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Attention Deficit Disorder & Adrenal Hormones

July 15, 2012

I take issue with the word “disorder” in attention deficit disorder (ADD). It’s not a stretch to suggest that the disorder of ADD is actually a normal physiological response to the many insults of the modern world. The hyper-vigilance, distractibility, and impulsivity of ADD could all be predictable evolutionary adaptations intended to help us be safer and more successful in stressful environments.

Stress is not just mental, it quickly jumps to a physiologic effect. When the brain perceives stress, it sends both chemical and nerve signals to the adrenal glands ordering them to make two short-term stress hormones [epinephrine and norepinephrine] and the long-term stress master hormone cortisol. Not eating regularly enough and getting low blood sugar also spike cortisol levels. Cortisol is now known for promoting the dreaded stress-gut that gives chronically stressed people that apple shape.

Epinephrine and norepinephrine both promote the “fight or flight” response to the world by stimulating increased tone in the sympathetic nervous system. Other attributes of the “sympathetic state” are the tendency to freeze up, tense muscles, shallow breathing, and divert blood flow away from the extremities and digestive tract toward the large muscles. The sympathetic nervous system also interrupts digestion and makes it harder to concentrate and integrate and make new memories. If you have ever had trouble getting someone else (or yourself) to see a new point of view in a heated argument, you can probably thank the sympathetic nervous system for that gem of human psychology.

It all makes perfect sense if you think about it; if your body senses a threat (stress) it gets everything ready for a fight or flight from danger. Cortisol helps us prepare for stress by mobilizing resources to raise blood glucose and cholesterol. This sugar boost is good if you’re about to sprint away from an angry rhinocerous, but not so good (AKA promoting diabetes and heard disease) if the stress is an email or a phone call.

Here’s the problem: Unless you are actually being attacked, we don’t benefit from our sympathetic fight or flight response to modern stress. We just get ADD, cold hands and feet, impulsive carbohydrate eating and poor digestion. Stress hormones also directly promote the “modern epidemics” of abdominal obesity, high blood pressure, elevated cholesterol, diabetes, and heart disease. These conditions are crippling our “disease-care” system. (It’s too big of a stretch to call it “health care” anymore.)

Different people develop the symptoms of ADD for different reasons. As we learn more, it’s becoming clear that ADD is a mulch-factorial syndrome, not a single-cause disorder. We’ve been tossing all the different routes and version of ADD under a single umbrella diagnosis. This happens all the time in medicine–we want the convenience of understanding and explaining things simply (e.g. “my finger hurts because there is a splinter of wood in it”). The problem is that ADD and most neurological disorders are more complex than this.

In this way, conventional doctors can simply connect the dots between identifying symptom-A and then writing down drug-X on the prescription pad in the hopes that symptom-A goes away. This is called “symptom suppression” or “allopathic medicine”. Sadly, this point and shoot drug prescription is still the mainstay of conventional medicine.

Lets talk genetics. One explanation for why some people exhibit more ADD symptoms (and are more likely to get the ADD diagnosis) is that they may have a variant in the COMT enzyme. COMT (standing for Catechol-O-methyl transferase if you must know) breaks down the excitatory  neurotransmitters: epinepthrine, norepinephrine and dopamine. If you have a variance in this enzyme, these excitatory neurotransmitters hang around in your synapses longer and can promote hyperactivity, short attention, anxiety and hypervigalance. See below.

Neuroscience of ADD

We all experience ordinary and predictable stressful events (e.g. disagreements, bills, phone calls, traffic jams) that amount to stressful stimuli and lead to the production of catecholamines. One of the differences in people with genetic COMT defects is that the neurotransmitters spawned from the stimuli can easily pile up make little things amount to nerve-jangling “emergencies”. I think this is part of what is going on with at least a subset of ADD patients. The supplements SAMe (S-adenosyl methionine) can help support people with COMT mutations. If you also have a genetic variant of the MTHFR  gene, then methyl-folate (a more advanced form of the vitamin folic acid) can help. There’s more, much more, but this begins to show the advantages of testing your genetics.

If neurotransmitters are the software, then our nueroanatomy is the hardware. There are developmental changes in the brain’s circuitry that make the symptoms of ADD more likely to present. Let’s talk about how some of that neuroanatomy gets set up and how it relates to the presentation of ADD. We know now that before we are born, our mothers begin to condition us to stress. High levels of maternal cortisol can actually cause predictable changes in brain anatomy that hard-wire us for the hyper-vigilance, distractibility and impulsivity we call ADD. Direct effects on brain anatomy include: decreased hippocampus size and function, increased amygdala size and reactivity, and decreases in the size of the anterior cingulate cortex (ACC). The good news is that we can rewire our brains with interventions like cognitive therapy, high dose DHA supplements.

