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Saturday, January 30, 2016

Using Probiotics to Treat ADHD

It turns out the bacteria in your gut may have more to do with mental health than previously thought.   According to a recent article on the Psychology Today website, probiotics have recently been gaining traction as treatment in the world of psychiatry.   However, probiotics still have a long way to go before they become standard treatment for ADHD.

Studies Examining Plausability and Effectiveness
Two studies have been published regarding the role of probiotics in ADHD treatment.  In one study done by  functional medicine practitioner, Michael R. Lyon,  and  published in one of his books, 75 children with ADHD were examined and a majority were found to have high levels of yeast and pathogenic bacteria, with low levels of beneficial bacteria.  The author concluded that probiotics might play a role in healing ADHD, but did not do a clinical trial to document that it works. 

In a second study, done by in Finland and recently published in Pediatric Research, 75 children were randomized at birth to receive either placebo or Lactobacillus rhamnosus GG.  By the age of 13, 6 out of 75 were diagnosed with ADHD.  All of them were in the placebo group.  This data could be interpreted as meaning that the probiotic prevented development of ADHD in the treatment group.  However, if that were the case, one would also expect that the prevalence of ADHD in the entire group would be less than the  prevalence of ADHD in Finland, which it is not.   One would also expect that the prevalence of ADHD in the placebo group would be the same as the background prevalence of ADHD in Finland, which it also is not.  The other issue is that the probiotics were given to these children as infants as a preventive measure, not as treatment for ADHD once it was diagnosed, so the study cannot tell us whether later supplementation would be helpful or not.  

Studies Examining Harms of Probiotics
Most studies done on probiotics do not directly assess for harms, so we do not really know whether or how often side effects occur.  Clearly when you are treating someone with live bacteria, there is always a risk of active infection rather than harmless colonization.  This isn’t such a big risk in people with developed and healthy immune systems, but could be an issue if we are talking about treating infants preventatively.  There have been case reports of infants with normal intestines developing blood infections from probiotic supplements.  So, even though supplements are available for infants, there certainly are questions as to whether they are entirely safe for all infants, especially newborns.

Another issue to be aware of is that some probiotic supplements contain gluten, which can be a problem for some people with ADHD.

The cost of quality probiotics such as Culturelle is from $12-25 per month at the time this article is being written.  If you culture your own yogurt, the price might be closer to $5 per month.

Should You or Shouldn’t You?
There is little harm in trying probiotics in the form of yogurt or other fermented foods people normally eat, unless you have a known sensitivity to the food.   Similarly, taking a probiotic supplement likely will not result in harm as long as the person taking the supplement has no risk for lower than average immunity and isn’t taking a supplement containing inactive ingredients to which he or she is sensitive (ie gluten).  

However, in the face of known possibility for harm (infection) in infants, it is a good idea to avoid probiotic supplements in infancy until more is known about their safety.  Parents who want to be sure their child is colonized with the right bacteria should still do it the natural way—skin-to-skin contact with their infant and breastfeeding.

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