ADD/ADHD Attention Hyperactivity Disorders

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


Understanding the real health problems, and causes, underlying the explosive growth in the diagnoses of ADHD and treatment with amphetamines

Rates of ADHD incidence in the United States vary significantly between regions, but are generally noted as 5-10 times greater than in other countries. This is because many aspects of our nation's environment have gone unregulated regarding serious known causes of neurodegeneration. Lead and mercury toxin in the form of carbon compounds carried in gaseous states from dirty coal-fired power plants and smelters are now recognized as a significant cause of neurodegeneration in the entire population. You might read the section on Lead and Mercury toxicity on this website to access EPA reports etc. Commercial food production has also gone unregulated and allowed to foist harmful ingredients onto the population, such as processed sugars and transfats that are implicated in severe problems with advanced glycation endproducts (AGEs) and imbalances related to essential fatty acid deficiencies, as well as food preservatives, coloring, and engineered glutamates created to increase addiction to the food. A number of common environmental chemicals are now shown to accumulate in the body and cause ADHD symptoms, including organophosphate and organochloride pesticides, as well as PCBs. PCBs are polychlorinated biphenyls, an organochloride used as coolants, dialectric components, plasticizers, adhesives, fire retardants, and casting agents. While PCBs were finally banned in the U.S. in 1979, and the Stockholm Convention in 2001, these chemicals, 99 percent of which were developed by the Monsanto Chemical Company, do not break down easily in the environment, creating decades of accumulative toxicity. Monsanto is the same company that has given us both the Roundup herbicides and genetically modified Roundup Ready corn, wheat and soy, that are eliciting much worldwide concern, despite assurances from the company that these hold no future health risks (see article on this website entitled Genetically Modified Foods: the threat to public health). Accumulation of glyphosates from Roundup herbicides have also been found to affect glutamate receptor metabolism and potentially contribute to ADHD. Avoidance of environmental toxins, as well as clearing of the accumulations in the body, via chelation or detoxification, along with targeted antioxidant therapy, may be needed to help restore the central nervous system.

There are many causative links to the various problems that may result in significant neurodegeneration. Since this health problem is multifactorial, there is no way to connect specific problems and environmental threats linearly in data analysis. Because of the complexity of the disorder, a specific cause of neurodegeneration will affect one part of the population more than another, depending upon the whole array of health problems with these individuals. This is why we see some individuals exposed to unhealthy dietary habits without symptoms. This problem of a simple direct data link does not negate the health threats, and scientists are now working on a more complex and holistic system of analysis. The individual patient needs to maintain an objective view and work to decrease all of these threats to neurological health, in oneself, and in the whole population. Ignoring health threats does not make them go away. It is widely agreed that a variety of causes contribute to ADHD, and even the potential that genetic and epigenetic propensities may play a part in the disease. In 2014, the results of a long-term study of 64,332 children and mothers in Denmark, sponsored by the University of California Los Angeles Fielding School of Public Health, and the University of Aarhus, in Denmark, showed that the taking of acetaminophen during pregnancy, especially during the period of fetal brain development, in the second and third trimesters, increased the risk of the child developing ADHD by age 7 by 13-37 percent. The lead author on the study, published in JAMA Pediatrics, Dr. Beate Ritz, cited the hormonal disrupting effects of acetaminophen, as well as the neurotoxicity and increased oxidative stress, and the fact that acetaminophen crosses the placental barrier into the fetus easily, as the probable causes, and that combined with other genetic, epigenetic and environmental factors this may create or contribute to neurodegenerative ADHD. The lesson to be learned is to adopt a more holistic view of risk and cause to finally decrease this rising incidence of ADHD in the population. If there is epigenetic tendencies inherited, the epigene of the parents need to be improved through better diet and habits as well, as well as the overall cleaning up of environmental causes that could alter the human epigenetic code. Epigenetic tendencies are proven to be reversible over a couple of generations if these measures are enacted. The future health of our society, and our children is at stake, and the health of the human brain is fundamental to the success of our society.

