Health Conditions A-Z Mental Illness ADHD 4 Supplements for ADHD Management By Kirstyn Hill, PharmD, MPH Kirstyn Hill, PharmD, MPH Kirstyn Hill has worked as a clinical pediatric and women’s health pharmacist since 2020. She was driven to work with a patient population that is not often able to easily speak up for themselves and require unique approaches to medical counseling and understanding of their health conditions. Kirstyn is also a healthcare writer; she is passionate about closing education gaps between healthcare and the community. health's editorial guidelines Published on September 11, 2024 Medically reviewed by Kathleen Daly, MD Medically reviewed by Kathleen Daly, MD Kathleen Daly, MD is a board-certified psychiatrist with a specialty in women's and transgender mental health. learn more AntonioGuillem / Getty Images Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children, adolescents, and adults. Although ADHD rates decrease with age, at least half of children with ADHD will continue to have symptoms through adulthood. Classic symptoms include hyperactivity, impulsivity, and inattention, which are symptoms that can affect school, work, or overall quality of life. Medications used to treat ADHD typically include stimulants, such as Ritalin (methylphenidate), and non-stimulants, like Strattera (atomoxetine). However, these medications have potential side effects and long-term effects, leading some people to wonder about alternative treatment options. Some people may also be wondering if there's anything they can take in addition to their prescribed medication to further help manage their ADHD. Certain supplements have been shown to help manage some ADHD symptoms, including omega-3 fatty acids and melatonin. While supplements aren't a replacement for prescription ADHD medications, some people may find benefit in taking them to help treat their ADHD. Be sure to talk with your healthcare provider before adding any supplements to your ADHD treatment regimen. Omega-3 Fatty Acids Omega-3 and related fatty acids play an important role in the inflammation, development, and overall health of the brain and nervous system. A healthy brain and nervous system is necessary to prevent and treat behavioral dysfunction and psychological disorders, such as ADHD. Low levels of omega-3 fatty acids have been reported in people with neurodevelopment and mental disorders, including ADHD. Based on this and the role fatty acids play in brain health, many researchers have evaluated the use of omega-3 fatty acids in treating ADHD. A 2017 study found that children and adolescents taking omega-3/6 fatty acids saw improvements in the following ADHD symptoms: AttentionHyperactivityImpulsivityShort-term memoryVisual learningWord reading Research has also found that fatty acids may help improve treatment when taken with prescribed ADHD medications. For example, one study of children taking omega-3/6 fatty acids with methylphenidate found that the children required lower doses of methylphenidate and experienced fewer medication-related side effects. Although many studies report some benefits of omega-3 fatty acids in ADHD, others have found the supplement not very helpful. Also, most of the available studies were conducted in children and adolescents under the age of 18. More research is needed to fully understand the benefits of omega-3 fatty acids in ADHD in people of all ages. Omega-3 and other fatty acids can be taken as a supplement or consumed through your diet. There are numerous types of omega-3/6 fatty acids, and the amount available in each product varies. There are no specific dosage recommendations for ADHD, as the studies that have been conducted use numerous doses and different types of omega-3 fatty acids. Common side effects include stomach discomfort, nausea, and diarrhea. Melatonin Melatonin is a naturally occurring hormone produced in the body during darkness, playing a role in circadian rhythm and sleep regulation. In people with sleep disturbances, melatonin supplementation can help improve your sleep-wake rhythm and decrease the time it takes to fall asleep. Although not a specific symptom of ADHD, difficulty falling asleep is a common issue for children and adults with ADHD. Sleep disturbances affect normal functioning in all people but can easily worsen symptoms and normal functioning in people with ADHD. Side effects of stimulants used to treat ADHD also include sleep disturbances. For this reason, melatonin supplementation may be useful for some people with ADHD. Much of the research on melatonin in people with ADHD found the supplement decreased the time it took to fall asleep and allowed children to stay asleep for longer. For example, it's estimated that children with ADHD who took melatonin fell asleep 20 minutes earlier and slept 33 minutes longer. One study in children with ADHD also taking methylphenidate found that melatonin improved sleep in over 60% of participants. In general, melatonin dosing ranges from 1-10 milligrams (mg) and should be given about 30 minutes before bedtime. In studies of children with ADHD, melatonin doses typically ranged from 3-6 mg. However, because research on melatonin in children is limited, there is no agreed-upon dosage. Talk with your healthcare provider about what dosage might be appropriate. Melatonin is considered safe when used short-term. Although side effects are rarely reported, they can include headache, drowsiness, and dizziness. Zinc Zinc plays a role in brain neurotransmitters and melatonin production, which