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Writer's pictureSara L

Zinc and ADHD: Recommendations and dosing



Zinc is involved in many aspects of how our cells work. It is required for the catalytic activity of hundreds of enzymes (proteins that turn one thing into another thing that our bodies need), and it plays a role in enhancing immune function, making our genetic material, healing cuts and scrapes, helping our cells talk to one another and divide to create new cells. Zinc also supports healthy growth and development during pregnancy, infancy, childhood, and adolescence and is involved in the sense of taste. Zinc is important in the production of dopamine and norepinephrine, which are two brain chemicals especially important in ADHD (these two brain chemicals run low in ADHD). Zinc is like the Swiss Army knife of minerals in your body.


In ADHD, Zinc typically runs low compared to neurotypical children¹ and may play a critical role in why ADHD presents the way it does². We have a few reasons why:


  1. In ADHD we have inflammation happening at baseline. This inflammation causes any zinc we have floating around in the blood to collect in the liver and spleen, which means that zinc isnt available to the rest of the body and the brain³.


  2. In hyperactive ADHD, when a child drinks anything contains artificial dyes/colors, this will cause their body to pee out more zinc compared to neurotypical children who drink the same drink. This lead researchers to believe that children with ADHD are so sensitive to artificial dyes because these dyes drive down their body's supply of zinc, worsening behavioral issues³.


  1. Zinc is involved in the formation and health of synapses. Synapses are the gaps between the cells that the cells use to talk to each other, using chemical signals like dopamine, serotonin or norepinephrine for example. When zinc is low, the cells in the brain can't talk to each other.


  2. As we mentioned previously, dopamine levels are off in the ADHD brain, and this is thought to contribute to some of the symptoms we see in ADHD. Zinc is important in terms of how the dopamine transporter works. This transporter is a protein that sits on the surface of brain cells that make dopamine, and it shuttles any dopamine that is outside of the brain cell, back into the cell to be used later thereby controlling levels of dopamine in the brain at any given time. When zinc levels are low, the transporter protein doesnt work they way it should, contributing to ADHD symptoms.


What the studies looking at zinc in ADHD say:


1. A study in Turkey found that zinc sulfate was superior to placebo in reducing hyperactive, impulsive, and impaired socialization symptoms in children with ADHD. However, it didn't seem to help much with attention deficiency symptoms. Interestingly, the effects were more pronounced in older children and those with lower initial zinc levels.


2. Another study combined zinc with amphetamine treatment and found that adding zinc allowed for a lower dose of amphetamine to be effective. This is particularly intriguing as it suggests zinc might help reduce the amount of medication needed, potentially minimizing side effects⁶.


3. Some research suggests that stimulant medications used to treat ADHD might lower zinc levels, and supplementation could help address this. This highlights the importance of considering nutritional factors when managing ADHD with medication.


4. A systematic review of multiple studies found that zinc supplementation does seem to have a positive effect on ADHD symptoms, but the overall impact is small and more research is needed to draw firm conclusions.


It's important to note that while these results are interesting, the overall effect of zinc supplementation on ADHD symptoms appears to be positive, but small, and more research is needed to fully understand its potential benefits.


Potential benefits of zinc supplementation in ADHD: Lessened hyperactivity and impulsivity


Recommended Magnesium Dosages for Children with ADHD


A word on the Recommended Daily Allowances (RDAs) numbers.  These guidelines were established by The Institute of Medicine of the National Academies as well as the Food and Nutrition Boards. These RDA values are based on meeting the nutrient requirements of 97 to 98% of ‘healthy individuals’ without the metabolic and nutritional complexities of ADHD.  The Food and Nutrition Board acknowledges that the RDAs that they recommend are not intended for individuals with specific health conditions (like ADHD).


In addition, the RDAs are the amounts recommended from all sources, food and supplements. Children with ADHD may be getting a lot less zinc from food compared to their neurotypical friends due to metabolic issues and underlying genetic and co-morbid issues, driving their levels of zinc down.


Below is a table with the RDA amounts for healthy individuals

Age

Male

Female

1-3 years

3 mg

3mg

4- 8 years

5 mg

5 mg

9-13 years

8 mg

8 mg

14-18 years

11mg

9 mg

19+ years

11mg

8 mg

By comparison, children with ADHD are going to require higher doses of supplementation compared to their neurotypical friends as they are likely not getting enough zinc from food alone.


Children with ADHD may need supplementation that exceeds these RDAs HOWEVER do not supplement zinc at higher levels than shown in the RDA table above without first testing, and without medical supervision, because high levels of zinc can be toxic to children. Zinc levels require regular monitoring when supplementing. 


