ADHD in Adults

Attention Deficit Hyperactivity Disorder, or ADHD, is a condition we normally associate with children. But it is estimated that one in twenty adults meets the criteria for Adult ADHD. Most of these people likely showed symptoms as children; a study that tracked children with ADHD into adulthood found that only 10% completely grew out of it. In recent years, many well-known and accomplished people have shared that they have ADHD, including actor/singer Justin Timberlake, Olympic swimmer Michael Phelps, and Olympic gymnast Simone Biles. There are many tools available to help adults with ADHD to make the most of their unique neurological style. But the first step is to recognize the patterns. 

Having a brain with ADHD can be challenging. The disorder is characterized by a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with daily functioning. Some people struggle to pay attention in various aspects of their life. They might make careless mistakes, not seem to listen when spoken to directly, fail to follow through on tasks and instructions, show poor organization, avoid tasks requiring sustained mental effort, and get easily distracted (including by their own thoughts). These people are more likely to fly under the radar than hyperactive people. Hyperactivity in adults takes the form of fidgeting, tapping or squirming, restlessness, difficulty engaging in quiet activities, talking excessively, and interrupting others. While many adults with ADHD are high-functioning, creative, dynamic people, the lack of organizational skills may impact work performance, and the lack of emotional regulation may impact relationships. The result is often anxiety and low self-esteem.

Since there can be significant overlap with other issues, particularly anxiety, post-traumatic stress disorder (PTSD), and depression, it’s important to determine which came first, or which is the primary condition. It can be hard to focus when your mind is racing with anxiety or consumed by depression. Insomnia can be related to ADHD and exacerbated by ADHD medication, but it can also significantly worsen symptoms. Addressing underlying sleep issues is one of the best ways to improve focus, impulse control, and problem-solving. Post-concussion syndrome should also be ruled out as symptoms can be very similar. 

Because this disorder is often misunderstood, many people who have it do not receive appropriate treatment. But it can be quite liberating to realize that ADHD is just one type of neurodiversity, and there are ways to make the best of it. As a naturopathic physician, I look at each person as an individual and develop a plan to optimize their brain function. That plan may include addressing the profound gut-brain connection; I have seen many children with a history of ear infections and repeated antibiotic use, for instance, who later manifest symptoms of ADHD. Studies now show a link between changes in the gut microbiome and ADHD. Nutrition can play a significant role in brain health. Adequate levels of iron, B12, and Vitamin D, as well as balanced blood sugar levels, are all crucial. Fish oils can help the brain. Balancing the nervous system through natural medicine can help focus the mind and calm the body. Perimenopause or PMS can also exasserbate ADHD and there are excellent strategies for both. I help my patients to work on reducing stress, improving sleep, and getting regular exercise. Mindfulness techniques can help develop the capacity for prolonged attention and self-regulation, and to dial down stress and restlessness. Moreover, organizational skills that may come naturally to some people can be learned, just like you would learn a sport or instrument. Although medications can be helpful for some people with ADHD, the best way forward for optimal functioning is to combine medication with a brain-supportive lifestyle, natural medicines, and skills development. 

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. Contact at www.getwellhere or 250 897-0235.  and 

Eight Important Lab Tests You Should Know About

Many of us go to the doctor and just get the basic blood work they recommend.  We may or may not hear back from the doctor regarding the results.  I recommend that patients take a more active role in their health by learning about blood tests and getting copies of their results.  (Locally, Lifelabs offers patients online access to most blood work.)  It is helpful to understand which tests to request from your conventional or naturopathic physician and optimal levels you should be aiming for.

Thyroid:  For patients dealing with fatigue or depression, I often recommend a full thyroid panel.  The thyroid governs metabolism, affecting energy and weight loss. Typically just a TSH test is run, but sometimes imbalances in the thyroid can be picked up by testing free T4, free T3 and thyroid antibodies.  If the thyroid hormones levels are borderline, I recommend supporting the thyroid non-pharmaceutically.

Ferritin:  Another important test for fatigue and depression is ferritin.  This test measures iron stores.  Lack of iron can cause anemia, which can cause fatigue.  It can also lower dopamine levels in the brain, which affects mood, motivation and food cravings.  Too much ferritin can be a sign of excess iron storage which can damage the cardiovascular system and many organs.

Insulin:  For patients with weight issues, dementia and some hormonal imbalances, checking fasting insulin is an excellent tool to understanding how the body is dealing with blood sugar.  Adult onset diabetes is characterized by insulin resistance at the cellular level.  Therefore, it takes a lot of insulin to help carry sugars from the blood to the cells.  Even before elevated blood sugar is detected, this high insulin can be a sign of insulin resistance.  High insulin levels promote fat storage and are hard on the circulation.  Programs that reverse insulin resistance can accelerate the process of weight loss, protect the cardiovascular system and more.

Homocysteine:  Patients who have a personal or family history of cardiovascular disease or dementia  / Alzheimer’s are wise to have their homocysteine levels checked.  This amino acid, if elevated, is a risk for increased strokes and Alzheimer’s. The “normal” range is stated as being under 11 umol/L, but studies show that the risk of Alzheimer’s is increased in people whose homocysteine is over 7 umol/L.

Vitamin D3:  The rate of vitamin D3 deficiency in Canada is staggering. Gerry Schwalfenberg, an assistant clinical professor in the department of family medicine at the University of Alberta, said testing showing that “the fact that 60 to 70 per cent [of Canadians] have inadequate levels [is] not good,” given that vitamin D insufficiency is being linked to so many chronic diseases.  Vitamin D is an important preventer of autoimmune disease, viral illness, cancer, heart disease, diabetes, osteoporosis, MS and more.  Having your levels checked is therefore wise.  The optimal level of vitamin D is over 125 nanomoles/litre.

C Reactive Protein (CRP):  Inflammation is an important risk factor for cardiovascular events, like strokes and heart attacks, and it creates an environment that supports cancer growth.  It is a symptom of autoimmune disease, obesity, diabetes and other important health conditions.  The C Reactive Protein in our blood is a reflection of general inflammation levels.  While the normal range is under 5.0, the optimal range is under .8 for men and under 1.5 for women.  Breast cancer survivors are wise to monitor CRP since elevations are associated with higher reoccurrence rates.

Vitamin B12:  The levels of this important nutrient can diminish with age as absorption becomes more difficult.  Vitamin B12 can be depleted by many medications, such as metformin (diabetes), birth control pills, and antibiotics.  I am most concerned about acid blocking medications that many of my patients use for long term management of acid reflux.  I much prefer to treat the cause of this problem than to manage it with a medication that impairs the digestion and absorption of a number of important nutrients.  Acid blockers also can set up a more alkaline pH that promotes the growth of a weakened, dysfunctional set of intestinal bacteria.

Small Intestinal Bacterial Overgrowth Testing (SIBO):  SIBO is a condition in which the wrong bacteria are growing in the small intestine, creating abnormal fermentation of carbohydrates into methane and hydrogen.  SIBO patients suffer from gas, bloating, digestive concerns and many other health conditions.  When indicated, I test patients through a university laboratory in PortlandOregon.
Be proactive with your health care by getting the blood work you need to understand your health and take steps to prevent illness.

Dr. Deidre Macdonald is a naturopathic physician who has practiced medicine in downtown Courtenay for 17 years. For more information, contact The Macdonald Centre for Natural Medicine at 250 897-0235 or via www.getwellhere.com