brainparts

  • Amygdala—The brain’s “fear hub,” which activates our natural “fight-or-flight” response to confront or escape from a dangerous situation. The amygdala also appears to be involved in learning to fear an event, such as touching a hot stove, and learning not to fear, such as overcoming a fear of spiders. Studying how the amygdala helps create memories of fear and safety may help improve treatments for anxiety disorders or post-traumatic stress disorder (PTSD).
  • Prefrontal cortex (PFC)—Seat of the brain’s executive functions, such as judgment, decision making, and problem solving. Different parts of the PFC are involved in using short-term or “working” memory and in retrieving long-term memories. This area of the brain also helps to control the amygdala during stressful events. Some research shows that people who have PTSD or ADHD have reduced activity in their PFCs.
  • Anterior cingulate cortex (ACC)— the ACC has many different roles, from controlling blood pressure and heart rate to responding when we sense a mistake, helping us feel motivated and stay focused on a task, and managing proper emotional reactions. Reduced ACC activity or damage to this brain area has been linked to disorders such as ADHD, schizophrenia, and depression.
  • Hippocampus—Helps create and file new memories. When the hippocampus is damaged, a person can’t create new memories, but can still remember past events and learned skills, and carry on a conversation, all which rely on different parts of the brain. The hippocampus may be involved in mood disorders through its control of a major mood circuit called the hypothalamic-pituitary-adrenal (HPA) axis.

Lets talk about drugs. The strategy of masking symptoms with drugs without identifying or addressing the cause of a health problem is the sad mainstay of modern allopathic medicine. Practically everyone in medicine is doing it–so most people (and their doctors) fail to recognize the short-sighted insanity of the practice. Meanwhile the pharmaceutical industry has been getting stronger and more influential in politics, regulation, marketing and spewing out reams of compromised medical research.

adderall-cereal1

Many things can worsen the symptoms of ADD, depression and anxiety. Poor quality or inadequate sleep are a “no brainer” here. Nutrient deficiencies and artificial food additives from processed food and poor digestion can certainly make mental matters worse. Toxins in our food and environment are well known to exacerbate cognitive problems. Perhaps less well established, but also true is that food sensitivities and allergies, and hormonal changes like puberty or menopause can all exacerbate cognitive problems too.

The side effects of symptom suppression are often accumulative as the real problems fester or get driven deeper. With ADD medications, these stimulants may well be whipping already tired adrenals deeper into fatigue. ADD meds can do an admirable job of masking symptoms–for a while. The benefits also often come at a hefty price. Meds aside, heavy coffee drinkers might be treating ADD as a “solution” to fatigue and poor focus.

To find out if you really have adrenal issues,  we can run a 4-sample salivary cortisol:DHEA stress index test. If you are in Washington where I have my medical license, I can order the test for you. I don’t order the testing on everyone because of the cost (~$150), and also because most of us in the modern world are probably experiencing some degree of adrenal fatigue. Sometimes though, seeing a graph of where your adrenal function is at can help motivate us to make lifestyle changes, track progress, and monitor setbacks.

Here’s my four-step program to address come likely causes of adrenal fatigue, and related ADD/depression/anxiety with the additional benefits of evading the “modern epidemics” (abdominal obesity, high blood pressure, elevated cholesterol, diabetes, and heart disease):

  1. Sleep: 7.5-9 hours a night, in an environment that is as dark, quiet, and undisturbed as possible. Go to bed as early as possible without phones or laptops or other stimulation. Using melatonin to induce better sleep is a fine idea if you have trouble falling or staying asleep.
  2. Exercise: regular moderate exercise is a great way to reduce stress, promote health, loose weight, feel better, improve sleep, balance immune function, and make better food choices.
  3. Nutrition: Eat frequently and regularly. Choose whole, fresh, nutrient-dense foods free of added sugar, preservatives and pesticides. Wild or pasture-fed animal products in moderation and plenty of whole fresh fruits and vegetables is the best way to eat. Things to avoid include corn-fed factory animal products, wheat, sugar, fast food and processed food. Also good to avoid are “naked carb’s”–this means “clothing” carbohydrates by eating them with fat and protein which slow the gush of sugar.
  4. Harmony: Meditation, yoga, tai chi, Qigong, heart math breathing. This is where neuroplasticity comes in handy. Neuroplasticity basically means that e can re-wire our brains to interpret and react to the cues in our environment so that we don’t “stress-out”. Even if we were hard-wired to be anxious or have ADD, we can change the way our brains work through various practices of stress reduction and mindfulness. The one I’m trying now is “heart math breathing”, and it is as simple as focusing attention on measured breaths: 5 seconds in, 5 seconds out. You don’t need any expensive equipment to benefit. I even found a free ap’ for my Android phone: MyCalmBeat. I think that starting ones day with 10-20 minutes of some mindfulness practice aimed at promoting mental calm can have enormous benefits.

