Thursday, December 4, 2008

Using Iron to Combat the Effects of Lead in ADHD

In the previous post, we were discussing the potential connection between lead exposure early in life and the subsequent onset of ADHD symptoms. We saw that higher lead levels are more likely to be associated with the hyperactive or impulsive symptoms of ADHD than the inattentive symptoms. At the moment, the amount of lead necessary to precipitate these negative symptoms is debatable, especially when individual variations are taken into account. However, a rough estimate of upper level lead limits can be found here. At the end of the post, I alluded to the fact that iron supplementation either via diet or pills may be effective as a possible treatment option. I will go into some of the details here:

Iron supplementation has been found to be useful in multiple cases regarding ADHD. Numerous studies have indicated that a large percentage of individuals with ADHD are iron deficient. Iron is responsible, among other things, for the synthesis and regulation of levels of the key brain chemical dopamine. Dopamine deficiencies are often seen in multiple brain regions (especially in the area behind the forehead, called the prefrontal cortex) in individuals with ADHD. Additionally, iron is a key component of hemoglobin, which is responsible for carrying oxygen in the blood to other organs and tissues in the body. Not surprisingly, many ADHD individuals have lower than average oxygen levels delivered to their brains.

Finally, other co-existing or comorbid disorders of ADHD also have been associated with iron deficiencies. One of the most notable is Restless Leg Syndrome (RLS), which is characterized by unwanted leg movements during rest, and is thought to be a major contributing factor to many types of sleep disorders and impairments. Individuals with ADHD have been shown to suffer from Restless Leg Syndrome at disproportionately high frequencies, when compared to the general population and iron deficiency may be a key contributing factor to Restless Leg Syndrome seen alongside ADHD.

However, one of the unexpected benefits of iron, especially with regards to ADHD, is its potentially protective role in reducing the negative effects of early lead exposure. In a couple of correspondences in the August 2007 edition of the journal Environmental Health Perspectives, some key findings were summarized involving the protective role of iron to lead-induced damage. One of them (based on previous literature) reported on how lead can negatively impact levels of free dopamine (which is often correlated with ADHD, as many of the positive effects derived from most stimulant medications is due to their abilities to boost levels of dopamine in between neuron cells).

Additionally, lead is also thought to inhibit the interactions of dopamine and its targets as lead can alter the presence of these targets or dopamine receptors. Both of these reduce proper dopamine function, and it is thought that adequate levels iron can offset some of these negative effects (on the flip side, iron deficiencies are thought to exacerbate several of these negative occurrences). Finally, iron is also thought to restore a balance in the blood-brain barrier, which serves as a sort of controlled gateway, regulating the passage of nutrients and necessary neuro-signaling chemicals into (as well as keeping toxic substances out of) the brain. The role of iron is thought to restore and offset some of the negative and damaging effects of lead on the blood-brain barrier, which is especially sensitive to toxins during the early stages of life and childhood.

There is some dispute and controversy over some of these findings, however. Another study (which is frequently cited in numerous journals on toxins/heavy metals and ADHD or cognitive disorders) was done on the protective effects of iron and zinc on Mexican schoolchildren exposed to lead showed no statistically significant results as far as improving cognitive function.

While I do not advocate excessive iron supplementation, (watch for upper limits which are described here), I do strongly suggest that pregnant and nursing mothers, as well as children and adults with ADHD do ensure that their iron intake is adequate. It is interesting to note that magnesium deficiency is also affiliated with increased ADHD symptoms. Due to the role of estrogen in improving magnesium retention, women require less daily magnesium than do men (a table of recommended daily magnesium intake can be found here). However, in iron, the opposite is true. Several factors, including less efficient iron binding and loss of iron due to menstruation and pregnancy result in higher iron requirements in pre-menopausal women. A summary of recommended iron levels for men women and children can be found here.

In addition to the potential role of iron in protecting against lead damage, will be discussing how boosting iron intake can offset the effects of ADHD and other related comorbid disorders in future posts.

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Anonymous said...

I have no idea if I have a high lead level or not but I do know I have been iron deficient most of my life, sometimes severely. I have also had ADHD most of my life.

It wasn't until almost 2 years ago that a very persistent doctor did more than just prescribe the routine iron tablet to fix my "anemia" and pushed for tests that I found out I have celiac disease. As you know, celiac disease untreated results in anema.

So I wonder, what comes first? The celiac disease? The anemia? The ADHD?

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