:rolleyes:Hello there,

I'm trying to compile a MASTER LIST of supplements, vitamins, oils, or ANYTHING ELSE (Example: ancient Kangaroo toe-nail shavings from the pinky toe) that help in conjunction with Adderall (or even without Adderall), their usefulness in relation to ADD (if possible, the specific sub-type its best suited for), but MOST importantly, DOSING INFO! Its very hard to find this online (or maybe I'm not looking in the right place.) :P

Thanks for anyone that can help!

******************************************
Supplement:

Sub-type:

Dose:

Any additional Comments:

Just be careful that you screen through the recommendations for ADHD-specific supplements, a lot of website just dump a bunch of "brain-boosting" or memory boosting compounds, that aren't specific to any particular disorder. For example, I guarantee that Ginkgo biloba will show up on a countless number of lists, even though it's effectiveness for ADHD is limited (however, some people swear by it, so maybe it's not all bad). Seriously, though, just make sure you don't receive a laundry list of B vitamins and general "mind-booster" herbs.

A good way to check the validity of some of these supplements or cures is to go to this site: http://www.ncbi.nlm.nih.gov/sites/entrez From there, enter the search box with the supplement of question alongside either "ADD" or "ADHD". This will lead you to quick summaries of key studies and findings for that particular supplement or vitamin and its effectiveness for treating ADD or ADHD. For example, searching "ADHD zinc" will give you about 15 studies (not all are completely relevant, but a good number are). Additionally, look at the right panel, and you can find some related articles of potential interest.

For starters on doses, here is a great site (http://ods.od.nih.gov/Health_Information/Information_About_Individual_Dietary_Supplements.a spx) to get recommended amounts for most vitamins or minerals (as well as upper limits and toxic/dangerous levels of these):
http://ods.od.nih.gov/Health_Information/Information_About_Individual_Dietary_Supplements.a spx

Hrm? Toenails?

The current state of the research behind the disorder of ADHD supports the following:

1) There are NO nutritional supplements found to be effective for the treatment of ADHD

2) None of the nutritional studies ( going back to the 1970's) have been shown to have longitudinal validity & reliability :

Can unaffiliated researchers replicate those studies exactly, and then get the exact same results, over time, and have them published in peer reviewed journals?

3) That's the "gold standard" for ALL scientific research.

4) The main reason for the above is that supplements & nutrients cannot cross the blood brain barrier to get to the Mesocortical Pathway,which is the "route" Dopamine travels throughout the brain.

That's an accurate reflection of the current state of the research and not a personal indictment.

tc

mctavish23

(Robert)

:rolleyes:Hello there,

I'm trying to compile a MASTER LIST of supplements, vitamins, oils, or ANYTHING ELSE (Example: ancient Kangaroo toe-nail shavings from the pinky toe) that help in conjunction with Adderall (or even without Adderall), their usefulness in relation to ADD (if possible, the specific sub-type its best suited for), but MOST importantly, DOSING INFO! Its very hard to find this online (or maybe I'm not looking in the right place.) :P

Thanks for anyone that can help!

******************************************
Supplement:

Sub-type:

Dose:

Any additional Comments:

I'm not sure about the more obscure supplements, but I trust mctavish. he's well informed.

for real you can get ancient toe clippings?


While supplements might not be useful for treating ADD directly, I think a multivitamin could be beneficial in general. Just eating a balanced diet, getting enough sleep and getting enough exercise can help anyone. These things don't really 'treat' the ADD as such, it's more like - if your body is 'running' properly and your getting all the things you need, it will probably make the problems caused by ADD easier to deal with.

Be careful with supplements if you are taking any other meds. Some supplements can cause serotonin syndrome when taken with SSRIs. (L-Tryptophan, St John's Wort) and others provide other effects that may interfere with medication, KavaKava and a few herbs that provide stimulant action.

I agree with Mctavish. I've yet to find quality research (75+ subjects, double blind, placebo controlled with less than 25% dropout rate published in a peer-reviewed journal) that substantiates claims for any supplements in regards mental health, or even in general well-being.

