Supplements for ADHD in Adults: Natural Brain Support That Actually Helps

Yay. [sighs] And we're live. [laughter] Hi Dr. Rose. Hi Colin. Good to see you. Um oh, I'm I'm [snorts] hold on. I'm technic I'm glitching again with my audio. Hold on. I'll be right back. Hold on. Hold on. Hey everybody, we're just waiting for um Colin to get some audio issues settled. We're letting a few more people join us. If you haven't um joined us in the past, um this is going to be myself, Dr. Sasha Rose, and Colin Renard. We are talking about ADHD there we go. And you're back. Sorry. Yeah. I'm back. Yes, I'm here. Yes. So, I was just saying that we are our topic tonight is natural brain support for ADHD. Yes. So, we want to welcome everybody to the MedMatrix Method podcast, where one to two times a week we talk all things functional medicine and how to take a more personalized, preventable approach to your health. And as Dr. Rose said, we're talking about ADHD today. I get I get this topic a lot. Not maybe so much about patients directly. Well, a lot of times patients, but patients ask about their kids a lot. Mhm. They're like, you know, my kids and my kids' friends and things. So, um we can begin by just introducing for those of this those that are listening who are maybe new to the podcast. Um I'm Colin Renard. I'm one of the lead clinicians in the practice. Uh my background is pretty diverse. I have a background in chiropractic medicine and natural medicine. Um I practice medicine at MedMatrix as a PA. Uh I'm board certified in multiple disciplines including an anti-aging and I'm fellowship trained in functional medicine. Um and I think between Dr. Rose and myself we have over 30 years of functional medicine experience. So, I think we I think we do pretty good, right? So, I'll I'll let you introduce yourself next. [laughter] Yeah. Uh my name is Dr. Sasha Rose. I'm a naturopathic doctor. I'm a licensed acupuncturist. Um I am as well one of the lead providers here at MedMatrix. And I've been practicing functional medicine for over 20 years. Um I One reason that I really love having the opportunity to do this podcast is because it it it really does let us kind of dive into some of these very common topics. So, for example, ADHD. Um again, as Colin said, you know, it's often people bringing it up about their children. Um but what I think is maybe a different angle or especially interesting about um today's episode is that we're mostly going to be focusing on ADHD in adults. And um that's kind of deserves its own its own time and attention. Yeah. So, um a couple of housekeeping things before we start. As I said, we stream uh our podcast one to two times a week live and then we are also available for streaming later on Spotify or Apple Podcast. Uh we take questions during our live stream. So, if you have questions, drop them in the comment box if you're listening on YouTube or on Instagram, just drop them in the comments. And uh we want to offer a medical disclaimer that this podcast is for educational purposes only. Uh Dr. Rose and myself like to talk all things health care and longevity and wellness, but this is not meant to nor to replace any medical advice. If you're seeking medical help or attention, please refer to a physician. If you are interested in giving us your medical advice, you can become a patient though through MedMatrix and we'll talk about that later towards the end of the podcast how you can do that. So, to start us off, Dr. Rose, I I you mentioned this very briefly, but with ADHD, a lot of people think about this as really children, you know, a children's problem or attention deficit issues and kids that struggle with learning or behavioral issues in school, but I I think it's really important that we talk about this not just from a child's perspective, but as you said, just a personal perspective from an adult or anybody and many people think ADHD is really just a brain issue like with attention, you just don't function properly, you're not behaving well, but I think it's important that we talk about what actually goes on in the brain. Like why why this is actually a thing, sort of what the stigma behind that so we can sort of get rid of the stigma. Um, what are your first thoughts when you think about ADHD or educating a patient about what this actually means clinically or scientifically? Yeah, I think it's a really good question cuz I think um, as you mentioned, people um, think of ADHD is only applying to children. Um, you know, the H is in there for hyperactivity, so people kind of think of you know, the child who can't sit still in a classroom. Um, and I think for a lot of um, adults who are dealing with this, they most likely were also dealing with it as children and there is a ster- unfortunately in our culture right now, there is, I think, a stigma that gets attached to it sometimes quite early on. And so, when I'm seeing my adult patients, there's often um, some shame that goes that comes along with it and sometimes even maybe some hesitancy to kind of talk about it or just like it it unfortunately can kind of translate into an individual not feeling smart, not feeling intelligent and that was potentially kind of baked in early on. And so Yeah. it's really not I think a part of our role. I don't know if this is your experience, but I feel like you know, talk about being educators and I think some of that is kind of doing what we can to peel some of that that stigma away and some of that shame away and really just get into kind of the the nitty-gritty on executive function and attention regulation and the neurotransmitters that are involved, the prefrontal cortex and kind of just talking about it just as like a you know, it's it's just a it's kind of a you know, neurotransmitter issue. It's kind of a executive function issue. It's not inherent intelligence or lack of. Tell me what else how else you talk to your patients about it. I was going to say I think the way you explain that is really important because when I think there's this almost inherent feeling because of potential stigma, you know, there are certain things in healthcare that are very stigmatized. Certain disease processes, [clears throat] you know, STDs are very stigmatized or obesity can be stigmatized or whatever, but when we think about something like a brain chemistry issue, there is this stigma and you said it beautifully of like, well, they're not as intelligent or they lack maybe willpower or they weren't raised right or something, you know, if you know, if kids that are hyperactive, it's like, well, the reflection of the parents or something. They're not raising their