The Role of Supplements & Processed Food in ADHD Management

Welcome back to Thriving with ADHD, where we delve into practical tips for adults navigating life with ADHD. In this episode, we're celebrating a fresh start to the year by tackling the significant role of nutrition and natural supplements in managing ADHD symptoms.

Join our host, Nada Pupovac, as she welcomes back Meredith Rappaport, an experienced Physician Assistant from Animo Sano Psychiatry. Meredith brings a wealth of knowledge from her extensive career in mental health, exploring the powerful intersection of medication management, psychotherapy, and the vital impact of nutrition on brain health.

In this discussion, Meredith breaks down the concept of neuroinflammation and its pervasive presence in mental health conditions, including ADHD. Together, we explore how certain antioxidants, like N-acetylcysteine, vitamin D, and omega-3 fatty acids, play crucial roles in supporting brain health, reducing inflammation, and potentially enhancing the effectiveness of ADHD treatments.

This episode also sheds light on the potential benefits of lithium orotate and American ginseng as alternative or supplemental treatments for ADHD, emphasizing the importance of a personalized approach to mental health care.

Finally, we touch on the impact of diet, particularly the Mediterranean diet, on reducing neuroinflammation and promoting better brain function, offering practical insights for day-to-day living.

Whether you're seeking to optimize your mental health or explore integrative approaches to managing ADHD symptoms, this episode is packed with actionable insights and expert guidance.

Tune in and empower your journey towards thriving with ADHD!

Disclaimer: Always consult with a healthcare provider before starting any new treatment to ensure it's appropriate for your individual health needs.

Thank you for listening to Thriving with ADHD. This show is produced by Animo Sano Psychiatry. For more information about our clinic, please visit animosanopsychiatry.com.

Animo Sano Psychiatry has introduced new services for enhancement of our patients' mental health - ASP Concierge and Health & Wellness Program. Please visit our website to learn more.

Animo Sano Psychiatry is constantly looking for the talent in behavioral health. If you are a psychiatrist, nurse practitioner, physician assistant, or mental health therapist, we'd love to hear from you. Visit our Careers pages to learn more about the available positions. https://animosanopsychiatry.com/careers/

Transcript

Welcome to Thriving With adhd, a podcast we'll share every day practical tips to thrive in life as an adult with adhd. This podcast is brought to you by Animo Sano Psychiatry, a behavioral health practice with a specialist ADHD clinic based in North Carolina. And this is your host Nada Pupovac.

 Welcome to Thriving with ADHD, dear ADHD community. In front of the Animo Sano team, I wish you a happy new year. We hope it brings you happiness and peace. We are back with a new important topic, the role of nutrition and natural supplements in ADHD symptom management. Our guest speaker is Meredith Rappaport, physician assistant at Animo Sano Psychiatry.

Meredith , is a devoted physician assistant in the mental health field. She's passionate about understanding human thoughts and emotions. Since 2008, she has worked in mental health field as a social worker at first and psychotherapist And then becoming a physician assistant and earning additional certification in psychiatry.

Her approach combines medication management and psychotherapy for comprehensive care. Meredith provides services for children, adolescents, and adults addressing anxiety and depression. Depression, ADHD, autism, intellectual disabilities, and behavioral challenges. She values patient trust and collaborates with families to meet mental health needs by utilizing their strengths.

 Meredith, welcome back to Thriving with ADHD. I'm delighted to have you back. You're really excellent. We had some amazing chats in the past, so I'm happy to have you back. This month we talk about nutrition and supplements in ADHD management. So yeah, I'm happy to have you back. Great. Well, thanks for having me.

I appreciate it. Yeah. Uh, okay. Let's kick off with the first question. So can you explain the connection between, Neuroinflammation and A DHD and how natural antioxidants can play a role in managing these symptoms. And I'm sorry if I mispronounced n neuroinflammation, so you might No, it was better.

Okay. It's perfect. Okay. Um, neuroinflammation is a really interesting topic and it certainly is something that I'm sure there is a ton of research on that I am, you know, certainly not an expert in or probably not aware of. So if those listening have, um, more knowledge on this, uh, than I do, I'd be glad to hear it because I think this is kind of, you know, cutting edge stuff, but, um, I will talk about it today as I do as a clinician.