The entire population is affected by the causes of neurodegeneration, although most of us do not have symptoms significant enough to warrant concern. We need to understand that symptoms are often like the tip of an iceberg. The real threat to navigation in life is the body of the iceberg below the surface. By the time you see the tip protruding from the water, it may be too late. The time to understand, treat, and prevent neurodegenerative threats to your health is now. Waiting until old age and the onset of Alzheimer's or Parkinsonism is not a wise choice. You can now take advantage of all of the research performed to understand ADHD and neurodegenerative conditions by utilizing a knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist that is also skilled and educated in herbal and nutrient medicine. Neurological health is no different than the health of your cardiovascular or digestive system, and should carry no stigma prompting avoidance of proper health maintenance.

For a more complete understanding of ADHD and neurodegenerative conditions, go to the article on this website entitled Parkinson's, Alzheimer's, ADD and other Neurodegenerative Conditions. Understanding your health problem is the key to an effective proactive approach to cure and management. You may not be able to understand all of the science and physiology of your health problems, but whatever level of understanding you achieve, this will be the most important aspect of your health care. The patient is always the primary person involved in effective health care treatment and health maintenance. Your other physicians are here to help you with your goals, and hopefully can integrate their care and advice in the most efficient manner.

There is an underlying link to many of the common health problems now affecting up to a fifth of the population, and this concerns gradual focal degeneration of the central nervous system. Whether your child is affected by attention deficit and hyperactivity disorder, you are bothered by problems with attention span, or your parents are diagnosed with Alzheimer's or a Parkinson's disorder, the health concern is a complex and multifaceted problem that concerns the health maintenance of the tissues and function of our brain.

It is now confirmed with scientific study and measurement that ADD and ADHD involves neurodegeneration. Modern imaging techniques allow scientists to measure both volume and function of sections of the brain involved with our cognitive control of attention span and hyperactivity of the brain. These studies confirm that patients with a chronic history of ADHD and ADD, no matter what the age, consistently reveal a decrease in size of these brain centers, as well as decrease in function. The knowledge that we now have of the physiology of neurotransmitter production, neurohormonal connection, cell receptors, and regulatory proteins has revealed that the problems in ADHD concern a complex health problem associated with oxidant stress, metabolic disorder, circulatory problems, and hormonal imbalance. The key to correcting this problem is to take a holistic approach to correct and improve all of these systems in the body. An individualized approach is also necessary, as the overall problem is very complex, and a one-size-fits-all assembly line medical approach will not work on a majority of patients. Seeking expert advice and management of your health treatment, maintenance or prevention is the smart choice.

An array of environmental causes may contribute to ADD and ADHD

What are the causes or contributors to attention deficit and hyperactivity at an early age? ADHD has also proven to be a neurodegenerative condition, even at an early age. We all know by now of the growing problem of hyperactivity in children and the treatment with the dopamine reuptake inhibitor Ritalin, an amphetamine, that is also used to treat adult ADHD. Clinical blinded placebo trials have shown that such chemicals as artificial food coloring and sulfite and benzoate preservatives have increased hyperactivity in children diagnosed with the disorder. Studies at Washington University in St. Louis, and at the University of Southamtpon in England gave proof that these common food additives worsened hyperactive behavior in children, and that removal of these chemicals from the diet improved the ADHD (The Lancet 370(9598):1560-7; McCann D et al). Subsequent investigation by the NIH resulted in an announcement of unclear conclusions regarding this subject, but acknowledgement of risks with chemical food additives in almost all commercial food products is not expected. How do benzoate preservatives and artificial food dyes contribute to neurodegenerative pathology? Once again, the answer is complicated, but a few key points elucidate the basic process. Read on.

Benzoic acid, a common food preservative, has been demonstrated to cause oxidative stress. These preservative acids also have a negative consequence on cellular membranes, that both act to insure effective metabolism at dopamine receptors, and to protect the cell from environmental cytotoxins that enter the bloodstream. Cell membranes protect the mitochondria in our brain cells, the small oxygen factories that supply energy to our cells, and which are the subject of much study of the root of neurodegeneration. While organic food preservative acids, such as benzoic and sorbic acid, are stable, or cytostatic, under conditions used for food preservation, they may cause a disruption of the cellular plasma membrane and cause a cytocidal effect when they reach our brain, especially under acidic conditions in the body. Acidity in the body is increased when there is too much intake of simple carbohydrates like sugar, refined grain, beer, granola, etc. Periods of high body acidity may also occur with poor stomach function, or poor hormonal regulation of key antacids, such as calcium. High body acidity may make benzoic acid food presersetives toxic and damaging to our brain cells.

