“What can I do naturally for my ADHD without Adderall?” ~Maddie H, Scottsdale, AZ
Dr. Nicole Sundene, NMD
Adderall shortages have been challenging for doctors and patients. Because I have been getting this question regularly since the October Adderall shortage began, I thought I would talk about how I use Naturopathy, Herbal Medicine, Nutrition, and Hormones in my Holistic Hormone and Psychiatry practice. Conditions such as brain fog and ADHD are very common in Women’s Health. ADHD when left untreated can cause depression and anxiety from failing to execute tasks properly.
This blog will go over the most important nutrition, herbs, and lifestyle factors I use to treat ADHD naturally without stimulant medication.
Is there actually an Adderall shortage? Yes.
Doctors have been forewarned about this for a year, but I was still shocked to see it actually begin to happen in October and more horrified to hear it is predicted to continue due to an increased demand coupled with blunted production.
People cannot get the ADHD drug they rely on? WHAT?!?
As the “OG Ritalin Child of the 90’s” I hate to admit I slightly panicked when I heard there was an Adderall shortage. Then I laughed and thought, “This does not pertain to you. You no longer need medication for your ADHD like you did back then.”
Yet back in the 90’s if I was suddenly unable to get the medication I relied on for my ADHD it could have been devastating for my education. This is also a medication patients should not suddenly stop should they not be able to obtain it, and generally requires tapering especially when the patient has been on it for many years for their ADHD.
Sadly this Adderall shortage is impacting many women and teens in my practice as well as their families, and I am being asked often for ADHD alternatives. Of course Naturopathic Medicine is a bit more complicated than just popping a new natural pill for ADHD....so of course I had to write a blog about all the different factors that should be addressed between nutrition, herbs, supplements, and testing to find the "Root Cause."
Today, I wanted to share a bit of insight from my own journey of learning how to manage my ADHD symptoms naturally. As I shared in my story about ‘Why I Became a Naturopathic Doctor” I was going from different specialist to specialist all trying different medications out on me to see if it would help my symptoms. This specialist loop involved constantly going to a Psychiatrist every month for ADHD, Anxiety, and Depression.
Back in the nineties as my ADHD worsened and I progressed through the different options, dosing, timed release vs instant released, I grew weary of taking ADHD medications, and the cost continued to sky rocket as my insurance did not pay for it.
As time went on and that vicious stressful loop of doctor’s appointments failed me and I ended up at a Naturopathic Doctor’s office….I began to feel better on the nutrition changes and herbs, and gradually needed less and less Ritalin.
Now keep in mind this was back in the 90’s before Adderall, Strattera, and Vyvance were prescribed. The doctor prescribed either brand named Ritalin or methylphenidate. It was like Dairy Queen for ADHD patients back then, and we only had two flavors, chocolate or vanilla.
While I was grateful to finally have a diagnosis of my condition as a teenager, and a better understanding of how to cope with it, I frankly never liked the medication options. Thankfully now ADHD patients have other medication options they can try as well as pursuing my type of natural and nonstimulant Adderall alternatives I prescribe in my Naturopathic practice.
Did you know I am actually allergic to Adderall?
My doctor did try prescribing Adderall to me, but I had an allergic reaction to one of the food colorings used which is a common trigger or irritant in ADHD patients as I recommend avoiding ALL food colorings in my “ADHD Diet” that is 100% free for anyone to follow and use, and exactly what I do for myself, and my patients with ADHD. If you need further recipe ideas and eight weeks of meal plans, simply pick up my PGE-2 Diet program to implement easy recipes, meal plans, and weekly grocery shopping lists.
The worst thing about my ADHD Diet is when I fall off of it over the weekend and indulge in bad foods and cannot concentrate well on Monday.
So the Adderall shortage does not directly pertain to me, but it affects many ADHD patients as it is still one of the most commonly prescribed ADHD medications. Adderall became more commonly prescribed as I was tapering off Ritalin towards natural treatments for my ADHD.
