Non-Drug Treatment of ADD/ADHD
Exclusive Interview with Lendon Smith, MD
Lendon H. Smith earned his MD degree and began the practice of medicine almost 55 years ago and has fought for children's health and nutrition issues for over three decades. Dr. Smith was among the first to caution against sugar, white flour, and junk food known to contribute to sickness, hyperactivity, obesity, allergies, and many illnesses in children and adults.
He has authored or co-authored 15 books, dating back to 1969. He appeared on the Phil Donohue Show more than 20 times and The Tonight Show 62 times. He was awarded an Emmy for his "My Mom's Having a Baby" after-school special. Dr. Smith has had a truly illustrious career, going from US army medic to pediatrician to national bestselling author.
You can reach Lendong Smith at lsmith13@qwest.net
Optimal Wellness Center (OWC):
You have been active on the issue of behavioral problems in childhood for many years. How did you first get involved with the issue of ADHD and related behavior disorders?
Lendon Smith, MD:
My father was a pediatrician and he believed that behavior was more genetic than environmentally produced. I was going to be a psychiatrist from about age 15 on. I felt that if we straightened out one generation, every one, including their children, would be normal after that - Freudian concept (wrong!).
In my fourth year in medical school I attended a lecture by a Portland pediatric neurologist. In the 1930s he was in charge of a home for "oddball" children. One of his clients was a wild and crazy girl. He told his nurse to give her a dose of bromide. She reached up and by mistake got hold of the benzedrine bottle. In about 30 minutes the girl was asleep.
The doctor said to the nurse, "That bromide works." The nurse said, "What did you say?"
Of course she had to fill out an accident report, but the two of them could not believe the therapeutic results. They repeated the maverick dose the next day and the girl calmed down again. The doctor wrote a paper about this and it was reported in one of the pediatric journals. He noted that most of the kids he was seeing for this same syndrome had had some sort of "hurt" to the nervous system at birth such as:
Cord around the neck
Prematurity
Second of twins
Collapsed lungs
He felt it was a "hurt" to the part of the nervous system that had to do with self-control. He had no idea why a stimulant had this calming effect. We now know that it is because there is not enough norepinephrine in their limbic system, the part of the brain that is supposed to filter out unimportant stimuli.
This serendipitous result of an accident has now allowed the psychiatrists and pediatricians to prescribe this type of narcotic drug to 4,000,000 kids on any given school day, and even pushed some of them into psychosis and homicide.
I was one of those drug-pushing pediatricians for a couple of decades. Then it became clear to me that there was a pattern to the behavior of these children. Genetics is there, of course, and can result in "hurts" to the nervous system, but my patients were 80% boys. I found in examining them --- trying to find some common denominator that I could use as a diagnostic criterion --- that they were exquisitely ticklish.
They were unable to disregard unimportant stimuli.
That is why they have trouble in the classroom with 30 other kids burping, coughing, passing gas and dropping pencils. The teacher says, "Charlie, sit down and stop moving around." No wonder home schooling is becoming popular.
Blood tests were not helpful, but hair tests showed me that they were all low in calcium and especially magnesium. No wonder they craved chocolate. (There is more magnesium in chocolate than any other food on earth.)
I began to treat them with oral doses of 500 mg magnesium and 1000 mg calcium daily. It took three weeks, but 80% of them were able to get off Ritalin or dextroamphetamine, or whatever stimulant they were on. It did not work on all of them. As time went by, I had them take vitamin B6 if dream recall was poor and essential fatty acids if they had dry skin or a history of eczema. If they had ear infections as infants, they were taken off milk.
As time went on, I found it worked on adults if they had symptoms of ticklishness and inability to disregard unimportant stimuli. Apparently these people have some enzyme defect, genetic or nutritional, that prevented them from making norepinephrine, a stimulant, which we all now recognize is made to help the filtering device in the limbic system do its job.
