Part III - Alternative Treatments and ADHD - Multivitamins

Multivitamins

     Though it has been suggested that vitamin and nutrient deficiencies can lead to significant cognitive impairment and declined performance on intelligence tests, the assumption that such supplementation may subsequently aid children diagnosed with ADHD has not been proven with extensive and convincing research data.^H Adequate research studies with large sample sizes, sufficient trial times and randomized controls appears lacking in the investigation of the role of multivitamins in relation to ADHD.  Some studies have shown preliminary evidence of benefit for adults taking multivitamin supplements to treat ADHD symptoms, yet caution to accept efficacy is warranted due limitations such as small sample size and short-term trials.^I  During an 8-week trial, 14 adults diagnosed with ADHD were observed while taking a 36-ingredient micronutrient formula.^J Though results showed improvement of symptoms, the effects are questionable at best due to the small sample size, short trial length and method of evaluation (self, clinician and observer reports).^J In addition, researchers admitted that due to the limitations of this study design, the outcome  “does not in itself prove efficacy”.^J Research studies involving children have been performed with some level of similarity, yet also with notable limitations. A fully blinded, randomized, placebo-controlled trial looked at 93 children with the ADHD diagnosis and tested the efficacy of multivitamin supplementation on symptoms.^K Results indicated that subjects receiving vitamin and mineral supplementation improved in overall function, including reduced impairment and improved attention but did not show reduced levels of hyperactive and impulsive symptoms when compared with the control group.^K The researchers subsequently commented that, “Although direct benefit for core ADHD symptoms was modest, with mixed findings across raters, the low rate of adverse effects and the benefits reported across multiple areas of functioning indicate micronutrients may be a favourable option for some children, particularly those with both ADHD and emotional dysregulation.”^K Therefore, though these findings point to potential benefit, they do not provide overwhelming evidence for efficacy at this time. In addition, though some benefit was found, it was mild and did not address all levels of the symptom profile, namely the hyperactive and impulsive actions that frequently are the most challenging to deal with in such cases. Some research studies have performed trials with ADHD-diagnosed children to determine if deficiencies in vitamin and hormone levels exist. By investigating deficiencies, such studies have attempted to suggest the importance of supplementation in these populations. In a 2014 study of 77 kids, researchers looked at levels of ferratin, vitamin D, vitamin B12, adrenal and gonadal steroid levels, celiac antibodies, and thyroid hormones and antibodies.^L Subjects were divided into three groups: children with the ADHD diagnosis, children with the Asperger’s diagnosis, and children with no diagnosis (control group).^L Deficiencies were found in both diagnosed categories when compared with the control group, thus leading the researchers to conclude that vitamin D and B12 supplements would benefit these populations.^L Despite the observed levels of deficiency, however, this study did not investigate the outcome of ADHD-diagnosed children taking these vitamins, thus bringing into question the validity of the claim of likely efficacy.

References

H. Benton D. Symposium on nutrition and cognitive efficiency. Proceedings of the Nutrition Society. 1992; 51: 295-302.

I. Rucklidge JJ, Framptom CM, Gorman B, Boggis A. Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial. The British Journal of Psychiatry. 2014; 204: 306-315.

J. Rucklidge JJ, Taylor M, Whitehead K. Effect of micronutrients on behavior and mood in adults with ADHD: evidence from an 8-week open label trial with natural extension. Journal of Attention Disorders. 2011; 15:79-91.

K. Rucklidge JJ, Eggleston MJ, Johnstone JM, Darling K, Frampton CM. Vitamin-mineral treatment improves aggression and emotional regulation in children with ADHD: a fully blinded, randomized, placebo-controlled trial. Journal of Child Psychology and Psychiatry, and Allied Disciplines. Published Online: October 2, 2017 (doi: 10.1111/jcpp.12817).

L. Bala KA, Dogan M, Mutluer T, Aslan O, Dogan SZ. Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs). Journal of Pediatric Endocrinology and Metabolism. 2016; 29: 1077-1082.