Life sometimes keeps us quite busy, doesn’t it? I apologize to you, my readers, for the scarce blog posts. I’ve been in the process of pulling off an epic home move of about 1700 miles! So, I write this post while in a campground in Lamoine, Maine USA where I’ve been hunting up a new home for my family and I.
I did quite a bit of research reading about ADHD recently, and thought I would share a few thoughts about it. Most of these thoughts are summarized in the flow chart drawing I created; refer to it when reading this blog post and you’ll see what I mean. What can be learned from a simple uBiome stool sample that can help with ADHD? Well, it turns out that there is quite a bit to look at there! As usual, this isn’t meant to replace your physician’s advice, and it is an example-which may not exactly describe your situation. You should consider using uBiome to run your (or your child’s) sample to see what your particular situation consists of.
The first thing to consider is the imbalance that frequently occurs in a microbiome. You see, it isn’t just about how many species of bacteria live in your gut, it is also about the relative numbers of those species. uBiome, after processing your sample, shows this in the simplest way by clicking on Taxonomy tree. In this format, the larger circles indicate larger populations while the smaller ones indicate, well, smaller. Clicking on each allows one to expand the data down from the phylum level all the way down to the genus level (remember, all life is cataloged by Kingdom, Phylum, Class, Order, Family, Genus, Species. We usually use Genus, Species to identify organisms, such as Homo sapiens or Helicobacter pylori.) When expanding these circles, often there is an obvious imbalance. At this point, I’m going to share some very specific information, and some or all of it may not apply to you or your child. It is an example of how a uBiome analysis can correlate with a condition and symptoms, directing some interventions. One recent patient case was a good example; the only large circles were Firmicutes, which is not such a bad thing. Opening that led to Clostridia being dominant, while Bacilli was minimal. This is meaningful because Bacilli includes Lactobacillus-one of the definite “good guys” that keep things working well. The phylum Actinobacteria was also minimal, significant because it includes another desirable genus, Bifidobacterium. This organism is an initial colonizer of the gut, tames the immune system, and also works with Lactobacillus to produce BDNF.
BDNF stands for Brain Derived Neurotrophic Factor, and it is necessary for the brain to develop new connections and grow/adapt to the life an individual leads. It is needed for plasticity, that ability of the brain to learn and adapt as needed. Low levels of BDNF are associated with ADHD. Your microbiome helps your brain to produce BDNF. Remember that a big part of what your brain learns to do as you grow up is actually blocking things out, not paying attention to more of them. It is a learning process, and in order to concentrate to accomplish tasks we must learn to attenuate non-essential information. This is also necessary for the brain to conserve fuel, because having a neural response to every incoming signal would burn a lot of fuel-in fact, enough to run out in some areas and cause Oxidative Stress.
Oxidative stress can result from depressed levels of antioxidant reserves or from too much stimulation. When nerve cells get overstimulated, they build up waste products and the energy-producing mitochondria become damaged. This is a “cellular death spiral”, because as soon as the mitochondria become damaged, the cell’s capability to metabolize fuel and produce energy is compromised, leading to more oxidative stress and further damage. This has been identified as part of the disease process in Alzheimer’s and Parkinson’s as well as ADHD and Autism. One of the problems that can promote Oxidative Stress is Inflammation.
Inflammation occurs when the immune system become too reactive and begins to attack tissue that is “self” and not “intruder/enemy”. Bifidobacteria are known for helping to dampen the immune inflammatory response, and a deficiency of Bifido contributes to inflammation. Again, inflammation is a key building block of…yes, all the same neurologic diseases. Low levels of Bifidobacteria and Lactobacillus are also significant because these organisms produce a neurotransmitter called Gamma Amino Butyric Acid or GABA.
GABA is an inhibitory neurotransmitter in the brain, and calming drugs or herbs often boost GABA levels. Valerian root or Valium (copycat drug companies, you know?) are good examples as is Kava Kava. Low levels of Lacto and Bifido gut bacteria result in low levels of GABA at the brain. Low levels of GABA at the brain result in less inhibition…ergo, more stimulation! And, the process continues in a positive feedback loop.
It is interesting to note that one intervention that helps elevate GABA and BDNF is exercise. Kids with ADHD are known for often being hyperkinetic, so if you wondered why, it is their brain’s way of balancing the equation to save nerve cells! When kids are reprimanded by teachers and parents are shamed into medicating their children’s “high energy”, it can be detrimental to the developmental process for this reason. This doesn’t mean that doing nothing is better, as a child must be able to focus in order to be able to learn. It just means that medicating their energy level down does not address the root causes of the problem.