The CSPI newsletter keeps publishing stories about research that invalidates claim after claim of supplements. In a recent issue, they recommend that multivitamins be taken every OTHER day due to too much folic acid and vitamin A.

They recommend daily aerobic exercise, a diet rich in fruit, nuts, vegetable, whole grains, low in white flour and sugar, an only lean meats an non fat dairy. Fish twice a week. We need a small amount of healthy oil. They suggest some people do better on high protein diets and others do well on more balanced diets. CSPI says there is very weak support, if any, that proves that vitamins in pill form are effective.

There are clearly supplements, Calcium, Vitamin D, Folic Acid, Potassium etc that are critical to some people with certain health problems that may be recommended by medical professionals.

The current state of the research behind the disorder of ADHD supports the following:

1) There are NO nutritional supplements found to be effective for the treatment of ADHD

2) None of the nutritional studies ( going back to the 1970's) have been shown to have longitudinal validity & reliability :

Can unaffiliated researchers replicate those studies exactly, and then get the exact same results, over time, and have them published in peer reviewed journals?

3) That's the "gold standard" for ALL scientific research.

4) The main reason for the above is that supplements & nutrients cannot cross the blood brain barrier to get to the Mesocortical Pathway,which is the "route" Dopamine travels throughout the brain.

That's an accurate reflection of the current state of the research and not a personal indictment.

tc

mctavish23

(Robert)

A search on pubmed will show you are COMPLETELY wrong here and have absolutely no idea what you are talking about. There's a wide variety of supplements proven to be effective for ADD. ANY stimulant is also going to be effective to some degree for ADD, and there's a wide range of supplements with stimulating qualities. I've also had some luck with a few that don't have a lot of research - research doesn't equate to effectiveness, but there's plenty of research out there for a wide variety of supplements that proves you wrong.

I don't feel like repeating myself for the millionth time here so I won't list out every supplement I'v researched or tried, but fish oil, ALCAR, piracetam, nicotine and several others have a pronounced effect for me. Many others have had luck with other supplements.

I would invite you ( and anyone else) to read any of the following :

Barkley,R.A.(2006), Attention Deficit - Hyperactivity Disorder : A Handbook for Diagnosis and Treatment.New York. Guilford Press

Chapter One : The Nature of ADHD

The Environment as Etiology (p.14)

CHADD "Fact Sheet # 6 : Assessing Complementary and /or Controversial Interventions."

(http://www.chadd.org/fs/fs6.htm)


Mash,E.J., & Barkley,R.A.,(Eds.) (2003) Child Psychopathology ( 2nd Ed.) New York: Guilford Press

II Behavior Disorders

2. ADHD Barkley (Ed.)

Mash,E.J., & Barkley,R.A.,(Eds.) (2003) Treatment of Childhood Disorders ( 2nd Ed.) New York,Guilford Press

Both of the above books are huge volumes and are at the office.The others I've taken home, as I'm about to present on ADHD to our Pre- Doctoral Interns. So, I'll try and get the exact page #'s,etc. later today, when I go in to dictate.

Rief, Sandra F. (2003) The ADHD Book of Lists,San Francisco,Jossey-Bass.

Section 1: Understanding, Diagnosing and Treating ADHD

1-26 ALTERNATIVE AND UNPROVEN TREATMENTS FOR ADHD (pp.92-93).

There are many more,however, they all say the same thing;which is what I've already paraphrased.

Individual studies in and of themselves, show promise.

However, that doesn't equate with longitudinal validity & reliability

For example, the research on Omega 3's,which I take daily, seems to show the most promise.

However, the above statement remains accurate.

The key is "longitudinal validity & reliability," as the "gold standard" for all scientific research.

If any of those studies had already obtained that level, then it would be world wide news, and world wide rejoicing.

I don't have a problem with supplements,etc.

As someone who has severe ADHD Combined type and actually made it out of grad school, I've devoted the last 23 + yrs to reading the research,on an almost daily basis.

That's what I'm doing over the holiday weekend.

