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!
Şahin TD, Karson A, Balcı F, Yazır Y, Bayramgürler D, Utkan T.
Behav Brain Res. 2015 Jun 23;292:233-240. doi: 10.1016/j.bbr.2015.05.062. [Epub ahead of print]
Lei K, Li YL, Wang Y, Wen J, Wu HZ, Yu DY, Li WF.
J Zhejiang Univ Sci B. 2015 Jun;16(6):487-95. doi: 10.1631/jzus.B1400342.
Microb Ecol Health Dis. 2015 May 29;26:28177. doi: 10.3402/mehd.v26.28177. eCollection 2015.
Deepmala, Slattery J, Kumar N, Delhey L, Berk M, Dean O, Spielholz C, Frye R.
Neurosci Biobehav Rev. 2015 Aug;55:294-321. doi: 10.1016/j.neubiorev.2015.04.015. Epub 2015 May 6. Review.
Frye RE, Rose S, Slattery J, MacFabe DF.
Microb Ecol Health Dis. 2015 May 7;26:27458. doi: 10.3402/mehd.v26.27458. eCollection 2015.
Afzalpour ME, Chadorneshin HT, Foadoddini M, Eivari HA.
Physiol Behav. 2015 Aug 1;147:78-83. doi: 10.1016/j.physbeh.2015.04.012. Epub 2015 Apr 11.
Mishra V, Shah C, Mokashe N, Chavan R, Yadav H, Prajapati J.
J Agric Food Chem. 2015 Apr 15;63(14):3615-26. doi: 10.1021/jf506326t. Epub 2015 Apr 6.
Pärtty A, Kalliomäki M, Wacklin P, Salminen S, Isolauri E.
Pediatr Res. 2015 Jun;77(6):823-8. doi: 10.1038/pr.2015.51. Epub 2015 Mar 11.
Shim SH, Hwangbo Y, Yoon HJ, Kwon YJ, Lee HY, Hwang JA, Kim YK.
Nord J Psychiatry. 2015 Mar 9:1-6. [Epub ahead of print]
Shan Y, Man CX, Han X, Li L, Guo Y, Deng Y, Li T, Zhang LW, Jiang YJ.
J Dairy Sci. 2015 Apr;98(4):2138-49. doi: 10.3168/jds.2014-8698. Epub 2015 Jan 23.
The role of the brain-derived neurotrophic factor genotype and parenting in early life in predicting externalizing and internalizing symptoms in children with attention-deficit hyperactivity disorder.
Park S, Kim BN, Kim JW, Jung YK, Lee J, Shin MS, Yoo HJ, Cho SC.
Behav Brain Funct. 2014 Nov 25;10:43. doi: 10.1186/1744-9081-10-43.
Mayer EA, Knight R, Mazmanian SK, Cryan JF, Tillisch K.
J Neurosci. 2014 Nov 12;34(46):15490-6. doi: 10.1523/JNEUROSCI.3299-14.2014. Review.
Liu DY, Shen XM, Yuan FF, Guo OY, Zhong Y, Chen JG, Zhu LQ, Wu J.
Mol Neurobiol. 2014 Oct 30. [Epub ahead of print]
Fukuchi M, Kirikoshi Y, Mori A, Eda R, Ihara D, Takasaki I, Tabuchi A, Tsuda M.
J Neurochem. 2014 Jun 26. doi: 10.1111/jnc.12801. [Epub ahead of print]
Gut Microbes. 2014 May-Jun;5(3):404-10. doi: 10.4161/gmic.29232. Epub 2014 May 16. Review.
Med Hypotheses. 2014 May;82(5):522-8. doi: 10.1016/j.mehy.2014.02.003. Epub 2014 Feb 12.
Popa-Wagner A, Mitran S, Sivanesan S, Chang E, Buga AM.
Oxid Med Cell Longev. 2013;2013:963520. doi: 10.1155/2013/963520. Epub 2013 Dec 5. Review.
Wang Y, Kasper LH.
Brain Behav Immun. 2014 May;38:1-12. doi: 10.1016/j.bbi.2013.12.015. Epub 2013 Dec 25. Review.
Marosi K, Mattson MP.
Trends Endocrinol Metab. 2014 Feb;25(2):89-98. doi: 10.1016/j.tem.2013.10.006. Epub 2013 Dec 19. Review.
Joseph N, Zhang-James Y, Perl A, Faraone SV.
J Atten Disord. 2013 Nov 14. [Epub ahead of print]
Savignac HM, Corona G, Mills H, Chen L, Spencer JP, Tzortzis G, Burnet PW.
Neurochem Int. 2013 Dec;63(8):756-64. doi: 10.1016/j.neuint.2013.10.006. Epub 2013 Oct 16.
Kwon DH, Kim BS, Chang H, Kim YI, Jo SA, Leem YH.
Biochem Biophys Res Commun. 2013 May 3;434(2):245-51. doi: 10.1016/j.bbrc.2013.02.111. Epub 2013 Mar 25.
Garcia RJ, Francis L, Dawood M, Lai ZW, Faraone SV, Perl A.
Arthritis Rheum. 2013 May;65(5):1313-8. doi: 10.1002/art.37893.
Hariri M, Djazayery A, Djalali M, Saedisomeolia A, Rahimi A, Abdolahian E.
Malays J Nutr. 2012 Dec;18(3):329-35.
Marazziti D, Baroni S, Picchetti M, Landi P, Silvestri S, Vatteroni E, Catena Dell’Osso M.
Eur Rev Med Pharmacol Sci. 2012 Feb;16(2):270-5. Review.
Hsu YC, Chen HI, Kuo YM, Yu L, Huang TY, Chen SJ, Chuang JI, Wu FS, Jen CJ.
J Hypertens. 2011 Dec;29(12):2339-48. doi: 10.1097/HJH.0b013e32834c628f.
Ng F, Berk M, Dean O, Bush AI.
Int J Neuropsychopharmacol. 2008 Sep;11(6):851-76. doi: 10.1017/S1461145707008401. Epub 2008 Jan 21. Review.