My Psychiatrist stopped the Adderall and returned me to Ritalin as we worked together to lower the dose. It took us a very long period of time to taper me off Ritalin as I was on a very high dose. So if you are wondering if Naturopathy can be helpful for severe ADHD cases, my answer is yes, and it certainly cannot hurt mood and concentration. But please read my comments at the end of this blog to ensure you will be successful with treating ADHD naturally. Natural treatments for ADHD still require a daily regime and discipline.
The good news from my story about "How I Became a Naturopathic Doctor," is that I began to notice that when I followed the Food Trigger Elimination Diet my Naturopathic Doctor placed me on, my attention span was much better. Suddenly I had better energy, I got tasks done efficiently, I was no longer procrastinating! My ADHD was no longer this giant obstacle in my day. Getting things accomplished in an orderly flow became easy, and the more I improved, the more I naturally wanted to adhere to the nutrition and lifestyle choices that helped my concentration and mood the best.
Suddenly my brain was crystal clear, and I was no longer experiencing annoying ADHD fumbles from forgetting things or locking my keys in my car!
I graduated from college as I continued to work on my ADHD with natural remedies. The concentration demands of studying were ending and it was time for me to get a job. I realized the medicine I had been relying on for many years to help me focus on accomplishing tedious school related tasks was no longer really necessary. I often did not take ADHD meds on the weekends and just relied on them when in class, studying, and going to the library. I did not need to take them to concentrate at my job at the health food store, and suspected I no longer needed them at all. I also didn’t like how it made me constantly sweaty with a dry mouth, so I began to research nutritional treatments for ADHD. It became my final Biochemistry Thesis project for graduation, and was my final grade for spring quarter.
My final graduating Thesis was twenty eight pages about “Docosahexanoic Acid and Nerve Conduction.” I had compiled pages and pages of nutrition research studies on animals that demonstrated that the nervous system does not work well without this critical Omega-3 fatty acid. I broke down the biochemistry of how the fatty acid was needed to form healthy cellular membranes and concluded with my hypothesis that nerves in humans would likely not function as efficiently or effectively if deficient in this fatty acid. I worked extremely hard on the project and was very proud of my Thesis paper.
However, my biochemistry professor was a "Know it all" very grouchy bossy nerve conduction Kinesiologist that angrily scribbled across my paper “UTTER RUBBISH! What you eat has NOTHING to do with your nerve function! This is not a potential treatment for ADHD, depression, anxiety, dementia, Alzheimers, MS, or cognition. Animal studies are utter nonsense and cannot be extrapolated to human data….” Which went on for several pages in angry blue sharpie with a giant B- next to it! I was horrified to receive a B- and not the expected A+ for all my hard work compiling research studies, also knowing I had gone far beyond my other classmates and was hoping to get the special recognition he would give to his favorite papers.
Mainly though I was just really excited to share all of my ADHD research with my professor, and instead of him being glad.... I made the nerve conduction professor mad!
Considering we spent two full quarters just going over how a nerve makes an "action potential" or conducts energy, I should have known he would not be open to my nutrition research. But in that same time period we discussed the anatomy and physiology of nerve cell membranes and they were made up of these very fatty acids that were needed to make proper action potentials or in regular language “thoughts and movements.” The cellular membrane lacking Omega-3 is akin to a frayed electrical cord that cannot efficiently send electrical signals.
So I laugh about this twenty five years later as there are now a plethora of research studies cited on my blog about “Flax vs Fish: Omega-3” proving my crotchety angry biochemistry professor wrong. My ADHD nutrition theories were not so radical after all back in the nineties!
In 1999, after compiling all this research on fish oil as a fish hating Scandinavian woman with ADHD, I began experimenting with high doses of a particular extract of fish oil called DHA or docosahexanoic acid. Every day I took between 2000-10,000mg of DHA. On longer study or test days I needed the full 10,000mg.
For most children with ADHD I now start them at 1000mg, there are great chewable “DHA Juniors” that taste good and make it easy to give to children. This is the most important nutrient for patients with ADHD in my opinion.
My biggest pet peeve in Naturopathic Medicine is that I am seen as the “Crazy Witch Doctor” for using nutrition, herbs and fish oil for children with ADHD, when other doctors are giving children with ADHD stimulant medications known to stunt their growth as the main side effect, and somehow I am the irresponsible doctor here? If you or your child needs medication, that is okay, I get it, but we have our system in how we treat ADHD patients set up backwards, and in order to "First, Do No Harm," as the oath every doctor is required to take, we should look at these nutritional interventions as the start of treating ADHD, and not as the only remaining option when medications fail ADHD.
