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Finally Focused: The Breakthrough Natural Treatment Plan for ADHD That Restores Attention, Minimizes Hyperactivity, and Helps Eliminate Drug Side Effects by [James Greenblatt, Bill Gottlieb]
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Finally Focused: The Breakthrough Natural Treatment Plan for ADHD That Restores Attention, Minimizes Hyperactivity, and Helps Eliminate Drug Side Effects Kindle Edition

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Editorial Reviews

Review

 “Finally Focused is one of the smartest books on ADHD in many years.  It is filled with a clear, effective, science-based program that gives you all the building blocks to treat ADHD naturally and effectively. I highly recommend it.” – Daniel G. Amen, MD, Founder of Amen Clinics and New York Times bestselling author of Healing ADD and Change Your Brain, Change Your Life


“Finally Focused
offers up a powerful and compassionate alternative to the current reality that two thirds of ADHD patients are taking powerful medications, the long-term consequences of which have never been evaluated. James Greenblatt’s work honors the notion of 'above all, do no harm,' and does so while achieving impressive results.” – David Perlmutter, MD, #1 New York Times bestselling author of Grain Brain and The Grain Brain Whole Life Plan
--This text refers to the paperback edition.

Excerpt. © Reprinted by permission. All rights reserved.

1

The Miracle Mineral

Plus: Magnesium

I’ve been treating children with ADHD for thirty years--and I can’t remember one child with the disorder who didn’t benefit from taking a magnesium supplement.

Take Noah, for example. Twelve-year-old Noah and his parents were in my office for help with the same stressful symptoms that have brought thousands of frustrated parents and unhappy children to my clinic: Noah was impulsive, hyperactive, and inattentive, and his life at home and at school was in shambles.

His parents told me that as a young child, Noah was often fidgety and couldn’t sit still for more than a few minutes. Noah himself told me the only time he felt happy these days was when he was “wandering around” outside. 

Noah, said his parents, had done well in school until he was in the second grade, when he started to interrupt his teachers constantly. Sometimes the school called, asking that Noah be taken home.

Noah struggled socially, too. He found it hard to make friends. He couldn’t sit down and play a board game without becoming restless when the other children took their turns. Sometimes when he lost the game he threw the board at a friend. Playdates became increasingly rare.

When Noah was eight, his parents took him to a doctor, hoping an ADHD medication might provide relief. The doctor agreed to the treatment and prescribed Ritalin.

But the drug made things worse. Noah became extremely emotional. He cried easily. His appetite disappeared.

He was taken off Ritalin and put on Adderall.

He stopped feeling sad all the time, but instead started feeling agitated and anxious. After a month on the drug, Noah developed a facial tic.

Adderall was halted--and Noah’s problems continued, year after year.

When Noah became my patient, he was hyperactive, found it hard to focus, and--because he couldn’t control his impulsiveness--didn’t have any friends.

Noah’s story and symptoms made my first choice of treatment obvious: Twice daily, Noah was to take 200 milligrams (mg) of brain-balancing, body-calming magnesium.

One month after he started magnesium, I also restarted Noah on a low dose of Vyvanse (20 mg), a stimulant medication.

And this integrative approach--treating Noah with a key nutrient and a dose-regulated stimulant--produced tremendous results.

“I’m doing awesome,” Noah enthusiastically said to me when I saw him and his parents two months later.

He told me that he could sit still and participate in class. And that he was making some friends.

“I used to feel like my brain was a dull knife,” Noah said, sitting between his smiling parents. “It didn’t work right. It couldn’t cut through anything. But now it’s like a sharp knife--it works great.”

Why Magnesium Works

How can one nutrient make such a big difference in the symptoms of an ADHD child--in her life, and in the lives of her parents, teachers, and friends? There are many answers to that question.

The first fact to know: Magnesium plays a role in more than three hundred enzyme systems, biochemical spark plugs that ignite cellular activity. For example, if magnesium is minimal, so is ATP (adenosine triphosphate), the fundamental fuel that powers every cell. Blood sugar isn’t correctly regulated, and the immune system is weakened. Most important for your ADHD child, the brain is compromised.