According to "The ADHD and Autism Nutritional Supplement Handbook" by D. Godbout Laake and P.J. Compart MD, the recommended zinc dosages for children with ADHD are higher than the RDA's above. Please see table below:

Age (years)

Dose (mg)

Frequency

Total daily dose from all sources (mg)

2 to 5

5-10

1-2 times per day

10-20

6 to 10

10

2 times per day

20

11+

10-15

1-2 times per day

20-30

What form of zinc is best?


When it comes to zinc supplements, you might notice different forms like zinc citrate, zinc gluconate, zinc oxide, or zinc sulfate. These different forms can affect how well your body absorbs the zinc.


For instance, zinc citrate and zinc gluconate are absorbed similarly, with about 61% absorption in young adults. Zinc oxide and zinc sulfate have slightly lower absorption rates at about 50%. However, zinc sulfate has been linked to more gastrointestinal issues, so it might not be the best choice if you have a sensitive stomach. It is also the least easily absorbed form of zinc, so best to avoid it overall.


The type of zinc I recommend is Zinc Picolinate as it is more easily absorbed than other forms of zinc¹⁰. Pure encapsulations has a form of Zinc Picolinate either as 15mg per capsule https://www.pureencapsulationspro.com/zinc-15.html?size=60%20capsules or as 30mg per capsule https://www.pureencapsulationspro.com/zinc-30.html?size=60%20capsules


There is even a liquid form to really help tailor the amount you give your child https://www.pureencapsulationspro.com/zinc-liquid-15-mg-120-ml.html

It contains 3.75mg zinc per 1 ml of liquid. So you could give 1.5ml of liquid for 5.624mg zinc, or 2ml for 7.5mg, or 2.5ml for just under 10mg of zinc and so on so forth based on how much you are trying to dose out.


Ideally zinc is taken on an empty stomach, but it may cause tummy upset, so it's ok to take it with food. If you child is taking other supplements, do not give zinc at the same time as calcium, iron, folate or P5P¹. If taking an multivitamin and supplementing zinc separately, check the total dosing to make sure the amounts of zinc being given are not too high.


Loop in your child's healthcare provider when considering zinc supplementation so they can keep an eye on your child. Let them know if your child is experiencing any side effects, like those listed below.


Toxicity: nausea, dizziness, headaches, gastric distress, vomiting, lethargy, fatigue and loss of appetite.


High levels of zinc can drive down copper in the body. Low copper can cause numbness and weakness in the arms and legs¹¹. High zinc can also lower iron levels in the body can cause anemia.


Do not use the form of zinc that you squirt into your nose. It can cause you to loose your sense of smell¹¹.


Medications your child may be taking that magnesium intetacts with:

Antibiotics, Penicillamine, diuretics. If you child is taking any of these talk to their healthcare provider about stopping the zinc supplementation during the time that you are taking those medications


Natural sources of zinc in food



While we've focused a lot on supplementation, it's worth noting that zinc is naturally present in many foods. Some good dietary sources of zinc include:


- Oysters (the highest natural source)


- Red meat and poultry


- Beans and nuts


- Whole grains


- Dairy products


Incorporating these foods into your diet can help ensure you're getting enough zinc through natural sources.


Summary


While zinc isn't a magic bullet for ADHD, it might be a helpful addition to a comprehensive treatment plan for some individuals after testing has been performed to confirm low zinc in the body. As with any supplement, it's crucial to consult with a healthcare provider before starting zinc supplementation, especially for children.


Remember, managing ADHD is often about finding the right combination of treatments and lifestyle changes. Zinc might be one piece of that puzzle, but it's important to look at the bigger picture of nutrition, medication, therapy, and lifestyle strategies in managing ADHD symptoms.


When considering zinc supplementation in ADHD, keep these key points in mind:


1. Zinc could be helpful for ADHD related hyperactivity. Doesnt seem to help with inattention.


2. Stimulant might lower zinc levels, so if taking a stimulant might be worth testing to see if zinc levels are low.


3. If considering zinc supplementation, consult with a healthcare provider first. They will have to do testing, like trace mineral hair analysis, to make sure that zinc is low and needs to be supplemented in the first place.


4. Supplementing with zinc when taking a stimulant might allow lower doses of stimulant to be used whilst still providing ADHD symptom control.


4. Be aware of the different forms of zinc supplements and their absorption rates. Zinc picolinate is the form I recommend.


4. Be mindful of potential interactions with medications, especially antibiotics.


5. Monitor for any side effects and report them to your child's healthcare provider.


This site is for general informational purposes only and does not constitute the giving of medical advice. The contents do not constitute the practice of medicine, nursing, or other professional health care services. No provider–patient relationship is formed. Please consult with your child's healthcare provider when considering supplementation for children.



¹Godbout Laake, D. & Compart, P. J. MD (2013) The ADHD and Autism Nutritional Supplement Handbook. Fair Winds Press.











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