kids the right way or something, but it's it's really important to, I think, for my patients, um and I'm seeing this a lot more in my adult patients where they are getting ADHD diagnoses, but they're seeing a specialist, and um there's almost this uh affirmation that they feel, sort of to say, "Well, I'm I I'm not stigmatized because I knew something was sort of wrong with the way I perceived certain thoughts or the way I handled myself, and I feel almost validated that I can use this as a way to understand myself better." So, that's I I really think it's important when patients do hear it and understand it, and that's how I try to talk to people about it is really from a validating perspective of saying, "Okay, how do we understand how you learn? How do we understand how to treat you better?" Um So, it sort of is a better way, I think, for us as clinicians to better direct care, too, if we can understand this about our patients, and I think it's also really important to distinguish what what that means for patients, like symptoms-wise, because certain symptoms show up differently in children versus adults, you know, and this can be very relatable to people because it sort of broadens that va- that validity, like I said, if we can understand what the symptoms are, then you can sort of understand how this how it applies to you. So, I think some of the examples of that really with the symptoms is, you know, hyperactivity in children, um uh a a lot of times I see, and and I have this myself a little bit. I've never been diagnosed ADHD, but I think probably all of us have some sort of spectrum of attention issues I th- in the in the advent of cell phones, right? And Yeah, right. and technology, you know, we all have short attention spans, um but most adults I see, they have this internal restlessness kind of thing, and I I I can relate to that. Um brain fog can be a big thing for adults, feeling overwhelmed. And then also feeling very emotional or emotional sort of reactivity or emotional highs and lows I've seen in some of my patients. Do you what do you what are your thoughts there with symptoms with children versus adults? Do you see differences? Yeah, I I mean I think it can ADHD can present differently. There's obviously some commonalities but some differences between children and adults I think. Like I kind of gave that example of a child having a hard time conforming to the traditional school structure having to be physically still day in and day out. And that with I would say most of my adult patients who either have had a have a diagnosis of ADHD or who whom we suspect that they might have ADHD. As you said it's a little bit of that short attention span kind of internal more of an internal restlessness than external. Um And some I was going to say brain fog and overwhelm which as you know we will talk about and we talk about we have talked about a lot is kind of other things that can influence things like brain fog and and feeling overwhelmed. But one one piece that I find really interesting and I have this one patient in particular that I'm thinking of who used this term which is time blindness and described working. She loves what she does. She has a corporate job. She works a lot and she has figured out a way to basically partially manage her ADHD in that she will set alarms and you know um notificate posted notes alarms basically telling her it's time you have to get up you have to work you have to stop what you're doing and move on to the next because if she doesn't, she literally has no idea if it's been 15 minutes that she's been working on this project or 3 hours. It like she has no internal perception of that. And it just stuck with me, her description of that and and she used she herself used the term time time blindness. Um So, um Very interesting. I like that. And cuz I think we all have that sense of you know, and it if it's an ADHD thing or not, but I feel like that's why something like this could be a spectrum for maybe anybody in some way because if you think about it, we could all get lost doing something in some way, right? People who work like all hours of the night or whatever and they don't sleep or but I think if if it if it's disrupting your function day-to-day, that's really really a struggle. That's really interesting. And for and for her, I think interestingly, even though she was like diving really deep into one task, it was impacting her her quality or her productivity of work because she was not completing other ones, right? So, she was kind of it it you could say time management, but it for her it was really specifically this kind of time blindness. Yeah, it's almost like you become unconscious and the whole world disappears around you and you're just so focused on on what you're doing. So, um one of the a couple of the other things I think what that are really important as we introduce this topic and get into it is really what's the cause of this. I think that's where most people try to understand and I think that's really the important part of the stigma piece is if we can understand what are some of the root causes are and from a functional medicine lens, right? We're functional medicine practitioners, we don't look at this as oh, you have ADHD, so you need, you know, a stimulant. You have a stimulant, you know, deficiency. It's not a thing. Um Ritalin deficiency is not a thing. So, uh Adderall deficiency is not a thing. So, when we talk about functional medicine in regards to root causes of ADHD, things that I see a lot are a lot of lifestyle things. I don't know if this is what you're seeing, but I see a lot of issues with sleep or anxiety or nutrient deficiencies, stress and and I mentioned earlier the the these things, these things we have, you know, in front of us all the time and I even find myself I'm on with a patient sometimes and my phone and it's like it dings. It's like, "Oh, an email. Oh, what what what is this?" You know, it's like just don't worry about it. You know, you're it it's fine. It's not it's not important. You know, back in the day we checked email when you were at a computer, right? Or a voicemail when the phones were plugged into the wall. If you were gone for the day, you didn't get a phone call cuz we didn't have phones. You had to check your voicemail when you got home. Um but we're so tuned in, so I think that that has really changed our brain chemistry significantly is this overstimulation that we have. Um but I also see issues with like gut hormone gut dysfunction, hormone dysfunction. Uh what are what are some of the things you see in relation to ADHD as root cause potential? Yeah, root