I'm certainly not a researcher. I am a clinician in practice. And so I do talk about these things with my patients as far as what is the best way to do it. available at the clinical level. I mean, like I said, I'm not constantly following up to, you know, um, really cutting edge research necessarily, but I do have some information on neuroinflammation that I share with patients.

And so, um, that the more maybe kind of known stuff at this point, and it's probably going to be presented here. Fairly simplistically, which I hope is a good thing. Um, but, um, because my own knowledge of it, the brain is so complex that, um, my own knowledge of it is probably fairly on the, you know, um, amateur side.

So it's a neat topic. Um, neuroinflammation is not just unique to ADHD. It's seen in almost all, if not all mental health conditions. And it's something that, um, They can see on functional MRIs is that we have some inflammation happening and bipolar and schizophrenia and in depression and trauma and ADHD.

And there are other mechanisms and other things that we see in ADHD, um, in brain research, but we're going to just focus on this. So 1st, I guess a good question would be. What is neuroinflammation? Um, if you do like a basic Google search, which you will get back from AI is that, um, let's see neuroinflammation.

I'm reading this, you know, right from it refers to the inflammatory response within the brain or spinal cord, which can be triggered by various factors like injury, infection, or toxic substances. And while it's a normal immune response to protect the brain when prolonged or excessive, it can lead to damage to neurons and contribute to the development of neurodegenerative diseases, things like Alzheimer's, Parkinson's, making it considered bad for brain health.

So I think we're all familiar with inflammation. We've all stubbed a toe or we've all had a cold that caused, you know, mucus or difficulty breathing, injured, injured a limb. Okay. And inflammation can happen anywhere in the body. And like they were saying, you know, like it's a normal response. It's the body trying to help, uh, get rid of a problem.

Right? Um, so for instance, like you're like, I think if I use an example of a different organ than the brain, it might be a little more straightforward. So, um, to talk about how does. How does inflammation occur? So we know in the lungs, right? You could get punctured lungs from a car accident that could cause inflammation, an inflammatory response.

So that's like an outside injury, like they mentioned to the brain. Um, or, uh, you could have an internal injury, uh, like a hemorrhage or something like that. Uh, when they say infection, that's a big one that can cause inflammation in the body, right? You get, Strep throat or you get, um, a virus or a, or you get a bacteria that's affecting a certain organ and that can cause inflammation to happen.

Um, they mentioned, uh, here toxins or substances. So with the brain you might see alcohol or a drug overdose that can cause. insult or injury to the brain or mold or lead. There are also theories of ADHD about copper, zinc imbalance, um, and some various other, um, things they see, you know, um, when they, when they look at, um, nutritional factors and, and, um, chemical metabolic factors.

There's so many things, again, that can contribute to inflammation in the body. And so that's why it's really more general to mental health than it is necessarily to just ADHD, but it is seen here too. And so again, it's a normal response, but when it's prolonged and it's excessive, it can create big problems.

Um, when we have these harmful stimuli, or, you know, again, it could be that you have a genetic predisposition or something like that. Um, this inflammatory response. It's, um, it can damage these healthy neurons and we always thought, okay, well, we have this blood brain barrier. It's so protective.

How is that happening? But really, whenever there's an immune response like that, whether it's the gut or whether it's happening in the brain, if there is a protective layer, right, and we have to have our gut protected from the rest of our body so we don't get it. E. coli and feces going off and setting off extensive systemic infection or testicular.

The testicles have a encapsulation. The brain has an encapsulation. But whenever there's an immune response, the interesting thing that happens is that barrier has to become more permeable and it has to allow these, these These reactions are these like cytokines, chemokines, um, these things, these chemicals, the microglia that get, um, you know, these things that get inflamed, it's, we've got to let these other chemicals come through to the blood brain barrier from the rest of the body in order to treat the condition.

And so, unfortunately, other things can get through too. If your, if your gut is, um, is not really good. You have bad bacteria kind of in the gut. There is a there is a superhighway from the gut to the brain. We know of so whenever you've heard of leaky gut, I'm sure that's when the same thing happens in the gut that that becomes more permeable, becomes more porous or more open to allow these things through loud fluid through to sort of clean out the gut.

But unfortunately, other bad things can come into and sometimes again, this can lead to bad brain health. So yeah, Why it can be bad because of this excessive inflammation that lasts too long that can damage neurons. Um, There's this blood brain barrier disruption, like I talked about, allowing these harmful substances to enter, and then you mentioned something about oxidative stress or antioxidants, and so what is that?

