Natural Remedies for ADHD: How to Augment Treatment with Medication

Medication is a valuable tool for managing the core symptoms of attention deficit hyperactivity disorder (ADHD). For those people who do not want to take the medication route behavioral therapy, nutrition and lifestyle changes, and/or brain training, among other natural therapies designed to improve focus and impulsivity may help alleviate some ADHD symptoms.

The fact remains: Between 80%-85% of patients with ADHD experience a positive response to methylphenidate and/or amphetamine — the two main classes of stimulant medication. Still, the widely-cited Multi-Modal MTA Cooperative Group Study¹ concluded that medication combined with behavior therapy is the optimal treatment of ADHD in school-age children. Here, we discuss the natural treatments used by many individuals with ADHD to augment medication.

[People Also Ask: Is ADHD Medication Right for My Child?]

¹ The MTA Cooperative Group. A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry. 1999;56(12):1073–1086. doi:10.1001/archpsyc.56.12.1073

"There's no way to predict in advance if a child or an adult will be helped by any individual ADHD treatment, even medication," says Duke University's David Rabiner, Ph.D. His advice? It is critical to monitor your ADHD symptoms (and those of your child) to know what's working — and to be open to a variety of changes in nutrition, exercise, sleep habits, and more.

Many experts recommend keeping a symptom log to track improvements, setbacks, and side effects on a daily basis. This can help to pinpoint the areas of greatest need and, when shared with a medical professional, may suggest new strategies or treatment approaches.

[Free Download: What to Eat (and Avoid) for Improved ADHD Symptoms]

Behavioral therapy for ADHD is a structured discipline strategy that aims to teach children new ways of behaving by rewarding desired behavior, such as following directions, and eliminating undesired actions, such as losing homework. The American Psychological Association says that behavior therapy should be the first line of treatment for children with ADHD under five. It can be effective for older children as well.

New research, additionally, shows that behavioral parent training (BPT)—which teaches parents skills for effective, productive interactions with their ADHD children— reduces parental stress and instances of non-compliance. Popular BPT programs like Incredible Years and Triple-P typically span 12 to 20 sessions, each of which focuses on teaching parents new, specific techniques for addressing problem behaviors. The ultimate goal of these programs is to strengthen the parent-child relationship while teaching strategies for long-term behavior improvement.

The omega-3 fatty acids found in fish oil are important in brain and nerve cell function. The body cannot make omega-3 fatty acids by itself, so people have to get them through food, supplements, and vitamins. There are two types of omega-3 fatty acids in fish oil, EPA and DHA. The best supplements have two or three times more EPA than DHA.

[Free Download: Fish Oil Treatments for ADHD Symptoms]

While the benefits of omega-3 fatty acids are clear, evidence of their role in treating ADHD symptoms is currently inconclusive, according to the National Center for Complementary and Integrative Health. A 2018 review¹ of several studies involving children with ADHD undergoing omega-3 treatment, for example, found some evidence to support the role of the nutrient in ADHD treatment, while a similar review in 2017² found otherwise.

¹ Chang, JP., Su, KP., Mondelli, V., Pariante, CM. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. July 25, 2019. Doi: 10.1038/npp.2017.160

² Catala-Lopez, F., Hutton, B., Nunez-Beltran, A., Page, MJ., et. al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials. PLoS ONE 12(7): e0180355. https://doi.org/10.1371/journal.pone.0180355

CBT aims to change irrational or negative thought patterns that interfere with staying on task or getting things done — two obstacles for individuals with ADHD. For a person with ADHD who thinks, "This has to be perfect or it's no good" or "I never do anything right," CBT challenges the truth of those thoughts by getting the patient to examine the evidence.

