Mar 30, 2022

Disclaimer 

Our Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By following this protocol, you understand and accept that the recommendations in the protocol are for initial guidance and need to seek medical professional advise.  

Get Help

Hyperactivity and Focus​

In 2007, the global prevalence of children with hyperactivity and difficulties focusing was estimated to be 5.29%. (21) More recent estimates suggest an increased prevalence of 7.9%. (26) Children with concerns of inattention or hyperactivity may present with lower levels of certain nutrients, such as zinc, vitamin D, and omega-3 fatty acids. (2)(3)(17)

Inflammation and oxidative stress have also been associated with an increased risk of cognitive or behavioral difficulties.  For these reasons, interventions aimed at correcting nutrient inadequacies, decreasing inflammatory markers such as CRP, IL-6, IL-12, and TNF-α, or improving antioxidative capacity may be helpful, particularly if corrections are associated with improved attention or behavior scores. (1)(15)(16)

The ingredients presented in the protocol below may help address concerns and mechanisms of decreased inattention and hyperactivity in children or adults.

EPA and DHA

500-1000 mg EPA and 200-650 mg DHA, once per day, for a minimum of 8-16 weeks (5)(6)(7)(15)

  • Improved parent ratings (using the Conners Parent Rating Scale (CPRS)) of children’s inattention, hyperactivity, and impulsivity in children with ADHD (25)
  • Improved behavior ratings, utilizing scales such as the Conners Rating Scale, in children diagnosed with ADHD (23)
  • Improved oxidative stress by increasing glutathione reductase and superoxide dismutase activity; improved plasma inflammatory markers by decreasing levels of CRP and IL-6 in children with ADHD when compared to baseline levels (15)
  • Increased erythrocyte cellular EPA and DHA and improved working memory in children with ADHD (29)
  • Systematic review and meta-analysis found n-3 PUFA effective in improving cognitive performance in adolescents with ADHD and/or n-3 PUFA deficiency (7)
  • Systematic review and meta-analysis of 10 studies found n-3 PUFA improved emotional lability such as oppositional behavior and conduct problems in children with ADHD (9)
EPA and DHA

Zinc

10-15 mg as elemental zinc (from zinc sulfate or zinc oxide), 1-2 times per day, for a minimum of 5-13 weeks (4)(11)(28)(30)

  • Increased attention was observed in children with ADHD when concomitantly administered with methylphenidate compared with methylphenidate alone (19)
  • Increased serum zinc concentrations correlated to improvements in symptoms of anxiety, depression, and social skills in children with low zinc levels and/or at risk for zinc deficiency (11)
  • Reduced required dose of amphetamine by 37% when given 30 mg zinc per day in children with ADHD (4) 
  • Overall prevalence of clinically significant attention deficit and hyperactivity decreased as well as CPRS scores for attention deficit, hyperactivity, oppositional behavior, and conduct disorder; additionally, behavioral improvements were amplified in children with mothers of low education (28)
Zinc

Vitamin D

2000 IU total per day, minimum 12 weeks (4)(11)

  • Prophylactic supplementation of 100 μg (4000 IU) per day for 24 weeks decreased the frequency of migraines and number of days with a headache in patients aged 18 to 65 when compared to placebo (10)
  • Calcitonin gene-related peptide (CGRP) decreased to 153.26 ng/L compared to 188.35 ng/L in placebo and correlated with an improvement in migraine disability assessment questionnaire (MIDAS) suggesting that vitamin D may have anti-nociceptive effects leading to migraine improvement (11)
  • Patients with episodic migraines experienced 9 fewer days with migraine compared to 3 fewer days in placebo groups; additionally 29% of patients in the treatment group experienced at least a 50% reduction in number of migraines compared to 3% in placebo (4)
Vitamin D

Pycnogenol

1 mg per kilogram of body weight, once per day, for a minimum of 4 weeks (12)(13)(8)(27)

  • Associated with normalized total antioxidant status (TAS), improved glutathione to oxidized glutathione ratio and total anti-oxidative capacity in children with ADHD (13)
  • Children with ADHD experienced improvements in attention, visual-motoric coordination, and concentration as well as decreased hyperactivity; notably, symptoms relapsed one month after ceasing supplementation (27)
  • Improved hyperactivity and glutathione to oxidized glutathione ratio in children with ADHD; additionally, catecholamine concentration normalized demonstrated by decreased adrenaline and noradrenaline (12)
  • Improved attention in children with ADHD; additionally oxidative damage decreased as shown by improved TAS and decreased DNA damage (8)
Pycnogenol

Lactobacillus rhamnosus GG

10 billion CFU per day of Lactobacillus rhamnosus GG, for a minimum of 1-6 months (16)(20)

  • Improved overall quality of life (PedsQL Child Self-Report Total Score) in children and adolescents with ADHD; reduced IL-12 p70, TNF-α, and IL-10 compared to baseline in children and adolescents with ADHD (16)
  • Supplementation during the first six months of life decreased the risk of neuropsychiatric disorders such as ADHD and Asperger syndrome over a 13 year follow-up study (20)
  • Systematic review of seven studies showed supplementation reduced risk of developing ADHD or Asperger syndrome when given to mothers one month prior to delivery and six months postpartum while breastfeeding (22)
Lactobacillus rhamnosus

Attachments

Support your prescription with these additional resources