Women and ADHD, Part 2: Can I Treat This Without Meds?

Health Tips / Women and ADHD, Part 2: Can I Treat This Without Meds?

“I lose my keys endlessly. I pay big bucks in unnecessary late fees on bills that I put down somewhere and just forget about. After I finished college, I never read another book–it was just too much work. I can cope with a magazine article, but hardly ever remember what I’ve read. I even have trouble following conversations. There’s just too much chatter in my head.”

All ADHD symptoms.

Last week we talked about how researchers are finally recognizing that the diagnosis of adult attention deficit hyperactivity disorder (ADHD) has been sorely overlooked in women, primarily because theirs is usually the inattentive type of ADHD, rather than easily observable hyperactive form most often diagnosed in boys and young men.

As a result, it’s been estimated that millions of women of all ages have been unable to achieve their maximum potential creatively as well as in the workplace and in relationships. Many have been incorrectly prescribed antidepressants and/or anti-anxiety meds, suffering a bouillabaisse of side effects and no positive gains. The right medication can change their lives.

“I don’t want to take drugs. I don’t want the chemicals in my body.”
I hear this a lot at WholeHealth Chicago, and it can be a challenge, especially because ADHD meds can work really well. I usually let patients know that just because capsules come from a natural apothecary or a GNC doesn’t necessarily mean there’s anything “natural” about them. They just happen to have been classified as nutritional supplements by the FDA.

If you don’t wish to take ADHD meds, you can try the suggestions below. They’re all quite safe, but understand they’re just a different kind of chemical, sold over-the-counter.

Also, if you’re one of the 90% of people who start their day with a cup of coffee, you’re already taking a long-recognized ADHD medication. Clinical studies using tablets of pure caffeine have shown some benefit, though nothing dramatic. To lessen the famous coffee jitters that accompany caffeine, some caffeine products sold in health food stores include a little theanine, a mild tranquilizer.

It’s all about neurotransmitters
At the heart of the matter, all ADHD patients have difficulty producing or correctly processing certain neurotransmitters, the brain chemicals that allow cells to communicate. Most of us are familiar with the stress-buffering neurotransmitter serotonin. When a person has depression and/or anxiety, doctors prescribe the immensely popular SSRI drugs (selective serotonin reuptake inhibitors, like Prozac, Zoloft, Lexapro) to raise serotonin levels.

An astonishing increase in SSRI prescribing made the news recently, with women outnumbering men 16.5% to 9.5%. I’d wager that a lot of those women actually have ADHD and are getting the wrong prescription, though I suspect many people of both genders are anxious and depressed about what’s been happening along the Potomac.

Norepinephrine and dopamine are the “ADHD neurotransmitters.” A person with inattentive ADHD usually benefits from a chemical to increase norepinephrine. Someone with hyperactive ADHD needs more dopamine. Adderall, Vyvanse, and Ritalin, the three most commonly prescribed ADHD meds, affect both. By the way, the main reason you yourself might have ADHD is genetic. Go ahead and ask your father or mother.

Here are some supplements to improve your ADHD neurotransmitters
DMAE (dimethylaminoethanol) was released in the 1950s as a medication specifically for ADHD to increase both dopamine and norepinephrine. Since so little was known about ADHD, it didn’t sell well. When the FDA wanted further clinical trials, Riker Labs, the company that owned the patent, didn’t think it was worthwhile and released it into the public domain. DMAE is now an orphan drug and no longer requires a prescription. Some people swear by it while others think the effect is a placebo. Although DMAE is available as a supplement, it probably works better when it’s combined with other ingredients to enhance neurotransmitter levels, such as in the product Neurotone (more below). Here’s a link to more information on DMAE.

The amino acids tyrosine and phenylalanine are called precursors, meaning your brain needs a sufficient amount of each in order to produce more dopamine and norepinephrine. The two are usually combined into a single supplement, one of the best being Brain Energy. You can take one tablet twice a day or two tablets in the morning.

Although a deficiency of the neurotransmitter acetylcholine is not part of ADHD, our brains need this neurotransmitter to balance the rest of them. In addition, there have been good clinical trials showing that merely boosting acetylcholine will improve memory and concentration. Citicoline, taken twice daily, can be used with other ADHD supplements.

For ADHD supplementation, you get best coverage and take the fewest number of pills by combining Brain Energy with a second product called Neurotone. This a combination of ingredients that have shown positive results for focus and concentration. Neurotone contains the DMAE and Citicoline mentioned above, plus Acetyl-L-Carnitine, Phosphatidyl serine, DHA (an omega-3 critical for brain health), gingko biloba, ginseng, and ashwagandha.

The price may seem high, but if you calculate purchasing the ingredients separately, Neurotone is actually a bargain.