Too little magnesium weakens the brain because the mineral plays a key role in the formation of neurotransmitters, chemicals that help send messages between brain cells. If magnesium levels are suboptimal, your child is likely to have imbalanced levels of two neurotransmitters: attention-regulating dopamine, and mood-regulating serotonin. Low magnesium can also undercut the functioning of glutamate receptors, areas on brain cells that assist the movement of neurotransmitters.

The end result of a magnesium-deprived brain? In children and adolescents, it’s often the symptoms of ADHD. Research links low magnesium levels in children with:

•    Poor concentration

•    Irritability and anxiety

•    Depression and apathy

•    Mood swings

•    Fatigue

•    Sleeping problems, like insomnia

Okay, low levels of magnesium are bad for your ADHD child. But why are levels low? Shockingly, magnesium deficiency could be a side effect of the ADHD drug your child is taking!

Yes, stimulant drugs like Ritalin and Adderall that are intended to help ADHD might actually be complicating the problem--because they leach magnesium from the body. In my experience, a deficit of nerve-nourishing magnesium is often behind ADHD drug side effects like irritability, agitation, anxiety, insomnia, facial tics, and nail-biting. Add supplemental magnesium to the mix, and all those symptoms are likely to disappear. That’s what happened with Noah. He couldn’t take an ADHD drug without side effects. But when he took the drug and magnesium, he was fine. (Or as Noah said, he was awesome.)

Noah is hardly alone. Relieving the side effects of ADHD with magnesium has generated more “Thank yous” from parents and their children than any other ADHD treatment I use.

Many Children Are Low in Magnesium

But even if your ADHD child isn’t taking an ADHD medication, odds are 50‑50 that he has a low level of magnesium. Research shows that half of Americans (including children) get less than the government’s Recommended Daily Allowance (RDA) for magnesium1--probably because we Americans eat so many processed foods, most of which are stripped of magnesium during processing.

In the first decade of the twentieth century, when Americans ate more whole foods, people ingested 475 to 500 mg of magnesium daily. That level of intake has declined decade by decade, until now we consume 175 to 225 mg daily.

The nonstop pace of modern life also puts us under nonstop stress, which drains the body of magnesium.

How many ADHD children are actually deficient in magnesium? Nearly all of them!

In one study, doctors measured the magnesium levels of 114 children with ADHD and found that an astounding 110 of the children--96%--were deficient in magnesium.2 My clinical experience is similar, with rates at 90%.

Because magnesium deficiency is so common among children with ADHD, and because supplementing with magnesium can make such a huge difference in a child’s behavior (on or off medication), I recommend every patient with ADHD take a supplement of the mineral. The appropriateness of my approach to magnesium supplementation is confirmed by many scientific studies on magnesium and ADHD.

Scientific Support for . . . The Power of Magnesium to Heal the Symptoms of ADHD

I’d like to tell you about several studies that show the importance of magnesium in ADHD . . .

Less hyperactivity, inattention, impulsivity, and opposition--with 200 mg of magnesium a day. In the most recent study, Egyptian scientists measured magnesium levels in children with ADHD, finding deficiency in 72%.3 They also found that those with the lowest magnesium levels had the most hyperactivity and the lowest IQs.

They divided the children into two groups: half took 200 mg of magnesium daily and half took a placebo. After eight weeks, the children taking magnesium had “significant improvements” compared to the placebo takers. Specifically:

•    hyperactivity was 90% less

•    inattention was 66% less 

•    oppositional behavior was 33% less

•    executive function was 40% better (Executive function includes keeping track of time, finishing work on time, problem-solving, and using memory for everyday tasks.)

Add magnesium, symptoms decrease. Subtract magnesium, symptoms return. In a study of 40 children with ADHD, French scientists supplemented their diets with magnesium and vitamin B6, a “cofactor” that helps cells use magnesium.4

As levels of magnesium went up over two months, symptoms went down. The children were less hyperactive, aggressive, and irritable; had more focus at school; and slept better.