Lets use this Adderall shortage as an opportunity to turn DHA fish oil into first line treatment for ADHD in children. Especially children that are growing! Adults over fifty on stimulants are also risking their heart health, therefore natural medicine that is effective is clearly the best choice in ADHD.
While my ADHD methods are alternative, and not mainstream, I am confident they are effective because I rely on them myself, and also see the children with ADHD in my practice improving after just 1-2 appointments, to the point they do not even need to get to the Naturopathic lab stage of us working together. They are improved enough with just DHA and a probiotic that their parents text me that they don’t need to come back as their psychiatrist has already tapered them off their ADHD meds. So I am confident that my methods work. I know from experience that the only time they don't work is with an ADHD patient or parent that is too disorganized to implement them and adhere to them as a new daily routine.
WHAT IS DHA?
DHA or docosahexanoic acid is the precise extract of fish oil I recommend for ADHD, TBI: Traumatic Brain Injury, and for pregnant women to take with their prenatal vitamins to ensure their baby has the highest IQ possible per the latest women’s health research studies. Be sure to use only the finest brands free of heavy metals and parabens.
VERY IMPORTANT: Please just do me a BIG FAVOR and stop the Omega 3,6,9 nonsense if you have ADHD and ONLY use the DHA concentrate of an Omega-3 as a supplement. Read my full Omega-3 blog to find out more about the science behind the why. Otherwise most women are already getting plenty of Omega-6 and Omega-9 from diet.
Research studies demonstrate that too many Omega-6 and Omega-9's from nuts and grains can actually become inflammatory in excess especially during Omega-3 deficiency and essentially “clog” the brain and worsen ADHD symptoms similar to inflammatory trans fats and saturated fats. Not all patients can burn these types of fats for fuel and the ADHD patient needs way more Omega-3 than the average bear! This is why inflammation can persist even when vegetarian or vegan.
If you need a nutrition program with recipes that are chock full of Omega-3 rich foods, and lower in inflammation driving foods you can pick up my mind/body/spirit PGE-2 Diet program. There is a vegan version, and a meat containing version. There are eight weeks of meal plans, grocery shopping lists, and dozens of healthy recipes that follow the rules of my ADHD Diet. The yoga and aromatherapy meditations are also critical for learning to better control a hyperactive mind.
VERY IMPORTANT: Only use my trusted brands of DHA: Carlson, Arctic Omega, Nordic Naturals, Thorne, and Pure Encapsulations in Fullscript. Most other fish oil brands patients show me I find poor quality if not disgusting spoiled rancid fish oil full of mercury, lead, and arsenic that I would not even feed to my dog! If you are burping up bad smelling fish oil that means it is rancid and you should throw it away and get an above Naturopathic Doctor trusted brand.
Be careful with this supplement, as a poor quality one may cause more inflammatory damage to your brain, than be helpful. Inflammation is a huge trigger for ADHD symptoms which is why I recommend my anti-inflammatory PGE-2 Diet with all common trigger foods removed for my ADHD patients until they have been tested for triggers.
Please stick with a good quality brand especially if pregnant or using this as medication for ADHD.
In America anything can be put in a bottle and labeled DHA and sold for a high amount. This is perfectly legal, and why patients should stick with prescription grade supplements recommended by their Naturopathic Doctor to avoid falling victim to poor quality or fake products.
Oftentimes people state that Natural Medicine didn't work for them, when really they were not using the correct dose of the natural medicine, or a high quality enough form of the medicine.
Quality of DHA is especially important when looking at replacing stimulant medications with natural alternatives.
For me and many of my ADHD patients, taking this form of DHA fish oil in high doses is like watering a dying brain! Worst thing about fish oil is it causes blood thinning. So those on blood thinners need to check with their doctors as with anything otherwise a slight blood thinning effect is protective against “The Virus.”