Most of my colleagues don't read anything.

Therefore, I'm concerned with trying to provide them, and everyone else I come in contact with, the most up to date and scientifically accurate data.

There have been countless studies done on diet,nutrition,etc., and ADHD.

The above comments are true. If they should change, then I for one, would be thrilled to see it.

I'll leave you with a sincere thanks for bringing those studies up, as well as something I've said to my colleagues, as well as in the Forum:

"Research isn't personal.It's either valid & reliable for the long haul or it isn't.If it changes, then I'll change with it."- mctavish23

One of the things I'm thankful for today, is The FORUM.

Thanks again and have a safe & happy holiday weeekend.

tc

mctavish23

(Robert)

I think what Mctavish is saying that science provides a framework that requires people making claims to provide evidence of their result and describe a way that others can repeat the results.

Scientists expect to be challenged and disproved and to accept their pet theories may be disproved. They will then change their behavior and move on. Even evil big-pharm cos drops claims for products found to be dangerous or ineffective.

You betcha Johnson and Johnson would be cranking out barrels of repackaged eye of newt or rose petal oil if they could prove they would cure ADHD or Depression.

I wold be the first to accept a CAM treatment that stands up to repeatable challenges, based on observations and looks into a non-falsifiable question.


The key is "longitudinal validity & reliability," as the "gold standard" for all scientific research.

If any of those studies had already obtained that level, then it would be world wide news, and world wide rejoicing.
.....

The above comments are true. If they should change, then I for one, would be thrilled to see it.

"Research isn't personal. It's either valid & reliable for the long haul or it isn't.If it changes, then I'll change with it."- mctavish23


Science constantly changes. They do not always make the right findings. Some of the weaker studies on pub med were small, open labeled, had a high dropout rate, were based on self reporting or lacked adequate blinds. These studies may be enough to suggest further research is needed, but not proof in themselves.

(S. G. Friedman, Ph.D.)
It’s not that science can be relied on to always provide the
Truth. We’ve all been jerked and pulled by the capricious
findings of science too many times to be so naïve. I mean,
until they make up their minds about chocolate, coffee and
red wine, count me in. Scientists themselves concede that a
fact is only a fact until it’s replaced by a better one.

However, what science does offer, far better than common
sense, conventional wisdom and other ways of knowing, is a
process of self-correction over time that is achieved by two
fundamental activities – public, peer-review and verification
of findings across independent groups of researchers. Thus,
although what is known today may indeed change tomorrow,
it is the very best, most reliable information available at this
moment.
There have been numerous challenges to homeopaths to subject their claims to scrutiny using accepted scientific methods. £10,000 (http://www.quackometer.net/blog/2008/06/10000-if-you-can-show-homeopathy-works.html) is one (http://www.quackometer.net/blog/2008/06/10000-if-you-can-show-homeopathy-works.html).

Some claims are just so ridiculous they don't even warrant research; especially those products who offer no plausible mechanism that can explain how they act on the body beyond placebo effect.

This kind of science is called 'tooth fairy' science and is likely the reason that Johnson and Johnson isn't out there testing eye of newt or the memory of water as cures for cancer, acupunture for birth control, or eel lips for pain relief.

Sciencebasedmedicine.org
As Harriet Hall put it in her excellent analysis of a study (http://www.sciencebasedmedicine.org/?p=44) purporting to show that acupuncture is useful for GERD:This study falls into the category of what I call Tooth Fairy science. You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.
Some CAM cures are based on preposterous mechanisms relying on BELIEF rather than PROOF to show efficacy that no commercial entity would waste money to really run valid tests. (Well, except the US govermnent, who funds http://nccam.nih.gov/ . This site is funding relatively good research. It was intended to PROVE effectiveness where possible; instead it is slowly debunking claims. )

I had a chance to (briefly) look at the 2 "huge" volumes I referenced earlier.

In Child Psychopathology, the subject of food additives is addressed on pages 62-63, under "Environmental Toxins."