High intake of benzoic acid preservative, coupled with a lack of healthy fats, or lipids, that make up the phospholipid membranes, and with a deficiency of oxidative potential to clear the damage, results in neurodegenerative cell death and functional cell membrane disruption that may occur at an early age. As mentioned, advanced glycation endproducts (AGEs) are also a dietary and metabolic problem that affects healthy cell membranes. When children eat too much processed food with these ingredients, it is easy to understand how the health of their brain cells are damaged. The problem in children is probably easily reversed by sticking to a healthy diet that avoids preservatives and food dyes, transfats, and simple carbohydrates, and includes sufficient antioxidant foods and omega-3 fatty acids. Even parents that believe that they are keeping their children's diet healthy are sometimes mistaken, as large intake of fructose, in the form of fruit juices and supposedly healthy carbonate beverages, can create an excess of AGEs. Over time, without ingredients for cellular repair, such as antioxidants, essential fatty acids, attention deficit and hyperacitivity disorder may become chronic. All scientific studies of neurodegeneration now demonstrate a measurable decrease in tissue quantity in key areas of the brain that are the result of this type of cellular damage, utilizing newer functional MRI imaging. This objective data is irrefutable.

The study of artificial food coloring in food causing or contributing to ADHD has produced no definitive chemical cause, but studies and clinical reports of observed effects on children with hyperactivity disorders are now numerous, and in 2011, the FDA is again asking a panel of experts to review the scientific literature and advise on a possible increased warning or even ban of many of these chemicals. Most or the artificial dyes and colorings in food were approved by the federal government in the 1930s, prior to the creation of the modern federal food and drug administration, and a number of common food dyes have been found toxic and banned in the U.S. in the past. So far, little evidence has been found to directly link specific chemicals to specific harmful effects, and experts believe that the future research will reveal how these chemicals work in tandem with other environmental chemicals or physiological problems in the brain. The concern surrounding these artifical food dyes has prompted some major food chains, such as Whole Foods and Trader Joes, to refuse to sell foods with artifical coloring. Since these bright food colors are very appealing to children, the industry is fighting regulation with much money. The Center for Science in the Public Interest is pushing heavily for a stronger FDA response, citing recent research linking a worsening of ADHD in children with these food chemicals. FDA researchers state that this research is very difficult to interpret, and standard methods of scientific evaluation have not delivered a clear and specific link between artificial food colorings and the pathology of ADHD in the broad population.

The study of various chemical food additives on neurotoxicity is now extensive, and experts in the field, when reviewing many large studies, find that the potential for neurotoxicity of a wide variety of synthetic food chemicals is indeed confirmed. Large studies have shown repeatedly that decrease or elimination of certain of these food additives has both shown a decrease in symptoms of ADHD patients, and has apparently improved cognitive function in the broad population. In 1986, a dietary policy of lowered sucrose, synthetic food colors and flavors, and two preservatives (BHA and BHT) over 4 years in 803 public schools in New York was followed with a 15.7% increase in mean academic percentile ranking above the rest of the nation's schools who used the same standardized tests. Prior to this dietary policy, these schools had not shown any deviation from the national standards (Int J Biosocial Res; 1986; 8(2): 185-195). Other studies since this time have duplicated such findings. A variety of studies have found specific physiological defects that would explain the pathophysiology, such as differences in protein enzymes that degrade histamine in the brain, and other aspects of oxidative stress that are affected by various of these chemicals. fMRI studies of brain activity associated with these provoking foods also demonstrated a physiological explanation, or association. Studies at prestigious medical schools have shown a significant improvement in severe ADHD symptoms with a modified ketogenic diet, as well. The ketogenic diet has long been proven to effectively treat epilepsy, even in children that do not respond to standard medications (see the article on this website entitled Nutritional Healing in Standard Medicine). While extreme diets are difficult to adhere to, these studies do show that modification of the diet, and eating fresh whole foods, while avoiding processed foods, may be an important part of the overall treatment strategy.

