Daily, I take my vitamin B’s, vitamin C, but vitamin D?
A couple of years ago a routine blood test showed that I had very low levels of vitamin D. You know, that vitamin that is produced automatically in our bodies when we are in the sunlight? Having lived in sunny California for over a decade, it was one of the health concerns that I had never worried about. However, my low level of vitamin D seemed to concern my doctor… a lot. Apparently research is now uncovering that the importance of vitamin D goes well beyond bone growth, a healthy immune system and calcium absorption. It is starting to be appreciated as an essential micronutrient in the overall wellness of our brains especially in increasing our impulse control, pro social behavior, memory and planning…ADHD symptoms anyone?
Which got me thinking – if I could have vitamin D deficiency living in what most would agree is one of the “vitamin D capitals of the world,” then what about all those people with ADHD who lived where the skies were not always so sunny?
Well, it seems that my vitamin D deficiency is not unusual, even for people in California. In order to get enough vitamin D the “natural way,” you have to live at latitudes below Los Angeles and risk thirty minutes of sun exposure, without sunscreen, twice a week. Something we can bet that the American Academy of Dermatology wouldn’t recommend. So it’s not surprising that approximately 70% of the U.S. population have low vitamin D levels (Patrick & Ames, 2015).
So what’s so important about Vitamin D and ADHD?
Vitamin D was found to be significantly lower in children and adolescents with ADHD (Goksugur, et al, 2014). In our body, vitamin D increases the level of an antioxidant that helps prevent damage to neurons in the brain (similar to how it’s thought that Omega-3 fatty acids seem to improve brain function in people with ADHD). It also helps increase the amount of dopamine and norepinephrine in the brain which we know help in the treatment of ADHD and the reduction of ADHD symptoms. Finally, vitamin D is also known to boost the production of another brain chemical called Acetylcholine which helps us maintain focus. As we know inattention and lack of concentration are two of the main symptoms of ADHD.
How to get your vitamin D levels tested
If you are wondering if you have enough vitamin D, check with your doctor. Your doctor can order a test called 25-hydroxyvitamin D (25-OHD). Even though there is still some debate as to how little is too little vitamin D, most experts agree that anyone with a 25-OHD level of less than 15 ng/mL or 37.5 nmol/L needs more vitamin D.
How to get more vitamin D if you need it
Ideally, enough direct sun exposure would provide us naturally with all the vitamin D we need. However, considering the risks, it’s probably a better idea to get vitamin D from either foods or supplements.
There are three vitamin D super foods:
- Salmon (especially wild-caught)
- Mackerel (especially wild-caught)
- Mushrooms (exposed to ultraviolet light)
Other food sources of vitamin D include:
- Cod liver oil (warning: cod liver oil is rich in vitamin A; too much may be bad for you)
- Tuna canned in water
- Sardines canned in oil
- Milk or yogurt — fortified with vitamin D
- Beef or calf liver
- Egg yolks
- Orange juice (fortified with Vitamin D)
- Ready-to-eat breakfast cereals (fortified with Vitamin D)
Over the counter Vitamin D supplements:
Currently, Boston University vitamin D expert Michael Holick, MD, PhD recommends a dose of 1,000 IU a day of vitamin D for both children and adults – even if you are getting plenty of safe sun exposure.
The vitamin D Council recommends that healthy adults take 2,000 IU of vitamin D daily — more if they get little or no sun exposure.
Do not give your child vitamin D without having your child’s blood levels tested.
As always, I recommend that you talk to your doctor about supplements and dosages.
It seems all vitamin D is not created equal.
Nutritionists recommend taking vitamin D supplements in the form of vitamin D3 or cholecalciferol. This is the natural form of vitamin D that your body makes from sunlight.
Can you take too much vitamin D?
Too much of any good thing can be a bad thing and nearly all vitamin D overdoses come from supplements. Vitamin D is “fat soluble” vitamin, which means extra amount of this vitamin isn’t just eliminated from the body and it can accumulate and become toxic. If you are taking too much vitamin D, it can cause an abnormally high blood calcium level, which could result in nausea, constipation, confusion, abnormal heart rhythm, and even kidney stones.
Again, always be sure to keep your doctor in the loop when it comes to any supplements you may be taking so they can help you monitor and account for it in your overall health plan.
Does vitamin D interact with other medications?
Yes, it seems it does, especially with steroid medications such as prednisone. Always, always…consult with your doctor before taking vitamin D supplements.
There are still many unknowns when it comes to what causes ADHD symptoms. As we continue to search to put together the part of the ADHD puzzle, it seems that we might just be starting to appreciate the role that vitamin D plays in overall mental health, including ADHD.
What do you think? I’d love to hear your comments.