On supplements: These can help too and ought to be considered on an individual basis, but I think it’s a mistake to focus on supplements to the neglect of the sleep, exercise, nutrition and harmony practices listed above. These practices are the foundation of helping your adrenals get back to ideal functioning.

Thyroid hormone issues often follow adrenal stress. Your thyroid gland sets the metabolic thermostat for almost every cell in your body. High thyroid makes you hot, nervous & jittery. Low thyroid hormones can make you feel tired, cold, sore, irritable and slow (i.e. brain fog). TSH, FT4, FT3, RT3 are the four tests I order most commonly for people with low thyroid symptoms. I’ve got a special deal with where I can run those four tests for $70 (without insurance, this might cost almost $600). The RT3 is a key thyroid test. Most MD/allopaths don’t check this one. If you don’t check RT3, the other lab tests may look totally normal and hide a major problem. High thyroid symptoms merit the same tests plus two anti thyroid antibody tests for an extra $47 (normally over $160).

Next down the chain of hormonal problems related to stress are the sex hormones—including Testosterone, DHEA, Estrogen, and Progesterone. When these are off, people can experience depression, irritability, low libido, and women might experience long, irregular or painful menstrual cycles, digestive problems like IBS, male pattern hair growth, and poly cystic ovarian syndrome (PCOS).

For the ladies, I can run an 11 sample salivary hormone profile that tracks the cycling hormones over an entire cycle (~$200). Once again, allopathic medication has swooped in to save the day with medications (birth controll pills, etc.) that try to mask the symptoms—without treating the causes. Carefully tracking symptoms and specific lab tests can reveal where the problems lie, and target more effective natural treatments to get you back on the road to feeling better. But guess what? Sleep, stress reduction, exercise and nutrition are the best long-term cures to ballance sex hormone problems too.

The mantra of treating hormonal problems in naturopathic (and “functional medicine”) is to start with adrenals then to address thyroid issues and finally to address the sex hormones. If your thyroid or sex hormones are off, it’s important to “treat” your adrenals to a better stress-busting lifestyle.

OK, let’s get back to ADD for a little bit. Did I get distracted there?

Years ago as I started medical school, I took the ADD medications for a short time myself. They had a truly miraculous effect with regard to improving my focus on one hand, and vicious side effects like insomnia and amphetamine addiction on the other. I quickly became exhausted, and was quickly in the habit of waking myself at 6AM, taking the meds, going back to sleep, and letting the amphetamines wake me up an hour later—not unlike a reanimated zombie. I was a naturopathic medical student at the time, and seeing the road ahead, I stopped taking them after three months–even though the short term effect on my ability to focus was profound. I could see that things were not headed in a good direction.

The medications may seem like a godsend as we struggle to train our children to adapt to schooling and the modern commercial world. I am also deeply concerned about the ultimate cost. I don’t doubt that ADD medications have helped turned lives and families around. I think children have more resilience in their adrenal glands and can handle the extra wear and tear on the adrenal glands and other systems from the medication for longer than adults can. I routinely get messages form people who have been taking the stimulant medications for over ten years and they are typically chronically fatigued, no longer getting any benefit from the medications and thoroughly addicted to them.

We live in an age when ADD, anxiety and depression are so prevalent that they are becoming commonplace. Also commonplace is the allopathic practice of using medications to suppress these *critically* important symptoms. All three conditions are the natural response to stress as mediated by the adrenal stress hormones in ourselves (and our mothers as we developed). I fear that eventually, society as a whole will pay some catastrophic costs if we don’t start recognizing and addressing the source of our stress: the profound discord between what human life evolved to need and the increasingly bizarre expression of technology and corporate greed we have been forced to swallow in a teetering and overpopulated world.

The cause, as I have mentioned, is in large part modern stress. To promote health and human welfare in human society, we will need to reduce stress by tackling the monumental task of reducing human population. Also key to reducing stress will be shifting the allocation of our subsidies and resources to help more people spend more of our time doing what humans were meant to do: exercising in nature and having a natural relationship to our food. We can probably further reduce our stress by choosing to cook and eat own home-grown food with people we care about. That way we may go to sleep feeling good, and greet each day with more stress-busting gratitude, mindfulness and ease.

That’s enough for today, I’m going to go walk in my parking strip and back yard gardens now.

