Issue 133: Your ADHD Blueprint

Welcome back! I hope you enjoyed the last issue’s introduction to ADHD and root causes. If you haven’t read it yet, you can find it here.

The ADHD brain is fascinating and full of unique strengths and advantages. However, its neurodivergent wiring can also make life feel overwhelming and frustrating at times, especially when it comes to managing distractions, calming feelings of overstimulation, and finding effective strategies for day-to-day life.

This week we are exploring assessments to understand what is happening inside the body. Nutrient status, blood sugar balance, neurotransmitters, and even digestion and the microbiome - and more! - can trigger or worsen symptoms of ADHD.

In Wellness,  Mary Virginia

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Where to Begin On Your ADHD Journey

First things first:
Test and assess, don’t guess!

Your first step will be to find a reliable psychologist, psychiatrist, or other appropriate ADHD-informed practitioner who is trained in ADHD diagnosis and other brain/psychological conditions.

Remember to trust yourself and your experience during this process! Be open and clear about your symptoms. Seek a practitioner who listens actively during your work together.

It's important to pursue a proper diagnosis to determine whether the symptoms you see are actually ADHD or some other issue, or perhaps even a complex presentation of several conditions. We can’t just assume it’s ADHD (or only ADHD) even if the symptoms seem to match up pretty closely.

After this, we can explore the underlying factors so you and your care team can define what interventions will work best for you, from medication to food/nutrients to lifestyle patterns.

Getting the Full Picture: Let’s Get Clinical

One of the coolest things about the nutrition care process is that my clients discover how much their daily food and lifestyle choices affect how their bodies and brains function. It’s really empowering! As the expert of yourself, you have the privilege of using this information to experiment and find out what works best for you.

The exploration we do in a nutrition clinic illuminates both how your unique body is natively designed to interact with the world around you (your genes) and how it is actually functioning right now.

Our discoveries are made through a structured process of lab tests, taking a look at the signs from your body, and learning more details about your symptoms. These assessments altogether show us what’s working well and what parts of you need more support - everything from your genetic pathways to your digestion to your stress response. Out of this data blossom personalized options for rebuilding wellbeing.

Most of all, realize that there is no one-size-fits-all approach to interventions. Each person comes with a unique biochemistry, environment, family life, co-existing conditions (I refer you to Volume 132 again), and more.

Standard Blood Work

These are blood tests that you (or I, with your permission) can request from your doctor. They give us information on your nutrient status for things like protein, electrolytes, vitamins, and minerals and on your metabolic health and energy production, e.g. blood glucose, cholesterol, and thyroid health.

Every cell in our body requires nutrients to function. Our energy is produced because of a series of nutrients we get from our food + oxygen. Our body is built out of protein and minerals. Our brains and nervous systems must have amino acids, electrolytes, and B vitamins, but also iron, magnesium, vitamin C, and more. When I look at standard blood work, I see a whole world of your nutritional status.

And just like it sounds, standard blood work gives the best information when we get it at least annually. We will determine which tests are most useful for you when we take your health history. Here’s a list: please know that I just touch on some of what we get from them.

Complete Blood Panel with Differential (CBC with Immune Markers)
A marker for iron, B vitamins, hydration, immune response, and more.

Comprehensive Metabolic Panel (CMP)
A marker for glucose (blood sugar), sodium, potassium, calcium, proteins, liver and kidney function, and the acidity of your blood.

Lipid panel
Cholesterol markers and triglycerides (blood glucose, thyroid, stress, and hormone related).

Homocysteine
A marker for B vitamin and choline status; influences the body’s master antioxidant/detoxification; affects the heart and blood clotting.

Hemoglobin A1c, Glycomark
Blood glucose measurements: amount over time and spikes/dips.

Insulin, C-Peptide
Insulin measurements; how the body addresses elevated blood glucose.

Thyroid Panel
TSH, Free T4, Free T3; energy production; metabolism of food; growth; physical and brain development.

Iron Panel
We can look first at hemoglobin, hematocrit, and RDW for iron status; iron is necessary to transport oxygen to make energy. Also used to fight infection.