All of the above causes of neurodegeneration leave our bodies more susceptible to inflammatory degeneration. Most studies of neurodegenerative disorders now focus on excess inflammatory processes and lack of oxidative clearance as the prime problem in neurodegeneration. Studies show that increased exposure to viral illnesses, and the penetration of some strains of these viruses deep into the organ tissues, generates excessive lipopolysaccharides that are released from antigen cell walls, and increase pro-inflammatory cytokines such as interleukin-1 (IL-1). The chronic increases in expression of IL-1 has been shown to have both direct and indirect mechanisms that exacerbate neurodegeneration of dopaminergic neurons. IL-1 directly triggers 6-OHDA-triggered dopaminergic toxicity, and increases oxidative stress. Lipopolysaccharides were found to directly accelerate and increase motor signs in study animals, showing a positive link to direct hyperactivity cause. We can't completely eliminate the viral illness from our world, but we can work to create a healthier response to viral illnesses in our bodies. Herbal and nutrient medicine provides a number of proven chemicals to both clear viral infections and support the complement immune system in its attempts to clear the chronic viral DNA and RNA from our cells.

Besides these common dietary and environmental problems linked to ADHD, which can be easily avoided or regulated, a host of other environmental problems are also now linked to symptoms of ADHD. A 2013 article in the medical journal International Journal of Occupational Medicine and Environmental Health (linked below in additional information) noted that organophosphate and organochloride pesticides like the now ubiquitous Roundup, polychlorinated biphenyls (PCBs) in a vast array of industrial products, as well as organic lead, mercury and manganese pollution, most of which is airborne and affecting our drinking waters and foods, are proven to cause symptoms of developmental disorder, ADHD, behaviors such as inattention, poor quality of alertness response, and other symptoms that may be misdiagnosed as ADHD. Added to this is the vast amount of plastic micro-particles and beads accumulating in our drinking waters from cosmetic products in recent years, leading to a phasing out of such products, but leaving us with dramatically polluted waters coated with floating micro-particles and beads of plastic that attract PCBs and other pollutants to their surface, as well as themselves causing biochemical interference with human physiology and disrupt hormonal mechanisms. In a December 15, 2013 article in the New York Times, Dr. Sherri A. Mason, and environmental chemist at the State University of New York in Fredonia, describes how these plastic micro-particle beads, about the size of a dot from a pen on paper, and coming mainly from cosmetic face scrubs, creams, soaps, acne products, synthetic clothing fabrics, foam materials, and other commercial products, now are found in concentrations of 1.1 million bits or microplastic per square mile on the surface of the Great Lakes. As we drink water and eat meat and fish laden with these products and their coating of PCBs and other neurotoxins, the incidence of ADHD and other neurodegenerative problems rises.

In summary, the known history of causes of increased incidence of neurodegenerative disorders in the United States population include unhealthy ingredients in commercial processed foods that go unregulated, increasing amounts of lead, mercury and other heavy metal organic compounds in the air, water and food, primarily from dirty coal fired power plants that go unregulated, now ubiquitous organochloride pesticides and PCBs, and the increased oxidative stress and decreased immune health generated by our modern lifestyle, diet, and environment. As individuals, and as a population, we can change these harmful aspects of our world now, and clean up both our own bodies, and the environment. By utilizing Complementary and Integrative Medicine (CIM), understanding and improving our habits, and urging our politicians to act now, future generations as well as our own will benefit immensely. As the number of U.S. youth diagnosed with ADHD rises to over 11 percent, the time to act is now, and the subject of ADHD and neurodegeneration should no longer be treated lightly. Experts in psychiatry at prominent university medical schools were recommending the integration of Complementary Medicine in the treatment and prevention by 2014 (see study links in Additional Information) due to the alarm at the enormous number of children prescribed amphetamines, anti-psychotics, and sleep medication, incurring an incredible crossover between ADHD patients and substance abuse disorders in the adult with a history of ADHD, as well as an alarming rate of symptoms secondary to this treatment.

