11/15/2019
Dr. K here...One of my biggest pet peeves in clinical practice is when I see a child prescribed Ritalin or Adderall for ADHD without first screening the child for iron deficiency. ⠀⠀
Multiple, multiple studies have now shown that iron deficiency is strongly linked with ADHD symptoms. And several other studies have shown that those same kids have clinical improvement in symptoms when they are supplemented with iron. No need for stimulants when iron deficiency is repleted!⠀⠀
Kids with “ADHD” should get basic bloodwork done to screen for anemia and iron deficiency. This includes (minimum!) a complete blood count, ferritin, and whole blood lead. (Lead toxicity worsens anemia, not to mention the neurological problems it causes.)⠀⠀
Remember that serum iron isn’t super helpful in diagnosing iron deficiency. CBC changes showing a trend toward hypochromic, microcytic cells suggest iron deficiency. Ferritin checks for iron stores and is more reliable in most, but not all cases. (Remember as an acute phase reactant it can be elevated in times of inflammation)⠀⠀
A note to my naturopathic colleagues: typically with adults we look for ferritin to be >60 ng/mL. (Lots if research supports this for better sleep, hair, energy, etc.) But for kids I routinely see ferritin levels under 60, even in super healthy kids. My theory is that they simply use iron so quickly for growth. Supplementing to a target of 60 is almost certainly unreasonable and unnecessary and potentially increases risk of harm. ⠀⠀
Kids who would benefit the most from iron supplementation are probably those with ferritin under 20.⠀⠀
We have lots more tips in our ADHD e-book in the shop. www.naturopathicpediatrics.com/shop⠀