help regulate dopamine levels. Dopamine is an important neurotransmitter that plays a role in many brain functions, including the physiology of ADHD. Zinc also plays a role in numerous brain pathways that help keep the brain healthy and functioning normally. Many studies have shown that zinc levels in the body are lower in people with ADHD. One study found that zinc supplementation helped treat hyperactivity symptoms in people with ADHD and low zinc levels. Zinc doses as high as 150/day led to a reduction of hyperactivity, impulsivity, and socialization issues in people with ADHD. However, overall, data on zinc supplementation in people with ADHD have been inconsistent. Studies with lower doses (30 mg/day) did not see significant benefits. One study found that adding zinc to methylphenidate treatment in children did not significantly affect hyperactivity or impulse symptoms but appeared to improve inattention. Based on the inconsistent and low-evidence data, there are no specific recommendations for zinc in the treatment of ADHD. Zinc can be found as a supplement or consumed through your diet. Foods that contain zinc include fish, poultry, and red meat. Common side effects of zinc include stomach pain, diarrhea, metallic taste, and vomiting. Magnesium Magnesium is an essential mineral that helps create cellular energy, playing an important role in proper functioning and structure of brain cells. Low magnesium levels are associated with lower cognitive ability, processing, and attention span, as well as increased agitation, fatigue, and lack of concentration. Magnesium deficiency has been found in children with ADHD and may be correlated with hyperactivity, inattention, and impulsivity. Due to these reasons, it is believed that magnesium supplementation may be beneficial in people with ADHD. More research is needed to determine if magnesium can truly help in ADHD management, but research has been somewhat promising. One small study of children with ADHD without magnesium deficiency evaluated the effects of 6 mg per kilogram (kg) of magnesium daily with vitamin D 50,000 international units (IU) a week for eight weeks on ADHD symptoms. The study showed mild improvement in emotional issues but no change in inattention or hyperactivity. Studies that have seen magnesium's benefits in ADHD symptoms have used doses around 6 mg/kg/day. Higher doses of magnesium (greater than 10 mg/kg/day) can be harmful. Therefore, doses less than 200 mg daily are recommended. Side effects of magnesium include stomach pain, nausea, and diarrhea. Other Supplements for ADHD Other supplements have also been found to potentially play a role in treating ADHD symptoms, including: Carnitine: Carnitine is a molecule that helps with energy production, specifically in oxidation and fatty acid transportation. Numerous studies have evaluated the use of carnitine in children with ADHD. However, these studies failed to show a significant difference in ADHD symptoms. Iron: Iron is a mineral necessary in numerous bodily functions, including the production of dopamine and norepinephrine. Studies have shown that iron levels are often lower in people with ADHD. A small study found that children with ADHD and low iron levels saw an improvement in symptoms when they received 80 mg/day of ferrous sulfate (a type of iron). However, other studies have not found a relationship between iron levels and ADHD. Probiotics: Data have shown a connection between the bacteria in your stomach and how they affect your brain health. Therefore, probiotics have the potential to positively affect neurodevelopment disorders like ADHD. However, the results of available studies contradict each other and are overall fairly small. More studies are needed to show the effects probiotics may have. Considerations and Precautions No supplement has been found to be more effective in treating and managing ADHD than prescription medications. Therefore, using multiple treatment approaches may be useful for someone experiencing ADHD symptoms. If you are interested in using supplements to manage ADHD, it is important to speak to your healthcare provider. Your healthcare provider can review your or your child's medical history and medication list to determine if starting a certain supplement would be safe or beneficial. ADHD is a complex disorder that requires personalized and comprehensive management, whether with medication, therapy, or other approaches. Supplements are not regulated by the U.S. Food and Drug Administration (FDA). If you and your healthcare provider decide that using a supplement is right for you or your child, find a supplement that has been third-party tested. Organizations like the U.S. Pharmacopeia and NSF International test products so you know that the ingredients listed are the only ingredients in the product. A Quick Review ADHD is a neurodevelopmental disorder that can cause symptoms like hyperactivity, impulsivity, and inattention. The symptoms can affect school, work, or overall quality of life. Certain supplements, including omega-3 fatty acids and melatonin, may be beneficial in helping to manage some ADHD symptoms. Other supplements, such as magnesium and zinc, show promise but need more research. While supplements aren't a replacement for prescribed medications, they can offer an additional approach to ADHD treatment. Talk with your healthcare provider to understand more about supplements for ADHD treatment and if any can be safe and effective for you or your child. 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