Complementary Medicine utilizes a number of treatment strategies to affect these disease mechanisms in neurodegenerative disorders. Antioxidant herbs and supplements are utilized, 5HTP from the griffonia seed may be prescribed, as well as herbs that are effective acetylcholinesterase inhibitors and dopamine agonists, and acupuncture may reduce stress levels and benefit adrenal function, as well as stimulate key areas of the brain to achieve better function. Hormonal balance can be analyzed inexpensively in labs that test saliva or bloodstick samples, and topical creams that adjust hormonal levels with very safe low dosage herbal extracts can be utilized. Evidence-based herbal medicine allows the acupuncturist/herbalist to utilize dopaminergic herbs in treatment, and work on neural cell membranes to improve dopamine receptor function over time. Nutritional knowledge helps the Licensed Acupuncturist to effectively guide changes in dietary habits that specifically work for the individual. A number of herbal chemicals have been proven effective as a part of the therapy for various neurodegenerative disorders, such as Huperzine, and these may be incorporated into the overall treatment protocol. In addition, herbal and nutrient medicine may be combined to provide effective chelation of heavy metal toxins, as well as an aid to the glutathione metabolism and other mechanisms of detoxification. Since the disease mechanism is complicated, logic dictates that the treatment protocol will also be complicated. The Licensed Acupuncturist, utilizing Complementary Medicine, can integrate effectively with the M.D. specialists and help make the right choices to narrow this complicated treatment strategy and find the most efficient treatment for each individual. Quality of herbal and nutrient products is also important, and FDA regulation is almost nonexistent. The Licensed Acupuncturist has access to professional products that insure quality and reliable effectiveness.

ADD and ADHD, Attention Deficit and Attention Deficit Hyperactivity Disorder, may also be neurodegenerative conditions with a similar pathological concern to the more well known neurodegenerative diseases, Parkinsons and Alzheimers, although different in manifestation of symptoms

Attention deficit and hyperactivity disorder has been linked to dysfunction with the D3 dopamine receptors, but the pathology is still poorly understood. Neural degeneration, or metabolic dysfunction related to dopamine enzymes, both could be causative of ADHD disorder, and this is demonstrated by the neuroimaging studies demonstrating atrophy or size decrease in key areas of the brain in ADHD patient populations, as well as the metabolic studies, such as those that demonstrate that excess benzoic acid (food preservative) may induce protein kinase A (PKA) pathways that are autophagic (self-destructive) in a nitrogen starved cellular metabolism. Certain areas of the brain associated with ADHD have been found to consistently smaller than normal in patients both young and old that have been afflicted with ADHD. Hyperactivity in these areas of the brain, which leads to short attention span, is a result of overstimulation of dopamine D3 receptors due to a decrease in the number of these D3 receptors overall. Experts are now calling for potential screening for genetic propensities of dopaminergic polymorphisms in childhood, although the ethical considerations of genotyping are raising alarms as well. Polymorphisms are variations in the genetic code than cannot be maintained just by the occurrence of mutation, and the dopaminergic variations concern areas of the genes that express dopamine or the various dopamine receptors. Whether this is due to an actual genetic inheritance, or not, or a combination of genetic, epigenetic and environmental factors is still unknown. What this does tell us is that we need to include correction of the dopaminergic system in therapy. Some studies in the last decade have linked the variations of effects of acupuncture stimulation to these polymorphisms, and studies at the Kyung Hee University College of Oriental Medicine have shown that the patients that respond most positively to acupuncture with treatment of cigarette smoking cessation had much higher expression of a dopaminergic polymorphism of the DRD2 Taqi A allele (PMID: 15992222). Such study shows that potential for acupuncture stimulation as part of the protocol to treat ADHD safely with a holistic array of treatments that may someday be easily refined by patient screening.

The reasons for loss of the dopamine D3 receptors and neurodegenerative atrophy of these areas of the brain associated with functions of attention span, memory, control of muscle spasticity etc. are the subject of current study, and may reveal more and more novel ways to utilize Complementary Medicine in a long-term treatment protocol. G-proteins are immunoglobulin (Ig)-binding proteins produced in chronic low grade infections and allergic immune responses. G-protein coupled receptors are stimulated by a variety of chemicals in the brain, including neurotransmitters such as dopamine, hormones, light-sensitive compounds, odors and pheromones. Neurohormonal imbalance as well as hypersensitivity disorder may stimulate G-protein receptors that are overexpressed due to chronic deep subclinical infections. Since parts of these G-protein receptors can be glycosylated, excess accumulation of advanced glycosylation endproducts (AGEs) are also a known cause of dysfunction (see my article on AGEs under For Practitioners - Treatment Protocols). Overexpression of G-protein coupled receptors then produces excess accumulation of G-proteins and may cause deficiency of dopamine. Activation of dopamine D3 receptors by excess G-proteins inhibits the enzyme adenylyl cyclase, a second messenger, causing dysfunction and desensitization of a percentage of dopamine D3 receptors. In ADHD, as in Parkinson's, loss of a percentage of these neurons or receptors could have led to overactive stimulation of the surviving healthy neurons, causing hyperactivity of the mind as well as attention deficit. The goals of therapy must not be to just block specific functions in the brain with drugs, but to actually work in a comprehensive manner to stop the disease mechanisms and restore healthy cells and function to the parts of the brain that have suffered neurodegeneration.