Goksugur, S. B., Tufan, A. E., Semiz, M., Gunes, C., Bekdas, M., Tosun, M. and Demircioglu, F. (2014), Vitamin D status in children with attention-deficit–hyperactivity disorder. Pediatrics International, 56: 515–519. doi: 10.1111/ped.12286
Rhonda P. Patrick And Bruce N. Ames. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar, schizophrenia, and impulsive behavior. FASEB Journal, February 2015 DOI: 10.1096/fj.14-268342
DeNoon, Daniel J. (2009) The truth about vitamin D how much D do you need Retrieved February 27, 2014, from http://www.webmd.com/osteoporosis/features/the-truth-about-vitamin-d-how-much-vitamin-d-do-you-need
Klein, Sarah. (2014). 7 signs You May Have A Vitamin D Deficiency. Retrieved February 27, from http://www.huffingtonpost.com/2014/04/29/vitamin-d-deficiency-signs-symptoms_n_5200408.html
Ahh Valentine’s Day. A whole day traditionally devoted to celebrating love. And as it is quickly approaching, my thoughts turn to relationships, all sorts of different ADHD relationships, and how ADHD can be a test for even the strongest connections.
When I work with adults, often the focus of our coaching sessions turns to a request for the best ways to handle conflicts with partners. I often hear these concerns:
“I’m tired of always being late. No matter what I do, I can’t seem to get there on time. I feel awful and he gets so disappointed and angry with me.”
“We got into a huge fight last night. She says I don’t listen to her and zone out in conversations. It’s not that I don’t care, but the problem is – she’s right.”
“I can’t believe I did it again. I missed our anniversary. I had it on my calendar, even left myself a note, but I completely spaced out about the date again.”
When one half of a relationship has ADHD, small adjustments in communication and expectations can make a world of difference. Here are some strategies and tools to try so your Valentine’s Day and everyday is harmonious and loving:
1. Post it, post it, post it. Lists can be a valuable time and relationship saver. You can use the basic post it note, sync your phones so they share messages and reminders or use dry erase paint on the kitchen wall – just make sure the list and reminders are in a prominent place so they can be seen and updated often.
Side notes– For non-ADHDers – Stay calm and caring if you verbally cue your partner to do something. ADHDers – remember, reminders are not meant to be nagging nor judgmental. They are merely attempts to help keep everyone on track and aware of what needs to be done.
2. Be clear and concrete in your communication. Don’t just say you are going to work late. Try to set a time range that you plan to leave the office. Then set your watch to go off ten minutes before that time so you can wrap things up or call to say you will be later than expected. It may save many dinners from being cold or tossed in the trash with an angry hungry spouse waiting for you.
Side note – for non-ADHDers, ask for clarification. If your partner says they will come by after work, ask what that means…right after they get out at five, after they go home and change, sometime around dinner, etc. That way you both clear on the expectations.
3. Schedule planning meetings. Whether you connect in the morning to review the day’s events or sit down on Sundays to map out the week, make sure you review the list and calendar together, updating what needs to be done and cross checking any scheduling conflicts.
4. Before you launch into emotional discussions, ask if the other person is available to listen. This ‘availability’ means that the other person is in a place to focus and attend to what is being said. Limit other distractions and keep the conversation short and to the point. Ask the listener to repeat what he/she heard to determine if what was heard and absorbed is correct.
5. Know each other’s love language. Each one of us has a way we show and experience love. If your spouse feels love through your helping around the house, then start a conscious practice to finish that to do list. Or if they feel connected to you when you spend quality time together, schedule dates and attention. If feeling appreciated means giving your Valentine a thoughtful gift, be sure to keep a stash of paper and bows for those occasions. Your conflicts may not even be ADHD related, but merely misunderstanding of how you express and feel loved.
Each of these tips can be applied to any ADHD relationship to increase connection and reduce misunderstanding, whether that is professional, personal, parental or romantic.
I wish you all a wonderful, loved filled ADHD Valentine’s Day!
The past couple of months have been doozies for me.
You know those times when the first technical challenge happens and you try to laugh it off and chock it up to “life”? For instance, when your PC crashes for the third time that year and you scold yourself for expecting it not to do that again. Or when you fix your PC, reload all your programs and suddenly your online calendar system bizarrely duplicates every single appointment you’ve ever scheduled. Definitely an “O.M.G.” moment. And then, in a matter of days…your cell phone dies (OK it was a 4G trying to handle 6G updates), the power goes out for the entire day only in your neighborhood and you have barely enough juice left in your battery to cancel all appointments. And then, the crème de la crème…the straw that breaks the camel’s back…the final “W.T. #.” moment – you realize that a small switch has been turned off in one of your systems and any payments received in the last 50 days did not get processed.