May we all be well!

trmorrisnd headshotDr. T.R. Morris is a licensed naturopathic medical doctor (ND). He is currently serving as faculty and consultant to the Institute for Functional Medicine (IFM). The IFM mission is to revolutionize medicine by teaching the latest genetic, nutritional, hormonal and other biochemically-based integrative medicine techniques to MDs and other practitioners looking for new tools to prevent and treat chronic disease. In the past, T.R. served as the medical director of a large integrative clinic and taught (genetics, physiology, biochemistry, microbiology, cellular & molecular biology) for 10 years for various medical programs in the Puget Sound. He sees patients in person (or long-distance via Skype consultations) from his home office in Seattle.
Contact Dr. Morris

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18 Comments leave one →
  1. October 29, 2012 1:53 pm

    Hello SBC. Thank you for reaching out, and I’m sorry to hear of your troubles. Band-aid drugs used to cover symptoms of underlying problems and imbalances are rarely the answer to chronic health issues. Unfortunately, the benefits of drug therapy often fade and leave behind a pile of side effects stronger than ever. Perhaps nowhere else is this more true than with stimulant therapy used in adult ADHD. I have personally taken those drugs for ADHD myself and have now been off of them for 14 years. It takes deep dedication to your health, but you definitely can get free of them too.

    I am developing a heath consultation agreement that will enable me to advise people in other states. I’ll let you all know when it’s ready.

    Please stay safe with the coming storm on the East coast.

  2. Dallas Gillespie permalink
    December 17, 2012 11:08 am

    This article is so inspiring and helpful. Thank you! I am just starting my own long journey off Vyvanse. I am curious what I might be able to expect after several months or years of taking a more realistic approach towards correcting my cronic low energy and ADD problems. That being said, have you been able to get your focus to a point that it is actually comparable to how you felt while on the ADD drugs?

    • January 31, 2013 5:10 pm

      Focus is like a muscle, it will gets stronger with exercise and practice. Getting good sleep, regular moderate exercise, and having a good diet (high protein, plenty of healthy fats, and especially avoiding sugars, simple carbohydrates and artificial ingredients) are all very important to getting off the ADD drugs and having good focus naturally. I’m not sure my focus exceeds or equals the level I had on the ADD drugs (or that I would want it to), but I have been able to get it to where I need it to be highly functional.

  3. January 13, 2014 9:42 am

    Thank you for your 1st paragraph and information!! I also take exception to the word disorder! I’d love to change the name, maybe to ADWMSA (Attempt at DealingWithModern Society Ability) I have worked with “gifted” children whom I have found to have so many attributes in common with ADHD that I’m tempted to use them synonymously. Many “attention deficit” children actually hyper focus, wanting to go much deeper with their curiosity and explore, and make many connections, which their brains can do exceptionally well. You might even say “hyper-ly” well. They don’t want to make surface connections but are required to. It certainly could be argued as an evolutionary adaptation to our society, to react quickly to stimuli, including making many, many connections, or that feeling of not being allowed to do more than surface, which subconciously raises adrenaline. When I suggest these scary initials (adhd) to help parents look at their children’s behavior as more than “good” or “bad”, it is sadly met with denial and fear. I will be sending them to your website, though we are not in Washington. Thank you! It’s a start! Therapists have noted that those with “ADHD” who DO monitor their behavior, showing less outward hyperness, are more likely to have symptoms of anxiety and are medicated for it instead. In other words, those children who DO obey and sit still in their seats, (or adults) either from behavior training or a more normal prefontal cortex, are still dealing with the same stress hormones in their bodies. I believe understanding the chemicals in our bodies is so important, knowing their measurements can help us know what we’re dealing with, becoming aware of thyroid function, etc. And I am grateful for the acknowledgement of the simple, not-for-sale changes a person can make. Thank you. One other natural aid, and another slight of our fast-paced times: human touch. Research has shown what it can do for all stress symptoms, slowing heart rate and other “fight or flight” responses, and can even balance the other side of it: waking up the hypo or depressed symptoms. If you have someone within healthy social reach, give them a hug/get a hug. 7 to survive, 12 to thrive. Teachers are not allowed to, though they sometimes just break the rules and do it b/c they know it matters so much. Evolutionarily, hugs makes sense too.

  4. February 5, 2014 10:32 am

    Sir, you don’t have ADHD.

    At least not like I do… As my psychopharmacologist says, and as do the countless good articles I have now read. IF you are missing the key chemical, the amphetamines actually make you calm and sleepy. I feel a peace and calm that I have not felt in decades. I typically yawn, a really good one as each dose hits. I feel I actually sleep at night, which I haven’t done in decades (despite excellent consistent sleep habits. I was “appearing” to sleep just fine… but the brain was simply working and focusing all night on random dream patterns. Or that is my guess.).

    Now, in my case, I have zero problems with hyper-focusing lots… I have problems existing around silly people, poorly proportioned spaces, seeing things out of order, or hearing incorrect statements, or even just taking it easy as I cannot help processing 1000 different ideas, conversations, things I see around me. These things are like an ice-pick in my brain. Its somewhat helpful to have the drugs, so one can exist a bit more normally in a relaxed way… Oh, and to sleep. Again, I feel like I have not slept in a decade and this was driving me crazy.