Some research supports the assertion that CBT can help adults better address their ADHD-related challenges. However, some in the scientific community would like to see more rigorous research conducted with carefully constructed controls. In its 2010 report¹ titled, “Current Status of Cognitive Behavioral Therapy for Adults Attention-Deficit Hyperactivity Disorder,” researchers from Massachusetts General Hospital and Harvard Medical School wrote: “The conceptual and empirical basis for CBT approaches in adult ADHD is growing and suggests that targeted, skills-based interventions have a role in effectively treating this disorder, however… randomized controlled trials with active control groups are needed and intervention packages must be tested across multiple trials by more than one research group.”

¹ Knouse, LE., Safren, SA., Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatric Clinics of North America. September 2010. https://doi.org/10.1016/j.psc.2010.04.001

An ADHD diet rich in proper nutrition is a powerful tool for managing ADHD symptoms. Studies by Massachusetts Institute of Technology neuroscientist Richard Wurtman,Ph.D.¹, and others have shown that protein triggers neurotransmitters responsible for inducing alertness while carbohydrates trigger drowsiness. Protein also prevents surges in blood sugar that may increase hyperactivity. High-fiber foods such as fruits and vegetables, whole grains, and legumes can help stabilize energy levels. If you or your child is taking a stimulant medication, a low-fat breakfast will maximize its effectiveness. Fats can cause the body to absorb the medication more slowly, delaying the drug’s effectiveness.

Depending on their age, children need between 24 to 30 grams of protein a day. Adults need 45 to 70 grams. Many nutritionists recommend starting the day with a breakfast comprising a balance of complex carbohydrates and protein such as eggs with whole wheat toast or whole grain pancakes with yogurt.

¹ Wurtman, Richard J. “Nutrients That Modify Brain Function.” Scientific American, vol. 246, no. 4, 1982, pp. 50–59., doi:10.1038/scientificamerican0482-50.

Several ADHD vitamins and minerals are key to producing and regulating neurotransmitter levels in the brain, especially when a child or adult is deficient in one of them. Vitamin C is a building block of neurotransmitters, while iron and vitamin B6 increase dopamine levels. Zinc regulates dopamine, and may help treat ADHD symptoms in some children when used with conventional medication and treatments.¹

[Free Guide: The Best Food for ADHD Symptoms]

One small study² showed ferritin levels (a measure of iron stores) to be low in 84% of children with ADHD, compared to 18% of a control group. Low iron levels — and low zinc levels, as well — correlate with severe ADHD, however, patients should not begin using supplements without the supervision and direction of their doctor.

¹ Akhondzadeh, Shahin. “Zinc Sulfate as an Adjunct to Methylphenidate for the Treatment of Attention Deficit Hyperactivity Disorder in Children: A Double Blind and Randomized Trial.” BMC Psychiatry, vol. 4, no. 9, 2004, doi:10.1186/isrctn64132371.

² Konofal, Eric, Michel Lecendreux, Isabelle Arnulf, and Marie-Christine Mouren. “Iron Deficiency in Children With Attention-Deficit/Hyperactivity Disorder.”Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 12, 2004, pp. 1113.

Exercise helps the ADHD brain function more effectively and efficiently. One well-known benefit of exercise is an increase in endorphins, which can improve mood. Exercise also elevates the brain’s levels of dopamine, norepinephrine, and serotonin, which increases focus and attention.

Studies have shown¹ that short-term aerobic exercise, including yoga, has positive effects on attention, hyperactivity, impulsivity, executive function, and other ADHD symptoms. Walking for 30 minutes four times a week will also do the trick, and skill-based exercises like martial arts or ballet are especially effective for those with ADHD.

¹ Cerrillo-Urbina, A., García-Hermoso, A., & Sánchez-López, M., et.al. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials: Exercise and attention deficit hyperactivity disorder. Child Care Health and Development. 2015. doi: 10.1111/cch.12255

Brain training for ADHD is growing in popularity and availability. Programs can be found for smartphones, computers, tablets, and beyond. Various brain training systems claim to improve common executive functioning challenges among people with ADHD, such as attention, impulsivity, and working memory. Many of the programs have layouts that look and feel like video games but are designed to exercise these specific brain functions.