It is too bad that psychiatrists have failed to recognize that if a stimulant acts as a calming agent, then they must shore up the flagging enzyme that is under-producing. This all fits with the damage that we have done to the top soil. It is washing and blowing away and with it, the magnesium. The psychiatrists have made ADD/ADHD a disease, like pneumonia.
It is actually a syndrome due to a defect in the screening device of the brain. I understand that since they had made it a disease they can be compensated for treating it. Another rule they have used: "If the Ritalin works, they need it." Sort of like a Ritalin deficiency.
They had another one: "Dyscalcula" if one is bad at math. They are good with words. For instance, they know that vegetarian is an Indian word meaning: "poor hunter."
OWC:
Is ADD/ADHD a single disorder with a single cause or optimal treatment or is it more of a broad term to describe nearly all children with behavior problems?
Lendon Smith, MD:
I am glad you said "disorder," because as I mentioned previously, the condition is not a bona fide disease, but a collection of symptoms and signs that seems to get in the way of a child being educated. The teacher or school administrator is usually the one who suggests that the child see a doctor for the behavior problem (psychiatrist or pediatrician), whom they know will put the kid on Ritalin or a similar drug.
The doctor hears the story from the parents that her child (usually her son) will be thrown out of school unless something is done. She has tried isolation, spankings, standing in the corner, etc, but nothing seems to work. She also knows that a one-to-one situation would be effective.
The teacher may write down the symptoms noticed: restlessness, talkative, doesn't seem to listen, forgetful, short attention span, distractible, class clown, wants attention, may be a bully, as well as a few other related symptoms and signs.
The doctor knows what to do. Usually without even an exam, except a quick look in the eyes, and a listen to see if his heart is beating, the doctor reaches for his prescription pad and writes one out for Ritalin, 5 mg, #20 (or one of the newer drugs of the same type). "Try one or two in the morning after breakfast, and see what the teacher says. It may wreck his appetite, however."
The next day, the very first day of treatment, his attention span is better and he cannot eat his lunch. It works. It is a miracle. The doctor is called and thanked profusely. He assumes since it works that the boy needs it.
When I became familiar with nutrition, I found that if a stimulant drug had a calming effect like the above, it meant that the child did not have enough norepinephrine (a stimulant) in his limbic system, and that I could help with a good diet and some supplements which should shore up the enzymes in his brain that make that neurotransmitter.
If he had ever had ear infections, I stopped his dairy products, and added calcium 1,000 mg, usually at bedtime.
If he was ticklish, I added magnesium - 500 mg is usually safe for child or adult.
If he was a "Jekyll and Hyde" type of person (severe mood swings), he had intermittent low blood sugar and he needed to nibble all day to keep his blood sugar up. Or at least eat some additional protein and less carbohydrates for better maintenance of blood sugar levels. No sugar or white-flour junk food.
If he could not remember his dreams, he needed vitamin B6 - 50 mg is about right.
If he ever had eczema or dry scaly skin, he is to take the essential fatty acids.
If he had dark circle under his eyes, he was eating something to which he is sensitive. Milk, wheat, corn, chocolate, eggs, citrus. Usually it is his favorite food.
I often ask these children what they like to eat. I often get a smart-alec answer, like, "rutabagas, turnips, parsnips, and broccoli." (The mother is sitting in her chair shaking her head.) People tend to eat the food to which they are sensitive. It is like the alcoholic who has low blood sugar. The child who loves milk is usually sensitive to it. They continue to drink dairy products, because somehow they need the calcium, but they are so sensitive to it, it does not get absorbed. Blood and hair tests will reveal the deficiencies.
OWC:
What are some of the causes and cures for ADD/ADHD? Do you recommend diagnostic tests for nutritional deficiencies? Are there obvious signs of deficiencies other than the ones mentioned previously?
Lendon Smith, MD:
Over time back in the 1960s and 70s, I began to notice there were certain common symptoms and signs amongst the "hyper" children I saw who had been pre-diagnosed by the teachers.
In addition to being 80% boys, they were usually blue-eyed blondes or green-eyed redheads.