    From this article, and all the differences you describe I suspect your approach would deal with very very mild ADHD, which from my perspective is a bit like laziness. What I experience is pain, and constant mental noise, and the outward symptoms are a habitual response to deal with that pain and now in my mid-30s.. (Im just figuring this out)… an accelerating degradation into insanity.

    • Karen permalink
      April 2, 2016 5:32 am

      To BLAHHH

      I don’t know the guy personally but oh yeah he has ADD. And although you took the same emotional WTF to his first paragraph as I did initially, I do get what he is saying overall.

      I have severe… they the docs love calling it severe,,, ADD but was ADHD as a kid. I have mediated some stressors by internalising them so less outward fidgeting and much more inward anxiety. Don’t know how, likely conditioning from unapproving peers and adults constantly telling me to stay still and shut up.

      After a while a brain has got nowhere to go but inside itself.

      While I agree I was born this was, while also agreeing my predisposition to how I filter the world around me, especially this world of today, turns up the anxiety receptors and this combination of Nature and nurture causes ADD and its a bitch.

      I would like to make a specific distinction that I know is critically important. Stress and anxiety are not interchangeable attributes. In anxiety my ADD is exacerbated significantly, burns me out, cause depression as a result of dealing. Anxiety is for me created through over stimulation of PROCESSING the world cognitively through my 6 senses, yes six; most of us are highly sensing or are intuitive. But the process is internal, it’s physical as in muscles and synapses… processing of data.

      High stress on the other hand is a boon to an ADDer, the higher the more focused and sharp we are, especially in situations of crisis… while everyone else is panicking… I’m as calm as a cucumber, quick, decisive…ahhh to bottle that. Critical stress is a more emotional reaction to a situation first and foremost and the physical reaction in the brain follows as all hormones and neuro transmitters firing away… little grey matter muscle pumping going on just then, unlike in anxiety,

      If I need to get fixated and need something done… fear or anger galvanises me as the next best thing to floundering around when anxiety ridden…the difference being anxiety muddles thoughts, fear or anger focuses them, calms the thoughts down to the straight essentials needed. I seem to grasp the best idea first with no more thoughts swirling around to muddy it.

      I have been in life and death situations and been the only coherent saviour in the bunch…no bragging… but get me overwhelmed and anxious I’m a total twit babbling away disjointedly while internally fielding images, idea, connections at lightning speeds with my mouth trying to hopelessly express it all,,, trying to verbalise this web of brain material just throws the wrench in the works.

      I have a saying… I live my life in retrospect because in the moments of day to day life with all the external varied stimuli crashing in through every sense,,, whirling me to anxiety trying to sort and helplessly trying to limit it all inside… I look back in the moment when I’m next alone and can’t believe I couldn’t filter myself in the moment and save such embarrassment I get from registering the faces of those I was imposed on to. Not their fault, I’d run from myself if I could.

      But then the paradox of being the super version of me I could only dream of and everyone’s savior in the moment… a precious few specific moments in my lifetime…. super stress immediate crisis and life altering events… how sad to be so keenly vividly aware of these paradoxes within myself but utterly hopeless to capitalise on any of it because stimuli is the name of the game for both my joy and pain of these sides of myself.

      It’s how my body responds to stimuli, how my primal brain perceives it, that determines if I’m a verbal diatribe or a voice of calm and reason.

      So yeah, I’m type babbling here so in closing, the Doc has a good point, and so do you. It’s both. Genetic and environmental factors combine.

      The thing is unless ADD babies are born with no way to sense their world,,, there is no way to avoid Mother Nature making them. Stimuli is a given, receiving it is a given, our genetics are the bitch that cranks it up and keeps on giving.

      Meds are a tool but a pill taken orally cannot isolate its target and so doe’s greater harm than good to the rest of the body by far. The poor kids being medicated to early graves is to me no solution for a bit of harmony in the home or at school.

      ADHD will in time and with persistent structure and patience from peers, teachers and family.. morph into ADD or find useful expression in a hyper driven career… we need to stop conforming people and start working to their strengths and accept what make us different and capitalise on that.

      Such is life, we all have something.

      • April 2, 2016 2:35 pm

        Thanks for your weighty post, Karen. Another way to think about ADD is that it is a “hunter’s way” of seeing and reacting to the world that is only dysfunctional in the context of the modern “farmer’s world.” You might like to check out the book: ADD A Different Way of Seeing.

  5. Karen permalink
    July 17, 2016 4:07 pm

    Hey Doc ,
    Im glad you liked my above post, typing babable it may be, but sensical non the less.

    The hunter vrs farming thing is a bit simplistic and forgive me, but egotistical. Its like as an ADDer you resent it being seen as a deficit in modern society and so attempt to elevate it to some exaulted plane of past superiority, to make yourself and other like minded feel better about themselves.