Magnesium
Over 600 biological processes need magnesium!

Folate
Blood cell production; DNA repair; cell division; neurotransmitter synthesis (and more). Can assess somewhat from the CBC in MCV, MCH, MCHC, and RDW, too.

Vitamin B12
DNA synthesis; blood cell production; nerve function; turning food to energy.
Can assess somewhat from the CBC in MCV, MCH, MCHC, and RDW, too.

Vitamin B6
Genes and genetic pathways related to mood, focus, melatonin synthesis, and brain development require B6.

Celiac Disease Testing
Celiac disease can interfere with the absorption of nutrients as gluten creates inflammation that damages the lining of the digestive tract.

Additional Assessments

Assessments can also include hormonal status, such as whether the client is in perimenopause or menopause or struggling with too much/little estrogen or testosterone.

Separately, it’s typically very helpful to have environmental allergy testing and to do an assessment for food allergies. The histamine increase related to allergy, including food allergy and sensitivities, can make ADHD symptoms markedly worse.

Let’s Get Functional, Functional!

Functional testing literally means that we are assessing how your body is functioning! These are a series of specialized tests that give a more nuanced picture of what’s happening that may be disrupting the flow of your physiological and biological systems and contributing to your symptoms. For example, we can look at your gut microbiome in a stool panel, or determine how well you are making and metabolizing your mood and focus/attention neurotransmitters via an organic acids test.

Stool Panel
Assess digestive health and food metabolism (Tiny Health; GI MAP; GI360, others).
A referral to a gastroenterologist might also be considered, depending on the GI symptoms.

Organic Acids Test
This in part assesses nutrient status, neurotransmitter metabolism, HPHPA (which can interfere with dopamine metabolism), and candida/yeast (Mosaic, Diagnostic Solutions, Genova, others).

Mold Testing
I’m most familiar with Mosaic.

Hair Testing for Heavy Metals
Heavy metals in the body can bind nutrients and bind to receptors on cells, wreaking havoc with health (High lead can lead to ADHD symptoms).

Consider Genetic Testing

Genetic testing provides information on your genetic blueprint and evaluates risk. Risk, however, is not the same as outcome! Epigenetics is the influence of the environment on gene expression, and this is why all genetic information must be evaluated along with lab tests and clinical assessments.

Since ADHD is highly influenced by dopamine status, it’s interesting to see how the body is natively designed to synthesize and metabolize dopamine and dopamine receptors on neurons. This includes dopamine related genes, plus MTHFR, COMT, and others.

3X4 Genetics provides nutrigenetics/nutrigenomics testing to understand how your body interacts with nutrients and which biochemical pathways might benefit from additional nutritional and lifestyle practice support.
I order the 3X4 Genetics test for my client. When the kit arrives, the client registers it and includes my practitioner code: MCOF001. That way I will receive the results and will be able to interpret them in the full context of my clients health status.

Full Clinical Functional Evaluation

And finally, there is what we learn from detailed clinical forms and our conversations with each other! My own forms gather a ton of information, and I have been told many times by clients that they had not considered their constellation of symptoms and timeline of health and life experiences so fully before this.

We connect a lot of dots that let us get started in shaping our next steps.

Comprehensive Medical and Social History
This includes all medication, recent blood work or other testing, and diagnoses, and also your life experiences.

Nutrition Focused Physical Exam
It’s amazing what our bodies tell us about our health and nutrient status by what we see just looking at each part of them.

Detailed Review of Food Choices and Current Supplements
Not just what you eat, but also how you eat it, your food environment, likes/dislikes, cultural considerations, etc.

Lifestyle Choices and Behaviors
Sleep, movement, time in nature and sun, relationships, stress, hobbies/pleasures, mindfulness/faith practices, environmental components, etc.

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But Wait, There’s More!

Delving into how to support those with ADHD to function with more joy and success in their worlds has been eye opening even for me. It’s a rich fabric of opportunities to understand and to support the ADHD brain and body.

So come back for the next issue! I’m going to detail evidence-based interventions that truly make a difference to make the daily life of someone with ADHD easier and more pleasant.