ADHD and Brain Inflammation: Quench the Fire

September 12, 2016 | Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

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 ADHD and Brain Inflammation: Quench the Fire
A recent article in the Neuroscience Letters highlights a very troubling finding pertaining to methylphenidate, better known as Ritalin, Concerta, Daytrana, Methylin, or Aptensio. Long-term consequences of this drug are unknown but this animal study raises the serious questions about the safety of its use. Read on to learn more about what neurological hazards may result and, more importantly, nutritional options to cope with the brain inflammation linked with ADHD.

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ADHD Medications Cause Neurological Inflammation

Ritalin, or methylphenidate, is the drug of choice for attention deficit hyperactivity disorder (ADHD). It is the go-to medicine to treat ADHD, often given and used without second thought. The April 2016 study in Neuroscience Letters investigated the effects of methylphenidate treatment in rats for 21 days. Researchers were trying to evaluate what the long-term consequences of the medication were on the brain.

Different doses were used for the five groups of animals treated and evaluated. At the end of the study, several measurements were taken. The hippocampus, memory center of the brain, cortisol, and oxidative stress markers, antioxidants, and inflammatory levels were analyzed. What they found was that the brains of these animals were quite stressed by the methylphenidate drug. No matter what dose was given, there were increased levels of the stress hormone cortisol. Social and motor behaviors were affected and noticeably decreased.

All doses of the medications caused high levels of lipid peroxidation, a breakdown in the cell membranes, literally punching holes in the protective membrane that surrounds cells. Mitochondria, the energy producing organelles inside cells, were stressed because major antioxidants for the mitochondria and nerve cells were depleted and high levels of inflammatory markers like TNF-a and IL-1beta were found. In the 21 days that the rats were treated with Ritalin, nerve cells changed in quality and shape within vital brain structures. The authors concluded that “chronic treatment with high doses of methylphenidate (Ritalin) can cause oxidative stress, neuroinflammation and neurodegeneration in the hippocampus of the adult rats.”

While this is an animal study which consisted of three weeks of high dose ADHD drug treatment, it hopefully raises serious questions about use of this drug in humans, especially children who are often on it for several years. Research has shown us that small doses of chemicals like secondhand smoke or Roundup/glyphosate can cause serious concerns even from small repetitive doses years later. What risk occurs with long-term Ritalin use? Although research has yet to evaluate long-term use of this drug in humans, including children, stimulating an already stressed and less resilient brain with Ritalin seems to be like playing Russian roulette with the neurodegeneration card.

Scientists and the medical field have known about this for the last few years. They have a treatment plan in place for stopping the oxidative stress of high dose Ritalin with another extremely powerful medication, Topamax. This anti-seizure medication, Topamax, works by inhibiting or deadening the nerves so they cannot excessively fire. It’s mechanism of action is not specifically known, but it is thought to affect GABA pathways in the brain. Managing GABA levels naturally is more user-friendly. This is one area to focus on with natural ADHD management and medical treatment.

Environmental Factors Leading to ADHD

Last week’s article, Feed the Brain: Fundamentals for ADHD focused on nutrients often deficient in those with ADHD. This is the basic place to start with ADHD. Nutritional deficiencies are just one environmental factor that relate to a breakdown of focus, brain energy, memory, behavior. ADHD is actually a complex disorder influenced by several environmental challenges. High levels of inflammation or oxidative stress, challenged mitochondria function, insufficient glutathione, heavy metal toxicity, trauma, environmental toxins, methylation defects, and major digestive tract and gut flora challenges are known causes of ADHD. Genes do play a role, but what is happening with these environmental factors can essentially turn the gene risk on or off.

Two Key Factors

There are two especially hot topics of research in ADHD and environmental factors or non-genetic research. One major focus is on the relationship between the gut flora and the brain. Another major focus pertains to the level of inflammation within the brain and how it affects brain mitochondria and antioxidant status. These concerns can influence each other. This information is absolutely critical for anyone trying to get the brain healthy in the face of ADHD.

Gut Flora Protects Against Brain Inflammation

The gut flora not only regulates intestinal function and gut health, but the gut flora talks to the brain and vice versa. This pathway is called the microbiota-gut-brain (MGB) axis. Researchers believe that a critical breakdown in this MGB axis especially in prenatal, infancy, and early childhood contributes to several disorders like ADHD and brain inflammation. Researchers were just starting to understand that gut flora influences brain development five years ago, but now we are now seeing the extent of this dual relationship.

Research published this month describes how lack of healthy gut flora contributes to poor brain repair. Scientists are finding disruptions in the gut flora brain axis alters key receptor sites in the brain for the chemical messenger NMDA which provides excitatory activity. BDNF function is altered and the neurotransmitter GABA is interrupted. This essentially means that the NMDA (excitatory), BNDF (repair compound), and GABA (inhibitory) are not functioning normally.

This creates a snowball effect on other compounds, leading to higher levels of oxidative stress while simultaneously affecting modulatory systems (quinolinic acid-kynurenine pathway) within the brain that manage glutamate (excitatory neurotransmitter). The end result is increasing levels of oxidative stress in the nerve tissue and to the delicate mitochondria that produce energy. All of the oxidative stress induced must be quenched by antioxidants.

Antioxidant depletion and mitochondrial damage occurs, which is the other hot topic of focus in ADHD. Protecting mitochondria, restoring antioxidants, reducing inflammation, and focusing on the gut microbiome need to be at the heart of protecting brain and quenching the burning fire of ADHD in children and adults. Children at risk and individuals in family planning stages must be aware that probiotics in birth and development help protect the brain from increased risks of ADHD and other neurodevelopmental disorders. 

The take away point is that ADHD is multi-faceted. Infancy exposure to healthy flora sets the stage for many things, but without it, brain-gut communication becomes troubled. Support normal flora. Use enough antioxidants to quench the fire and protect the mitochondria, while ensuring quality sleep. Improvements in behavior and focus take time. Feed your brain and quench the fire to manage ADHD.

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