    Here is the rub. We arent a hunter gather society anymore. So its stil a deficit unless you work with it to its best advantage.

    heres the good news… as I said in the end of my last post… everybody has something…

    My neighbour isnt ADD but on par, he is very anti social and cant overcome it even though he is incredibly lonely. His work life is a force of will for him since he has to deal with people and hed rather not at all.

    Some people are enviously happy and world globe trotters, very social and open minded… however they cant be relied upon to address serious issues in specific concrete ways and stick with it over a long time period… its not thier nature.. they love, live laugh and move on like social butterflies. They are notoriously hard to pin down for long term monogomous relationships and building family in one spot too.

    So many examples its crazy of different personalities and coping mechanisms they employ to fit in to this NORMAL narrative weve created largely through social myth and media about what that should look like.

    I think we each have to assess our strengths and weaknesses in any given enviroment and social exposure. Not all enviroments, jobs, amount of people and socialisation are the same …not one block apart, not even between jobs. So the real focus should be on knowing who you are and how best you thrive and where you dont so well. Mediate the things you can or are willing to…or just say Fuck It.. and be who you are and make others work around you.

    Every person, no matter who they are, no matter how well the FRONT or medicate their weaknesses does this…not just ADDers…

    No one is better than the other, perhaps better in a specific task, in a specific place and time, but we all have something.

    My point…there is no shame in being different…DIFFERENT IS THE NORM,

    so thanks for the caveman vrs victorian cottage farmer piece but Ive hunted and Ive farmed…Im good at both and Im wayyyyy ADHD…

  6. Karen permalink
    July 17, 2016 4:42 pm

    by the way.. adhd isnt the missing of a KEY CHEMICAL as some have stated… its the inefficiant use of or transmission through our neural senders…the ends of our neural fibers that send and recieve messages through chemical and electricl stimulation… they suck at it… like a grime that deposits on a sparkplug …it just cant emit and recieve the chemicals…boosting chemicals to get a bit more though is the medication method of choice for ADHD but seriously, it cant be targeted so ot floods every nero pathway and not ever one is gummed up so side effects are often not pleasant.

    Stimulant meds to increase apparently conductivty in brain is also a pain because it too cant be targeted and goes throught your body in every nerve…like your heart for example… my previous remark about us killing kids,, their hearts cant take it over time, let alone every other organ getting stimulated and cutting their expected life in half.

    There are however a few, very few nero boosters that work on these receptors that are non chemical and non stimulant. Will it solve everything? ofcourse not but it helps a great deal without the side effects and damage to your body. One is an oldy but a goody, it has helped me immensely, Its called Moclobemide, its not available in the US but pretty much every other country uses it.

    Here is a wiki Link…

    Do not be concerned that it is an MOAI, since it is a different kind of these, its reversable… its uptake into and out of your system is 12 hours. You dont withdraw, you have to take it obviously 2 times a day to keep it up well for best effect., between 400 to 600mg total. start at 300 and take your time moving up, more isnt always better effect, just more. So stop where it works for you.

    THINGS TO NOTICE… very little procrastination and anxiety… it get smuch less quickly. improved mood and engagement in your day,,, probably because of the latter. Your labido is not effected negatively…rather improves. your patience will improve…. probably because of the latter…
    No withdrawl, piss all noted side effects and not tolerance built up over time so no real need to take more than what works even years down the road.
    Plays well with other medications, but can enhance them too…remeber its improving chemical and electrical pathways so really this should be no suprise if it does as its said to in your neuro pathways to improve ADHD.

    So be careful and remind your doctor or ER doctor that you are on it so they can adjust doseages of meds… you could get more than you.they barganed for depending on what they give you… ps if you are a drug user… dont be an idiot, I already know what you are thinking…get help if that crossed your mind dum ass.

    It has zero food, alcohol an ddrug interactions save one drug. It doesnt interact severly with seritonin if you additionally take that though all other MOAI will that are not the reversible kind of MOAIs ( WARNING* seritonin toxicity is a huge concern for all other MOAI, it can kill you.)

    Why isnt it sold in the USA> ask your pharmasuticle companies that would likely go broke from thier other anxiety and ADHD meds after you find out about moclobemide.

    DO your due diligence. Moclobemide is an old drug but a very good one. new insnt better just as more isnt always better. It has been heavily tested and written about for years on every continent in the major scientific journals and studies. Go and search and read them.

    Enjoy. PS even my Psychiatrist who is 40 ish didnt know that moclobemide existed or that there was a difference in MOAI drugs, the reversible and non reversable types, apparently pharmasutical companies are much consulted or employed in our education systems ( no joke) … the NON-reversible kind require hard core diets and restriction and often can cause severe health issues if clients are not diligent in following them.

    Now that I informed her about moclobemide ( I, like many adhd’s, do research on my own after the 6th kind of drug had uncomfortable side effects like those that came before).

