Written by Jessica Patella, ND. Twelve weeks of vitamin D supplementation significantly improved aspects of cognitive functioning related to an ADHD diagnosis.
Attention-deficit hyperactivity disorder (ADHD) is a chronic condition that makes it difficult for a person to pay attention, control impulsive behaviors and includes hyperactive behavior 1,2. An estimated 2-9% of children and adolescents are affected by ADHD, which can also effect and cause disruption to other family members, peers and teachers 1,3. Pharmaceutical therapy is the main treatment, primarily amphetamines and methylphenidates, but these drugs have limitations and many parents delay treatment due to drug side effects 1,4. An estimated 24.7% of children diagnosed with ADHD used at least one complementary and alternative medical therapy 1,5.
Recent research has been examining the effects of vitamin D in brain development during the early prenatal and childhood stages. The research indicates that lack of vitamin D during these prenatal and early stages of life effect brain structure and function 1,6. Yet other research has found maternal levels of vitamin D showed no relation to ADHD in offspring 1,7. Due to mixed results the researchers in the current study were interested in investigating further 1.
The purpose of the research conducted was to determine if there was a difference in vitamin D levels in children with ADHD versus those that didn’t have a diagnosis of ADHD 1. A total of 50 children with ADHD (28 male, 22 female) and 40 healthy controls without ADHD (21 male, 19 female) were included. ADHD was diagnosed by a psychiatrist using the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV). All children with ADHD received methylphenidate drug treatment. Dietary intake of vitamin D, physical activity and sun exposure were all assessed as possible confounders at baseline and the end of the study 1.
A blood level of vitamin D was collected for each child in the study. The vitamin D levels were categorized as follows: Severely low (<10 ng/ml); Low (10-29 ng/ml); Normal (30-100 ng/ml); Toxic (>100 ng/ml). Children with ADHD were then divided into 2 groups: ADHD and vitamin D deficiency (n=40); ADHD with normal vitamin D levels (n=10). Those in the ADHD and vitamin D deficiency group were then randomized to receive either a placebo (n=20) or vitamin D supplementation (3000 IU cholecalciferol; n=20) daily for 12-weeks 1. The results were as follows:
- Blood serum vitamin D levels were significantly lower (P<0.001) in children with ADHD compared to controls.
- 80% of the ADHD group had below normal levels of vitamin D in the blood, whereas only 30% of the healthy controls showed below normal levels.
- There were no significant differences between the ADHD and control groups in regards to diet, physical activity and sun exposure.
- After 12-weeks of vitamin D supplementation, there was a significant increase in blood serum vitamin D levels (mean increase =20.14 ng/mL; P<0.01) and 82.6% of this group ended with vitamin D levels above normal. There was no change in the placebo group.
- Children with ADHD that took vitamin D showed significant improvement in conceptual level, inattention, opposition, hyperactivity and impulsivity (P=0.024, P=0.037, P=0.025, P=0.001, P=0.001, respectively). There was no change in the placebo group.
This was the first study to examine the effects of vitamin D supplementation at a dose of 3,000 IU daily in children. A small percentage of the children taking vitamin D reported mild abdominal pain, loss of appetite or diarrhea 1.
One of the mechanisms that may decrease symptoms of ADHD from vitamin D supplementation, is that vitamin D is needed to produce dopamine and norepinephrine, both of which are essential neurotransmitters in the brain. These neurotransmitters help reduce the negative symptoms of ADHD. Vitamin D also increases production of acetylcholine, which helps maintain focus, concentration and supports growth of neurons for higher cognitive functions 1,8.
In conclusion, children with ADHD had great vitamin D deficiency, which shows the importance of measuring vitamin D blood levels. This study showed that supplementing vitamin D in children with ADHD improved cognitive functions. This is a small sample size study and larger studies are needed to confirm results 1.
Source: Elshorbagy, Hatem Hamed, Naglaa Fathy Barseem, Waleed Elsayed Abdelghani, Hany Abdelaziz Ibrahim Suliman, Ashraf Hamed Al-Shokary, Sameh Elsayed Abdulsamea, Akram Elshafey Elsadek, Yehia Hamed Abdel Maksoud, and Dalia Mohamed Abd El-Hassib Nour El Din. “Impact of Vitamin D Supplementation on Attention-Deficit Hyperactivity Disorder in Children.” Annals of Pharmacotherapy 52, no. 7 (2018): 623-631.
© The Author(s) 2018
Posted September 16, 2019.
References:
- Elshorbagy HH, Barseem NF, Abdelghani WE, et al. Impact of Vitamin D Supplementation on Attention-Deficit Hyperactivity Disorder in Children. Annals of Pharmacotherapy. 2018;52(7):623-631.
- Arns M, van der Heijden KB, Arnold LE, Kenemans JL. Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: the sunny perspective. Biological psychiatry. 2013;74(8):585-590.
- Wehmeier PM, Schacht A, Barkley RA. Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. Journal of Adolescent health. 2010;46(3):209-217.
- Leroux JR, Turgay A, Quinn D. Advances in ADHD treatment. Can J Diagn. 2009;26:49-52.
- Kemper KJ, Gardiner P, Birdee GS. Use of complementary and alternative medical therapies among youth with mental health concerns. Academic pediatrics. 2013;13(6):540-545.
- Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Frontiers in neuroendocrinology. 2013;34(1):47-64.
- Gale CR, Robinson SM, Harvey NC, et al. Maternal vitamin D status during pregnancy and child outcomes. European journal of clinical nutrition. 2008;62(1):68.
- Cui X, Pertile R, Liu P, Eyles D. Vitamin D regulates tyrosine hydroxylase expression: N-cadherin a possible mediator. Neuroscience. 2015;304:90-100.