That's when these inflammatory mediators trigger the production of these reactive oxygen species, which can learn to, so oxidation is sort of a breakdown process, and unfortunately with that, it leaves waste. There's sort of some trash or some gunk that's left over from an oxidation process. And that can sit in the brain and that can cause poor, not optimal function of the brain.

A lot of us are living in these neuro inflamed states a lot, or even like a mild one from stress. Stress is another biggie. And so our brains just maybe we're functioning, we're going to work, we're going to school, we're getting things done, but we're not functioning optimally. And maybe we've never even known what that feels like.

Um, so aging is another one stress, toxic exposures. We talked about, um, some of those toxic exposures can be pollution, cigarette smoke. Those can cause oxidative stress. Aging causes oxidative stress. High metabolic activity, just doing, doing, doing, doing, doing, so more on stress. Um, the effects of oxidative stress can damage proteins, lipids, DNA.

Our brain is primarily made of fat cholesterol lipids. That kind of thing. And we need those proteins. Um, in order we need damaging these proteins and lipids is not good. We need that stuff to make the brain function well because that is what our brain is made of. Um, oxidative stress can contribute to aging.

Um, and again, those neurodegenerative disorders, mental health disorders, and may also play a role in neuropsychiatric, um, Like I'm saying more psychiatric disorders, not just neurodegenerative, but mental health problems like anxiety and depression, which we often see in tandem with combined. Yes, exactly.

Yeah, exactly. Um, you mentioned you asked what kinds of antioxidants, right? Yeah, they're really managing. Yeah, there's a lot of things we can do. I love talking about brain health and how to keep a healthy brain. Um, I was trained in, um, neuropsychiatry before this and we, I worked with a lot of people with ADHD on the young end of the spectrum and a lot of people with Alzheimer's and Parkinson's and, um, various other neurodegenerative diseases.

It's on the other end, it's as well as brain, um, traumatic brain injuries and things. And so it's not necessarily just about masking symptoms in my treatment with people, it's because those symptoms are often your body's way of telling you something's wrong. Exactly. Yeah. But trying to work on improving the brain's function and the brain's health, and that maximizes the ability for us to utilize our medications as well. 

We're talking supplements as adjunctive treatments. Um, and let me, let me name a few, there's a lot of things we can do, but one of the big things we want to do, like is to keep that neuro inflammation down. And there's, and there's several things we can do and it's, it's an exciting topic. Um, so I love seeing people that are interested in this, especially if they're worried about their brains aging and that kind of thing.

So, um, We wanted to protect that, not just the barrier by keeping the inflammation down, but the cells themselves, the brain is rich in what's called PUFAs or polyunsaturated fatty acids that are really susceptible to oxidation. Um, and so we want to make sure that we're keeping that oxidative stress down by trying to avoid those things that we talked about before.

But if we can't, um, We want to really keep the mitochondria of each cell functioning well, and those are the powerhouses that produce the energy, and they generate, um, uh, they generate the power of the neurochemicals going from one place to the other. So causing, uh, these disturbances, we, you know, like I said, can lead to some cell death and some other things.

What can we do? Um, one of the big ones that I love, uh, is this brain health triad. I would say that would be N acetylcysteine, vitamin D, and. Um, uh, Omega three fatty acids, and there are specific dosages and ranges that we would want to follow people to see because this is really not a one size fits all.

We just talked about all the different things that can cause the neuro inflammation and What if it's a genetic thing? That's a different treatment than somebody who has a lot of stress in their life versus different, multiple comorbid mental illnesses or whether it's a nutritional deficiency.

So this is not a one, one size fits all. And ADHD is complex like that too. ADHD may have several different root causes, but there's multiple. avenues that we can, it's not, I don't want to say attack, but we can address it from, for good, for good mental health functioning. And really everybody can benefit from this, not just people with ADHD, keeping our brains functioning as best we can, but people in ADHD in particular, um, we have seen, you know, good results from some of these things.

So, uh, one of these antioxidants would be something called N acetylcysteine. It's an amino acid. It has anti inflammatory and anti antioxidant properties. And it's important for various health reasons, but one of them is that's probably the most It's it's it's probably the most potent antioxidant in your body.