But when the children stopped taking the two nutrients, their magnesium levels started to decrease--and so did the behavioral improvements created by the mineral. “Clinical symptoms of ADHD appeared in a few weeks, together with a decrease” in levels of magnesium, reported the scientists in Magnesium Research.

The scientists concluded that magnesium supplementation “could be required in children with ADHD.” Not just recommended, but required.

Better brain waves, better behavior. In a similar study, published in the journal Neuroscience and Behavioral Physiology, doctors supplemented the diets of ADHD children with magnesium and B6--with very positive results.5 The children had less hyperactivity, better attentiveness, and less anxiety.

Looking at the children’s behaviors at school, the researchers noted the children had “improvement in task performance,” “decreases in the proportion of errors,” and “increases in the rate of work.”

The supplemented ADHD children also had a complete disappearance of two types of activities sometimes seen in ADHD: perseveration (rote, repetitive behaviors and movements); and stereotypy (senseless acts or words).

The doctors also took EEG (electroencephalographic) measurements before and after the supplementation with magnesium and B6. The postsupplement brain waves were far more normal: fewer spikes and flurries of random activity; and higher frequencies, a type of brain wave linked to better focus.

More happiness, less loneliness, better sleep. In several other studies, the diets of children with ADHD were supplemented with magnesium and other brain-supporting nutrients, like omega‑3 fatty acids (EPA and DHA) and zinc--an approach I use in my own practice, where children typically take more than one supplement.

In one such study, published in the medical journal Lipids in Health and Disease, German researchers gave hundreds of children with ADHD a daily supplement containing magnesium, zinc, omega‑3 fatty acids (EPA and DHA), and an omega‑6 fatty acid (GLA).6

After three months, the researchers saw a “clear reduction” in symptoms of ADHD, including hyperactivity, inattention, and impulsivity. They also saw fewer emotional problems, less isolation (among “children who were described as loners”), and fewer problems with sleeping.

“No Ritalin was needed.” Writing in the Journal of the American College of Nutrition, a team of French researchers reported the case history of L., a seven-year-old boy, and one of 52 ADHD children they had treated with magnesium and vitamin B6.7

“L. developed a breath-holding spell in his first year, he was hyperexcitable at 3 years, and reports sleep disturbances at 5 years,” they wrote. At the end of nursery school, when L. was six years old, “the clinical evaluation indicated aggressivity, anxiety . . . inattention and no self-control.”

At that time, the doctors discovered his magnesium levels were low and began supplementing with the mineral and vitamin B6.

Six months later, L. had normal magnesium levels. He also had normal sleep, no aggressivity, and was “more tender, more concentrated, more quiet.”

Magnesium is effective. The last study I’d like to tell you about is a “meta-analysis”--a study that analyzes the results of several other studies. In this meta-analysis, researchers looked at six other studies on magnesium and ADHD. Their conclusion: magnesium shows “promise” in the effective treatment of ADHD.8

Bottom line. In my practice, magnesium is more than a promise. It is a much-needed and effective treatment for the symptoms of ADHD, and a way to eliminate side effects from ADHD medications.

How to Supplement with Magnesium

Supplementing your child’s diet with magnesium is fairly straightforward.

Should my child be tested for a magnesium deficiency? The likely answer is no. Most magnesium tests are inaccurate. They measure blood levels--when 99% of the mineral is found in cells and bones. Such a test is likely to show a child with ADHD has a “normal” level of magnesium--when, in fact, he’s deficient. A hair test for minerals is a better indicator of a magnesium deficiency, and I routinely order this test to determine levels of lithium and copper--but even without the results, I know in advance that every child with ADHD will benefit from supplemental magnesium.

Should my ADHD child take magnesium? Yes, if your child has been diagnosed with ADHD. It’s that simple.

Other indications that make the necessity for taking magnesium even more compelling:

•    Your ADHD child is on a stimulant medication--which drains the body of magnesium.

•    Your ADHD child has side effects from a stimulant medication--which magnesium can often resolve.

•    Your ADHD child sleeps poorly, is anxious, and/or is prone to constipation--all telltale signs of a magnesium deficiency.