The second book, Treatment of Childhood Disorders, is based strictly on empirically supported treatments ,so no mention of any alternative treatments were made.

tc

mctavish23

(Robert)

A search on pubmed will show you are COMPLETELY wrong here and have absolutely no idea what you are talking about.

I think you will find yourself very much in error there. mctavish23 has shown to have a strong, in depth knowledge of ADHD and its treatments. I have not see you demonstrate the level of expertise to make the above statement about him. To disagree is on thing, that kind of judgment might need a tad more support to be taken seriously.

There's a wide variety of supplements proven to be effective for ADD. ANY stimulant is also going to be effective to some degree for ADD, and there's a wide range of supplements with stimulating qualities. I've also had some luck with a few that don't have a lot of research - research doesn't equate to effectiveness, but there's plenty of research out there for a wide variety of supplements that proves you wrong. I don't feel like repeating myself for the millionth time here so I won't list out every supplement I'v researched or tried, but fish oil, ALCAR, piracetam, nicotine and several others have a pronounced effect for me. Many others have had luck with other supplements.If the supplements work for you, that is good. To say that those who would like a bit more substance as to effectiveness do not know what they are talking about is something I would not like to defend.

As I keep stressing, anything might possibly be perceived as helpful for an individual and that is wonderful for that person. Also a validated treatment might not work for an individual and that is not a good thing for that person. Science deals with individual stories such as this in a very limited way (case studies). Medical science primarily deals with what can be shown to be effective or not effective for the many and the goal is to do the research with controls to, as much as possible, make sure it is the effectiveness of the treatment that is being measured and not something else.

So far, except for fish oil, the results of studies for ADHD supplements have resulted in not one supplement showing scientifically, positive results for the disorder. I wish it were otherwise but unfortunately it is not.

Over the years, I have seen these type of supplements come and go. So far almost all of supplements and miracle treatments have gone. Virtually none have held up to date. Some such as dietary interventions have worked for a few. Currently Omega-3 looks interesting and neurofeedback is still under study. Hopefully these will pan out.

In the meantime, work goes on trying to find ways of helping those who are ADHD. If it is successfully done, it will be scientists with all their restrictions that will do it.

If you fully believe something has been helpful, please keep talking about. You may be the catalyst that helps find a new effective intervention. I encourage this. To take science to task for for not uncritically accepting this, however, is neither logical nor helpful.

There, my two cents worth.

Dizfriz

Over the years, I have seen these type of supplements come and go. So far almost all of supplements and miracle treatments have gone. Virtually none have held up to date.


Me too!!! If I get time, I may compile a somewhat complete list of supplements that have come and gone or I have tried and quit.

The virtually unregulated supplement industry is adept at sailing along, updating their product line every time the wind blows. Watching trends and tailoring product names, packaging, and ingredients to give them (the industry) the biggest bang for the buck. In the US, the DSHEA is largely responsible for allowing irresponsible claims and lack of regulation.

One thing we really need to scrutinize regarding most studies is the trap of assuming that correlation implies causation. If I give 10 people a magic pill for ADHD and 4 of them get better eventually, does that necessarily mean that it was the pill that cured their ADHD? The only correct answer is "possibly". Many of the so-called "studies" have extremely small sample sizes or fail to control key variables (even those sometimes published in prominent journals). Many of the supplements/vitamins/nutritional approaches out there are based on case studies, which do not possess the same clout as double-blind, controlled clinical trials. So we should look with interest on the results of these studies and include the "possibility" factor.

Some studies, which are referred to as "meta-analyses" take these other studies one step further by pooling the data. Although some use somewhat biased and questionable statistical methods, most of them are a step in the right direction.

To piggyback on what mctavish23 has been saying, fish oil/omega 3's do seem to be the most statistically significant supplemental method out there today. However, some other treatment methods, such as amino acid treatment have also shown to be considerably effective treatments for certain subsections of the ADHD population. Amino acids, especially the larger, bulkier "fatty" ones do have the ability to cross the blood-brain barrier, as do fatty acids in fish oils. However, getting them to go to the correct region brain, as mctavish23 mentioned, remains a chore. However, none of these supplement treatments have shown to have the same broad, far-reaching, widely-encompassing effects of medications, especially over the long haul.

