The Case: 

• Amanda has trouble concentrating, staying on task, and remembering everything. 
• Her son, Logan, is also struggling with concentration. He can’t sit still in school or focus on his homework. 
• She’s hesitant to go to a doctor because she doesn’t want to solve this issue with medication.

Many people think that ADD (Attention Deficit Disorder) is something that only affects kids but actually it’s estimated that between 3-6% of American adults suffer from ADD and it's possible that number is way higher as it's not always diagnosed.

The Investigation

I suspected right away that the issue for Amanda and her son was related to ADD. I was happy to explore how we can support her and her son without turning to medication. 

Joining me to talk about Amanda’s case in this episode is Dr. Darin Ingels. He focuses on environmental medicine with special emphasis on Lyme but also MS, autism, Pediatric Acute-onset Neuropsychiatric Syndrome (PANS and PANDAS) and chronic immune dysfunction, including allergies, asthma, recurrent or persistent infections and other genetic or acquired immune problems. If you are a fan of the show, you may recognize his name since he helped us out with a Lyme Disease case (episode 18).

Defining ADD (and How it’s Different from ADHD)

Attention Deficit Disorder (ADD) is different from ADHD in that ADHD has a hyperactivity component. What they have in common is that someone with either disorder will find it difficult to focus on a task or have attention to details, they may experience general forgetfulness, struggle to stay organized, and as a result things that others find easy to do feel complicated to someone with ADD. 

While many people associated ADD and ADHD with children, adults can also experience it (although ADHD is less common in adults). 

Has ADD Become More Prevalent in Recent Times?

This is an ongoing argument and some say that only the diagnosis has become more prevalent. Dr. Ingels doesn’t agree. He feels that there are more kids on the ADD spectrum than a generation ago. And, he points out that ADD is more common in America than in other parts of the world, like Europe. 

What Causes ADD?

There is still research to be done before this question can be fully answered but Dr. Ingels feels that there are many contributing factors in our modern world. This includes items in our diet like corn syrup, food dyes, preservatives, and processed foods. It also includes environmental toxins like pollutants, volatile organic compounds, petrochemicals, household chemicals, pesticides and herbicides. 

While these may not be directly linked, they can affect the gut and there is a very strong and proven connection between gut health and brain health. 

He also feels there may be a generational effect where kids are not just dealing with the things they are directly exposed to but the things that their parents and even grandparents were exposed to. This epigenetic impact may simply be a reduced ability to metabolize toxins that has been passed down through the generations. 

Diagnosing ADD

There are no definitive tests for ADD. Diagnosing ADD or ADHD is a clinical diagnosis based on an umbrella of symptoms that place the patient on a spectrum of the disorders. A patient does not need to have every symptom but they are likely to have the ‘hallmark’ symptoms of being easily distracted, difficulty following through on tasks, and forgetfulness. Many doctors, psychiatrists and psychologists will make the diagnosis on these symptoms alone. However, other symptoms may also be present.

Once a child or an adult has been diagnosed, it’s time to search out the root cause of the issue. There may be dietary changes that can help either by eliminating foods that may be triggering or by improving gut health and supporting detoxification pathways. 

Finding the Root Cause or Trigger for ADD (Important Tests for ADD)

Reducing ADD and ADHD symptoms may be possible without medication if the root case of the symptoms can be found and countered. There are a few tests that Dr. Ingels uses to get a better picture of what might be exacerbating the symptoms:

• Testing for Nutritional Deficiencies. One of the key things Dr. Ingels will test for deficiencies in Vitamin B6 and Magnesium. Deficiencies can show up in cognitive function, mood control and behaviour. These deficiencies can be detected with a blood test. 
• Gastrointestinal Health. The gut brain connection plays a big role in understanding ADD. Dr. Ingels will sometimes do a stool test to look at what’s going on with the gut bacterial balance. He’s looking for a potential yeast overgrowth, parasites, microbiome imbalances or inflammatory markers.
• Metabolic Function. An organic acid test is a urine test that looks at many areas of metabolism, from how we process fats and carbohydrates to the detoxification capacity, neurotransmitter metabolism and antioxidant status. This can help identify the root cause.
• Food Reactions. Food reactions aren’t always allergic reactions or anaphylactic reactions as we sometimes think of them. They can be sensitivities or intolerances that present days after the food is consumed. Elimination diets or food sensitivity testing can help to diagnose food as a root cause or trigger for ADD symptoms. Keep in mind that food sensitivities may not present as allergies but rather cause Mast Cell Activation (as explained in  episode 67).
• Genetic Testing. An inability to metabolize or detoxify may be a genetic condition. Some people will do SNP testing to determine if this is at play. A common gene looked for is the MTHFR gene. 

Balancing ADD Symptoms (and Avoiding Medication for ADD)

Taking an integrative medicine approach to ADD means dealing with the root cause of the symptoms. That’s why testing is so crucial. 

If food is a catalyst, then the first step is to eliminate any foods from the diet that may be a trigger. Commonly, testing would be done on many foods including corn, wheat, gluten, eggs and dairy. 

If there are nutritional deficiencies, then supplementation is recommended as is dietary adjustments to rectify deficiencies. 

Restoring gut health is another important step in treating ADD symptoms.

If there are inflammatory markers in the stool test or if the patient has IBS, Crohn’s or Colitis they may have a very low butyrate which would be corrected by supplementing with  Enterovite

And, if there are genetic indications that detoxification is a challenge, then it’s important to detoxify slowly and to support the detoxification pathways by supplementing with B vitamins, folate, and phosphatidylcholine as well as certain therapies like saunas and colon hydrotherapy. 

Reducing exposure to toxins is also key as well as maintaining a healthy weight. Dr. Ingels says that carrying extra weight can increase symptoms so losing weight, getting active, and building muscle can all help. 

Reducing ADD Stimulants

In addition to removing environmental toxins and eliminating or reducing food triggers, Dr. Ingels also reminds patients that screen time and EMFs can also be triggers. So, make sure to keep these at a daily mini...