Optimal Wellness Center (OWC): You have been active on the issue of behavioral problems in childhood for many years. How did you first get involved with the issue of ADHD and related behavior disorders?
Lendon Smith, MD: My father was a pediatrician and he believed that behavior was more genetic than environmentally produced. I was going to be a psychiatrist from about age 15 on. I felt that if we straightened out one generation, every one, including their children, would be normal after that - Freudian concept (wrong!).
In my fourth year in medical school I attended a lecture by a Portland pediatric neurologist. In the 1930s he was in charge of a home for "oddball" children. One of his clients was a wild and crazy girl. He told his nurse to give her a dose of bromide. She reached up and by mistake got hold of the benzedrine bottle. In about 30 minutes the girl was asleep.
The doctor said to the nurse, "That bromide works." The nurse said, "What did you say?"
Of course she had to fill out an accident report, but the two of them could not believe the therapeutic results. They repeated the maverick dose the next day and the girl calmed down again. The doctor wrote a paper about this and it was reported in one of the pediatric journals. He noted that most of the kids he was seeing for this same syndrome had had some sort of "hurt" to the nervous system at birth such as:
He felt it was a "hurt" to the part of the nervous system that had to do with self-control. He had no idea why a stimulant had this calming effect. We now know that it is because there is not enough norepinephrine in their limbic system, the part of the brain that is supposed to filter out unimportant stimuli.
This serendipitous result of an accident has now allowed the psychiatrists and pediatricians to prescribe this type of narcotic drug to 4,000,000 kids on any given school day, and even pushed some of them into psychosis and homicide.
I was one of those drug-pushing pediatricians for a couple of decades. Then it became clear to me that there was a pattern to the behavior of these children. Genetics is there, of course, and can result in "hurts" to the nervous system, but my patients were 80% boys. I found in examining them -- - trying to find some common denominator that I could use as a diagnostic criterion -- - that they were exquisitely ticklish.
They were unable to disregard unimportant stimuli.
That is why they have trouble in the classroom with 30 other kids burping, coughing, passing gas and dropping pencils. The teacher says, "Charlie, sit down and stop moving around." No wonder home schooling is becoming popular.
Blood tests were not helpful, but hair tests showed me that they were all low in calcium and especially magnesium. No wonder they craved chocolate. (There is more magnesium in chocolate than any other food on earth.)
I began to treat them with oral doses of 500 mg magnesium and 1000 mg calcium daily. It took three weeks, but 80% of them were able to get off Ritalin or dextroamphetamine, or whatever stimulant they were on. It did not work on all of them. As time went by, I had them take vitamin B6 if dream recall was poor and essential fatty acids if they had dry skin or a history of eczema. If they had ear infections as infants, they were taken off milk.
As time went on, I found it worked on adults if they had symptoms of ticklishness and inability to disregard unimportant stimuli. Apparently these people have some enzyme defect, genetic or nutritional, that prevented them from making norepinephrine, a stimulant, which we all now recognize is made to help the filtering device in the limbic system do its job.
It is too bad that psychiatrists have failed to recognize that if a stimulant acts as a calming agent, then they must shore up the flagging enzyme that is under-producing. This all fits with the damage that we have done to the top soil. It is washing and blowing away and with it, the magnesium. The psychiatrists have made ADD/ADHD a disease, like pneumonia.
It is actually a syndrome due to a defect in the screening device of the brain. I understand that since they had made it a disease they can be compensated for treating it. Another rule they have used: "If the Ritalin works, they need it." Sort of like a Ritalin deficiency.
They had another one: "Dyscalcula" if one is bad at math. They are good with words. For instance, they know that vegetarian is an Indian word meaning: "poor hunter."
OWC: Is ADD/ADHD a single disorder with a single cause or optimal treatment or is it more of a broad term to describe nearly all children with behavior problems?
Dr. Smith: I am glad you said "disorder," because as I mentioned previously, the condition is not a bona fide disease, but a collection of symptoms and signs that seems to get in the way of a child being educated. The teacher or school administrator is usually the one who suggests that the child see a doctor for the behavior problem (psychiatrist or pediatrician), whom they know will put the kid on Ritalin or a similar drug.
The doctor hears the story from the parents that her child (usually her son) will be thrown out of school unless something is done. She has tried isolation, spankings, standing in the corner, etc, but nothing seems to work. She also knows that a one-to-one situation would be effective.
The teacher may write down the symptoms noticed: restlessness, talkative, doesn't seem to listen, forgetful, short attention span, distractible, class clown, wants attention, may be a bully, as well as a few other related symptoms and signs.