I think the real future of many types of supplements is to provide auxiliary functions to medication treatments. For example, the drug clozapine, which is often used to treat schizophrenia, has shown to be moderately effective for treating certain forms of ADHD. A few studies, such as the one here (http://www.ncbi.nlm.nih.gov/pubmed/15036600?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum), indicate that tyrosine (which can be taken as an amino acid supplement form) can boost the effects of this drug. Keep in mind, however, that the tyrosine in this study was done on rats and was injected as opposed to oral consumption. Nevertheless, similarities in amino acid metabolism across mammalian species and the relative ability of this amino acid to cross the blood-brain barrier, makes the crossover into oral doses for humans a strong possibility.

Additionally, there is another study (http://www.ncbi.nlm.nih.gov/pubmed/15070418?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) which indicates (at least statistically) the benefits of taking zinc along with methylphenidate. We need to be a bit more careful on this one, because, if you read the full article, specific controls were not in place (i.e. controlled trials of zinc in the absence of methylphenidate were not performed), Nevertheless, the statistical significance of the results, at least leaves the door open for its use as a viable treatment option as a supplement and an aid to a conventional ADHD medication.

While I know that most of Barkley's works are critical of the (lack of) evidence, I do believe that the reason many of the nutritional therapies failed to hold in the long run was do to the lack of sub-categorizing in some of the earlier studies. A number of review articles and meta-analyses lament on this fact. Individuals with ADHD and comorbid symptoms of depression, should not, for example, be lumped in with individuals who simply exhibit the classic Hyperactive/Impulsive subtype. The differences in metabolism and brain chemistry of boys and girls, as well as the different rates of development of brain regions in ADHD (which are also a function of gender), are all factors that need to be weighed in.

So my conclusion on this matter is that once we start to see highly-specific and controlled studies based on rigorous exclusion for age, gender, comorbid disorders and narrow subtypes, I do believe that we will begin to see nutritional and supplemental methods that will hold water and stand the test of time.

Feel free to disagree/correct me, I never take offense to either.

The current state of the research behind the disorder of ADHD supports the following:

1) There are NO nutritional supplements found to be effective for the treatment of ADHD

2) None of the nutritional studies ( going back to the 1970's) have been shown to have longitudinal validity & reliability :

Can unaffiliated researchers replicate those studies exactly, and then get the exact same results, over time, and have them published in peer reviewed journals?

3) That's the "gold standard" for ALL scientific research.

4) The main reason for the above is that supplements & nutrients cannot cross the blood brain barrier to get to the Mesocortical Pathway,which is the "route" Dopamine travels throughout the brain.

That's an accurate reflection of the current state of the research and not a personal indictment.

tc

mctavish23

(Robert)


sorry I doubt this true...what study are you refering to?....also there are supplements that do cross the blood brain barrier such as A-cytl-l caretine....L-tyrosine....also Ginko while its self may not do a great deal....taken with other meds and supplements its a god send.

It's not one study.

It's 30+ years of nutritional studies being UNABLE to establish longitudinal validity & reliability.

That's the ticket.

" Reliability" is the consistency of measurement or the degree to which an instrument measures the same way each time it's used,under the same conditions,with the same subjects."

It's the "repeatability" of your measurement or

Can other, non-affiliated researchers, come in and replicate your study exactly and get the EXACT SAME RESULTS ???

(and them have them published in a peer reviewed journal (for additional scrutiny).

"Validity " is the strenght of your conclusions,inferences, or proposals.

It's been posed as "Were we right?"

Put another way: Does it measure what is says it does (Validity)?

Can other researchers replicate the study and get the same results (Reliability)?

The other "key" elements are :

1)Longitudinal ( year after year, time after time).

2) The fact remains that nutrients & supplements (still) cannot cross the blood brain barrier to get to the Mesocortical Pathway ( Dopamine's "route" throughout the brain).

Without that as the "gold standard," no scientific research is "proven" to be effective.

