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