The doctor knows what to do. Usually without even an exam, except a quick look in the eyes, and a listen to see if his heart is beating, the doctor reaches for his prescription pad and writes one out for Ritalin, 5 mg, #20 (or one of the newer drugs of the same type). "Try one or two in the morning after breakfast, and see what the teacher says. It may wreck his appetite, however."
The next day, the very first day of treatment, his attention span is better and he cannot eat his lunch. It works. It is a miracle. The doctor is called and thanked profusely. He assumes since it works that the boy needs it.
When I became familiar with nutrition, I found that if a stimulant drug had a calming effect like the above, it meant that the child did not have enough norepinephrine (a stimulant) in his limbic system, and that I could help with a good diet and some supplements which should shore up the enzymes in his brain that make that neurotransmitter.
I often ask these children what they like to eat. I often get a smart-alec answer, like, "rutabagas, turnips, parsnips, and broccoli." (The mother is sitting in her chair shaking her head.) People tend to eat the food to which they are sensitive. It is like the alcoholic who has low blood sugar. The child who loves milk is usually sensitive to it. They continue to drink dairy products, because somehow they need the calcium, but they are so sensitive to it, it does not get absorbed. Blood and hair tests will reveal the deficiencies.
OWC: What are some of the causes and cures for ADD/ADHD? Do you recommend diagnostic tests for nutritional deficiencies? Are there obvious signs of deficiencies other than the ones mentioned previously?
Dr. Smith: Over time back in the 1960s and 70s, I began to notice there were certain common symptoms and signs amongst the "hyper" children I saw who had been pre-diagnosed by the teachers.
In addition to being 80% boys, they were usually blue-eyed blondes or green-eyed redheads.
About half of them had dark circles under their eyes (a give-away that they were eating something to which they were sensitive. Not necessarily allergic, but at least sensitive.) In most cases, that sign indicated a dairy sensitivity.
That stimulated me to ask about any ear infections the child had as an infant. Almost all had suffered from a few of those painful conditions. This is another clue that dairy products may account for some of the symptoms. Next question I asked the mother: "Does he drink milk?" Her answer: "Oh, yes, he loves it. Isn't he supposed to drink it?" Well, yes and no. If a person loves something, it suggests that he is allergic, addicted, or sensitive to it. Like chocolate or booze.
Next question for the mother: "Anything unusual about the pregnancy with him?" Many, but not all, of the mothers responded with some or all of the following problems:
Some mothers had delivery problems like:
Still other mothers reported problems during early infancy:
Some had all of the above; but some had none of them.
Then there followed the ear infections, as well as high fever and screaming after the vaccinations. He was a "touchy" kid.
My next question: "Does he have mood swings? Is he a Jekyl-and-Hyde person?" If yes, it is due to fluctuating blood sugar, as sugar (glucose) is a substance that the brain needs in a constant supply.
Then the physical exam started. He noticed what I was doing and needed constant reassurance that I was not going to hurt him. The heart was beating, and as I moved the stethoscope around to hear the different heart sounds, he would ask, "Can't you find it?" When I looked in his ears, and usually noted some retraction of the eardrums, he acted a if he could hear the light. The abdominal exam was difficult because he was so ticklish -- - exquisitely so. I had to forget the hernia exam, even though I had backed him up against the wall by this time. These patients were usually of wirey and/or athletic build; they were rarely obese.
Because so many of these patients had some or all of the above symptoms and signs, it suggested to me that they had a vitamin or more likely, a mineral deficiency. I did some blood and hair tests. All of them, yes, all of them, had a calcium and magnesium deficiency, despite the fact that many were drinking a quart of milk a day. Apparently they could not absorb the calcium from the dairy products because of their sensitivity. The intestines were rejecting it. It also explained why they loved the milk: somehow the body was telling them to drink it to get the calcium.
Another possibility: when they had ear infections, they were put on antibiotics and those frequently needless use of powerful drugs could have wiped out the friendly bacteria and allowed the yeast, candida to grow, or at least produce an intestinal dysbiosis, and poor absorption. As I mentioned previously, but can't stress enough, there is this rule: If you love something, you are probably sensitive to it.
Just to recap some of my previous statements, after a few years of trying to be a good diagnostician, I accumulated these findings:
1. If a person is ticklish, goosey, sensitive, and notices everything in his environment, as he is unable to disregard unimportant stimuli, it means that he is low in magnesium, and possibly calcium. Muscle cramps and trouble relaxing or going to sleep also suggest low magnesium and calcium. These symptoms correlate nicely with the hair test showing low levels of these two minerals.