To enhance your nutritional supplement vocabulary, know that supplements used for brain function enhancement are called nootropics, from the Greek “mind-bending.” They’re also called smart drugs or cognitive enhancers.

Taking several supplements for one specific condition in an attempt to cover all your bases is termed stacking supplements. The combined ingredients of Neurotone and Brain Energy create an ADHD “stack.”

Okay, enough with the pills!

Here are some steps for ADHD that require no pill swallowing
Try a food sensitivity elimination diet. Sometimes (though not often), there’s a food culprit. If you feel calmer after a couple of weeks on the elimination diet, reintroduce one food group every few days to locate the offender. Also, avoid artificial colors and preservatives and reduce sugar and other simple carbs, found in refined-flour products.

Concentration exercises  Concentration can be a major challenge for people with ADHD, but I’ve seen a few people reduce or even eliminate their meds using meditation and exercises. Here’s an excellent list from a website whose name made me laugh out loud. The 11 exercises described are all excellent.

Neurofeedback  This is a form of biofeedback in which you control your brain waves rather than more common biofeedback efforts in which you control heart rate, breathing, or muscle tension. As of 2017, there’s been some doubt about the effectiveness of neurofeedback for ADHD. I’ve certainly had patients tell me it was highly effective for themselves or for a child. Others are dubious. Most agree neurofeedback is time-consuming and expensive.

Early studies of neurofeedback were rapturous, but a little detective work showed some conflicts of interest among the investigators. US Secretary of Education Betsy DeVos thinks neurofeedback can cure ADHD without drugs (she also believes it’s not the education department’s purview to protect LGBTQ students, so there’s that too). What’s rarely mentioned is that she and her family are the chief investors in the largest neurofeedback company, Neurocore LLC. Neurofeedback for ADHD has not been approved by the FDA and is not covered by health insurance.

The most up-to-date study on neurofeedback appeared in this very month’s Lancet and the investigators had no conflicts of interest. They were unimpressed. Children receiving real vs. sham neurofeedback treatments had the same results.

Since neurofeedback generally requires about 30 sessions and will set you back several thousand dollars, I suggest doing a lot of research before signing any contracts.

Be well,
David Edelberg, MD

5 thoughts on “Women and ADHD, Part 2: Can I Treat This Without Meds?

    Hi Dr Boyd
    Your Comment is really interesting! However, although you say “obvious and easy to diagnose” you didn’t mention just how to go about this.

    Dr E
    Posted August 23, 2017 at 8:39 pm

    Thank you for this post. While never officially been diagnosed, I spent my entire child and young adult life wondering what was wrong with me and why getting through life took so much energy and effort. In my mid twenties, at my wits end, I found a book on ADHD and cried with relief because I could start fixing myself and changing habits I didn’t even realize I had. Fast forward, I am significantly better but still struggle when I let go of the methods I use to manage it. I found another book called the Drummer and the Great Mountain which is a phenomenal summary and suggestions to magage our way of thinking which is not a disease but can be used to bolster and enhance our lives. The writer also makes a nice podcast which has many great insights and has given me so many tools including eating, meditation, supplements and methods of organizing thoughts and life. I wanted to share it because I think it taps into a Whole Health method of management.

    Posted August 23, 2017 at 7:01 pm

    Excellent, Dr. Edelberg. Thank you! I’ll be sharing on Facebook.

    Gina Pera
    Posted August 22, 2017 at 10:57 am

    My son receives neurofeedback treatment and our insurance did not cover the brain mapping but does cover the treatments. We noticed noticeable improvements in mood.

    Posted August 22, 2017 at 8:48 am

    Very interesting report Dr. Edelberg on a phenomenon that is usually mostly associated with children. And glad to see that you pointed out that: A. Attention Deficit Disorder in women, (also children and men) is mostly a neurobehavioral issue predicated on neurotransmitter dysregulation; and B. it is highly responsive to stimulants like caffeine and Ritalin. But I was disappointed that you gave no mention to what perhaps is the most obvious and easy to diagnose and treat co-morbidity of (human) ADD/ADHD, and that is Sleep Disordered Breathing/Obstructive Sleep Apnea (SDB/OSA). This connection is well supported in the literature, for children anyway where an ongoing trial is underway at Lurie Children’s Hospital here in Chicago. There is also published evidence to support that SDB/OSA in women can cause maternal and fetal morbidity during pregnancy; I am not sure if neurobehavioral parameters were investigated in these mostly retrospective reports, but pre-term delivery and intra-uterine growth restriction (IUGR) are common problems in pregnant women who don’t breathe well during sleeping hours. Please do a search on the terms ‘gestational apnea’ against the term ‘IUGR’. I’m thinking this might open up a new area of research and would be interested in possible collaboration with you.

    Kevin L.Boyd,DDS
    Posted August 22, 2017 at 6:27 am

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