It is what it replenishes, which is glutathione. So you probably if you've heard of it, you might have heard of it because it's most often used to treat acetaminophen overdose or Tylenol overdose. Interestingly enough. So, um, but that's another way of showing how connected things in the body are. You can't just like deal with the brain or deal with this, but look at this, you know, NAC, an amino acid.

This is what we give people in the emergency room when they overdose on Tylenol. But it has many other health benefits, um, that may include chronic, for chronic respiratory conditions, fertility, and brain health. So it reduces the risk of cardiovascular disease and it's liver and kidney protective. As you, as I mentioned with the acetaminophen, it's liver protective.

And this can be taken, it doesn't have to be taken in huge amounts because of an insult. It can be taken regularly. And it does reduce these other risks, the really great health benefits. It may alleviate symptoms of mental health conditions and reduce substance use. craving. So I have used this with people who have, are wanting to quit marijuana or helping with, with, um, other, other substances that they may want to reduce their, , habitual use of.

And also I use this for kids with tics, uh, that have ADHD, autism, anxiety. So picking, um, picking their skin, their nails, um, pulling hair, things like that. So I've used it with that. And it's just overall really something that the brain needs to function. Well, I love this one. I really, I shouldn't, I don't push products on people, but I love the one that comes in gummies and can be taken because it has to be taken multiple times a day and in large amounts to be used in mental health for the mental health purposes of having a good functioning brain.

And the reduced inflammation in the brain and the antioxidant effects. We have to take quite a bit of it. So also by helping replenish that glutathione and regulate glutamate It does have the potential to, uh, to treat conditions such as Alzheimer's and Parkinson's again by decreasing inflammation in the fat tissue, which we have so much of in the brain and it may reduce insulin resistance and improve blood sugar regulation and it may improve immune function.

So there's just a lot of reasons that I want to kind of bring that one up. Another antioxidant I've mentioned here is vitamin D. Vitamin D is a critical ingredient for the production of serotonin. which serotonin is critical to produce melatonin. So there's, there's, for the most part, I would say, uh, from what I've been reading, maybe up to 70 percent of adults are deficient in vitamin D. 

Yeah. Over 60 percent of probably, uh, maybe 60 percent of kids, 67 percent of kids with ADHD, I believe, are also deficient. Um, this is critical for our brain function. And I love how many patients I have that come in that are already taking vitamin D. Um, Yes. Okay. And, uh, we need it to make, again, serotonin.

We, we, um, there are various studies that, um, we need probably more studies on vitamins and minerals and the impact they have on our brain health, especially if they are considered co factors or limiting factors that are absolutely necessary for the production of certain things in the brain like serotonin.

Um, but I, I have patients that come in with a, I get their values and their vitamin D is at a seven to 13 when I want it to be ideally between 40 and 60. And so we do a lot of replenishment of vitamin D. Um, another, uh, antioxidants, uh, that's of interest for people with ADHD in particular is called pycnogenol. 

This is a, that's French for pine bark. It's a, it's a French pine bark, uh, extract. And this is still under study. There have only been about two studies yet. Um, according to the Car Lat Psychiatry Podcast, which I'm a big fan of. Um, one was a negative and one was a positive that showed results for the ADHD treatment, uh, or ADHD symptoms.

Uh, the one that was negative was in adults, but positive for kids. Mm hmm. So, um, this is because this is high in, um, polyphenols, which are good for antioxidants. This is an antioxidant, uh, helper. So we got good results in kids. It seems to correct this copper zinc imbalance that has been posited and especially good with boys with ADHD.

Okay. Um, yeah, several controlled studies have demonstrated zinc deficiency as a behavioral response. Or a behavioral response to zinc supplementation in Children with ADHD. So that's another one. So, um, that may be part of the pathogenesis of ADHD, uh, omega three fatty acids. I mentioned, um, studies show.

more, um, consistent benefit from the EPA that is in there rather than the DHA. And we have to get that to certain levels. And we have, we want to caution people not to take too much or too little. So that's one that you'd want to talk to your provider about, but Omega three fatty acids I talked about earlier, very crucial to brain function because we need those fatty acids to, um, and the structure and maintenance of the brain cells.

Okay, some other natural therapies that are going to be antioxidant and or in nature anti inflammatory are rhodea rose rhodiola rosea. This is a supplement I've seen at Publix. I've seen it at Wegmans. I know they sell this one on the shelves. Uh, American ginseng is another, um, that we can talk about in a little bit.

