Calming hyperactivity in kids: our new medical columnist offers some foolproof solutions for the ADD/ADHD child who refuses vitamins, and covers the link between food and migraines

Q: My 11-year-old grandson has ADD/ ADHD and my daughter is desperate for a solution. She wants to try something natural like fish oils (instead of Ritalin), but he refuses to take vitamins. Which supplements are a must for kids with this condition and will any diet changes help? Can you suggest how to get him to take supplements?

--Marilynn, Denver, Colo.

A: Good for you for supporting your daughter's desire to go natural with this all-too-common diagnosis. Many parents are under pressure to drug their children. Many kids, especially boys, are just not built to sit in classrooms all day long, especially with the added agitation of handheld games, cell phones, and 24/7 video stimulation. They don't need drugs--usually. They usually need to run around, throw balls, climb, and squish their toes in the mud. Kids also need a lot of sleep. Ten hours a day through middle school is critical. Removing stimulants and limiting TV and computer use is a must. Encourage your grandson to participate in sports or outdoor activities to improve focus and self-esteem. Learning to play a musical instrument or to speak a second language are additional ways to keep kids mentally engaged.

Essential supplements to help these kids focus are fish oils, vitamin C, and the mineral magnesium. For fish oils, a blend of DHA and EPA (1,000 mg daily) is important. I like strawberry-flavored Nordic Naturals liquid or fish oil capsules for kids--yummy. Vitamin C is an inexpensive, easy-to-find nutrient. Give your grandson 1,000 mg (1 g) daily--how about an Emergen-C packet added to sparkling water with a straw? There are many ways to get magnesium. About 500 mg daily, at bedtime, can soothe the brain and muscles. Magnesium, my favorite muscle relaxant, is deficient in many Americans' diets. A to B Calm and Natural Calm are two powdered magnesium products widely available at health food stores. Several manufacturers make a vanilla-flavored calcium] magnesium liquid, which my 9-year-old likes. Calcium is an essential nutrient for preteens and teens to make sure their bones and teeth develop optimally. Soda, in particular, is an antinutrient to bones and teeth. Treat soda like cigarettes and alcohol--not allowed! Hopefully, by the time they are of age to decide for themselves, they won't have developed an interest.

Back to recommendations specific to ADD/ADHD management, and I use the word management intentionally. ADD/ADHD tends to be a chronic disorder that persists into adult years. The winning combination of judicious diet and nutrients may be needed long term. Try to reduce (ideally eliminate) wheat and dairy products from your grandson's diet. These foods are known culprits in cognitive disorders. Researchers have noted that wheat and dairy proteins, particularly, break down in the gut and form substances similar to endorphins (the body's opiates), which are deleteriously stimulating for kids with ADD/ADHD. High-dose EPA (an essential component in fish oil) supplementation has been shown to have efficacy comparable to Ritalin in reducing symptoms. Lecithin supplements or granules and the herb ginkgo can also help enhance mental focus and clarity.

If cleaning up your grandson's diet is not enough, he may need more testing. It can take months for wheat and dairy to clear, but improvements can be noticed within the first two weeks. Some kids with ADD/ADHD need folic acid. Some have heavy metal deposits that cause neurological compromise--they may need chelation and liver detoxification (with help from a physician knowledgeable in environmental medicine). Avoid microwaving food whenever possible, especially in plastic containers, because this can release toxic phthalates into food.

If the suggestions for supplement compliance don't work, try mixing medicines or supplemental nutrients into applesauce or a spoonful of nut butter. A compounding pharmacist may be able to work with you to concoct a nonsugary but tasty mix of fish oils, vitamin C, and magnesium.

Can Tea Cause Migraine?

Q: When I consume anything with tannins (from tea to herbal supplements), I develop a migraine. Could the tannins' tightening actions be a trigger?--Linda, Santa Cruz, Calif.

A: For years, medical researchers assumed that migraines were a vasodilation phenomenon, which results from too much blood flowing toward the brain when blood vessels expand. Many migraine medicines (Imitrex, Sumitrex, Maxalt) are vasoconstrictors and work by inhibiting blood vessel expansion. But they don't cure the problem. People taking these drugs end up with less pain, but suffer more frequent rebound migraines when the drugs wear off. Migraines occur for other reasons too, including platelet clumping, reduced levels of the "feel-good" brain chemical serotonin, and inflammation from chronic ingestion of food irritants. In your case, it is likely that the tannins are gastrointestinal irritants, creating a "leaky gut" that allows improperly digested food into the bloodstream and then generates an inflammatory response. The inflammation essentially puts pressure on the sensitive brain tissues. If you tend toward iron deficiency anemia, another possible mechanism may be a type of tannin-induced anemia. Tannins strongly bind iron. If your blood is low in iron (a serum ferritin score of less than 30) then tannins can result in transient anemia, causing insufficient oxygen to reach your brain. Tannins can also lower blood sugar and blood pressure, so if you have low blood pressure or tend toward hypoglycemia, the tannins could put you over the edge. If tannins are your only trigger then completely avoid high-tannin products, such as tea, pomegranates, persimmons, berries, and wine, particularly red wine, for at least 12 months."