like what are some of those root causes or factors that can worsen ADHD and maybe what, you know, from a neurotrans- I guess what I would say from a neurotransmitter standpoint, I think we're mostly dealing with kind of dopamine and norepinephrine and it's not are those for people that are neurotransmitters um primarily in the brain, although they are also kind of produced in the gut and um usually what we see is um when there's like a signaling issue with those with those neurotransmitters um kind of a people the individuals not necessarily getting the full benefit of those neurotransmitters and that can lead to kind of um I think of it in terms of that stimulation. Like I think of it in the terms of why do these medications that are stimulants, why are those working? Cuz they're kind of taking the place of what those our own inherent neurotransmitters, mostly dopamine and norepinephrine, are doing. Those are stimulating. They're kind of like feel good um and motivating neurotransmitters. And so when there's kind of a disruption in the signaling and in the pathways of those neurotransmitters, um and a lot of the things that you just mentioned can impact those, everything from you know, hormonal health to to gut brain axis to nutrient deficiencies, all of that, um then you're not really getting the full benefit of those um endogenous or your own neurotransmitters. And so what we're hoping to do from a functional medicine perspective is look at the whole person, look at all of these different pieces, nutrient deficiencies, hormones, stress, screen overstimulation as you've um put aptly. Um you know, even thyroid, like looking at all of that and to see well, you know, where is the issue with this neurotransmitter balance? You know, where can we kind of support this the whole body? Um and if necessary, yes, there are these medications out there, but really trying to do more of you know, what we do best, which is root cause medicine. Yeah. Do you think Do you think that as I don't want to say that we are getting We're not getting I don't want to say we're getting unhealthier as a society as time goes on, but sort of in a sense a little bit. Uh do you think that ADHD is becoming more I know your answer to this, but I want the audience to [laughter] hear your answer. Do you think ADHD Give my answer. Do you Do you think ADHD is becoming more prevalent in our culture and maybe more recognized? I mean, I there's more diagnostic uh resources and things, but as we become more and more maybe disregulated as a human species, right? Hormone dysfunction and blood sugar regulation and gut issues, is that why we're more ADHD, do you think? I do. Yeah. you think? I think it's a good question. Is there like Is there societally is there a rise in ADHD? And I think it's probably both. I think that there's both more of a awareness of it, a recognition of it, hopefully in both children and adults. Um and hopefully we'll get to a point where there it's less stigmatized, but just more of an awareness of it. Um but then I think, as you said, I mean, we're all guilty of that kind of like super short attention span and um you know, I feel like I used to have the capacity to kind of, you know, read a whole chapter of a book, and now I it's like that's like it feels like a struggle. It feels like an internal struggle Same. to not take a break and check my Instagram feed in the middle of reading a chapter. [laughter] I mean, that's ridiculous. So, I think it's I think you kind of have to be living under a rock a little bit to not be somewhat affected by yes, by how media, social media at least, has kind of impacted us. So, I think both both things have happened. That kind of the diagnostic, the awareness of it, but then also, unfortunately, the things everything that you mentioned in terms of exacerbating, contributing to a rise in that kind of attention dysregulation. Yeah, we're just like becoming different as humans. I think the way we operate, the way we live, so it's making this behavior I think more prevalent for people. Uh for those that are listening live, we thank you for being here. If you have a question, you can drop it the comment section if you're on YouTube or Instagram. We will answer questions toward the end of the the podcast, so drop us a question. Dr. Rose and I would love to hear from you. So, I want to move on to another really important uh piece of this puzzle that I think I see really often is blood sugar issues that can affect people's mood, their focus, uh they get tired during the day, right? They don't eat a good lunch at work, and then they're falling asleep at their desk at 2:00, um or they haven't eaten breakfast, they eat a muffin for and they're totally asleep by, you know, on their ride home from work or something. So, this I think is a really, really big topic when I'm talking about attention issues or focus issues in my patients is blood sugar regulation and how spikes and crashes in people's blood sugar, which could be related to diet or other metabolic dysfunction, can really lead to a lot of inattention, a lot of irritability, um you know, people that are eating, like I said, really bad food choices for big meals, you know, processed foods, simple carbs, a lot of sugar. Um so, what I I'm assuming I'm assuming you see this all the time in in terms of metabolic dysfunction Yes. or diet relating to cognitive issues. Yeah, what we can probably, you know, just by being with somebody for a brief amount of time and learning about what they are eating or not eating, what their meal schedules are like, um absolutely I think blood sugar is a huge part of it. It just makes like attention and executive function um and mood kind of stabilization so much harder when your um blood sugar is just, I guess, to overuse the term, kind of dysregulated. And I think that um it does become this vicious cycle where uh somebody's energy is tanking and they go through the Starbucks drive-thru and they get one of those [laughter] not a coffee, right? I mean, it's like I don't know the amount of sugar that's in those, but I mean, it's it's I understand it. Like you're tired, you don't have time, and it's available. And so you get a huge Frappuccino, whatever with lots of whipped cream and a couple shots of this and that, and you feel better, right? Like there's your there's your glucose hit. Um that's feeding the brain and you feel good and you feel like you can focus. Um and or there's also energy drinks, which can kind of, you know, maybe not impact your maybe or maybe not impact your blood sugar, but definitely kind of give you that shot of energy. And that