Seriously, I couldn’t make this stuff up…and if you are like me, I bet you know just what I am talking about.
Truth be told, it seems that only when systems, structures, tools or strategies don’t work or stop working that we really come to appreciate how super duper amazing they had been. For me it took running around like a chicken with my head cut off, trying to remember where I was supposed to be, when and with whom, that I realized how useful and supportive my carefully colored calendar system had been, now that it was no longer available on my new computer.
It might not surprise any of you that one of the biggest reasons people with ADHD have trouble following through, finishing projects or remembering appointments is the lack of support. For instance, we don’t follow through because we don’t have the necessary tools – like the display board needed to complete a science project. Or we don’t finish a project because a team member has been sick the past few days and not there to keep us motivated or on track. Or we completely miss an appointment because our handy dandy (OK, I’ll admit it a bit OCD) calendaring system is obsolete with our computer upgrade.
For some, this lack of support might stem from an independent “I can do it myself” spirit. For others it might be a matter of not knowing what supports are available. And for many struggling with ADHD, lack of support is the result of shame, guilt and eventual isolation from feeling like we have worn out our welcome and maxed out on the generosity and support from others.
Support, whether we like it or not or want it or not, is necessary. We might call it systems, structures and strategies and it comes in all shapes and sizes. We may not even realize what support is missing until the overwhelm, lack of progress and chaos have us on our knees. For me, when this happens I’ve learned to do a “support check” by playing one of my favorite games: “Person, Place or Thing.”
To play along, start by asking yourself:
Is this current craziness a result of a lack of “person” support?
“Person” supports might include physically helping you with a task or emotionally supporting you to get things done.
- The someone who helps you move or take boxes to the donation center when you are sorting through clutter.
- Your study buddy or the person you can count on to offer moral support and help you prepare for the big test or presentation.
- The person who, just by their respect and encouragement, motivates you to “get it done.”
- The people you don’t want to let down, such as a great boss, favorite teacher, awesome coach or team member.
- The other mom who trades off driving the kids to practices and games who makes it possible for you to keep just on this side of sanity and overwhelm.
- The person who listens to you verbally process your thoughts, who doesn’t need to say a word, but with them just being there to listen, it seems you’re always able to sort your thoughts out.
- The receptionist at the dentist’s office who always calls the day before to remind you of your appointment the following day.
- The book club gals who rotate their meetings every week so you know that at least once a month, you will do a thorough tidying of the house in preparation for your turn.
Is this current overwhelm the result of a lack of “place” support?
“Place” supports are those in your environment that make it possible for you to seamlessly get things done, help you minimize distractions and maximize strategies that work.
- The quiet office where you can close the door so you won’t be distracted by co-workers socializing in the hallway.
- The house where you can easily take a walk around the block to clear your head and get your dopamine flowing before sitting down to complete homework.
- The “white noise” of traffic outside your room so you can fall asleep.
- The gym just down the block so you can exercise and still be on time for work.
- The classroom right next to the bathroom so you don’t get distracted too much when you use it and need to get back to class.
- The workplace conference room spot where you can stand if you need to and is situated away from the view of the parking lot so you’re not distracted by who’s coming or going.
- The perfect school locker where you can see all your books and is located right by your classes.
- The longer daylight hours of summer that let you finish off some of those outside tasks before calling it quits for the day.
- The perfect spot for your desk, so you can see the board, hear the teacher and are surrounded by quiet students.
Is this chaos the result of the lack of support of a “thing”?
“Things” are the tools and items in our world that help us stay on track and get things done.
- A delightfully working computer without frequent technical glitches.
- The basket by the front door where you can put your keys and phone so you know where they are when you need to leave the house.
- The backpack with just the right pockets and space to keep your supplies organized.
- The container of pens and paper needed for taking notes.
- The planner you write in so you can refer to it later for tracking appointments, deadlines or tasks.
- That bookcase behind your desk that holds the day’s folders and allows you to see, at one glance, the patients’ charts left to complete for the day.
- Those bright yellow star shaped post-its used to remind you of an important task to complete.
- The alarm clock in your bedroom that is just annoying enough to help you get out of bed, but not so annoying that you want to smash it.
- The water that runs cold after a while to tell you it’s time to get out of the shower.
- The coffee pot near where you put your medication bottle so you won’t forget to take it when you pour your cup in the morning.
The supports for people with ADHD come in all shapes and sizes and can often go unnoticed until we are way past an “O.M.G.” moment.
So, the next time you find yourself wondering how you got from calm to chaos, or feeling like you went from “getting” it done to being “in over your head” and you can’t figure out why, play the game and ask yourself…is this the result of missing a “person, place or thing” support? You might be pleasantly surprised what you discover.
What are your best “person, place or thing” supports for managing your ADHD? I’d love to hear them.