    She did her own research and is impressed, prescribed it to me and Im very happy being off the medication yo yo thing because of undesireable side effects, like suicidal thoughts and feelings, low limbido, fast heart rate, chewing my mouth insides etc etc.

    She now uses it as it was always meant to be, as a first line treatment for OCD, ADHD, Anxiety, some Bi Polar etc etc,,, and I think its great becaus in Canada…its covered.

  7. Karen permalink
    July 17, 2016 4:45 pm

    sorry.. forgot the WIKI LINK though I dont believe in wiki for first line medical advice, it sums up and posts many major scientific reviews and studies I have read on Moclobemide, so this time its OK

    https://en.wikipedia.org/wiki/Moclobemide

  8. Jeff Deware permalink
    July 27, 2016 9:12 pm

    So is your point that ADD meds are not ok/you will not prescribe them to your patients? Im confused…

    • August 29, 2016 9:48 am

      I would say that ADD drug therapy can and should be the last resort. Long term, ADD drug use often leads to tolerance, increasing doses, addiction and then profound an unrelenting fatigue. I’ve had countless patients come to me after 10-20 years on these drugs, now on maximum dosing, with ADD symptoms through the roof, and they have been unable to get off the drugs. Sometimes they have gotten two or more different physicians to give them additional ADD prescriptions, or even tried street drugs like crystal meth to keep their energy up.

      Here are my thoughts. The first thing to do about ADD symptoms is to address modifiable lifestyle factors: sleep, exercise, nutrition, stress, and relationships. The next thing to do is to identify food and chemical triggers that spike ADD symptoms in individuals. An elimination diet (avoiding wheat/gluten, dairy, eggs, soy, corn, sugar, and food additives/preservatives) for 3-6 weeks, then carefully challenging the foods one at a time for 1-3 days to look for symptoms. Sugar and preservatives don’t need to be challenged, just avoid them for the rest of your life. IgG food “sensitivity” testing can also be informative. Then assess adrenal function with 4 sample salivary cortisol/DHEA testing and treat that if necessary. Then identify unmitigated traumas/PTSD and treat those. If you’ve done all this and still have severe ADD symptoms that are helped by low doses of ADD medications (AND YOU DON’T HAVE A PERSONAL OR FAMILY TENDENCY TOWARD ADDICTION/SUBSTANCE ABUSE) then low doses are probably okay. For those who metabolize caffeine well (normal CYP-1A2 genetics), they might as well drink 1-4 cups of coffee (or 2-8 of tea) instead of taking low dose ADD drugs. The effect is much the same and without the profound risks.

  9. Tammy Lundy permalink
    December 15, 2016 11:34 am

    Seeking help for anyone willing to offer advice that has experienced a similar situation. I am having issues that Dr. Morris stated would occur with the adhd stimulant medication in his article. But I did not experience having issues with the medication not working until a few months ago after I delivered my twins via c-section. This was my first pregnancy. I delivered twins in June 2016 and ever since then, 6 months ago, the adhd med that I take, Adderall, hasn’t been working like it used to. I don’t know how I could have built a tolerance because I stopped taking the Adderall as soon as I found out I was pregnant. So, I was without the medicine for 8 months (as the babies came early). Interestingly, I did not have any focus issues the entire 8 months of my pregnancy. Could that be due to the high estrogen/progesterone levels during pregnancy?
    Anyhow, I restarted the Adderall XR 20mg same dose as before I became pregnant (taken 1x day) and now it only seems to work the first day I take it. The more days I take it, the less effective it becomes. Make sense to anyone?
    Before pregnancy, I was taking Adderall XR 20mg (same dose/regimen) for 3 years and my off day was on Sundays in attempt to avoid tolerance. I have recently read articles explaining the women that have adhd can experience worse symptoms of focus, inattention, memory problems after pregnancy, perimenopause, and/or menopause. I feel like this is where I am at currently, and it has been horrible trying to care for my babies with the severe fog, memory/word recall issues, concentration, etc the list goes on and on. I don’t like to drive or go to the store like this so my husband or my mom has been doing the grocery shopping. I feel like I am very unaware of my surroundings and I have a difficult time organizing and getting tasks done, such as making dinner for my husband and I. I fear that I will be this way forever, and I can’t even imagine how much harder things are going to become once my babies start crawling and need me to prepare food for them. I obviously want the best for them and for them to eat as much whole, organic foods that we can do.
    I recently had an apt with a NP that practices functional medicine, and she is doing blood work and salivary hormone tests on me to see if I am vitamin/mineral deficient or if there is an imbalance of hormones. I am scheduled to discuss my results at the end of this month…Thank God!
    I am hoping there is an imbalance of hormones just so I can get some answers as to why I feel this way and why the Adderall isn’t effective anymore. Before restarting the Adderall, I went to an N.D. and she prescribed a combination of herbal drops as this was an attempt to go all natural as I have been researching how terrible Adderall is for the brain and body. I didn’t feel the drops were very effective and the N.D. told me that I’d need to make some diet changes while taking the herbs. I was not able to keep seeing her as my insurance does not cover alternative medicine, so I was not able to begin a food Elimination Diet or get tested for food allergies/sensitivities. I plan to have this done with the NP that I am seeing as my insurance will cover this practitioner. I am willing to change my diet: add or eliminate certain foods that could be causing issues. In the meantime, I would like to hear from anyone that have or maybe experiencing the same issues. Also, I read Karen’s comments, and I thought about her suggestion of using the moclobemide (If I can find where to buy this) but I would rather do things naturally if a diet change is the only thing needed to help with the issues I’m having.