you've got that spike and then you crash again, and it's just up and down. It's like it's you're kind of inadvertently trying to manage it, but you're really just having these big highs and lows. And with that kind of um that volatility, it just makes all this kind of daily functioning that much harder. And so kind of what you alluded to, it's like if somebody's going to get one thing from this podcast episode, ideally it would be eat a breakfast that has protein in it. Like eat something that's not just processed carbs. Um start your day like that. Just that. I mean, the the thing I think that can confuse people is like glucose is the main nutrient for the brain. But that doesn't necessarily mean eat sugary food. Straight straight up sugar, yeah. Yeah, straight up sugar is not the answer, but having having this dis disregulation in your blood sugar is really what we're talking about um and how it can improve or sort of totally out of whack your focus. Um so I think that's a really good point. And I I do see I mean, I don't know how many patients I see at a time where there is metabolic dysfunction, insulin resistance, prediabetes. It's it for a lot of my new patients and you would probably agree it's it's a lot. It's it's There's a lot of people in the diabetic range. diabetic range. It's pretty common. Yeah, it's really common and you know, when we when we think about how that can affect overall like mood, focus, it it's probably a lot of people a lot more than we think. Um So, as we talk about this from almost a food perspective, talk about what not to do. What should we do? What what are the most important things that we can naturally support, you know, being calm and cognitive performance and just ADHD in general? I mean, there's tons of studies that I've seen that are really identifying food and nutrients as extremely important factors of brain cognition and ADHD. Magnesium, omega 3s, zinc, B vitamins, you mentioned protein. I think protein is really one of the most important things you can do for your body and I and I'm really excited to see that a lot of people in the media and the the mainstream sort of knowledge about food is, wow, I need to be eating more protein. I don't love that big food companies are putting protein in like pasta to make it sound like it's healthier. It's not. But hey, at least the conversation is starting like, okay, protein is really important. So, do you have any like aside the things I was mentioning, do you have any specifics that you're educating people on or putting people on with a nutrient person from a nutrient perspective with ADHD or cognitive dysfunction? Yeah, so I guess like when I'm if I if you know, if I'm trying to simplify it, make it something that somebody can actually do and they don't feel like they have to kind of overhaul their everything that they eat. Um I would definitely agree with you in terms of, you know, the actual, you know, nutrients being what you what you listed there in terms of the omega-3s and magnesium, etc. Um One thing in terms of stabilizing blood sugar, both protein and I would say and I would also include in that some healthy fats. When you When you add that to carbohydrate, you're lowering that volatility of blood sugar. So, if you're um you know, the example that I always give is if you're going to eat an apple, have a little bit of cheese or a little bit of nut butter with the apple because that that um absorption of the glucose from the apple is going to last longer. You're going to kind of get more bang for your buck. It's It's going to You're going to have You're not going to have Not that an apple's going to give you a sugar high, but, you know, as an example. [laughter] It might certain people. Maybe for some people. So, you're going to get like your energy is more sustained. Um just by adding in a little bit of healthy fat. I'm not asking anybody to go out and eat onion rings, um but I think healthy fats are often kind [laughter] of under underutilized. Yeah. Yeah, put some olive oil on something or like, you know, a nut butter or a slice of avocado, something. You know, yeah. I I I think the I think what I try to educate a lot of my parents that ask about ADHD cuz we don't, you know, at at Matrix we're not treating children under a certain age, so we do um we do have [clears throat] a lot of parents that come to us for their own health issues, but they ask about their children and oh, is there, you know, can you comment on this or whatever? Just in my career, I've I've seen parents with children and families and there's always this overwhelmingly obvious nutrition issue in kids. and the the research is overwhelmingly supportive of nutrition drives cognitive function. Like, oh my gosh, you know, so kids nowadays are just eating so much food quote unquote. It's not really food, it's like a food product. Things from boxes then cookies that have a superhero on the box, so that's why they buy it or it's a TV show or something. There is so much non-food food that children are eating and that is becoming overwhelmingly clear that that's driving cognitive dysfunction in children and ADHD. So, the nutrition part is really really important and I think from a practical perspective, that's where I always start when I do these things. I'm sure you would agree. I mean, with patients, even if they have a blood sugar issue or hormone issue, even if it's any issue, right? ADHD or brain fog or I can't sleep or whatever, we have to we have to talk about the food, right? I mean, it's imperative for for success. I don't I I think you would agree. Absolutely. Yeah, so just while we're on that topic, why don't you why don't you dive in a little bit more into um kind of that gut-brain piece and so including nutrition, but just kind of like the microbiome, neurotransmitter production, like talk about how all of that works together. Yeah, so you mentioned this earlier about, you know, some of the neurotransmitters, these these chemicals in your brain that make you feel good. Lot of you know, there's a lot of production in the in the gut. Most of our serotonin is made in the gut, which is many of your happy chemicals that makes you feel good. So, the this is an excellent sort of from a functional medicine perspective, the relationship of the gut to how you feel mentally is really well understood and really well researched in the literature. And this is where I think functional medicine one of the one of the highlights of functional medicine is we as practitioners understand this relationship really, really well. So, we can really dive into some specifics about how the gut affects the body