Just looking at those should hopefully help you understand how difficult a process that is ( for ALL research).

A perfect example of that process would be the DSM-IV TR diagnoses.

TR stands for "Text Revision".

What that refers to is the ongoing process of continued scrutiny needed to substantiate those diagnoses ( over time).

ALL of the DSM IV diagnoses are subjected to that level of longitudinal scrutiny.

That's the ONLY way they remain in the Manual.

The above statement IS accurate.

In the last 23+ years, I've read somewhere between 300-500 journal articles, 12-15 books, and been to 20-25 workshops on ADHD; at least 3 of which were nutritionally based (either in part or whole ).

I'm NOT oppsed to the idea of nutritional "treatments."

However, NONE of those data have reached that level of support.

In closing, please remember that "Anecdotal isn't statistically significant."
-Russell Barkley,PhD.


Thanks for the feedback.


tc

mctavish23

(Robert)

What interesting responses. I guess I posted this because I am a firm believer that what you believe becomes your reality, to an extent. To this end, I've found that B complex vitamins, also amino acids and caffeine have all greatly improved my concentration and well-being, in conjunction with Adderall. Am I looking for medical volumes worth of studies proving and/or disproving these things? Maybe not. As stated, science is constantly changing, and what might work for one person, may not work for someone else.

Perhaps there are supplements and vitamins that may help 1 in 10 people with ADD, combined type. Perhaps it could be 1 in 20. Or 1 in 50. Isn't the chance that I could be that ONE worth it enough to try? Or maybe I should say, it couldn't hurt and I am WILLING to try. I was simply looking for a starting point at which I could make myself the guinea pig. Such as, the fact that I keep hearing that fish oils/omegas may be helpful, what I want to know is in what quantity per day?? I'm also interested in personal examples of success, perceived placebo or otherwise, I am interested in hearing it. The mind/body connection is a strong mystique and you never know the power your mind holds over your body. ANECDOTAL WILL WORK FOR ME.

PS... the line about the ancient toe nails was a feeble attempt at a joke, just poking a little fun at the lengths some people will go with supplements.

Katy

That's perfectly fine.

I sincerely hope you get some benefit.

Because I have ADHD and work with kids who also have it, I feel obligated to keep up with the literature;which I do.

About 6-7 yrs ago, I had the privilege of being invited to hear a neurodevelopmental pediatrician from the Philadelphia area.

She was extremely impressive for a number of reasons beyond just her resume'.

When she was on break in med school, she went out of her way to go down to Chapel Hill,NC.

That was probably 30 yrs ago.

She went there to train with Mel Levine,MD

He's a pediatrician who teaches at the UNC Chapel Hill Med School.

He was one of the pioneers in promoting teaching to childrens strenghts.

He has a great web site devoted to learning.

It's called "All Kinds of Minds".

Check it out if you get a chance.

They have a cool online newsletter that's free.

It's not about ADHD, but I think you'll like it.

She also trained with Joe Biederman,MD at Harvard.

He's probably the most prolific psychiatrist/ research in the world.

What she said was that someone had recently asked her "If ADHD involves Dopamine so

much, why can't you just take L-DOPA?"

Her repsonse was "Location, Location, Location."

Supplements and nutrients CANNOT cross the blood brain barrier to get to the

Mesocortical Pathway; which is Dopamine's route through the brain.

Simply put,without that,they can NEVER work to impact ADHD.

In closing, my belief is that it's imperative to know what works and why, as well as what doesn't.

Once again, research isn't personal.

Those statements were and are accurate.

If they were to change tomorrow, I wouldn't hesitate to spread the news.

By the same token, I also will continue to try and post the most up to date research I

can find.

I wish you good luck & good health.

tc

mctavish23

(Robert)

The key is "longitudinal validity & reliability," as the "gold standard" for all scientific research.

If any of those studies had already obtained that level, then it would be world wide news, and world wide rejoicing.


illicit inference. Not necessarily. Perhaps the government censors natural cures? Have you ever seen an ad on tv for herbs?