Magnesium + ADHD

Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) have become so commonplace on therapy caseloads and in classroom settings around the globe.

As an occupational therapist with years of experience working with children affected by ADD and ADHD, I have seen how this diagnosis can challenge every aspect of ones life. I believe it would be a tragedy and great disservice to children and families affected by this condition, if we didn’t first evaluate the current research on effective alternative treatment methods for these children before we continued to recommended the continued disbursement of pharmaceuticals.

After an afternoon spent delving into the research of common nutrient deficiencies among the Attention Deficit Hyperactivity Disorder (ADHD) population, it became clear as day to me that an overhaul and re-evaluation of current medical practices are in order for this overdiagnosed and over-medicated childhood behavioral disorder. 

Research shows and undeniable link between magnesium deficiency and Attention Deficit Hyperactivity Disorder.  A brief review of research not only showed a strong indication that children with ADHD show remarkably lower blood-serum levels of magnesium and other key vitamins and trace minerals (like zinc, B6 and copper) than typical peers, but also revealed that supplementation of magnesium can have a significantly positive impact on behavioral performance and cognition status.

Since magnesium is vital for healthy brain function, involved in over 300 biomechanical reactions in the body, it is easy to see why a deficiency in this key nutrient could negatively impact brain function in children. 

The bioavailability of magnesium affects the function and binding of neurotransmitters to their receptors, such as serotonin and dopamine. (8)  We know that dopamine plays a crucial role in executive functioning skills, such as the ability to self-regulate and control impulses.  Magnesium also supports the calming actions of GABA (8)

By some estimates, 80 percent of Americans are deficient in magnesium.  Poor dietary habits and magnesium depletion in soil are known culprits.  If the general adult population is this deficient in magnesium, one could imply that among children (who often eat a less varied diet), the deficit would be slightly more.

One study (1) that assessed the magnesium levels in children diagnosed with ADHD, concluded that out of 116 children, 95% of them were deficient in magnesium.

A prospective population-based cohort study of 684 adolescents at the 14- and 17-year follow-ups found that higher dietary intake of magnesium reduced behavioral problems by 95% (reduced attention problems, aggressiveness and delinquency). (2)

One study (3), published by the Egyptian Journal of Medical Human Genetics, was conducted in order to assess the magnesium level in ADHD children and compare it to the normal levels in children.  It also assessed the effect of magnesium supplementation as an add on therapy, in magnesium deficient patients.  Out of 25 patients with ADHD, 18 of them (or 72%) were determined to have magnesium deficiency.  After supplementation with magnesium, the group improved as regards cognitive functions as measured by the Wisconsin card sorting test and Conners’ rating scale.   Little to no side effects were noted with supplementation.  The study concluded that magnesium supplementation in ADHD, proves its value and safety.

Another study (4) , also published in the Egyptian Journal of Medical Human Genetics, found that magnesium, zinc and copper deficiencies were found in (65%), (60%) and (70%) of ADHD children respectively. Magnesium and zinc deficiencies were found to be correlated with hyperactivity, inattention and impulsivity, while copper was not.

Another study (5), that looked at 50 hyperactive children that met criteria for the DSM IV diagnosis of ADHD, concluded that 6 months of supplementation with magnesium significantly decreased hyperactive behaviors.

As a pediatric occupational therapist, who has worked with hundreds of children and families impacted by a diagnosis of ADHD, this research is quite alarming and has serious implications in the therapy profession.

Firstly, a diagnosis of ADHD, which is more often than not treated with serious brain-altering pharmaceuticals (Ritalin, namely), is typically based on simple behavioral observations from a teacher within a structured classroom setting.

Pharmaceuticals are too quickly administered to children as young as 4 years old, without first looking at other possible factors and methods of treatment.

Since Ritalin is classified by the Drug Enforcement Administration as a Schedule II narcotic, the same classification as cocain, morphine and amphetamines, it would be foolish for pediatricians and parents of children with ADHD to not first assess and address nutritional deficits and environmental issues first before medication is administered.

FOOD AS MEDICINE FOR ADD + ADHD

Fortunately, there are many foods you can start incorporating into your child’s diet to help improve their magnesium levels which can significantly impact their attention and impulse control. 

However, it is important to first recognize that only 30-40% of magnesium is actually absorbed through our food. The implication here is that supplementation, in combination with dietary changes, would be the most effective method for treatment.

The current RDA for magnesium for adults and children ages 4 and older is 400 mg.

This list below, from the Cleveland Clinic (10) shows the top Magnesium Rich Foods:

HOW MUCH MAGNESIUM IS IN YOUR FOOD?

