ADHD reduced by just 3,000 IU of Vitamin D and methylphenidate for just 12 weeks – RCT Feb 2018

The Impact of Vitamin D Supplementation on Attention-Deficit Hyperactivity Disorder in Children

Annals of Pharmacotherapy https://doi.org/10.1177/1060028018759471
Hatem Hamed Elshorbagy, MD shorbagy732000 at yahoo.com, Naglaa Fathy Barseem, MD, Waleed Elsayed Abdelghani, MD, ...

 Download the PDF from Sci-Hub via Vitamin D Life

Background: The role of nutrients and dietary factors in attention-deficit hyperactivity disorder (ADHD) remains unclear.

Objectives: The primary objective was to evaluate the serum vitamin D level in children with a diagnosis of ADHD. The secondary objective was to detect the effect of vitamin D supplementation on cognitive function in those with vitamin D deficiency.

Methods: A total of 50 children with ADHD and 40 healthy controls were included in the study. We measured the serum level of vitamin D. Patients with vitamin D deficiency were subdivided into 2 groups: one with vitamin D supplementation and the other without vitamin D supplementation. Further assessment and follow-up of children with ADHD was done. The Wisconsin Card Sorting Test, Conners’ Parent Rating Scale, and Wechsler Intelligence Scale for Children were performed at baseline and follow-up in all cohorts with an ADHD diagnosis.

Results: The diagnosis of vitamin D deficiency was significantly greater in children with ADHD compared with the control group (P < 0.05). Children with ADHD had significantly (P = 0.0009) lower values of serum vitamin D (17.23 ± 8.98) than the control group(31.47 ± 14.42). The group receiving vitamin D supplementation demonstrated improvement in cognitive function in the conceptual level, inattention, opposition, hyperactivity, and impulsivity domains.

Conclusion: Vitamin D supplementation in children with ADHD may improve cognitive function.