About half of them had dark circles under their eyes (a give-away that they were eating something to which they were sensitive. Not necessarily allergic, but at least sensitive.) In most cases, that sign indicated a dairy sensitivity.
That stimulated me to ask about any ear infections the child had as an infant. Almost all had suffered from a few of those painful conditions. This is another clue that dairy products may account for some of the symptoms. Next question I asked the mother: "Does he drink milk?" Her answer: "Oh, yes, he loves it. Isn't he supposed to drink it?" Well, yes and no. If a person loves something, it suggests that he is allergic, addicted, or sensitive to it. Like chocolate or booze.
OWC: Next question for the mother:
"Anything unusual about the pregnancy with him?"
Many, but not all, of the mothers responded with some or all of the following problems:
Nausea for all the nine months
Not much weight gain during the pregnancy
Threatened miscarriage with spotty bleeding
Overwhelming food cravings (sweets, chocolate, dairy, pickles, or whatever)
Emotional stress (e.g., stress from mother-in-law)
Fetus was always moving in the uterus ("he once kicked so hard, he knocked me out of bed.")
Some mothers had delivery problems like:
Placenta previa
Precipitous delivery
Nurse tried to hold him back
Big baby--- over 10 pounds
Small --- under 4 pounds
Blue coloring at birth
Needed the incubator for a few days
Still other mothers reported problems during early infancy:
Could not latch on to breast feeding
Constant colic for the first several weeks
Required many formula changes
Some had all of the above; but some had none of them.
Then there followed the ear infections, as well as high fever and screaming after the vaccinations. He was a "touchy" kid.
OWC:
"Does he have mood swings? Is he a Jekyl-and-Hyde person?" If yes, it is due to fluctuating blood sugar, as sugar (glucose) is a substance that the brain needs in a constant supply.
Then the physical exam started. He noticed what I was doing and needed constant reassurance that I was not going to hurt him. The heart was beating, and as I moved the stethoscope around to hear the different heart sounds, he would ask, "Can't you find it?" When I looked in his ears, and usually noted some retraction of the eardrums, he acted a if he could hear the light. The abdominal exam was difficult because he was so ticklish --- exquisitely so. I had to forget the hernia exam, even though I had backed him up against the wall by this time. These patients were usually of wirey and/or athletic build; they were rarely obese.
Because so many of these patients had some or all of the above symptoms and signs, it suggested to me that they had a vitamin or more likely, a mineral deficiency. I did some blood and hair tests. All of them, yes, all of them, had a calcium and magnesium deficiency, despite the fact that many were drinking a quart of milk a day. Apparently they could not absorb the calcium from the dairy products because of their sensitivity. The intestines were rejecting it. It also explained why they loved the milk: somehow the body was telling them to drink it to get the calcium.
Another possibility: when they had ear infections, they were put on antibiotics and those frequently needless use of powerful drugs could have wiped out the friendly bacteria and allowed the yeast, candida to grow, or at least produce an intestinal dysbiosis, and poor absorption. As I mentioned previously, but can't stress enough, there is this rule: If you love something, you are probably sensitive to it.
Diagnosis Recap
Just to recap some of my previous statements, after a few years of trying to be a good diagnostician, I accumulated these findings:
1. If a person is ticklish, goosey, sensitive, and notices everything in his environment, as he is unable to disregard unimportant stimuli, it means that he is low in magnesium, and possibly calcium. Muscle cramps and trouble relaxing or going to sleep also suggest low magnesium and calcium. These symptoms correlate nicely with the hair test showing low levels of these two minerals.
2. Poor dream recall is related to a need for vitamin B6.
3. A history of eczema or dry, scaly skin usually means a person is low in the essential fatty acids. These acids are also necessary for brain function. The nutmeg-grater feel to the skin on the thighs and back of the upper arms is usually a Vitamin A deficiency. White spot on the nails is due to low zinc.
4. A bad self-image could be the result if the parents, teachers, and classmates who are all screaming at him to sit still, shut up, and constantly asking disparagingly "What are you dong now?"