• Pumpkin seed - kernels: Serving Size 1 oz, 168 mg

• Almonds, dry roasted: Serving Size 1 oz, 80 mg

• Spinach, boiled: Serving Size ½ cup, 78 mg

• Cashews, dry roasted: Serving Size 1 oz, 74 mg

• Pumpkin seeds in shell: Serving Size 1 oz, 74 mg

• Peanuts, oil roasted: Serving Size ¼ cup, 63 mg

• Cereal, shredded wheat: Serving Size 2 large biscuits, 61 mg

• Soymilk, plain or vanilla: Serving Size 1 cup, 61 mg

• Black beans, cooked: Serving Size ½ cup, 60 mg

• Edamame, shelled, cooked: Serving Size ½ cup, 50 mg

• Dark chocolate -60-69% cacoa: Serving Size 1 oz, 50 mg

• Peanut butter, smooth: Serving Size 2 tablespoons, 49 mg

• Bread, whole wheat: Serving Size 2 slices, 46 mg

• Avocado, cubed: Serving Size 1 cup, 44 mg

• Potato, baked with skin: Serving Size 3.5 oz, oz, 43 mg

• Rice, brown, cooked: Serving Size ½ cup, 42 mg

• Yogurt, plain, low fat: Serving Size 8 oz, 42 mg

• Breakfast cereals fortified: Serving Size 10% fortification, 40 mg

• Oatmeal, instant: Serving Size 1 packet, 36 mg

• Kidney beans, canned: Serving Size ½ cup, 35 mg

• Banana: Serving Size 1 medium, 32 mg

• Cocoa powder– unsweetened: Serving Size 1 tablespoon, 27 mg

• Salmon, Atlantic, farmed: Serving Size 3 oz, 26 mg

• Milk: Serving Size 1 cup, 24–27 mg

• Halibut, cooked: Serving Size 3 oz, 24 mg

• Raisins: Serving Size ½ cup, 23 mg

• Chicken breast, roasted: Serving Size 3 oz, 22 mg

• Beef, ground, 90% lean: Serving Size 3 oz, 20 mg

• Broccoli, chopped & cooked: Serving Size ½ cup, 12 mg

• Rice, white, cooked: Serving Size ½ cup, 10 mg

• Apple: Serving Size 1 medium, 9 mg

• Carrot, raw: Serving Size 1 medium, 7 mg

SOME EASY WAYS TO INCORPORATE THESE MAGNESIUM RICH FOODS IN YOUR CHILD’S DIET:

• A slice of sprouted toast with a tablespoon of almond butter or sunflower seed butter (I top mine with raw honey for extra taste and nutrition)

• A handful of roasted pumpkin seeds or sunflower seeds for on the go snacks

• A side of 1/2 of an avocado with lunch or with eggs breakfast

• Adding nut butters like sunflower seed butter to morning oats

• A large scoop of organic cacao in a breakfast smoothie

• Spinach cooked in ghee with a sprinkle of sea salt as a dinner side

• Banana + almond butter + date + collagen protein shake (I use almond milk as the base)

• Banana + Avocado mash (for babies learning to self-feed)

• Banana + Avocado smoothie

• Serving Salmon and other oily fatty fish 1-2 times a week

• Roasted potato fries as a dinner side

*Affiliate links below

SUPPLEMENTS WE USE TO ENSURE HEALTHY MAGNESIUM LEVELS:

As always, I am not a physician, nor can I prescribe specific medical advice. Always consult with your pediatrician first before beginning any new supplements. These supplements are only for ages 4 and up.

Another way to improve magnesium levels in young children is through the skin or transdermally. Epsom salt baths and dips in the oceans are effective ways to absorb magnesium this way.

Sources:

1) Kozielec & Starobrat-Hermelin. (1997). Assessment of magnesium levels in children with attention deficit hyperactivity disorder (ADHD). Magnesium Research: Official Organ Of The International Society For The Development Of Research On Magnesium, 10(2), 143-148. (https://www.ncbi.nlm.nih.gov/pubmed/9368235)

2) Black et al. (2015). Low dietary intake of magnesium is associated with increased externalising behaviours in adolescents. Public Health Nutrition, 18(10), 1824-30. (https://www.ncbi.nlm.nih.gov/pubmed/25373528)

3) Farida El Baza, Heba Ahmed AlShahawi, Sally Zahra, Rana Ahmed AbdelHakim,
Magnesium supplementation in children with attention deficit hyperactivity disorder,
Egyptian Journal of Medical Human Genetics, Volume 17, Issue 1, 2016,
Pages 63-70, ISSN 1110-8630, https://doi.org/10.1016/j.ejmhg.2015.05.008.(http://www.sciencedirect.com/science/article/pii/S1110863015000555)

4) Farida Elbaz, Sally Zahra, Hussien Hanafy, Magnesium, zinc and copper estimation in children with attention deficit hyperactivity disorder (ADHD), Egyptian Journal of Medical Human Genetics, Volume 18, Issue 2, 2017, Pages 153-163, ISSN 1110-8630, https://doi.org/10.1016/j.ejmhg.2016.04.009 (http://www.sciencedirect.com/science/article/pii/S1110863016300283)

5) Starobrat-Hermelin B1, Kozielec T.  Magnes Res. 1997 Jun;10(2):149-56.  The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. (https://www.ncbi.nlm.nih.gov/pubmed/9368236)

6) National Institutes of Health Office of Dietary Supplements. Magnesium Fact Sheet for Health Professionals Accessed 12/8/2018

7) United States Department of Agriculture. Food Data Base Accessed 12/5/2018

8) U.S. Food and Drug Administration. Guidance for Industry: A Food Labeling Guide (14. Appendix F: Calculate the Percent Daily Value for the Appropriate Nutrients). 2013.

9) Greenblatt, James. Finally Balanced: Mineral Imblalances & ADHD. The ZRT Labratory Blog. May 25, 2017. (https://www.zrtlab.com/blog/archive/mineral-imbalance-adhd-magnesium/#_ednref5)

10) Magnesium Rich Foods. Cleveland Clinic. (https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food)