Micronutrients (vitamins + minerals) show benefit for children with ADHD and emotional dysregulation

Washington, DC, April 26, 2022 – A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that children with ADHD and emotional regulation randomized to take a micronutrient formula were three times more likely to show symptomatic improvement on blinded clinician ratings, compared to those in the placebo group (54% versus 18%). The micronutrient formula, consisting of all known vitamins and essential minerals, was administered for eight weeks.

“Supplementing with all known vitamins and essential minerals, at doses between Recommended Daily Allowance and Upper Tolerable Limit, may improve mood and concentration in children with ADHD and emotional dysregulation,” said lead author Jeanette Johnstone, PhD, Assistant Professor, Department of Child and Adolescent Psychiatry, Oregon Health & Science University and Helfgott Research Institute, National University of Natural Medicine.

“These findings, replicating results of a previous randomized trial of micronutrients in children with ADHD conducted in New Zealand, confirm that supplementation with a broad range of nutrients may benefit some children. These findings may offer guidance to doctors and families seeking integrative treatments for their children with ADHD and related emotional dysregulation,” Dr. Johnstone noted.

The triple-blinded study enrolled 135 medication-free children and their parents at three sites (Portland, Oregon; Columbus, Ohio; Alberta, Canada) and randomized participants to either micronutrient or placebo capsules for eight weeks. Three-quarters of the participants were adherent to the study protocol. The intervention was well-tolerated, with no significant differences in adverse events between the micronutrient and placebo groups, or safety concerns based on blood and urine tests. Parents, children and clinicians were blinded to treatment allocation and were not able to guess assignment better than chance.

In addition to behavioral and emotional benefits, children taking micronutrients grew 6mm more in height than those taking placebo after adjusting for baseline height. “The growth finding, also a replication from the previous child micronutrient study, is particularly encouraging, as height suppression is a concern with first-line ADHD medication,” Dr. Johnstone added.

In contrast to clinician ratings, parents, who were also blinded to their child’s treatment allocation, reported significantly improved behavior that was equal in both the micronutrient and placebo groups, with no significant between-group differences, highlighting the importance of blinded clinician ratings.

“No treatment is 100% effective for all with ADHD,” commented L. Eugene Arnold, MD, Professor Emeritus of Psychiatry & Behavioral Health at Ohio State University and one of the senior co-authors. “For example, about 2/3 respond to the first stimulant drug tried, which is an established first-line ADHD treatment despite emotional, appetite, and growth side effects. So, it’s encouraging that a good half of the children responded to this relatively safe treatment.”

“Future studies will focus on the micronutrients’ mechanisms of action and subgroup responses to understand for whom and why this intervention works. Mechanistic hypotheses to be tested include changes in the gut microbiome and its metabolome, reductions in inflammatory markers (e.g. cytokines), replenishment of minerals, and optimization of neurotransmission. In order to increase parent sensitivity to child behavior changes, we plan to utilize real-time data reporting methods such as ‘ecological momentary assessment’ using a phone or other device to capture behaviors when they occur,” added Dr. Johnstone.

Watch the families’ experiences with the micronutrients, while part of the studies on YouTube here and here.

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Notes for editors
The article is "Micronutrients for Attention-Deficit/Hyperactivity Disorder in Youths: A Placebo-Controlled Randomized Clinical Trial” by Jeanette M. Johnstone, PhD, Irene Hatsu, PhD, RD, Gabriella Tost, BA, Priya Srikanth, MPH, Leanna P. Eiterman, PhD, Alisha M. Bruton, ND, MS, Hayleigh K. Ast, ND, Lisa M. Robinette, MS, Madeline M. Stern, MS, Elizabeth G. Millington, MC, Barbara L. Gracious, MD, Andrew J. Hughes, MD, Brenda M.Y. Leung, PhD, L. Eugene Arnold, MD, Med (https://doi.org/10.1016/j.jaac.2021.07.005). It currently appears on the JAACAP Articles In Press page and will appear in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 61, issue 5 (May 2022), published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact the JAACAP Editorial Office at support@jaacap.org or +1 202 587 9674. Journalists wishing to interview the authors may contact Jeanette M. Johnstone, PhD, at jojeanet@ohsu.edu.

About JAACAP
Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

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