2. Poor dream recall is related to a need for vitamin B6.
3. A history of eczema or dry, scaly skin usually means a person is low in the essential fatty acids. These acids are also necessary for brain function. The nutmeg-grater feel to the skin on the thighs and back of the upper arms is usually a Vitamin A deficiency. White spot on the nails is due to low zinc.
4. A bad self-image could be the result if the parents, teachers, and classmates who are all screaming at him to sit still, shut up, and constantly asking disparagingly "What are you dong now?"
Ritalin works in just 30 minutes, while the minerals and the other supplements and diet changes take about three weeks to achieve results. The whole family has to stop the desserts, sugars, white flour, and "put-downs". Too many questions and commands lead to the poor self image.
OWC: Are Ritalin and other stimulant drugs being over used or at least oversubscribed? Is there a proper place for these drugs? Are there any children who can't be helped in any other way? If so, what % would you say fall into this category?
Dr. Smith: There is no doubt that these stimulant drugs are being over-prescribed for these out-of-control children. If, however, the prescribing doctor feels he/she has no alternative for the child who has been "diagnosed" by the teacher who is trying to scrape this child off the wall, the drug seems mandatory. "If it works, the child needs it" seems to be the motto.
Those of us working with these children like Dr. Doris Rapp and Dr. Billy Crook have no doubt that this is usually "a physiological screwup" and not a disease. (One reason it is called a disease is that insurance companies need a standard diagnosis before they will pay for the treatment.) ADHD and ADD have been now called diseases and have a diagnosis code number, for the psychiatrists along with the previously mentioned "disease" called dyscalculia.
ADHD will subsequently soon become a palpable disease called a neurosis when the child gets depressed and even suicidal if he is put down at every turn by teachers, parents, and his peers.
The only proper use for these drugs for a vast majority of kids -- - as I have come to realize -- - is that it will temporarily control the restless behavior.
If it works, it is not a "Ritalin deficiency", but likely a magnesium, calcium, or vitamin B6 deficiency. I have learned from my naturopathic and herbal therapists that our topsoil is becoming deficient in several minerals. The farmers are putting nitrogen, phosphates, and potassium (NPK) on the soil and their plants grow and look healthy but magnesium, zinc, selenium and other valuable minerals are depleted.
At the height of the dust bowl, the US Department of Agriculture put out a "white paper" saying that the minerals in the top soil were deficient and people may have to supply their own with supplements to avoid sickness and problems like early aging, heart attacks, joint problems, and surliness.
The point seems to be that sometimes we cannot get everything we need for healthy living from eating foods from the store or maybe even from organic farms, although those will likely be better.
Then, on top of that, if we or our children are eating the "Standard American Diet" (SAD) our nutritional status will only be worse. If a person has even one cavity, he is flawed already, and it is a clue that other nasties are just around the corner.
Maybe, a small percent, like ten percent or less of "hyper" children may need the drugs to calm them, mainly because they have had some sort of injury to their nervous system that diet will not touch.
Many of those, however, can be still be salvaged with neurodevelopment therapy. I have seen the work of those therapists and know of the miracles they can perform. Homeopathy is a well-known and sometimes surprising type of treatment, that has saved many of these "throw away" children before they give up and go into crime for their kicks.
There are so many side effects from the stimulant drugs, I would recommend that the diet modifications, outlined elsewhere, should be tried first. These children realize they are not so bad and will even start to smile and laugh. It helped me. I was the class clown in the 6th grade, because the teacher did not know what to do with me besides making me the "humor editor" of the class newspaper.
Optimal Wellness Center: There is currently a lawsuit against the maker of Ritalin and a psychiatric group for conspiring to create an all-encompassing diagnostic criteria for ADD/ADHD, which some claim could be interpreted to include nearly every kid in the US. Do you have any opinion on this issue?
Lendon Smith, MD: I know little of what the lawsuit claims, but I understand that psychiatrists have added a number of "psychiatric diseases" to their list of diseases for which they can be compensated by the insurance companies. They are up to at least 400 now, I believe. They have even added such bizarre conditions such as "dyscalcula", a condition of being poor in math.
I was a bed-wetter as a young child, and the psychiatric textbooks claim that it was because I hated my mother. The bed was soft and warm, like mom, and because I resented her (did I really?) I was paying her back for real or imagined putdowns. It was "Pee on you, Mom." as the manifestation of this deep-seated hostility. I found out after a few years of this, if I did not drink milk, I did not wet the bed. I was not my mother; it was the mother cow. So much for psychiatry.