I think you have a question about that. Um, the rhodiola rosea, that's not been studied in ADHD, but it did improve cognitive and attentive, um, symptoms in other populations, um, because of, uh, what's known as adapt, it's an adapt, it's an adaptogen and there are other adaptogens that are supposed to be very good for the brain, but they help people respond better to stress.

It was studied in Soviet astronauts, um, and they did better with the rhodiola rosea. Uh, with their cognition and responding to the stress better than placebo. And, I think those are all the ones I'm going to mention right there. I'm sure there are others and we'll get back to that American. 

We're going to talk a little more about lithium, which is another really. Yes. Yes. So I, yeah, I wanted to also thanks for sharing, um, details for the first question. Good reminder for me to go to, uh, for my dosage of vitamin D because it's crucial for brain. So, uh, just. gave me extra boost and motivation to just not keep going to the pharmacy.

So thanks for that. And, uh, yeah. Uh, so yeah, let's talk about, uh, lithium orothate and a treatment option for ADHD. Absolutely. This is, um, lithium is a fantastically interesting substance, and I'm talking about two different things here. There are different formulations of lithium. So lithium, the medication is known as lithium carbonate and lithium There's elemental lithium.

Um, and this is in the earth's soil. This is in the, uh, the earth's crust. This is in the water. And, uh, we have sort of synthetic versions that we've created, like lithium, uh, or tape that can be taken as a synthetic. I'm not really sure how it's created in these labs and things, but, uh, it's one that you can get over the counter lithium orothate.

And. So just to, these are taken in very different doses. Um, so I just wanted to make that distinction first. There are quite a number of studies that show the effectiveness of lithium to ease anger, agitate lithium, the medication. We have tons of studies, um, to, to show the, the reduction in irritation, anger, aggression, and, um, other symptoms that we may see in ADHD.

And while they're on, these studies are on pharmaceutical lithium. Clinical experience in many practitioners, um, has shown the nutritional lithium, and these are in much smaller doses, um, had a similar and a safer effect. Um, in studies that I'm mentioning here that would have looked at lithium carbonate, the medication, um, they have, there have been a few, most of them are either ADHD, but a lot of them are conduct disorder.

There just aren't enough studies probably done with lithium and ADHD yet, but. Lithium outperformed Haldol. It either outperformed or it performed as well as Haldol or Ritalin and Ritalin for aggression in some of these studies. One study found that after six weeks of taking the lithium, those, these were kids with conduct disorder, they had less aggression, restlessness, and better attention span. 

Um, so that's just some of the information. Why is lithium great? Because it's neuroprotective. It is, it reduces inflammation. But one of the cool things about lithium is we've always been. I think most of us thought, or at least it was kind of common thought, that once your brain was finished developing, age 25 or so, that's it, that's all the neurons you get, and you better take good care of them because if you don't treat them well and they die, that's all you're going to get.

And lithium has been shown in studies to actually increase brain, um, uh, Brain size, uh, and show regrowth or growth of new neurons. Oh, wow. Even after 25. Very powerful. Um, and it probably lithium, the medication is probably one of the only, if not the only, um, medications that we have that is not just symptom management in mental health, but it's also disease modifying.

And what I mean by that is it is neuroprotective. We do see generation of growth of brain. And, um, it's, it's a very. Very unique and important, um, aspect of mental health treatment. So, I have parents giving this to their kids. I've got parents taking it themselves for ADHD. And, um, it does improve mood. It does, um, Reduce irritability.

And, you know, a lot of times people with ADHD, it's irritability, difficulties transitioning from one topic to another or one activity to another, so it can reduce some of that. But again, it's healthy for the brain. It's one of the healthiest things we have for the brain. There's a lot of myths about lithium, um, medication, uh, uh, more recent studies have shown it does not cause weight that we can, you know, um, and I, I bring this up, not just because of, I bring up the medication point because I do use nutritional lithium. 

low doses for people with all kinds of things. But when it comes to neuro, uh, when people start to show cognitive impairment, we have excellent studies that show taking low dose lithium, 150 milligrams to 300 milligrams of the medication. And they would call that a homeopathic dose can really help, um, reduce the, um, the studies neurodegenerative conditions, like possibly Alzheimer's and dementia.