Ritalin, or methylphenidate, is a norepinephrine and dopamine reuptake inhibitor, which means that it works by increasing the level of dopamine stimulation. Ritalin only works in the ADHD patient when levels of an important neurotransmitter, Phenylethylamine (PEA), is increased. It has been established that Ritalin acts by stimulation of parts of the brain that have become underactive, possibly due to neural degeneration. Phenylethylamine is a trace neurotransmitter that is biosynthesized in the neural cells from the amino acid phenylalanine by enzymatic decarboxylation. Dietary sources of phenylethylamine do not reach the brain because they are quickly broken down by the enzyme MAO-B. Stories about how chocolate contains PEA and is beneficial are thus misleading. Increase in cell production of PEA is probably best aided by healthier protein metabolism, or liver function, but supplementation with L-phenylalanine, which does cross the blood-brain barrier, may be very helpful (more information below). Chemicals that are similar to phenylethylamines and are substituted may cause dysfunction in cellular metabolism of the real phenylethylamine in the brain. These chemicals include the drug ecstasy (MDMA), mescaline, ephedrine, amphetamines, Phen-fen, various anti-depressants, and some bronchodilators. We see that the potential for environmental and drug causes of ADHD are widespread and common. Even the taking of Ritalin, or the other drugs that treat ADHD, requires that healthy neural function, and increase in PEA, is achieved. This gives new meaning to the term 'PEA-brain'. Complementary Medicine can even help the patient taking these pharmaceuticals achieve better results.

Deficient decarboxylation via protein enzymes may be an important part of the pathophysiology of these various neurodegenerative disorders. Decarboxylation refers to the removal of carbon dioxide waste from the cell. Deficiency of enzymatic decarboxylation will not only result in low levels of the essential neurotransmitter phenylethylamine, but results in deficient metabolism of a number of key transformations of amino acids to amines in the brain. Tryptophan to tryptamine, tyrosine to tyramine, glutamic acid to GABA, 5-HTP to serotonin, and L-DOPA to dopamine are are regulated by decarboxylation. Deficiency of copper may decrease the rate of decarboxylation, as copper, and various ketones, are natural catalysts of decarboxylation. Chronic kidney deficiency could play a role in reduced ketone catalysts as well. Relative states of acidity could also play a key role in decarboxylase enzyme rates. A number of factors could influence this key metabolic function, and only a holistic approach can bring the whole organism back to proper function, or homeostasis.

Oxidative decarboxylation is a vital part of the metabolism of the citric acid cycle within the mitochondria of neurons that are subject to oxidative damage and neurodegeneration. Both antioxidant metabolism and supply of sufficient oxygen via adequate microcirculation are important to mitochondrial function in brain cells. One molecule produced by decarboxylation is histamine. Histamine dilates capillaries and increases capillary permeability to supply sufficient oxygen to brain cells. Histamine has different effects on different receptors in the body. In the stomach, histamine stimulates gastric secretions, while in the sinuses it stimulates swelling and congestion in allergic response. Chronic use of antihistamine medications, with allergy meds, asthma meds, or medications to control stomach acids, are well known causes of side effects in the central nervous system. Overuse of antihistamines may contribute heavily to the pathology of neurodegenerative disease.

Another subject of research concerning neurodegeneration and ADHD, Parkinson's and Alzheimer's diseases is the subject of cannabinoids. Cannibinoids are not only found in marijuana, but are endogenously produced in everyone's brain to control mood swings, pain perception, etc. One large long-term study at six universities across the world showed that a patient population that had a history of marijuana smoking exhibited a 15% decrease in risk of developing Parkinson's disease. Not everyone smokes pot, but everyone does produce cannibinoids in their brain. Endocannabinoids are important molecules produced in the brain that moderate symptoms of Parkinson's, and are also activated by decarboxylation. By enhancing decarboxylation metabolism in the ways mentioned above, and by other natural means, we may be able to prevent or reverse neurodegenerative disease in many patients. Although this is only one of the metabolic factors being researched at present, it may hold the key to reversal of neurodegenerative changes.