References

• 1. Arns, M, van der Heijden, KB, Arnold, LE, Kenemans, JL. Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: the sunny perspective. Biol Psychiatry. 2013;74:585-590. https://doi.org/10.1016/j.biopsych.2013.02.010. Accessed February 5, 2018. Google Scholar
• 2. Wehmeier, PM, Schacht, A, Barkley, RA. Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health. 2010;46:209-217. https://doi.org/10.1016/j.jadohealth.2009.09.009. Accessed February 5, 2018. Google Scholar
• 3. Leroux, JR, Turgay, A, Quinn, D. Advances in ADHD treatment. Can J Diagn. 2009;26:49-52. Google Scholar
• 4. Kemper, KJ, Gardiner, P, Birdee, GS. Use of complementary and alternative medical therapies among youth with mental health concerns. Acad Pediatr. 2013;13:540-545. https://doi.org/10.1016/j.acap.2013.05.001. Accessed February 5, 2018. Google Scholar
• 5. Eyles, DW, Burne, THJ, McGrath, JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013;34:47-64. https://doi.org/10.1016/j.yfrne.2012.07.001. Accessed February 5, 2018. Google Scholar
• 6. Russell, G, Ford, T, Rosenberg, R, Kelly, S. The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence. J Child Psychol Psychiatry. 2014;55:436-445. https://doi.org/10.1111/jcpp.12170. Accessed February 5, 2018. Google Scholar
• 7. Groves, NJ, Kesby, JP, Eyles, DW, McGrath, JJ, Mackay-Sim, A, Burne, TH. Adult vitamin D deficiency leads to behavioural and brain neurochemical alterations in C57BL/6J and BALB/c mice. Behav Brain Res. 2013;241:120-131. https://doi.org/10.1016/j.bbr.2012.12.001. Accessed February 5, 2018. Google Scholar
• 8. Vinh Quoc Luong, K, Thi Hoang Nguyen, L. Vitamin D and Parkinson’s disease. J Neurosci Res. 2012;90:2227-2236. https://doi.org/10.1002/jnr.23115. Accessed February 5, 2018. Google Scholar
• 9. Eyles, DW, Burne, TH, McGrath, JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013;34:47-64. https://doi.org/10.1016/j.yfrne.2012.07.001. Accessed February 5, 2018. Google Scholar
• 10. Gale, CR, Robinson, SM, Harvey, NC. Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr. 2008;62:68-77. https://doi.org/10.1038/sj.ejcn.1602680. Accessed February 5, 2018. Google Scholar
• 11. Whitehouse, AJ, Holt, BJ, Serralha, M, Holt, PG, Kusel, MM, Hart, PH. Maternal serum vitamin D levels during pregnancy and offspring neurocognitive development. Pediatrics. 2012;129:485-493. https://doi.org/10.1542/peds.2011-2644. Accessed February 5, 2018. Google Scholar
• 12. Liska, D, Quinn, S, Lukaczer, D, Jones, D, Lerman, R. Textbook of Clinical Nutrition: A Functional Approach. 2nd ed. Washington, DC: Institute for Functional Medicine; 2004:171-172. Google Scholar
• 13. Ross, AC, Taylor, CL, Yaktine, AL, del Valle, HB. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academies Press; 2011. Google Scholar
• 14. Ellison-Wright, I, Ellison-Wright, Z, Bullmore, E. Structural brain change in attention deficit hyperactivity disorder identified by meta-analysis. BMC Psychiatry. 2008;8:51. https://doi.org/10.1186/1471-244X-8-51. Accessed February 5, 2018. Google Scholar
• 15. Mithal, A, Wahl, DA, Bonjour, JP. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20:1807-1820. https://doi.org/10.1007/s00198-009-0954-6. Accessed February 5, 2018. Google Scholar
• 16. Steinmetz, JP, Brunner, M, Loarer, E, Houssemand, C. Incomplete psychometric equivalence of scores obtained on the manual and the computer version of the Wisconsin Card Sorting Test? Eur J Psychol Assess 2010;22:199-202. https://doi.org/10.1037/a0017661. Accessed February 5, 2018. Google Scholar
• 17. Cui, X, Pertile, R, Liu, P, Eyles, DW. Vitamin D regulates tyrosine hydroxylase expression: N-cadherin a possible mediator. Neuroscience. 2015;304:90-100. https://doi.org/10.1016/j.neuroscience.2015.07.048. Accessed February 5, 2018. Google Scholar
• 18. Orme, RP, Bhangal, MS, Fricker, RA. Calcitriol imparts neuroprotection in vitro to midbrain dopaminergic neurons by upregulating GDNF expression. PLoS One. 2013;8:e62040. https://doi.org/10.1371/journal.pone.0062040. Accessed February 5, 2018. Google Scholar
• 19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 2002. Google Scholar
• 20. Heaney, RP. Defining deficiency of vitamin D. Clin Lab Int. 2010;34:16-19. Google Scholar
• 21. Heaney, RP. Health is better at serum 25(OH)D above 30ng/ml. J Steroid Biochem Mol Biol. 2013;136:224-228. https://doi.org/10.1016/j.jsbmb.2012.09.032. Accessed February 5, 2018. Google Scholar
