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Daily Dose

Omega-3 Fatty Acids

1:30 to read

Many of the patients that I see who have problems with attention and focus as well as other behavioral and learning issues have been started on all sorts of different medications. For some children their medications seem to be “working well”. But, for some children it has been difficult to find the “right” medication to alleviate all of their symptoms.  Studies have shown that anywhere from 10%- 30% of children with ADHD do not respond favorably to stimulant medications. Therefore,  it is not uncommon for their parents to inquire about the use of alternative or complementary medications. In several cases their parents have already started “dietary supplements”, which at times they are reluctant to admit to, or ask for my opinion.  

Interestingly, there is recent data regarding dietary supplements that parents and pediatricians should be paying attention to…and open to discussing.  A study that was presented last fall at the American Academy of Child and Adolescent Psychiatry showed that omega-3’s “could augment the response in children aged 7-14 years who were receiving psychotherapy for depression and bipolar disorders”. There have been  studies as well that have shown “significant improvements with Omega-3’s relative to placebo for problems including aggression as well as depression and anxiety symptoms”.  There are also numerous studies looking at ADHD symptom improvement in those using Omega-3’s, and again the results have been mixed, made even more difficult by the fact that ADHD is a subjective diagnosis.  

Another issue that requires more study is how these fatty acids actually work within the body and brain. Omega-3’s are an important building block of the brain and it is present in the brain's cell membranes, where it is thought to facilitate the transmission of neural signals.  Current thought is that these fatty acids may change the cell membrane fluidity and may also have anti-inflammatory effects….but a lot of research continues on the issue of mechanism of action. 

Several of the studies looked at dosage of the Omega 3 fatty acid supplements and “it seemed that there were more positive trials related to higher daily doses of  certain omega 3 fatty acids including eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA).  There need to be further studies to address the amount and ratio of these Omega-3’s as they are used for supplements. 

So while the research continues as to the effectiveness of Omega 3’s on focus, mood, behavior and learning it is important for all children to consume enough Omega-3 fatty acids in their diet. Eating fatty fish a few times a week would be beneficial for the health of all children - and the decision to supplement beyond that may be a topic for discussion with your own physician. 

 

Your Child

Young Kids Overdosing on Dietary Supplements

2:00

It’s no surprised that the majority of American adults now take one or more dietary supplement daily. During the last decade, many households have switched from a simple multivitamin to more specific supplements for different dietary needs. It’s become a billion dollar industry even though many scientific studies have shown mixed results on the effectiveness of supplements on a person’s health.

What may surprise you though is the number of children that are accidently overdosing on dietary supplements found in the home. Children under the age of 6 are the most affected.

A typical scenario might play out like this.  A curious toddler opens a bottle of melatonin found on the kitchen counter, and accidentally overdoses on a supplement typically used by adults to help with sleep.

In that case, the doctor who treats the child may only have to deal with a very tired 3-year- old, but it might have been a far more serious scenario if a different dietary supplement, such as the energy product ephedra or the male enhancement herb yohimbe, had been swallowed.

"We see it all the time," said Dr. Barbara Pena, research director of the emergency medicine department at Nicklaus Children's Hospital in Miami.

From 2005 through 2012, the annual rate of accidental exposures to dietary supplements rose in the United States by nearly 50 percent, and 70 percent of those exposures involved young children.

"The biggest increase [in accidental overdoses] was in children under 6. It got our attention," said study author Henry Spiller, director of the Central Ohio Poison Center of Nationwide Children's Hospital in Columbus. Ninety-seven percent of the time, the children swallowed the supplements while at home, the study found.

The U.S. Food and Drug Administration (FDA) does not regulate dietary supplements, so there is no guarantee that the ingredients listed have been tested or that they are what they claim to be. The FDA can only take action if the supplements are shown to cause harm.