So we, I start people on that, uh, frequently, and, um, we want to see their brain. It's better not just sort of stay and kind of stay the course of that. I probably went on a little bit too long there, Neda, about that. No, no, that's, yeah, very interesting, so I learned something new and hopefully everyone else learned something new and would consider it.

I'm not sure, you know, guys, uh, who your provider is or if you're already taking lithium, but maybe worth bringing up with your provider and considering your, in your, therapy and medication. Right. Because lithium has a lot of myths surrounding it and, and like that it's again, a big weight gainer.

And the other one is that, you know, it can cause kidney damage and toxicity. Right. Yeah. And that is true, but that's it. If it's not managed and kept in a very tight, you know, it kept in a certain blood range, giving it at night helps prevent that. But let me just, let me just backtrack and say, we're talking about high dose lithium carbonate now, 600, 800 milligrams.

That's when we worry about those other things. At 150 to 300, I don't need to be following people's blood levels. I don't need to worry about their kidneys. I give this to people who are very, very, uh, elderly and, and have, you know, um, we may follow their kidney function if they have kidney problems, but I mean, this is not a risk at that.

It's not risky at those doses. And then we're talking way lower doses of that and lithium orotate if we're giving it as a supplement. And so we don't worry about those things. Don't worry about like, you know, weight gain or, um, kidney disease or thyroid problems or those things that these, these little, um, Again, it's much safer at these lower doses.

Um, and I think that's what I will, I will just kind of end there on lithium. It's just fascinating. There's books about it. Dr. James Greenblatt has a book out called, um, a Cinderella story, something like that. A doctor, he's a, he's a functional psychiatrist and there's some, he's got a book out about nutritional lithium.

That's quite good. I can find a link for you if you all want it. Yeah. Thanks for the recommendation. And, think listeners can, uh, , search for it, but we can also have it in the show notes. That's, that's no problem. So, okay. And let's now talk about, uh, American ginseng. Is that how you pronounce it?

Yeah. So, uh, you mentioned it earlier, but maybe let's go in more detail about it now. Yeah, and I'm certainly again, not the first to look at this. There's been, there's a lot of, um, uh, other resources you could go to, to hear more about this, perhaps the, um, Carlat Psychiatry Podcast, they did a, they did an episode on for natural therapies for ADHD on November 27th of 2023.

So you can. Carlitis, C A R L A T, you can Google that and that'll tell you much more in depth about the rhodiola rosea, the American ginseng, the pycnogenol, and the, uh, another thing that I didn't mention because it's maybe more, uh, for dyslexia. Um, so that's something you can reach out. But what they said in, in that podcast, and they do cite a lot of different research, um, is that there's several types of American ginseng, excuse me, of ginseng, there's Korean, Chinese, but, um, and they all have evidence. 

That they, uh, do it to show improvement in memory in various populations. What they all have in common is they contain something called ginsenicides, which, if I even said that correctly, I hope I did, but they modulate acetylcholine and glutamate. Those are two other neurochemicals in the brain, much like, other examples would be, uh, dopamine, serotonin, norepinephrine.

And most of the medications that we have for ADHD target, um, the more mainstream, they target more the dopamine, norepinephrine. But, you know, we have found, they're finding that in studies, there's, there's, other things that can help, you know, ADHD, like the adaptogens, um, antioxidants. And here we're talking about these ginsenicides.

So they modulate acetyl, they actually modulate neurochemicals, the acetylcholine and the glutamate. They've also have anti inflammatory and neuroprotective effects in the brain, just like lithium. So another really good thing for really anybody, doesn't just have to be ADHD. But did well, and this is one that I for people don't want to take medications.

This is a good one for adults in that show. They interview a Dr Richard Brown. He's a really well known child adolescent psychiatrist, and he has had the best experience with the American ginseng. Here's what the research said. They said that American ginseng improved working memory in several controlled trials, and the benefits are measurable after just a few hours.

But they also held up in studies lasting several months. Um, these were mostly conducted in, uh, healthy adults, but it also approved inattentive and hyperactive symptoms of ADHD in two placebo controlled trials in children. And I can provide those links if anybody wants them. And a typical dose is somewhere between 500 and a thousand milligrams twice a day.