• 22. El-Sheikh, M, Bishry, Z, Sadek, A. Attention Deficit Hyperactivity Disorder: An Egyptian Deficit Hyperactivity Disorder. An Egyptian Study. Cairo, Egypt: Ain Shams University Press; 2002. Google Scholar
• 23. Conners, CK. Rating scales for use in drug studies with children. Psychopharmacol Bulletin (Special Issue on Children) 1973; 24:24-29. Google Scholar
• 24. Goldstein, FC, Green, RC. Assessment of problem solving and executive functions. In: Mapou, RL, Spector, J, eds. Clinical Neuropsychological Assessment. New York, NY: Plenum Press; 1995:49-81. https://doi.org/10.1007/978-1-4757-9709-1_3. Accessed February 5, 2018. Google Scholar
• 25. Melika, L, Dar El-Nahda El-Masryia. Wechsler Intelligenee Scale for Children: Arabic Version. Cairo, Egypt:1984. Google Scholar
• 26. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911-1930. https://doi.org/10.1210/jc.2011-0385. Accessed February 5, 2018. Google Scholar
• 27. Kamal, M, Bener, A, Ehlayel, MS. Is high prevalence of vitamin D deficiency a correlate for attention deficit hyperactivity disorder? Atten Defic Hyperact Disord. 2014;6:73-78. https://doi.org/10.1007/s12402-014-0130-5. Accessed February 5, 2018. Google Scholar
• 28. Goksugur, SB, Tufan, AE, Semiz, M. Vitamin D status in children with attention deficit hyperactivity disorder. Pediatr Int. 2014;56:515-519. https://doi.org/10.1111/ped.12286. Accessed February 5, 2018. Google Scholar
• 29. Sharif, MR, Madani, M, Tabatabaei, F, Tabatabaee, Z. The relationship between serum vitamin D level and attention deficit hyperactivity disorder. Iran J Child Neurol. 2015;9(4):48-53. Google Scholar, Medline
• 30. Shang-Guan, LL, Zhao, YR. Serum levels of 25-hydroxyvitamin D in children with attention deficit hyperactivity disorder. Zhongguo Dang Dai Er Ke Za Zhi. 2015;17:837-840. Google Scholar, Medline
• 31. Tolppanen, AM, Sayers, A, Fraser, W. The association of 25-hydroxyvitamin D3 and D2 with behavioural problems in childhood. PLoS One. 2012;7:e40097. https://doi.org/10.1371/journal.pone.0040097. Accessed February 5, 2018. Google Scholar
• 32. Strøm, M, Halldorsson, TI, Hansen, S. Vitamin D measured in maternal serum and offspring neurodevelopmental outcomes: a prospective study with long-term follow-up. Ann Nutr Metab. 2014;64:254-261. https://doi.org/10.1159/000365030. Accessed February 5, 2018. Google Scholar
• 33. Gustafsson, P, Rylander, L, Christian, HL. Vitamin D status at birth and future risk of attention deficit/hyperactivity disorder (ADHD). PLoS One. 2015;10:e0140164. https://doi.org/10.1371/journal.pone.0140164. Accessed February 5, 2018. Google Scholar
• 34. Rickel, AU, Brown, RT. Attention-Deficit/Hyperactivity Disorder in Children and Adults. Boston, MA: Hogrefe & Huber; 2007. Google Scholar
• 35. Bryan, J, Osendarp, S, Hughes, D, Calvaresi, E, Baghurst, K, van Klinken, JW. Nutrients for cognitive development in school-aged children. Nutr Rev. 2004;62:295-306. https://doi.org/10.1111/j.1753-4887.2004.tb00055.x. Accessed February 5, 2018. Google Scholar
• 36. El Baza, F, AlShahawi, H, Zahra, S, Abdel Hakim, R. Magnesium supplementation in children with attention deficit hyperactivity disorder. Egypt J Med Hum Genet. 2016; 17:63-70. Google Scholar, Crossref
• 37. Rucklidge, JJ, Johnstone, J, Gorman, B, Boggis, A, Frampton, CM. Moderators of treatment response in adults with ADHD treated with a vitamin-mineral supplement. Prog Neuropsychopharmacol Biol Psychiatry. 2014;50:163-171. https://doi.org/10.1016/j.pnpbp.2013.12.014. Accessed February 5, 2018. Google Scholar
• 38. Mohammadpour, N, Jazayeri, S, Tehrani-Doost, M. Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: a randomized, double blind, placebo-controlled trial [published online December 7, 2016]. Nutr Neurosci. doi:10.1080/1028415X.2016.1262097. https://doi.org/10.1080/1028415X.2016.1262097. Accessed February 5, 2018. Google Scholar
• 39. Tolppanen, A-M, Sayers, A, Fraser, WD, Lewis, G, Zammit, S, Lawlor, DA. The association of 25-hydroxyvitamin D3 and D2 with behavioural problems in childhood. PLoS One. 2012;7:e40097. doi:10.1371/journal.pone.0040097. https://doi.org/10.1371/journal.pone.0040097. Accessed February 5, 2018. Google Scholar
• 40. Otten, JJ, Hellwig, JP, Meyers, LD, eds. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. Washington, DC: National Academies Press; 2006. Google Scholar