During the 13 years of the study, Spiller's team also found an increase from 2000 to 2002, when the rates of calls to U.S. poison control centers involving supplements rose 46 percent each year. From 2002 to 2005, the researchers found the rates of calls declined. Spiller suspects that is because the FDA banned ephedra in 2004, after supplements containing it had been linked with adverse heart events and deaths.

Overall, only about 4.5 percent of the cases in the study had serious medical outcomes. During the 13-year period tracked, 34 deaths were attributed to supplement exposure, Spiller said.

The supplements most often associated with the greatest toxicity were ephedra (ma huang,) yohimbe (found in male enhancement supplements and other products) and energy drinks and drugs.

Ephedra is now banned, but yohimbe is not. Nearly 30 percent of yohimbe exposure calls in the study resulted in moderate or major harm. Yohimbe can cause heartbeat rhythm changes, kidney failure, seizures, heart attack and death, the researchers noted.

Often, children find the supplements on a kitchen counter, Spiller said. Parents and others may equate dietary supplements with being natural, and therefore safe. Parents usually don't keep track of how many pills are left in a supplement bottle, he said, making it more difficult to tell poison control staff how many pills were taken in an accidental exposure.

Adolescents are also susceptible to overdosing on energy products loaded with caffeine and other ingredients that can cause abnormal heart rhythms or even a heart attack. 

Both Spiller and Pena suggest that parents and caregivers treat supplements the same way they do prescriptions or O-T-C drugs.  Keep all supplements in a locked cabinet or on a high closed shelf if young children are in the house or likely to visit.

Supplements are especially scary, Pena noted, because it's not always possible to know the potency of the product.

The study was published in the Journal of Medical Toxicology.

Story source: Kathleen Doheny, http://www.webmd.com/children/news/20170725/us-kids-overdosing-on-dietary-supplements#1

Your Child

Vitamin Deficiencies Linked to Kid’s Migraines

1:30

Those that have migraines say the pain is like nothing else - an intense throbbing or pulsing sensation in the head that can bring you to your knees.

The reason people get migraines is still a mystery, but a new study says scientists and doctors may want to add vitamin deficiency as a possible cause.

The study, presented at the 58th Annual Scientific Meeting of the American Headache Society, suggests that doctors treating patients with migraines may want to screen for vitamin D, riboflavin (B-2) and coenzyme Q10 deficiencies.

For the study, researchers at Cincinnati Children’s looked at existing data on 7,691 young patients who were migraine sufferers and their records of blood tests for baseline levels of vitamin D, riboflavin, coenzyme Q10 and folate. Of the study participants, 15 percent were found to have riboflavin levels below the standard reference range. A significant number of patients—30 percent—had coenzyme Q10 levels at the low end of the standard reference range. Significantly lower vitamin D was seen in nearly 70 percent of the patients.

The researchers also found that patients with chronic migraines were more likely to have coenzyme Q10 deficiencies than patients who had episodic migraines. Girls and young women were more likely than boys and young men to have coenzyme Q10 deficiencies at baseline. Boys and young men were more likely to have vitamin D deficiency, but the reasons behind these trends need further investigation.

Hershey says the study adds to an ongoing observation that a significant number of people with migraines have lower levels of these vitamins. However, this trend is not seen in all patients across the board.

Scientists have looked at the link between vitamin deficiencies and migraines before, but research has been inconsistent. This study shows an association, but does not prove that vitamin deficiencies cause migraines.

In general, taking these vitamin supplements at recommended doses probably can’t hurt, but much more research is needed to determine whether vitamins alone could help stop migraines. One challenge researchers face is that vitamin supplements are often an intervention used in addition to medications and other experimental therapies. It’s therefore difficult to determine whether improvements in the condition can be explained for reasons other than supplement use.

If your child suffers from migraines, you may want to ask your doctor to screen him or her for vitamin D, Coenzyme Q10 and riboflavin levels. You can then discuss adding supplements if the results show your child is deficient in any of these vitamins.

Story source: Jessica Firger, http://www.newsweek.com/vitamin-deficiency-causes-chronic-migraines-469227

 

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