overall, whether it's cognitive or ADHD or something else. So, there the microbiome or the build-up of your bacteria in your gut, sort of your garden in your gut is really linked to how your neurotransmitters are produced, how much inflammation you have, um and also sort of signaling from the gut to the brain, we call it the gut-brain axis. So, there's inflammation in the gut, things like leaky gut or intestinal permeability, infections, bacterial overgrowth, a fungal issue, a parasite. All this causes dysfunction in the gut, inflammation, which leads to the signal from your gut to your brain being compromised, where there's inflammation in the gut, it's sending a signal to the brain to be inflamed, and it goes back and forth, you know, on itself. So, we see neurobehavioral changes with very poor gut health all the time, and there are studies that show that certain bacterial strains in the gut can be related to certain [snorts] neurocognitive behaviors, certain autistic behaviors, or um certain types of uh behavioral issues and aggression and mania, depression, anxiety. So, there's a really, really important uh connection there. And this is a great way to understand what root cause medicine really is from functional medicine lens, right? If we're looking here, like the problem is here, but the solution is here, that it really takes a very seasoned person in this field to understand that connection, right? Your Your average, say, conventional medical practitioner may not understand the relationship, and that might be the reason that the patient is not feeling well. It's a really really good point. Do you have any thoughts about that? Did I miss something? Do you have any other I think you said it really well. I think um you know, you've we've talked I think a lot of people may have heard the term leaky gut. Um but I think that's another kind of link when there is a level of increased permeability in the gut lining. And so when that microbiome is is off when kind of that garden as you as you put it is kind of not so great. The soil's not so great in that garden. Um there's increased gut permeability and so you're going to it's basically the theory is that it's the start of inflammation systemically. So you're basically triggering an inflammatory response starting in the gut but that then can go, you know, throughout the body. So and that I would include the nervous system in that. I would include things like brain fog and fatigue. And that can be a little bit you know, there's so many things that can can contribute to that but we do know that that um that brain fog and obviously inattention are like a big part of ADHD and I would put that in kind of that potentially that leaky gut inflammatory connection. So another way to view that gut-brain axis. Yeah. I was just going to say have we done a podcast on leaky gut? If we haven't, we should. About time. It's about time. I was just thinking like we've done so many I can't remember. Let's stay tuned. We'll do a podcast on leaky gut. Absolutely. We can do a whole series like on, you know, leaky gut, gut, you know, how this the brain-gut connection whole thing. Well, stay tuned. We'll we'll we'll do that. Not to shift gears but another really important topic I think we we need to address on this podcast in particular when we talk about ADHD is the role that sleep plays. We talk about sleep all the time on the podcast. We've done episodes and up you know, galore on sleep um and how sleep is so underappreciated. So, sleep is and I actually just had a a patient yesterday who sleep and insomnia is one of is like the chief concern and it's almost as if well, I I can't even move on to other things because if you don't sleep, I don't really know we've got to figure that out first. You know, we can do the this and the that and you know, all these other things, but sleep is so critical. Um sleep is really how your body recharges and regenerates itself. So, sleep deprivation is known to cause a worsening of attention and it affects your circadian rhythm. It affects um impulse control and it affects um that neurotransmitter balance that we've been talking so importantly about. So, and I know we had a whole podcast on the lymphatic system, which is really this part of the brain that cleans itself, right? It's the waste product the waste um plumbing of the brain to clean itself. So, when we talk about sleep, I this is day one. This is like when we go through the medical history, what's your diet? Do you drink alcohol? Do you smoke? All right, how do you sleep? Right? Is it good? Is it 8 hours? Are you rested when you wake up? Do you track it with your little ring or an app? I know you track yours, Dr. Rose. You're big into that. Your family does the whole thing with the sleep um tracking. I know you guys love that. Um so, it's such an important piece of things and when you introduce this topic with patients with cognitive dysfunction, brain fog, ADHD, how do you start? Like how do you get going with a patient with education on sleep? Where do you intervene first? How do you make this happen when this is such a prevalent issue with these types of patients? Yeah, I would agree that sleep is more often than not um I guess sub-optimal we could say with people who are dealing with ADHD. Mhm. And unfortunately, it is commonly overlooked. I think it some of it can tie back to some of those other lifestyle pieces that we were alluding to where people have become again often times with ADHD they're kind of somebody is looking for ways to be stimulated, right? They're looking for stimulants and so there can be this reliance on caffeine, on sugar, um maybe even on over exercising for some people but some you know and so if you spend all of your waking hours kind of over caffeinating, you know, too much sugar it's not like you magically are going to be able to get to 10:00 p.m. and just lie down and be and have a deep, you know, restful night of sleep. It doesn't work that way. Are you sure? [laughter] You have a patience where that's their experience. So um so a lot of it's tied in to to that and um and then just that like we mentioned at the at the at the start uh that kind of internal restlessness. Like sometimes when we talk about sleep hygiene for people that doesn't come easily to somebody who's dealing with ADHD, right? Like that just kind of ability to slow down, put the screen away, um you know, that that is not so easy cuz they're they're they're they've been they've been revved up all day. Um but yes, I think kind of whether it's working with kind of these behavioral modifications, again back to the nutrition um whether