Ritalin works in just 30 minutes, while the minerals and the other supplements and diet changes take about three weeks to achieve results. The whole family has to stop the desserts, sugars, white flour, and "put-downs". Too many questions and commands lead to the poor self image.
OWC:
Are Ritalin and other stimulant drugs being over used or at least oversubscribed? Is there a proper place for these drugs? Are there any children who can't be helped in any other way? If so, what % would you say fall into this category?
Dr. Smith:
There is no doubt that these stimulant drugs are being over-prescribed for these out-of-control children. If, however, the prescribing doctor feels he/she has no alternative for the child who has been "diagnosed" by the teacher who is trying to scrape this child off the wall, the drug seems mandatory. "If it works, the child needs it" seems to be the motto.
Those of us working with these children like Dr. Doris Rapp and Dr. Billy Crook have no doubt that this is usually "a physiological screwup" and not a disease. (One reason it is called a disease is that insurance companies need a standard diagnosis before they will pay for the treatment.) ADHD and ADD have been now called diseases and have a diagnosis code number, for the psychiatrists along with the previously mentioned "disease" called dyscalculia.
ADHD will subsequently soon become a palpable disease called a neurosis when the child gets depressed and even suicidal if he is put down at every turn by teachers, parents, and his peers.
The only proper use for these drugs for a vast majority of kids --- as I have come to realize --- is that it will temporarily control the restless behavior.
If it works, it is not a "Ritalin deficiency", but likely a magnesium, calcium, or vitamin B6 deficiency. I have learned from my naturopathic and herbal therapists that our topsoil is becoming deficient in several minerals. The farmers are putting nitrogen, phosphates, and potassium (NPK) on the soil and their plants grow and look healthy but magnesium, zinc, selenium and other valuable minerals are depleted.
At the height of the dust bowl, the US Department of Agriculture put out a "white paper" saying that the minerals in the top soil were deficient and people may have to supply their own with supplements to avoid sickness and problems like early aging, heart attacks, joint problems, and surliness.
The point seems to be that sometimes we cannot get everything we need for healthy living from eating foods from the store or maybe even from organic farms, although those will likely be better.
Then, on top of that, if we or our children are eating the "Standard American Diet" (SAD) our nutritional status will only be worse. If a person has even one cavity, he is flawed already, and it is a clue that other nasties are just around the corner.
Maybe, a small percent, like ten percent or less of "hyper" children may need the drugs to calm them, mainly because they have had some sort of injury to their nervous system that diet will not touch.
Many of those, however, can be still be salvaged with neurodevelopment therapy. I have seen the work of those therapists and know of the miracles they can perform. Homeopathy is a well-known and sometimes surprising type of treatment, that has saved many of these "throw away" children before they give up and go into crime for their kicks.
There are so many side effects from the stimulant drugs, I would recommend that the diet modifications, outlined elsewhere, should be tried first. These children realize they are not so bad and will even start to smile and laugh. It helped me. I was the class clown in the 6th grade, because the teacher did not know what to do with me besides making me the "humor editor" of the class newspaper.
Don't give up on these children! Remember Edison, Sir Winston Churchill, and Einstein.
Books Written by Dr Lendon Smith:
1. The Children's Doctor - 1969
2. Encyclopedia of Baby and Child Care - 1972
3. New Wive's Tales - 1974
4. Improving Your child's Behavior Chemistry - 1976
5. Feed Your Kids Right - 1978
6. Foods for Healthy Kids - 1980
7. Feed Yourself Right - 1982
8. Dr. Smith's Low Stress Diet - 1984
9. Dr. Smith's Diet Plan for Teenagers - 1986
10. Vitamin C as a Fundamental Medicine - 1988
11. Hyper Kids Workbook - 1990
12. Happiness is a Healthy Life - 1992
13. Feed Your Body Right - 1994
14. How to Raise a Healthy Child (Hardcover or Paberback) - 1996
15. The Infant Survival Guide - 2000
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