Can herbal medicine affect these metabolic pathways, such as rates of decarboxylation? Although study is still underfunded in the West, and studies of herbal chemistry are still underpublished here, much research in China shows the potential for such herbal chemical benefits. Astragalus was studied in 2002 and shown to promote cell differentiation by means of inducing ornithine decarboxylase in animal studies. Myrrh is used in Chinese herbalism to speed tissue healing, and British research has revealed that it is able to increase dopamine-beta-decarboxylation. As research continues to reveal specific herbal remedies to these complex disease pathways of ADD and ADHD, these herbal chemicals need to be part of a more thorough and holistic individualized treatment protocol. Experts in the field are beginning to realize the potential for integration of this strategy. This statement from the University of Johannesburg, South Africa, in 2011, shows that University medical faculties are expanding their views to integrate effective Complementary Medicine: click to see this link: . In the United States, as well, parents have initiated a serious change in the treatment strategies and prompted improved research into Complementary Medicine. This statement in 2008 from Wayne State University School of Medicine, in Detroit, Michigan, demonstrates the rise in acceptance of Complementary Medicine by health care providers, prompted by a demand from parents: .

Although skepticism is still the norm, more and more herbal protocols are being recognized as effective in the treatment of ADD and ADHD. Two very safe, gentle and effective herbal tinctures, Bacopa moniera (brahmi) and Piper methysticum (kava) have been recognized by University medical researchers, as well as lignans from pine bark (Pycnogenol), krill oil (omega-3 EPA and DHA rich), zinc monomethionine, natural iron supplements (with copper), acetyl-L-carnitine, Hypericum perforatum (St. Johns Wort), and Gingko biloba, as well as a Chinese herbal formula called Ningdong. To see this meta-review from 2011 by the University of Melbourne Department of Psychiatry, click on this link: . Study of this typical Chinese herbal formula to treat neurodegenerative conditions and hyperactivity, such as Tourette's Syndrome (BioScience Trends 2012;6(4):212-218), Ningdong Granula, revealed that this herbal formula could increase the HVA (homovanillic acid) content in the brain sera, downregulate the expression of dopamine type 2 receptors, and inhibit hyperactivity behaviors in animal studies. Constituent chemicals, such as homovanillic acid (HVA), are shown to be potent antioxidants. This formula is composed of 8 common Chinese herbs, and variations of the formula are widely used in professional prescription in TCM, or Chinese Herbal Medicine. Controlled human trials have found the formula to be as effective as Ritalin in treatment of ADHD (Psychopharmacology (Berl) 2011 Mar 18; Li JJ Li ZW). The herbal components of Ningdong granules included Uncaria rhyncophylla and Gastrodia elata, the main herbs in the commonly prescribed Tianma Gouteng Yin formula (Gastrodia Clear Wind), as well as Haliotis diversicolor (Shi jue ming), Scolopendra subspinipes (Wu gong), Buthus martensi (Quan xie), and Ligusticum chuanxiong.

Lack of protection from oxidative stress seems a key to most of the theories concerned with the gradual worsening of these parts of the brain associated with ADHD. Oxidative stress may increase due to accumulations of toxic heavy metals in the tissues, misshapen proteins, or sticky plaque, accumulation, or excess stimulation of G-protein second messengers by adrenal hormones or other hormonal imbalances. These are just some of the metabolic stresses that result in excess metabolic oxidant free radicals and require increased antioxidant metabolism to clear. Transient ischemic attacks, or TIAs, often go unnoticed in the population, and studies reveal that the amount of neural cell death that results may occur over a number of days, and is related to the lack of antioxidant protection in different areas of the brain. Lead and mercury toxicity has been proven to cause neurodegeneration, and is an ubiquitous environmental toxin due to the tonnes of organic small particle lead and mercury pollutants that enter the air from coal fired power plants each year. Levels of cellular glutathione and SOD (super oxide dismutase) are key to neuroprotection in these cases. Restoration of antioxidant metabolism is the first step in a long course of therapy necessary to finally achieve a potential reversal of neuron cell death and return of function. In utilizing Complementary Medicine for these neurodegenerative problems, much patience is required. Some symptom relief can potentially be achieved quickly, but most improvement will be noted over a long period of time. Persistence with treatment and the choice of a knowledgeable Complementary Medicine physician is important. A long list of research herbal and nutrient medicines is listed below, with explanations of effects.