you're you know, using a wearable to kind of track your sleep but I think it's it's not as you do, you know, right off [clears throat] the bat the first visit you're talking about sleep. Um my experience is that it's not. It takes time, you know, and it takes commitment on the part of the patient um of slowly figuring out what is going to work. It's not like I'm handing somebody a magic pill for their sleep. I'm it's just not the way that you and I practice to give somebody a sleep medication and just say you're good. Like that's that that's not necessarily root cause medicine. So, I think acknowledging the role of sleep and um figuring out for that individual how to optimize um sleep. And then once that happens, it really is like a a gift to the nervous system. And when we're, you know, overall we're trying to regulate the neurotransmitters, regulate the nervous system, and as we have said in different ways on different episodes, like sleep is crucial to that. Yeah, I think you said it really, really well to sort of say you can you can't like we we we say all the time you can't out exercise a bad diet to lose weight or, you know, other goal body goal, but you can't really ignore or medicate good sleep. And if people are uninterested in recognizing that, it's almost like the buck stops there, essentially. Like we have to do this. And um I I think it's so under recognized in terms of the importance of not just only cognitive or behavioral function, but just how you how you exist in the world, you know, your mood or it affects your your blood sugar, your ability to detox, your gut health. I mean, there is so much regenerative properties going on there. So, I think we've again, sort of with the phone thing that I was talking about earlier, we have come to start to live in a world where, oh, I don't need a lot of sleep. You know, I can just I can just do it or, you know, people that are really, really high-level achievers. And achieving [clears throat] at a high level is not a bad thing. I mean, you and I do, you know, we try to do that, you know, that's part of, you know, being a professional or something is achieving high level, but there's there's this level of like overdoing and under doing certain things to keep you healthy, but I do think there was a silver lining to the COVID pandemic of oh wow, I don't sleep or I am too way too stressed or I don't take care of myself. So, I do think that people are starting to recognize some of these lifestyle things as being really important. Um you mentioned like, you know, from a root cause perspective as clinicians, our job is not necessarily, oh you don't sleep, here's a sleeping pill. But, are there Not that that's Not that there's anything wrong with that, but it's just not necessarily our style all the time. Um are there natural things or sort of supplementation protocols um that you love, you know, you have a a huge background as as do I in natural health care and using supplements and herbs and botanicals? Are there certain things you go to like right off the bat to help people with attention and supporting emotional regulation? What are What do you like that you use for people? Yeah, there's a number of um botanicals and um micronutrients, minerals, vitamins that I've seen work for people with ADHD. Um we, you know, the goal with any of these would be supporting the nervous system, supporting the adrenal glands, um and kind of overall helping with both attention and ideally emotional regulation. As we always say, it's a very personalized medicine. So, depending on how it's really presenting for a specific patient, if it's difficulty falling asleep, we might focus on certain things. If it's more of um you know, it's impacting my executive functioning at work, uh whatever, you know, that might kind of that will tweak kind of which individual products I'm going to recommend, but in general um and without giving actual medical advice, um you know, L-theanine is a really great amino acid. It's really great for sleep. It's really great for anxiety. Um that one's a favorite both in children and adults. Um some of the botanicals would be would include um lion's mane, maybe passiflora, rhodiola. Um Passiflora. And then um phosphatidylserine is a really good one. That one is one that I've actually used on with some patients who are trying to wean themselves off of Vyvanse or Adderall. Um so I've had some good results with that one. Um and then you know, various forms of magnesium. Usually three and eight or glycinate are usually the ones that I start with. Um Do you have some favorites for this? I I love those. I I love a you know, like a a rhodiola phosphatidylserine sort of combo. You know, rhodiola during during the day. Um you know, if there's anxiety, phosphatidylserine, magnesium at night. Um L-theanine a lot. Use that a lot. Um it it yeah, but to your point, it really does depend on the nature of the of the cognitive dysfunction or the sleep issue or the inattention. Um and this is where it's really important to get I'll I'll sell us a little bit. Dr. Rose, this is where Go for it. Go for it. [laughter] This is really where it's important to consult with a clinician that has experience from a functional medicine lens because patients can waste a lot of time and a lot of money especially nowadays where we we talked a lot about social media and phones, you know, you're scrolling, right? And if you don't sleep very well and you're up at 3:00 a.m., your phone probably knows that. So it's going to give you an ad for something to help you sleep probably if it's smart, which it probably does. Um and you buy it. And is it is it going to help you? Who knows? Maybe. But is it is it tailored to your concern is really the point that you very eloquently made, right? The The issues that we're talking about with cognitive dysfunction, ADHD, or sleep issues, or or um attention issues, mood issues, all the different types of interventions we use, whether it's a botanical or supplement, it's a specific target. We're trying to do something. So, this is where I think people get really lost. And this is where I think there can tend to be issues with there's a belief that oh, that doesn't work. You know, oh yeah, I tried rhodiola. That doesn't work. You know, well, it does. You're just not using it the right way, or you haven't been prescribed the right dose, or it needs to be at this time of day versus this. So, this is where I I will sell us, right? Cuz we know, you know, that functional medicine clinicians in this vein do a really good job of understanding the specifics, the what, the how, when, you know, those types of