There has been a great deal of interest in the use of natural supplements, such as omega-3 fatty acids, herbal preparations, and vitamin and mineral supplements, in the treatment of attention deficit hyperactivity disorder (ADHD)—but do they really work?
The research is inconclusive, at best, about most of these supplements, but there is evidence to show they may help people with ADHD who have nutritional deficiencies.
This article will discuss nutritional supplements for ADHD, including what works, what doesn't, and what we are still learning.
Stimulant medication is the most supported treatment for ADHD. Over 70% of children with ADHD respond to psychostimulant medications.
Still, there is interest in the use of supplements as complementary and alternative medicine (CAM) treatments for ADHD. These are treatments used instead of or in addition to traditional treatments.
Current research does not support the use of supplements as a stand-alone alternative to medication and/or behavioral therapy for ADHD. But some supplements may help people who have vitamin or mineral deficiencies.
Omega-3 fatty acids are an essential nutrient that you must get from your diet since your body doesn't produce them. Dietary sources include fatty fish like salmon and tuna, seeds such as flax and chia, and nuts such as walnuts.
Research is inconclusive about the efficacy of omega-3 supplements in treating ADHD.
A 2018 systematic review (answering a research question by collecting and summarizing evidence) and meta-analysis (using statistical methods to summarize results) of eight studies involving a total of 628 participants indicated that children and adolescents with ADHD tend to have a deficiency in omega-3 fatty acids. The review suggests omega-3 supplements improve clinical symptoms and cognitive performance in children and adolescents with ADHD.
A 2017 systematic review of 25 randomized controlled trials (trials in which participants are randomly assigned into one of two groups) showed inconclusive results. It found about half of the studies reported some beneficial effects of omega-3 fatty acids on ADHD symptoms, but the other half of the studies reported negative results.
Numerous other studies and reviews have been conducted on the use of omega-3s in treating ADHD, but differences in the studies make them hard to compare. Results from these studies vary.
Overall, it is unclear if omega-3 supplementation is helpful for ADHD symptoms, but it may be worth looking into if the person has a deficiency. Omega-3 supplementation is known to be less effective than stimulant medication.
Side effects of omega-3 supplements tend to be mild. They may include:
Omega-3 supplements may interact with medications that affect blood clotting.
People with seafood allergies should be cautious taking omega-3s as it is unclear if it is safe for them to take fish oil supplements.
According to some preliminary research, fish oil supplements may be more beneficial than docosahexaenoic acid (DHA).
Current evidence suggests supplementation with a dose of 1–2 grams of omega-3 daily with a substantial content of eicosapentaenoic acid (EPA) within the omega-3 formulation.
Check with your healthcare professional before taking omega-3 supplements or giving them to your child, especially if there is a blood clotting disorder or seafood allergy present.
Iron is used by the body to make hemoglobin in red blood cells. Hemoglobin transports oxygen to nourish your tissues. Dietary sources include meat (especially red meat), tuna, and dark leafy greens.
A 2014 study found an association between iron deficiency and ADHD symptoms in children. The study did not conclude that iron deficiency causes ADHD, but suggests that it could lead to ADHD symptoms in relationship with genetics, environmental risk factors, absence of iron supplementation, and diet.
A 2013 study indicated that Iron deficiency increased the risk of psychiatric disorders, including ADHD.
A 2012 meta-analysis found that people with ADHD tended to have lower iron levels than participants without ADHD. With these results in mind, people with ADHD may wish to be tested for iron deficiency.
Do not start taking iron supplements without first talking to your healthcare professional to see if it is necessary and safe. If a person is not deficient in iron, too much iron can cause significant problems.
Too much iron can be dangerous or even fatal, especially for children.
Side effects of iron supplements can include:
High doses of iron may decrease zinc absorption. Iron supplements can interact with other medications and supplements, as well. Consult with your healthcare provider or pharmacist about possible interactions.
The dosage for iron supplements depends on factors such as age, sex, how deficient the person is, and other considerations.
The maximum amount of iron daily from all sources, including food and supplements, is:
Vitamins and minerals are essential nutrients that you need to get from your diet for the proper functioning of your body. Vitamins are produced by plants or animals, while minerals come from soil and water and then are incorporated into plants and animals that we eat.
Vitamins have not been conclusively shown to directly affect ADHD, but they can correct deficiencies that may be associated with ADHD symptoms.
A small study of 20 participants found deficiencies in magnesium, zinc, and copper in children with ADHD. The study found that magnesium and zinc deficiencies correlated with hyperactivity, inattention, and impulsivity. This correlation was not found with copper deficiencies.
A 2018 study indicated the possibility that low levels of certain vitamins may contribute to ADHD symptoms. The researchers suggested it may be beneficial for people with ADHD to be checked for deficiencies.
Two of the commonly studied supplements for ADHD are magnesium and zinc.
Side effects of magnesium supplements include:
Very high doses of magnesium may cause magnesium toxicity, which is serious and can be fatal.
Too much zinc can cause side effects such as:
Both magnesium and zinc can interact with other medications and supplements. Consult your healthcare professional and pharmacist before use.
How much magnesium, zinc, or other vitamin and mineral supplements to take is highly variable depending on the person.
Talk to your healthcare provider to determine if you or your child needs vitamin or mineral supplements, and what dosage to take.
Melatonin is a hormone secreted primarily by the pineal gland (located deep in the brain). It regulates your sleep-wake cycles.
People with ADHD commonly experience problems with sleep.
The medications used to treat ADHD can also affect sleep.
Melatonin taken by children and adults with primary sleep disorders has been shown to:
While melatonin hasn't been shown to improve ADHD symptoms directly, it can help people with ADHD improve their sleep.
Melatonin is considered safe for short-term use, but there are no studies to determine safety for long-term use. No significant side effects of melatonin use in children have been reported.
Side effects of melatonin are uncommon but can include:
Typically, 3–6 milligrams (depending on the child’s weight) of melatonin is taken about a half an hour before bedtime.
There is insufficient evidence on the safety and efficacy of these supplements to support their use in the treatment of ADHD:
So many CAM treatments are suggested for ADHD that it can be hard to separate fact from fiction.
The organization Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) offers some advice for vetting these options.
CHADD suggests some red flags to look for that indicate the treatment is suspicious and should be avoided, including if:
Stimulant medications are the treatment most supported by evidence in the treatment of ADHD, but other treatments are sometimes suggested. While dietary supplements may not help ADHD symptoms on their own, they can help manage deficiencies that affect ADHD symptoms.
Before starting any treatment for ADHD, talk to your healthcare professional. It is important to determine if there are any deficiencies in you or your child before treating with supplements.
Living with ADHD can be challenging, so it is natural to look for ways to address its symptoms. But be aware that supplements are not without risks for side effects, toxic overload, or interactions with other medications. Because a product is "natural" does not mean it is safe. Be sure to discuss any supplements with your healthcare professional before taking them.