With 10 percent genocides, uh, and they named some brands you can check out and, um, I do use this with patients. I have one patient who's doing really well with it. He was very sensitive to and to us to, um, ADHD medication, side effects and things. So we use this and I think they say in that podcast. Uh, some of their patients had described it, or one of their patients had described it as going from like a tube TV to high death cognitively.

Okay. Okay. Interesting, . And you would definitely, yeah, as you said, you would definitely recommend with your patients, especially, especially if a regular medication is not working or people have an issue. So it's. I don't, I don't know if it's substitutes, not sure if that's, that's the correct word, but definitely something, uh, to have in your disposal if, uh, you can't work with the, uh, medication that you would normally use for, uh, ADHD treatment.

Correct? If I, did I understand this correctly? Yes. Yeah, and that's a complicated subject to that. I work a lot with my patients. I know that we all have what's called a standard of care and you come in and you see a provider and you should be getting the same treatment options. What is the best? What is the research show is the best for like, for instance, if you have a bladder infection and you go into primary care in California versus you go in Tennessee, you should be offered the same treatment.

type of treatment, um, for the antibiotics. Nobody should offer you, you know, prayer or, um, not that those kinds of things aren't important in health. However, you should be offered what's called the standard of care, which is the thing that is going to treat that the best, right, according to research and science.

However, we do like to give patients options because all medications come with risks and potential side effects. So sometimes these things are best. Some of these things may be just adjunct or maybe somebody would rather not take medications and they would rather use something like American ginseng and maximizing their vitamins but, um, and their nutrients and getting their gut brain, their gut health good and things like that and not use medications.

Um, but it can be either or it can be adjunctive or it can be Um, monotherapy, you know, maybe not again. I think when you're one of the major points from this is that there is no real monotherapy, right? We have to kind of figure out what's causing the issue, you know, is it because they're having post COVID brain fog and that's causing ADHD symptoms?

Or is it a traumatic brain injury? Is it a zinc copper imbalance? Is it, is it genetic? And there are a lot of evidence to show genetics, things like that. So we do want to find out what it is that's kind of causing these symptoms. Um, before we kind of decide, you know, which one of these treatments would be the most appropriate and which of them in tandem with each other.

But I think what the big point there is that there's no, um, one thing we have to do a lot of things. All right. Yeah. Yeah. Yeah. And I think your patients are lucky to have you because you are taking every, uh, case, as they come, , it's not one size fits all, so, um, and you're adjusting the treatment to, be tailored to that specific person.

So that's, that's, that's awesome. So, okay. And I think, uh, we can now move on to the next thing we want to talk about. And this is, so we are moving from supplements to the food. And I think very big thing, um, is processed foods. So, um, I know you said you're kind of very keen to talk about this. So let's see about particular ingredients, additives in the food, in the processed foods that are known to increase, uh, the ADHD symptoms.

Hmm. Mm hmm. The research is not There's some controversy and research about specific ingredients and ADHD and things like that. So I'm gonna stick with neuroinflammation here and how to keep that neuroinflammation down because we see it with all of these different things.

And again, it can come from so many different places that I think it's good to kind of keep our net wide here and talk about when we talk about foods and diet and additives and things like that. There's not real conclusive stuff. Is my understanding when I look at up to date, which is one of the more Just the very mainstream medical American medical model resource that we use in medicine to, um, access the most, um, up to date data and how to use it.

Clinically, there's they don't recommend elimination diets and cutting things out. And they don't, um, they said there's controversy about different dyes and different things like that. But, um, I think that in general, what we do know is that specific dietary factors are linked to neuro inflammation. And since that's what we're talking about today, um, those specific factors or dietary factors would be things like high saturated fats, which are found in like red meat, butter, and processed foods, trans fats found in many processed foods, um, added sugars, so like high fructose corn syrup, sugary drinks, So, um, Um, they're, uh, refined carbohydrates or another one, uh, white bread, pasta, and having a low dietary fiber intake that can disrupt gut microbiota balance.

So those are some of the big things that are, we're talking about in relation to neuroinflammation. Sugar in processed foods can contribute to neuroinflammation by causing a spike in blood sugar levels. And so this triggers a release of inflammatory molecules like those cytokines I was talking about earlier.

And this can lead to activation of the immune system. In the brain and potentially to damaging neurons. Like we're kind of circling back to question one. Um, especially when consumed in excess and these are going to be your foods. Your process foods are really going to be anything that comes from a package, uh, that you rip open or things that have a sugar plastic screw off top, things like that.

