Toward ‘element balance’ in ADHD: an exploratory case control study employing hair analysis

ABSTRACT

Background: Head hair analysis has been used for decades to clarify mineral relationships to symptoms of ADHD, but there is little consensus among findings. We sought to explore 33 hair element concentrations and their 528 calculated ratios among two groups of boys, one with ADHD and one without.

Method: 107 boys aged 7–12 years were recruited; 55 with ADHD and 52 non-ADHD Controls. Hair minerals were compared using Mann–Whitney U tests, p<0.01 was used for significance. Dietary data were obtained using a 138 item food frequency questionnaire (FFQ).

Results: There were three group differences on individual elements: bismuth/Bi: 8 fold higher in ADHD, chromium/Cr: 15% lower in ADHD and germanium/Ge: 11% lower in ADHD, Cr level being the strongest predictor of ADHD symptoms. We found thirty significant group differences in element ratios, two thirds involving Bi and eight of these showing that as ADHD severity increased, the ratios with Bi as the denominator decreased (r ranging from −0.263 to −0.433, p<0.01). From the FFQ, tinned fruit was consumed more often in the ADHD group. Hair arsenic levels were somewhat elevated across both ADHD and Control groups.

Discussion: While element ‘imbalance’ appears to be associated with ADHD, we did not replicate any previous study results of group differences on individual elements. We have raised the possibility that the ratios may be far more important than any one individual element in better elucidating the effects that minerals may have on the pathogenesis of ADHD. These are cautionary findings requiring replication.

KEYWORDS:

• ADHD
• mineral
• element
• hair analysis
• element ratio
• toxic heavy metal
• chromium
• bismuth
• pH
• microbiome

Acknowledgements

Thanks to Eric Kawabe of Dr Eric Kawabe & Associates, for assistance with hair testing protocols and to Dermot Gately, Professor of Economics New York University, for guidance on multiple analyses and for Figures 1–3. Thanks to Lucy Kioa, Kate Harris, and Hāna Retallick-Brown for assistance with data collection and entry; the Canterbury District Health Board, Whakatata House and other private referrers and all the families who participated.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Thanks to the Vic Davis Memorial Trust (E5672), the GAMA Foundation, and the School of Psychology, Speech and Hearing, University of Canterbury for ongoing research support, and a PhD Scholarship awarded through Gravida to support Kathryn Darling.

Notes on contributors

John C. Perham

John C. Perham is a retired self-educated independent research consultant/ soil specialist (EcoSoils Research, 1978-2001). For over forty years he has studied integrated soil, plant and animal mineral nutritional relationships and more recently those pertaining to human neurological conditions.

Nida I. Shaikh

Nida I. Shaikh is an epidemiologist and Registered Dietitian and an Assistant Professor in the Department of Nutrition at Georgia State University. Her overall research is focused on the intersection between nutrition and chronic diseases such as obesity, diabetes and mental health disorders and in developing dietary assessment instruments to assess the shifts in diets following globalization and urbanization.

Anna Lee

Anna Lee has a Masters in Cross-Cultural Psychology and is interested in the intersections between genes, physiology, environment and culture.

Kathryn A. Darling

Kathryn A. Darling has just completed her PhD looking at the long-term effects of micronutrients on ADHD at Te Puna Toiora: Mental Health and Nutrition Research at the University of Canterbury, Christchurch, New Zealand. She is currently in the final stages of training as a clinical psychologist.

Julia J. Rucklidge

Julia J. Rucklidge is a clinical psychologist and professor of psychology in the School of Psychology, Speech and Hearing at the University of Canterbury, Christchurch, New Zealand. She is the director of Te Puna Toiora: Mental Health and Nutrition Research that focuses on conducting clinical trials exploring the interface between nutrients and psychological symptoms.