Just a guess, but that highly artificial tastebud-burning chemical might play a role. I cant say for sure..
90s show that kids traveled into the internet through power lines to battle evil
Was this a real thing? Id love to watch it.
arent pushpops also good?
Yes.
use the expression you go girl in a sentence
You just did. Well, almost.
sometimes i tape my thumbs together and pretend Im a dinosaur
I actually had to look into this one, its just so ridiculous. I found out its a variation on a weird Google search autocomplete. Still. Weird. And how exactly did it bring this person here? Some mysterious are probably better left unsolved.
how do i become the next lisa frank
This. Is. Awesome. I really hope someone out there had an answer for you, kid. Id say a legal name change might put you on the right track, although I cant guarantee youll be the next. Someone might beat you to it. You better run, not walk, to file that court order.
Well, 90s children, thats about all the fun-poking Ive got for you today. Join us again next time for your regularly scheduled installment of Children of the 90s. Oh, and if any of you were the mysterious Googlers in question, fess up. Ive got so many things I need to ask you...
Available link for download