things. Um We are coming to the end One thing One thing to that to continue this just a little bit is the other uh another way that having a medical professional kind of involved in this is that drug-herb interaction piece. Oh, totally. Very good point. You know, for a lot of a lot of these patients with ADHD, they're on maybe like you mentioned earlier like a lithium or an Adderall. Um and a lot of my patients that are on those have also been diagnosed with something like with depression and or anxiety. So, they're also on SSRIs. They're also on SNRIs. And so, we have to keep an eye out for things like serotonin syndrome, um which is when there's kind of, you know, too much serotonin in the in the system. Um so, and other just other interactions that um I think it's it is just in the name of safety, it's important to have some guidance. So important. That's a really good point. Like, collapse for that. That's like really really good point. Um, we are coming up on almost the end of our podcast. We have, you know, a little bit of time left. If patients are people are listening, patients maybe our patient. If you're listening to us live on YouTube or Instagram, please drop us a comment if you have a question for us regarding this topic. Um, one more quick thing I want to talk about that I think is really really important before we get to some questions is when we we've talked a lot about different things in terms of root cause from adults to children. We didn't talk too much about hormones. You and I are big hormone people. We do a lot with hormones. We've talked a lot about hormones on the podcast. Um, how how are hormones especially maybe in children, right? Cuz there's things like puberty and and change in secondary sexual characteristics from puberty that can affect children as they grow. So, what what kind of influence do you see with hormones on ADHD or if not in children, in adults too? Men and women who go through hormonal decline as we age, what kind of things do you see in relation to hormones in ADHD patients? Yeah, I think I I know that hormones play a big role in with adults with ADHD symptoms. Um, I'm going to talk a little bit about my female patients and the hormonal component with them. I'm going to let you since we've kind of Okay. divided and conquered this in the past. [laughter] handle the the man and the testosterone [laughter] So, one thing that I find really interesting is that relationship and this does impact men as well, but I'll focus on my female patients which is that relationship between estrogen and dopamine. And estrogen is basically supports the production and the like uh receptivity or the sensitivity to dopamine. And so there's times in a woman's life when estrogen drops, and so that includes um that can um drops and or fluctuates. And so that can be sometimes puberty, it can be the premenstrual time uh on a monthly cycle um and it can be um perimenopause, right? And and postmenopausal. So those fluctuations, those drops in estrogen directly impact how a female body is um receiving and responding to dopamine. And so if somebody kind of has it has those tendencies anyway, those times in her life are often going to be that much worse. And so you're going to see the things like in a inattention, the brain fog, um sometimes it can present as depression. It's often kind of mis- diagnosed as depression. Um and one interesting thing I was listening to a a talk about specifically about women and ADHD, and this presenter, this medical doctor, was talking about um high-achieving women who often have ADHD, it's undiagnosed, undetected. Um and there's there's a very high rate of burnout in these women because they, you know, one way to kind of compensate for adults, not just women, is often this kind of like very high-achieving. And but your again, your nervous system, your adrenal system, can only do that for so long. Um and so there's just this kind of disconnect sometimes in terms of um what the person's presenting as, but then there's this underlying there's like a diagnostic gap basically. So, what I'm seeing and I just find that that estrogen and dopamine connection is really really fascinating. Yeah. So, tell me about tell me about the men. Oh boy. So, from a from a male perspective where our hormones are predominantly testosterone, the male dominant sex hormone, most of what I'm seeing in men is a lack of motivation and also low testosterone or suboptimal testosterone significantly affects men's mental state. Their mood, a lot of depression, anxiety, could it be attention span and feelings of like internal restlessness like we've talked about? Absolutely. And there's also a very interesting thing I've seen men all the time and this is it's a little bit not quite related but sort of is. With low testosterone or suboptimal hormone function, I see men have a lack of self-worth in a sense or like a feeling like a themself whether it's a self-esteem or it's a just feeling more in tune with themself, feeling confident. And you could relate that to something like an attention issue or or neurocognitive change because if you feel really good mentally, like really sharp, really you know, like I could tell a really good joke kind of thing or somebody says something and you have a really quick response, you know, that's a really quick, almost reflex of the brain, right? Almost like if you're driving and somebody stops short and you're like, "Oh, I've got to you know, your reflexes are really good." We have mental reflexes and I think mental reflexes are significantly impacted by hormone function. For men specifically testosterone, so if our mental reflexes are a little slow, yeah, why wouldn't we feel a little bit cognitively declined or brain foggy or our attention is low and we're looking to our phone for that dopamine hit, right? Something to kind of like wake us up and make us feel good. So, I see that a lot in men and I don't think a lot of men Same thing, I mean, I treat a lot of women, too, so I can speak for women, too, with with hormone deficiency, but I don't think men and women with hormone decline really understand that they have this going on until we start to treat them. And then 3 months, 6 months goes by and I follow up with them and you probably have the same thing and what then they're like, "Oh my gosh, I my brain is firing. I'm thinking. I'm answering my emails. I'm, you know, people at work are telling me that I'm on the ball." And you don't really realize it because it's a very slow to start a very slow to happen kind of issue. Doesn't happen overnight. So, I see that That's what I see a lot of is this this