Programs generally fall under neurofeedback training — which aims to change physiological activity by monitoring brain waves — and cognitive training, which focuses on improving specific brain skills like problem-solving and reading comprehension mainly through games and other exercises.

Whether brain training definitively works to improve ADHD symptoms, however, is still being researched. Some studies have demonstrated improved brain functioning in users. Critics, however, question how much users are actually benefitting. “Existing research does suggest that neurofeedback can result in improved attention, diminished hyperactivity, and enhanced executive functions, including working memory, for some patients,” said David Rabiner, Ph.D., and Ed Hamlin, Ph.D., in a 2017 ADDitude webinar. “However, some of the most important researchers in the ADHD field would argue that the efficacy of neurofeedback for ADHD has not been conclusively established. The bottom line is that research support for both stimulant medication therapy and behavior therapy is stronger than it is for neurofeedback at the moment.”

One brain training program, Play Attention, bills itself as a learning system that uses both neurofeedback and cognitive training to help users boost focus, refine memory skills, ignore distractions, and finish tasks. A series¹ of² randomized, controlled studies by Tufts University School of Medicine found that its users showed greater improvements in attention, hyperactivity, and executive functioning than students who used other programs.

[Free Webinar: The Right Way to Train Your Brain With Games and Apps]

¹Steiner, Naomi J., et al. “Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial.” Clinical Pediatrics, vol. 50, no. 7, 10 May 2011, pp. 615–622., doi:10.1177/0009922810397887.

² Steiner, Naomi J., et al. “Neurofeedback and Cognitive Attention Training for Children with Attention-Deficit Hyperactivity Disorder in Schools.” Journal of Developmental & Behavioral Pediatrics, vol. 35, no. 1, Jan. 2014, pp. 18–27., doi:10.1097/dbp.0000000000000009.

Green time is especially effective in helping kids recover from attention fatigue, which occurs after a long school day. Gardening, biking to school, and walking the dog in the park are all good ways to incorporate green time into the day.

Neurofeedback is a high-tech way, which claims to ease ADHD symptoms. During a session, the patient dons an electrode-lined cap and is asked to perform a complex cognitive task. The aim is to teach patients to produce brain-wave patterns associated with focus. Sessions are brief (30 minutes) and painless, but expensive. A course of treatment can range from $2,000 to $5,000.

Neurofeedback’s efficacy in treating ADHD symptoms is not conclusive, with multiple studies and reviews revealing opposing or weak evidence for the treatment.

[ADHD Directory: Find an ADHD Specialist or Clinic Near You]

Mindful meditation for ADHD is attention/awareness training that helps manage stress, develop positive emotions, and strengthen self-regulation skills. It involves silent meditation and becoming more aware during daily activities. In other words, you stay "in the moment" as much as possible. Researchers wrote in a 2015 review¹ of multiple, similar studies that mindfulness provides “promising preliminary support for its efficacy” in treating ADHD symptoms. More research, however, is needed to definitively prove its effectiveness.

How to Treat ADHD in Children: Next Questions

1. What ADHD medications are used to treat children?
2. Is ADHD medication right for my child?
3. What are common side effects associated with ADHD medication?
4. What natural treatments help kids with ADHD?
   • What are the most effective natural ADHD treatments for kids?
   • What foods can help control ADHD symptoms?
   • What vitamins and supplements should my child take?
   • Does brain training help with ADHD?
   • How much and what type of exercise helps kids with ADHD?
   • What types of therapy help patients with ADHD?
5. What if the medication stops working?
6. How can I find an ADHD specialist near me?

¹ Mitchell, J. T., Zylowska, L., & Kollins, S. H. (2015). Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions. Cognitive and behavioral practice, 22(2), 172–191. doi:10.1016/j.cbpra.2014.10.002