So, what would be some natural interventions? First, improved nutrition. Any food that is causing more inflammation needs to be removed from the diet. Often that is sweets (note that Clostridia like sweets) and sometimes specific items such as gluten containing foods. Adding probiotics that contain the Lacto and Bifido organisms (in this patient example) can of course be helpful, but more so if they are also fed the prebiotic fibers that they need to survive (again, ideally this is case-specific). Both can be added to a fruit and vegetable smoothie that is tasty. Neuroprotective supplements such as N-Acetylcysteine will help to minimize the neuronal damage that is occurring. Also DHA/Omega-3 oils are neuroprotective and have been shown to help with ADHD. Curcumin can also reduce the neuroinflammation and is protective as well. It can also help settle gut function and heal the membranes of the intestines if they were inflamed too. Eating less processed food and more fresh (organic as possible) fruits and vegetables helps.
All of these steps are best carried out after having a stool sample analyzed for gut bacteria. Only after seeing the “bacterial census” is it possible to be extremely specific. A different patient’s samples could result in different recommendations! Please contact me for more details should you wish to find out more or schedule an analysis. This does not have to be done locally, as I only need the data from uBiome and a patient questionnaire to determine recommendations. Some of the supplements recommended are not case-specific, such as NAC, DHA/Omega and Curcumin as these will help most types of situations as will a healthier diet. The probiotic formulation is ideally case-specific, as is the prebiotic fibers and these will preferentially feed some categories of organisms more than others.
With proper lab work and specific interventions, it is possible for many individuals with ADHD to control and manage their situation more effectively. For some, it will be more of a cure, with no medication needed. For others, it may mean less medication is needed or the medication works more effectively. It is important to realize that we are all different, and our situations are also different!
Sources for supplements: http://progressivelabs.com/ You’ll have to register to order from them, and it requires specifying who referred you. Please feel free to put my name on that line, and then you will be able to receive your supplements directly from the same manufacturer I use!
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6 thoughts on “ADHD and the Microbiome: Any useful connections?”
Hi Dr. Matthews!
I look forward to reading this post, but want to reference the figure as I do so. Unfortunately, being red-green colorblind makes it so I can not distinguish between the arrows that increase versus decrease. Would it be possible to change the color of one of the arrows so that dichromatic individuals can interpret it? I hope it’s not much work to do so, but it would be hugely helpful to a small but significant section of the male readership. 🙂
Hi Aaron, yes I will definitely create a modified version of that image! Thanks for asking.
Thanks! I just listed to parts 1 and 2 of your interview with Grace and Matt on the Gut Guardians podcast. Excellent stuff there, and I certainly learned a thing or two. I made a joke a few years ago that the metaclorians behind the force in the Star Wars world will probably turn out to be the microbiome. What you said resonates with that.
Look into serotogenic probiotics strains, such as E. Coli Nissle 1917 (Mutaflor) or probiotic strains of Clostridium and Streptococcus (AOR Probiotic 3). These up the production of serotonin in the gut, thereby lowering the amount of dopamine created (since serotonin and dopamine are both created from their precursor chemicals by the same enzyme, they keep each other in balance) and greatly affecting mood, attention, sleep and a lot of other neurological things. It is doing wonders for my daughter. There are a lot of studies on the NIH website on these bacteria and serotonin production, and a mixed bag of info on the internet about neurotransmitters and ADHD, sleep (serotonin is metabolized to melatonin which helps you sleep, so deficiency in one creates a deficiency in the other) and other symptoms.
So in first step we need to get a ubiome to see what is going on. does this mean we have different kind of ADHDs? or is it possible to classify them based on the diets people have?
Hi alefre, and thanks for reading my blog! well, there are different variations on ADHD of course. Of the several variables I listed (GABA levels, inflammation, dysbiosis for example) one person or another may have a bigger issue with one of these. The uBiome test is the least expensive/most effective test to see the bacteria involved. This helps in choice of probiotic and foods, because some people are low in Bifidobacteria, some are low in Lactobacillus, some low in other beneficials such as Faecalibacterium prausnitzii. Some people have big losses in colony diversity. There are probiotics specific to many of these, as you can buy strains of only Bifido or only Lacto, or you can buy some others such as Prescript-Assist which has 29 strains and would help diversity more. Similarly, if you’re missing some specific organisms, there are often specific prebiotics or foods that will preferentially feed those organisms over others. There are also other tests to assess levels of GABA, Glutathione and oxidative stress for example if one wants/is able to perform those. I can say from my experience that the green interventions help, but in some people some of these seem more crucial than others. This leads me to believe that yes, there are variations of ADHD as you suggested. It’s also likely somewhat of a “spectrum” although for some reason only Autism is described that way. Really, all brain dysfunctions could be seen on a spectrum from slight to debilitating. Thanks for the question!