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Neurological Health – Hyperactivity and Focus

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Dr. Alex Keller, ND
Protocols Fullscript Protocols
Neurological Health – Hyperactivity and Focus

Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through C-quality evidence.

A
Systematic review or meta-analysis of human trials
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study

Neurological Support – Hyperactivity and Focus

In 2007, the global prevalence of children with hyperactivity and difficulties focusing was estimated to be 5.29%.26 More recent estimates suggest a prevalence of 7.9%.27 Children with issues of inattention or hyperactivity may present with lower levels of certain nutrients, such as zinc, vitamin D, and omega-3 fatty acids.28,29,30

Inflammation and oxidative stress has 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 sought out, particularly if corrections are associated with improved attention or behavior scores.3,23,31

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)

500-1000 mg EPA and 200-650 mg DHA, once per day, for a minimum of 8-16 weeks1,2,3,4

  • Improved parent ratings of children’s attention across studies, and may improve hyperactivity, impulsivity, and working memory in children with ADHD1,2,4,5,6
  • Improved behavior ratings, utilizing scales such as the Conners Rating Scale, in children diagnosed with ADHD7,8
  • 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 when compared to baseline levels3
  • Increased erythrocyte cellular EPA and DHA; increased phospholipid DHA profiles in cellular membranes2,6
EPA and DHA in the Fullscript catalog

Zinc

10-15 mg as elemental zinc (from zinc sulfate or zinc oxide), 1-2 times per day, for a minimum of 5-13 weeks9,10,11,12

  • Improved various scores in attention, hyperactivity, impulsivity, oppositional behavior, conduct, and impaired socialization, as measured by the Attention Deficit Hyperactivity Disorder Scale (ADHDS) and the Conners Global Index and Rating Scales9,12,13
  • Increased attention was observed in children with ADHD when concomitantly administered with methylphenidate compared with methylphenidate alone14
  • Increased serum zinc concentrations with a negative correlation to symptoms of anxiety, depression, and social skills in children with low zinc levels11
  • Reduced required dose of amphetamine by 37%10
Zinc in the Fullscript catalog

Vitamin D

2000 IU per day, for a minimum of 8-12 weeks, or 50,000 IU per week, for a minimum of 6 weeks as vitamin D3 (cholecalciferol)15,16,17

  • Improved symptoms of inattention when used as an adjunct to methylphenidate17,18
  • Reduced ADHD total scores, inattention scores, hyperactivity scores, and behavior scores, and raised serum vitamin D levels, which were typically lower in children with ADHD than controls18
  • Increased serum dopamine levels in children with ADHD when compared with both baseline and placebo16
  • Improved evening symptom scores according to the Weekly Parent Ratings of Evening and Morning Behavior (WPREMB) in children with ADHD when concomitantly administered with methylphenidate15
Vitamin D in the Fullscript catalog

Pycnogenol

1 mg per kilogram of body weight, once per day, for a minimum of 4 weeks19,20,21,22

  • Improved glutathione to oxidized glutathione ratio and total anti-oxidative capacity, reducing oxidative stress and associated DNA damage in children with ADHD20,21,22
  • Reduced hyperactivity levels according to the Child Attention Problems teacher rating scale, Conners Teacher Rating Scale, and Conners Parent Rating Scale scores in children19,21
Pycnogenol in the Fullscript catalog

Lactobacillus rhamnosus GG

10 billion CFU per day of Lactobacillus rhamnosus GG, for a minimum of 1-6 months23,24

  • Improved overall quality of life, evaluated with the PedsQL Child Self-Report Total Score, observed in children and adolescents with ADHD23
  • Reduced IL-12 p70, TNF-α, and IL-10 compared to baseline in children and adolescents with ADHD23
  • Supplementation during the final month of pregnancy and during the first six months of life decreased the risk of ADHD and Asperger syndrome diagnoses over 13 years24,25
Lactobacillus rhamnosus GG in the Fullscript catalog

Disclaimer

The Fullscript 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 adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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References

4
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/28741625/
7
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/26551407/
18
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/31368773/
25
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/31965841/
26
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/17541055/
27
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/25733754/
29
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/29207548/
30
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/25864066/
31
Systematic review or meta-analysis of human trials
a
https://pubmed.ncbi.nlm.nih.gov/30594823/

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