Back in the nineties, the beauty of adding the high dose DHA omega-3’s in was that I began to actually need less and less DHA and Ritalin. My body did not become "tolerant" to the dose of the DHA and need it to be raised like Ritalin, instead I needed a higher amount in the beginning to extinguish the "ADHD fire in my brain", and now I just take 2000mg daily for maintenance.
The opposite happened when I was on Ritalin though and I needed to keep increasing the dose or it stopped working. When I first began taking Ritalin I only took 10mg. Then eventually I was on 20mg. Then 20mg twice a day. Then 30 mg three times a day. As I exceeded 100mg of Ritalin my brain was working right but my heart did not feel good, I had a racing pulse at times, I had drenching armpit stains that were embarrassing, and I feared I would get high blood pressure. Yet my concentration required that high of a dose.
So my brain was about 80% improved on DHA and Naturopathic Nutrition, but not quite at 100%, perfect, so I continued researching the herbs and vitamins in the health food store I worked in and began adding different well known memory herbs in for concentration. I recommend reading about my favorite ones: Ginkgo biloba and Rosemary. Check out my Rosemary Salmon recipe to treat your ADHD brain! Of course discuss with your Naturopathic Doctor before implementing anything new I will be reviewing today.
NATURAL ALTERNATIVES TO ADDERALL
Certain mild sedative herbs such as California poppy, Passionflower, and Hibiscus…. can also help ADHD patients concentrate and focus as I discuss along with my ADHD Tea recipe on my “Hibiscus Tea” and “ADHD Tea” blogs.
Ashwaghanda is safe and effective for agitated women and angry children and teens with ADHD. Ashwaghanda is generally considered safe even in pregnancy but please always check with your Naturopathic Doctor when pregnant!
Curcumin helps with those suffering from postviral, Lyme, Long Covid, or Mold Exposure brain fog. Be sure to use curcumin for ADHD and not Turmeric as it is not nearly as potent. When tapering someone off stimulants, or treating ADHD naturally I am using the strongest version of the plant, in this case use curcumin.
Liposomal Glutathione is also great for those with toxic, or post-immune brain fog, shortness of breath, asthma, and in need of detox support, I like the Pure Encapsulations brand available via Fullscript.
Be sure to work with a skilled Naturopathic Doctor or Herbalist when treating ADHD. Many adverse consequences to improperly managed ADHD can occur such as depression, anxiety, insomnia, poor self esteem, and school or work disruptions. It is important to work with someone that is experienced and skilled and not just randomly throw your child or self on the above list of supplements I am discussing today.
In addition to supplements and herbs for ADHD treating “The Root Cause,” is also especially important. It varies between patients and there is never one unique cause otherwise I would just create an exact treatment plan everyone with ADHD should follow and post it here.
But the Root Cause of my ADHD is different from many of my patient’s ADHD, and we are all a little bit like snowflakes. The symptoms look similar, but the pattern overall is different.
As a female hormone specialist I am first looking to see if the mental health cause is physical such as hormonal or nutritional. Things like anemia, menopause, perimenopause, PMS, hypothyroidism, and Hashitmoto’s thyroid disease can often cause brain fog and trouble concentrating in women.
If no insurance based lab testing is helpful we may conduct specialty testing such as food sensitivities, organic acid testing, neurotransmitter testing, stool testing, and infectious disease testing….all dependent on each patient with ADHD’s symptoms, story, health and travel history.
CAN NATUROPATHY HELP EVERYONE WITH ADHD?
No. Naturopathy unfortunately cannot help teens, children or women with ADHD in the following circumstances. I want every patient that enrolls in my practice to be a success story, so I do not recommend signing up to work with any Naturopathic Doctor if the patient is:
I understand the forgetful nature and chaos of ADHD. I have it myself, but I also follow through on my plans and appointments by following a very strict nutrition, herbal medicine, hormone, and lifestyle program which includes my top ten most important lifestyle tips for ADHD patients:
LIFESTYLE TIPS FOR ADHD
#1 Always plan to show up for appointments early to compensate for any ADHD forgetful fumbles. Bring magazines, books, or something to do once arrived early.