really, really strong connection in the brain. Um I guess, Dr. Rose, we did an amazing podcast cuz no one has any questions. We have one question and then I want to play a really quick like 1-minute game to sort of wrap up and and highlight everything. So, we have one question from online. And it's a really interesting question. Do you recommend breathwork to patients who struggle with ADHD? If so, what techniques uh do you have experience with breathwork? Do you teach breathwork to patients, Dr. Rose? Yeah, I do have experience with breathwork. I would say I wouldn't call myself an expert. Um No, I wouldn't, either. But I have um worked with experts and I try to keep it simple. So, there's all sorts of different methods. Um there's I think some one of the most simple one that um that I've found to work for for myself and for a lot of people is just simply the counting. Like you you know, you on your inhale, you count to four and on the exhale, you count to five and you just kind of focus on that and it really kind of brings you into the body and I think that that's largely how I mean it's that's nervous system regulation right there, right? Um, but I think that um, I think breathwork is good for all of us including patients and including people with ADHD. What what do how would you how would you approach it? Yeah, there's there there's a one technique that I've learned I don't remember even where I learned it, but it's um, counting in four. Yeah. With breathwork is this do you know what I'm talking about? So, it's a and you can um, you can use it as a tool for anxiety or panic or you know, like an acute situation too, but it's almost like you it's an inhale over like one, two, three, four, hold it for one, two, three, four, exhale over one, two, three, four and then pause again one, two, three, four. So, um, I think it's called box is it box Box that's square box breathing. Square breathing yeah, cuz you're going like inhale, stay, exhale and then you go back around. Um, that is one of the techniques I learned years ago for vagal nervous system regulation. Um, this sort of inherent part of your nervous system that is um, controlling like your auto automatic ability for anxiety and feeling overwhelmed. So, yeah, I'm I'm a big fan of breathwork. So, as a wrap-up for our podcast Dr. Rose, I have a really quick like 30-second true false game giving a really really quick sort of take home. So, um, true false, okay. ADHD is just about having too much energy. False. Adults can have ADHD even when they're not diagnosed as kids. True. Yeah. [laughter] People with ADHD can't focus. Uh false. ADHD is caused by laziness or lack of discipline. big false. Yeah, big false. Um everyone is a little bit ADHD. I would maybe say yes to that. Yeah, maybe. Maybe. Um I guess it it goes back to it's about severity and level of impairment and things. Yeah. ADHD can affect sleep patterns. True. Uh medication is the only treatment for ADHD. False. I was going to say I hope if you took home anything from this podcast [laughter] ADHD can impact emotional regulation. True. People with ADHD are less intelligent. Uh big false. Big false. And then ADHD brains respond differently to dopamine. Maybe true. Yeah, I think that we we sort of talked all about that. So, um for those listening live, we thank you so much uh for your attention. This has been really really fun, Dr. Rose talking all about this. I I I think this is a really really important topic. So, for someone that is struggling with focus or they're overwhelmed or they suspect they have ADHD, um how can MedMatrix support them? How do we as functional medicine clinicians just in like 30 seconds, what do we do that's different from other people that we help people with these types of issues? Yeah, somebody struggling with overwhelm, they suspect or they know they have ADHD, how you know, what are what are we doing to kind of support um neurologic function, brain function? Um kind of like we do with pretty much any case, we're doing a very comprehensive um health history, symptom history. We're doing nutrient and metabolic testing. We're always looking at thyroid and hormone uh baseline levels. We're looking at gut health and that's both just from a, you know, the the intake conversation to advanced testing. We're looking at gut health. As discussed today, you know, working towards sleep and lifestyle optimization. Again, as mentioned, very personalized supplement nutrition guidance. And I think as we said earlier, like if somebody's going to take anything away from this, like look at what you're eating for breakfast. Focus on protein. Focus on healthy fats. You know, do what you can to stabilize blood sugar. Um, and, you know, overall sleep hygiene. Just kind of looking globally at the at the issue, not just it's just about focus and it's just needs the right medication. Um, so yeah, looking at root cause, looking at somebody in a very comprehensive manner. Yeah, I mean, I think the take home really that's important to note is like ADHD is not a lack of potential. It's not a lack of intelligence. It's not that you're, you know, not to a certain level of intellect or something like that. It's it's really the brain needs the right things to function, the right environment, the nutrients, the hormones, the gut health, everything to to perform at its best. So, I want to thank everybody for for tuning in. If you've been here with us live, we thank you so much. If you're listening to us somewhere in the future, you can find us on Spotify and Apple Podcasts to stream. We do one to two podcasts a week where we focus on all sorts of functional medicine and health topics. If you are interested in becoming a patient of either myself or Dr. Rose or one of our other really seasoned clinicians. I think there's six of us now in the clinic. We have a great team. We see patients in Maine and New Hampshire only right now, but maybe in the future we would be closer to you. But if you are in Maine and New Hampshire, we would love to see you. If if to medmatrixusa.com, you can book a free discovery call. Um, thank you so much, Dr. Rose. Any final words of wisdom or you know, quote of the day or [laughter] You're not going to get that out of me right now, but Uh, no, I just think it's a really important topic, probably under discussed. And um, as always, I appreciate, you know, learning from you and learning with you. Same. Yeah, this is really fun. So, tune in, like I said, next week and every week we're here talking all things functional medicine. So, thank you very much, Dr. Rose. Thanks for all listening and we'll see you on the next one. Bye-bye.