They do make things up.
They HAVE to find someone to blame.
Who is around that is an easy target? Mom
The same goes for ADD/ADHD. Almost all children so touched with this syndrome eventually get a bad self-image, as all they hear are derogatory comments and commands like "sit down" or "stop that". Commands and questions like these are put-downs and tend to give a child a bad self-image. So the end result could have some psychiatric determinants.
When I started practice in 1950 there were a few thousand children in out country on "speed" or Ritalin for hyperactivity.
Now it is up to about 4 Million children a day getting Ritalin on school days.
The company keeps manufacturing the drugs because psychiatrists and pediatricians are prescribing them. The lawsuit might encourage doctors, parents, and teachers to look for some CAUSATIVE factors, such as nutritional deficiencies to explain the problem. It is not a disease.
Can we blame the government, or the "dust bowl" or the farmers for this careless handling of our topsoil? It used to be three feet thick. It is now down to an average of six inches.
OWC: Are there steps that parents can take, starting even during pregnancy to help reduce the risks of behavioral problems like ADD/ADHD?
Dr. Smith: A woman should not marry a man who is an incipient alcoholic (read: has hypoglycemic tendencies, a precursor to alcoholism), or has some of the obvious ADD symptoms and signs (excessively ticklish, restless, overreacts to stimuli), or is an obvious jerk and stupid, too. The meal at the wedding reception should have no booze for either wife or husband, and carrot cake.
She should start taking nutrients as soon as the couple decides to have a child -- - if they can predict this sometimes unpredictable event. Folic acid is a must to start before conception. He needs zinc, and they both should be on essential fatty acids, magnesium, calcium, and the B complex.
Vitamin C, starting at 1,000 mg a day for the first three months and then moving up to 5,000 mg a day until delivery day, has been shown to provide a more care-free pregnancy, a baby with few allergies, and an increased chance of being able to breastfeed successfully. (Dr. Frederick Klenner)
She should aim to gain about 30 pounds during the pregnancy.
The baby is more likely to be healthy and free of allergies. She should not drink cow's milk every day, if at all, and rotating the other ingredients of the diet would be important to prevent the possibility of allergies. No one should eat foods that come in packages.
Do not have sugar or white flour products in the house: someone will eat them!
Organically grown foods are better.
However, they still may not contain all the minerals needed for health. She should aim for breast feeding for the first year of the baby's life at a minimum. A lactation expert can help plan for that activity.
If possible, a home birth is less traumatic than a hospital one. Nurse, nurse, nurse is the smart way to feed the baby. No solids for the first six to eight months and then maybe some steamed zucchini or homemade applesauce to start. One might wonder about the vaccines, which we now know can be factors in the production of neurological symptoms.
Love and limits are the rules for rearing a non-neurotic child.
Ear infections should not be treated with antibiotics, if possible, as their use may lead to overgrowth of the yeast, Candidiasis and dysfunction of the intestines. These infections are a give-away that the child is eating something to which he is sensitive or even allergic, like cow's milk. (If the mother is drinking cow milk, those sensitizing proteins could be in her breast milk.)
There are safe natural methods of treating these infections. She can place a little vitamin C powder on her nipples every day and the baby will suck it off. The dose is about 100 mg of C per day per month of age: the six-month old would get 600 mgs a day. The dose would be 1,000 mg daily at one year and about 2,000 mg per day at age two, then decide how much daily for life after that age.
Preventing infections and the use of antibiotics should keep the baby's intestines functioning optimally. The dysbiosis of the gut may lead to improper nutrient absorption and nutritional imbalances. (From Dr Billy Crook)
If the child shows any of the telltale signs of hyperactivity like ticklishness, overreaction to sights and especially sounds, they would lead the alert parents to suspect incipient ADD. Magnesium in the 300 to 500 mg amounts daily should help. Once the parents are shouting and scolding more than they are complimenting and rewarding the child, then some psychiatric screw-up may be on its way secondary to the neurologic or nutritional defect.
Parents should be able to say nice things to their child twice as often as they give commands or ask questions.
Be nice to your child, hyper or not. He/she is the one who will put you away in a nursing home some day.
OWC: Is breastfeeding protective against ADD? If so, how is it protective?
Dr. Smith: No doubt about it.
Breastfeeding is protective in warding off the risk of developing ADD and a host of other problems.