#2 Make checklists for things you regularly need to remember when you leave the house, head to work, school, sports, or activities. Laminate the checklist so you or your child can check off things as you prepare for your day, then wipe it clean for the next day. Make one side for work/school and the other side for sports/activities.
#3 Bring a small notebook with you everywhere you go with your list of appointments and daily tasks for each day, as well as an ongoing “To Do” list for random tasks that you do not want to forget. Writing tasks with a bold marker and placing the list somewhere easily visible will help stay focused on the tasks in need of accomplishing, as well as the order to work on them.
#4 Text message yourself anything you need to accomplish quickly or don't want to forget. This is important when you are away from your ADD notebook. Then add the task to your "To Do" notebook and calendar. If the task is extremely important I leave it as an unread text message to myself so I continue to see the alert until the task is completed.
#5 Have an accountability partner to help hold you accountable to the tasks you need to complete, especially the ones you do not want to do. This can be someone else with ADHD that also needs to be held accountable or a friend or family member that is part of your mental health care team.
#6 Every night organize the things you are your child need to have a good day. I call this "Setting my tomorrow self up for a great day." Adults with ADHD or their children should stay committed every evening to creating an easy morning by laying out their clothes, packing their lunch, and organizing all their office or homework. This way in the morning it is all organized and ready to go. The sunglasses, keys, purse, and phone are all together and will not be a Stressy Scavenger Hunt. By creating this simple evening routine a lot of drama can be prevented each day. Especially for the ADHD patients and parents that are not morning people!
#7 Avoid "ADHD Overwhelm" by committing to completing at least three tasks each day you don't want to do. I like to always start with the easiest ones to get them over with. But by scheduling tasks, and remaining committed to keeping up with a busy schedule, ADHD patients can avoid the overwhelming anxiety and depression that can result from ADHD inactivity.
#8 Keep "ADD Stations" in each room that is a dish, or catch all tray that you commit to only setting your important items like keys, phone, jewelry, watch, wallet, or purse on.
#9 Invest in multiple sets of sunglasses, reader glasses, pens, notepads, and items ADHD patients frequently lose, and just keep them in every room in your "ADD Station." Consider adding tracking devices to important items like keys.
#10 Work on only one project at a time. Set an amount of time for the project and only work on that project. In college I kept a pretty canopy above my desk and would set a timer for an hour when I could get out of my "Study Cocoon" and take a break. Otherwise I would be up baking cookies, answering the phone, and washing dishes. By utilizing strong visual reminders, and keeping projects separate from each other, this is how we prevent the ADHD fumbles that annoy ourselves, friends, and family.
While treating ADHD from a holistic standpoint requires more work on the patient's end, the results are far more rewarding. Many of my ADHD patients state, “I am so happy to be off Adderall. I feel so much better physically without stimulants, and my brain is working better than ever.” So not being able to obtain a medication may also be an opportunity to explore Naturopathic Medicine!
Most of my adult ADHD patients are able to function completely without stimulants over a 6-12 month period of working together. While some of my severe cases are able to function 95% of the time without stimulants, yet reserve a small emergency supply for difficult adulting tasks like doing taxes or boring paperwork.
I hope you learned today that nutrition is the most important place to start with ADHD. The first thing I need my patients doing to improve their ADHD symptoms naturally is changing to a clean, Naturopathic diet. Proper nutrition is the foundation for a successful ADHD nonstimulant treatment plan.
The very best natural ADHD treatment is my "ADHD Diet" which involves eating a clean, anti-inflammatory diet free of food coloring and rich in Omega-3’s for proper brain health as I provide the recipes and grocery shopping lists in my PGE-2 Diet program if you need a full program.
My simple nutrition program is the exact recipe for success I follow myself! Remember my #1 Naturopathic Rule: Taking bottles of supplements without making nutrition changes is like throwing water bottles on a burning building. The bottles alone are not going to be strong enough by themselves! We must activate your "Inner healing power of nature" that every patient has inside of them via colorful and clean nutrition and herbal medicine.
If you need my expert help testing for your root cause of ADHD, improving your memory, concentration, or mood simply pop over to my SCHEDULE page. I would be happy to help!
Dr. Nicole Sundene, NMD
Naturopathic Medical Doctor
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!