Treating ADHD - Dietary Issues
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In looking for effective ways to treat Attention Deficit Hyperactivity Disorder (ADHD) without medication, researchers often focus on dietary issues (see Daily Health News , October 4, 2004). These issues have centered primarily on food additives, in particular artificial colorings, flavorings and preservatives. So I was surprised when a reader queried me about a possible connection between ADHD and celiac disease, which is an inability to digest gluten (a protein found in wheat and several other grains). It was hard to find an expert in this area, but I did -- Aristo Vojdani, PhD, MT, CEO of the Immunosciences Lab, Inc., a microbiology and immunology research facility in Beverly Hills, California. Dr. Vojdani said that his company did indeed have research concerning celiac and ADHD.
Indirect Connection - Celiac
Dr. Vojdani stressed immediately that there is no direct connection between celiac and ADHD. However, he says that there is indirect evidence that having antibodies against gluten, as happens in celiac, could make some neurological disorders, including ADHD, worse. The explanation about how this happens is somewhat complex -- in fact, you may find it takes you back to your high school biology classes...
If a person suffers from celiac disease, his/her body sees gluten and its related proteins as intruders and makes antibodies against them. This has critical implications for the gastrointestinal (GI) tract because the antibodies make it virtually impossible for the GI tract to digest anything with gluten in it. Symptoms include diarrhea, bloating and flatulence... and the body becomes unable to absorb nutrients.
ADHD also can be associated with gluten sensitivity. With gluten sensitivity, your body makes antibodies only against gluten, not its related enzymes. Being gluten sensitive means that you don't do well with gluten in your diet, but it doesn't have the broader health consequences of being unable to absorb nutrients that celiac disease does. You may have mild problems of indigestion, bloating, gas and nausea... or you may have no symptoms at all.
More to the point for us, however, is that, according to Dr. Vojdani's research, the antibodies against gluten impact the function of the brain. What happens in the brain -- very roughly speaking -- is this. Both celiac sufferers and those who are gluten sensitive can't digest the gluten peptide (peptides are very short proteins made up of an amino acid chain). Gluten peptides escape from the GI tract and get into the blood. Antibodies then form to fight these intruders. In spite of the antibodies, some of the gluten peptides manage to cross into the brain. Once there, they bind to receptors known as opioid receptors, which are primarily responsible for sensing positive pleasure-like stimuli. Like in a child's game of musical chairs, since the gluten peptides already have claimed a place on the receptors, when the opioid peptoids try to bind, there isn't any room. It is as if the gluten peptides have elbowed them out of line. The result is neurological impairment, which manifests in autism, ADHD or migraines.
Dr. Vojdani's work has focused largely on autism, but he says that there is reason to think that the inability to digest gluten peptide exacerbates symptoms in some people with ADHD, and also some migraine sufferers. His lab has found that about one-third of the autistic children have gluten sensitivity and he surmises that this would be true of about the same percentage of those with ADHD.
Now What? Testing
For those with ADHD, Dr. Vojdani suggests having a blood test to determine the presence or absence of the antibodies to gluten. This is a simple test, he says, and it will tell you if gluten sensitivity is an issue. If antibodies are present, you should eliminate gluten completely from the diet. (See Daily Health News , October 4, 2004 for exactly what this entails... another good source for information is www.celiac.com.) Dr. Vojdani says that while a gluten-restricted diet will have almost an immediate effect on ADHD symptoms for some people, more typically it will take three or so months to determine if the diet is helping.
This is just the beginning of findings associating poor digestion with autoimmune diseases. Stay tuned for more.
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