Um, you know, we all eat them sometimes, but when, when consumed in excess, this further amplifies the process. And it can cause disruption in the gut microbiome as well, which is often associated with highly processed diets, but that's a whole nother great topic, the gut microbiome and mental health. But, um, this can just, you know, if we're disrupting the gut microbiome, we're increasing blood brain barrier permeability, promoting that systemic information.

And also on top of dietary stuff, uh, some medications that we use even to treat ADHD can cause neuroinflammation, um, the stimulants in particular, um, but lower doses of ADHD medications are generally considered safe, but, um, and less likely to do that, but, um, that's something that people should be aware of too, not just the food, but even the medications that we treat with can, can, you know, can, uh, lead to that. 

Okay. And, um, thanks for sharing that. And, uh, is there anything else you would like to share on the processed food before we wrap up? I'd say that every, yeah. Thanks for asking. Cause I, I, I feel like everything I look at and I research kind of comes back to the, you know, what diet should you have? They always say the Mediterranean diet.

I've looked at many different sources on different days, different months, different times. And it seems like the research kind of comes back to having, you know, the best diet is the anti inflammatory diet. That is like the, the. The Mediterranean diet. So this is going to be, um, low in those, you know, high in fiber and, uh, low in those saturated, polyunsaturated, uh, uh, those, uh, saturated fats, trans fats, um, and low in the refined carbohydrates and low in the sugars and that kind of thing.

And now you see that for multiple health problems and, um, And whenever we talk about inflammation, that's the one that comes up. Okay. And, um, to just finish, , this conversation, if there is one thing that you would like our listeners to take away from this episode, what it would be? I think that, you know, mental health is, is complex interaction of multiple, um, it can be a complex interaction of multiple. 

Sources of pathology, and that that means that we have to address it in multiple ways. It would be nice if. You know, one medication fixed it, but, um, typically the nice part of this is there's so much we can do and again, not just people with ADHD, but I think a lot of us have symptoms of ADHD in the world that we live in now where we're so distracted because we're being pulled in so many, our attention is being pulled in so many different directions with all of our technology.

Your watch is going off. My screen is going off with messages. I have five email accounts, right? Oh my God. Yes. Yes. Yes. Yeah, so I think all of us can benefit from having a healthier brain. It's nice to know that inflammation, um, is a part of the picture. Uh, it may be one, it may be a blanket term to, um, help talk about a lot of different insults or pathologies that we need to address and that we can't address and there's just so much we can do.

And when you start getting into this stuff, it, it makes, I think what I've seen is it gives people a sense of. empowerment and, um, confidence and they feel like they're doing something for themselves, um, in their treatment. And when they get those results of like feeling better, um, that's really just, it's, it's wonderful to see.

Yeah. And if I understand correctly, so there are many natural supplements that we can use daily to improve function of our brains. And that's a way. not only manage ADHD symptoms, but improve our mental health overall, which is fantastic. So we're not going to have good mental health if we are deficient in vitamin B and B vitamins and D vitamins, um, in particular things like that.

And then as we know, poor sleep, stress, we're just not going to have good mental health anyways. Yeah. Yeah. And then as you said, nutrition and, uh, Of course, um, you also mentioned there are, different results regarding, uh, restrictive diets, but again, there are recommendations for what diet is the best out there.

It seems that it's Mediterranean. And then we talked on the podcast about many other things like, uh, sleep, like exercise, et cetera. So there are many ways that we can help improve our, , brain health. And that way, I hope it decreased the inflammation of the, , Our, , neurons as well.

So I hope that helps, um, that makes sense. So, but yeah, so I'm glad we talked about supplements and, uh, just reinforce the importance of taking. Um, the right vitamins and minerals to help our, uh, our brain function well. So that's awesome. There's so much we can do. Yeah. Yeah. There's so much we can do. 

Thanks so much, Meredith. I love this conversation. And, uh, I hope to see you again with some other exciting topic. All right. Thanks, Neda.

Thank you for listening to Thriving with adhd. This show is produced by Animo Sano Psychiatry. Please follow, rate or share our podcast on Spotify, Apple Podcast, or any other streaming app of your choice. Music is by Daddy's Music music from Pixabay. For more information about Animo Sano Psychiatry, please visit animosanopsychiatry.com