What essential fatty acids supplements can I try for my child with ADHD?

Leopold D. Galland, MD
Internal Medicine
If your child with attention deficit hyperactivity disorder (ADHD) has dry skin, follicular keratoses (tiny rough bumps, usually found on the back of the arms and popularly known as chicken skin), brittle nails, dry and unruly hair, or excessive thirst, she or he probably needs a dietary supplement of essential fatty acids (EFAs). A study done in the Department of Foods and Nutrition at Purdue University found that boys with ADHD had significantly lower concentrations of essential fatty acids in their blood than a control population. The lowest levels were found in those boys with the symptoms listed above. The deficiency of essential fatty acids probably represents a metabolic disturbance. It may be compensated for by supplementation with flax seed oil, fish oils, or evening primrose oil. There is no single supplement that will meet the needs of all children. I often use organic flax seed oil, generally one teaspoon per day. My reasons for choosing flax oil are that most Americans are deprived of alpha-linolenic acid (the leading omega-3 essential fatty acid in the diet) because of food processing and food choices. Supplying a nutritional dose of alpha linolenic acid allows the child to overcome this deficiency in the safest fashion.

If there is no improvement in behavior, concentration, or dryness, I may replace flax oil with fish oil, generally supplying 300 to 400 milligrams of docosahexaenoic acid (DHA) per day. DHA is the omega-3 essential fatty acid with the highest concentration in the brain. If hyperactivity or dryness intensifies with omega-3 supplementation, it indicates the need for omega-6 supplements. The leading omega-6 essential fatty acid in the diet is linoleic acid. Although deficiency of linoleic acid is extremely rare, the Purdue group found low levels of its major metabolites in the blood of children with ADHD. For those children who do not respond well to omega-3 essential fatty acid supplements, the most effective way to increase the levels of linoleic acid metabolites (omega-6 EFAs) is to supplement with evening primrose oil or borage oil, which supply the biologically active linoleic acid derivative gamma linolenic acid (GLA). Proper EFA supplementation will improve not only behavior but also dryness of the skin and hair and brittle nails.

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