The essential fatty acids and many other substances present are important for the development of the brain. The breastfed baby has a slightly higher IQ than the strictly bottle fed baby. Breastfed babies have fewer infections, and hence require fewer antibiotics than the bottle fed ones. As previously discussed, if antibiotics are used for every infection that comes along, the infant and child (and adult) is likely to develop the candida yeast infection in the intestines with its attendant problems of malabsorption or dysbiosis.
Also, the immune system does not learn anything; it is not strengthened when antibiotics are used. In addition, breastfed babies are more likely to develop a better set of jaws and optimally spaced teeth. (Dr. Weston Price.)
The benefits of breastfeeding are not limited to the substances in the milk itself. Closeness and bonding are an important part of growing up.
Babies breastfed are more likely to be secure -- - not spoiled -- -secure.
The best years of my life were spent in the arms of another man's wife -- - my mother.
OWC: What is your opinion of "Ferberization" of infants? (This is the allowing of infants to "cry it out" in their cribs)
Dr. Smith: I think that this concept sounds like an abomination of what parenting stands for. I understand this is what the Third Reich advocated, because in the 30s and 40s, the Nazi idea was to rear a tough Aryan race of children who would be obedient, used to stress, and learn to rise above the pain.
The Nazis had blue-eyed blonde true "Aryans" mate and reproduce, but the children were placed in nurseries with tough, no-nonsense nurses (like Elsa Koch) who "supervised" their care. The infants were only fed and changed at set intervals. Holding and cuddling was not allowed. The children thus treated -- - or not treated -- - in their infancy grew up to be stupid.
Love and cuddling conquers all.
If your baby cries, pick the poor thing up and try to find out what the matter is. Many people cannot believe that their baby could be hungry. You must remember that the stomach can empty itself in just an hour and a half. Assume that hunger is the cause. If the distressed little thing vomits, and then feels better, assume their is somethng wrong with the milk. It is most likely a sensitivity to cow milk.
Babies NEED people whom they can trust. They need to feel secure, and I might add, and a feeling that they are wanted.
OWC: What is your opinion of infants co-sleeping with their mother and/or parents?
Dr. Smith: William Sears in his writings and speeches advocates that infants sleep with their mothers. He even made a sling that the mother could wear so that the baby would always be near her and feel her motions and even hear her heartbeat, which would remind the baby of the wonderful life in the uterus.
Those wonderful, safe days of long ago; where are they now when we need them?
When babies sleep with or near their parents, especially mom, they are not being spoiled, they are being made to feel secure and accepted.
There were enough lights, sounds, and other stresses during childbirth that I would imagine that after birth, the poor kid must have a serious headache, at least. If he is a boy he might have a penis ache also, from the amputation of his foreskin. He needs all the comfort and warmth possible.
When we consider the rapid rate of growth in those first few weeks, the baby has to be fed frequently, and who best to satisfy that need? Mom, of course. I figured out how fast the baby was growing in those first few weeks. If we extend that growth curve straight up, and the baby continued to grow at the same rate, by the time he is 10 years old, he would be about 20 feet tall. He needs to be fed frequently and sleeping with mom allows this to happen during the night more easily for both mother and child.
The father should at least be "allowed" to change, cuddle, and find the lost pacifier under the bed. Let him know he is important in child rearing. He should even sing to his baby.
It would be helpful to have a crib-like device fastened to the adults' bed somehow so the mother can easily slide the baby straight over to her nice warm bed.
OWC: What is your opinion of the Feingold Diet for ADD? It seems to get a decent amount of attention. Do you think it is effective? Are there points you agree or disagree with?
Dr. Smith: About 30 years ago, I met the late Dr. Ben Feingold, an allergist in San Francisco. He had found that many people were sensitive to aspirin. They often developed asthma, nasal polyps, skin rashes and even irritability and odd behavior, including hyperactivity. When he had these patients, often adults, stop using aspirin, the symptoms, including surliness and hyperactivity disappeared.
That started the whole Feingold Association. He discovered that aspirin or salicylates were also in many foods, including citrus, some berries, and other fruits and some vegetables. Mothers of children with hyperactivity could tell when her child ate some of the forbidden foods. It certainly worked for some children.
I was on a panel of doctors talking to parents of these children, and asked him why he did not eliminate sugar while he was at it. Ben's reply was "I bit off a little more than I could handle with the salicylate business."
Eliminating salicylates still works for some. There are Feingold Associations in almost every city in the US.
Thanks Ben. You are one of our heroes.