    Sorry this post is so long, thanks for the help & suggestions! TL

    • December 27, 2016 3:38 pm

      Your body went through many changes with the pregnancy. One of them may have been the upregulation of the phase I and Phase II liver enzymes that break down the amphetamines in the Adderall. I am not a fan of people taking these drugs long term anyway, so I encourage you to consider that this may in fact be an opportunity in disguise. If this drug isn’t working, it’s time to double down on all the lifestyle pieces: sleep, exercise, diet, stress, relationships… that may have been underlying your ADHD all along. Also, if you have symptoms that fit the bill for adrenal and thyroid dysfunction, you may wan to consider getting your adrenal and thyroid function checked. Thyroid checking should always involve a TT3:RT3 ratio (normal >6) and a TSH (normal <2.5).

  10. Excelsior Watchdog permalink
    December 23, 2016 11:51 am

    “One of the differences in people with genetic COMT defects is that the neurotransmitters spawned from the stimuli can easily pile up make little things amount to nerve-jangling ’emergencies.’”

    Boom. I don’t even need genetic testing. I have this. With this, I went through separation/divorce while pregnant with my daughter, flooding her developing brain with sky high amounts of cortisol, and she is (high functioning) autistic.

    I appreciate the technical details. I’ve been studying molecular biology on my own, and this gives me so much more to work with. Unfortunately I’m in MN, not WA.

    • December 27, 2016 3:31 pm

      When we have children who had en-utero or early childhood exposures to high cortisol, the whole architecture of the brain around anxiety and hyper-vigilance can be affected long term. In these cases, it pays to consider that the child will likely have a tendency to over interpret cues for vigilance, anxiety, danger based on their brain architecture alone. These kids are the ones that are also more prone to develop PTSD as kids or adults compared to controls who experienced similar traumas without developing PTSD. This is without considering COMT variations, so I would caution you to avoid leaping to certainty in conclusions about cause and effect.

  11. December 27, 2016 2:32 pm

    This article was posted by one of my readers. I am not in 100% endorsement of this article. I respect that this article attempts to describe some of the risks of ADHD medication and that it also lists some other potential causes and contributors to ADHD. It is not written from an entirely logical or scientific manner though–and at least in part is appealing to the emotional side of parents and readers.

    The causes of ADHD and ASD (autism spectrum disorders) are almost certainly the combination of genetics and environment. “Environment” technically includes everything in our world that we are exposed to:
    video pollution: television, internet, video games, etc.
    daily chemical exposures: cleansers, solvents, fragrances, plastics, etc.–largely unavoidable in today’s world
    biologic exposures: mold, bacteria, viruses, parasites, pollen
    pollution: chemical, particulate noise, light,
    stressors: physical and emotional trauma, family dysfunction
    diet: which generally a tremendous amount of processed food, grains, pesticides, herbicides, artificial colors and flavors, preservatives, refined sugars, and GMO materials.

    Does it make sense to remove some or all of these environmental exposures from a child’s diet who is experiencing ADHD symptoms? Absolutely? Do we know which one of these things is causing a particular child’s ADHD? Absolutely not. There will be some commonalities, but everyone is going to be different.

    And then of course, there is the problem of having a “diagnosis” for ADHD at all. In my view, ADHD is likely a normal evolutionary patterned set of neurological and behavioral responses to the modern world. It may well be a normal evolutionary response to the interplay of multiple novile modern stresses. Does a child with ADHD tend to do well in modern schools–where sitting and listening or working quietly or peacefully in groups for 6-8 hours a day is required? No. Not at all. Does their objectively poor behavior or performance from the perspective of the school mean that we should medicate our kids to the point where they can all function in schools? No. It’s like assuming that any adult having issues with anxiety/depression/bipolar or schizophrenia has a medication deficit. What we have is a society that is increasingly out of alignment with our evolutionary human nature. Seeing increases in ADHD, autism, and adult anxiety/depression (and bipolar/schizophrenia) seems more likely than not to be a normal evolutionary response to a crazy toxic world. I think we should clean up our environment (see above definition) before considering the general medication of a growing number of children and adults.

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