How much magnesium is best? Dosages vary by age. Typically, I recommend magnesium glycinate, using the powdered product Natural Calm, from Natural Vitality, which contains 325 to 350 mg of magnesium per serving dose. (The product is widely available online, and in many pharmacies, like Walmart and CVS.) I like it because the child can take magnesium in a tasty drink, rather than swallowing a pill.

Here are the dosage guidelines I follow in my practice:

13 and older: 200 mg, twice daily.

10 to 12: 100 mg, twice daily.

6 to 9: 50 mg, twice daily.

Under 6: I recommend microdoses of 10 mg daily, in liquid form, using Liquid Ionic Magnesium, from New Beginnings. (Please see the Appendix at the end of the book for ordering information.)

What form of magnesium is best? There are many different forms of magnesium, like magnesium glycinate, magnesium oxide, magnesium citrate, and magnesium gluconate. In my clinical experience, all of them are equally effective, with one exception: magnesium oxide, which is poorly absorbed.

Lately, a few health experts have been touting magnesium L‑threonate as the best form of magnesium for the brain. That’s because several studies (all but one of them on laboratory animals) show brain-based benefits, like healthier brain cells and protection against age-related mental decline. There’s nothing wrong with magnesium L‑threonate but it is more expensive than other forms.

What brand is best? Magnesium supplements are generally reliable--what the label says, the product delivers. When consumerlab.com--a supplement-testing company--investigated twenty-six products, it found only one of them didn’t contain the amount of magnesium on the label. The “Not Approved” magnesium product was from the company New Capstone.

In my clinical practice I use a magnesium supplement from Natural Calm, a kid-friendly magnesium powder by the company Natural Vitality (not tested). I also use magnesium supplements from Pure Encapsulation (“Approved” by consumerlab.com), and from New Beginnings (not tested).

1. Rosanoff A, et al. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutrition Reviews. March 2012;70(3):153–64.

2. Kozielec T & Starobrat-Hermelin B. Assessment of magnesium levels in children with attention deficit hyperactivity disorder (ADHD). Magnesium Research. June 1997;10(2):143–48.

3. El Baza F, et al. Magnesium supplementation in children with attention deficit hyperactivity disorder. Egyptian Journal of Medical Human Genetics. January 1, 2016;17(1):63–70.

4. Mousain-Bosc M, et al. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Magnesium Research. March 2006;19(1):46–52.

5. Nogovitsina OR & Levitina EV. Neurological aspects of the clinical features, pathophysiology, and corrections of impairments in attention deficit hyperactivity disorder. Neuroscience and Behavioral Physiology. March 2007;37(3):199–202.

6. Huss M, et al. Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems--an observational cohort study. Lipids in Health & Disease. September 24, 2010;9:105.

7. Mousain-Bosc M, et al. Magnesium VitB6 intake reduces central nervous system hyperexcitability in children. Journal of the American College of Nutrition. October 2004;23(5):545S–548S.

8. Ghanizadeh A. A systematic review of magnesium therapy for treating attention deficit hyperactivity disorder. Archives of Iranian Medicine. July 2013;16(7):412–17.

--This text refers to the paperback edition.

Product details

  • ASIN ‏ : ‎ B01KE64XT8
  • Publisher ‏ : ‎ Harmony; 1st edition (May 9, 2017)
  • Publication date ‏ : ‎ May 9, 2017
  • Language ‏ : ‎ English
  • File size ‏ : ‎ 11198 KB
  • Text-to-Speech ‏ : ‎ Enabled
  • Screen Reader ‏ : ‎ Supported
  • Enhanced typesetting ‏ : ‎ Enabled
  • X-Ray ‏ : ‎ Enabled
  • Word Wise ‏ : ‎ Enabled
  • Print length ‏ : ‎ 274 pages
  • Lending ‏ : ‎ Not Enabled
  • Customer Reviews:
    4.7 out of 5 stars 431 ratings

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A pioneer in the field of integrative medicine, James M. Greenblatt, MD, has over 25 years of experience treating patients with mood disorders and complex eating disorders. An acknowledged integrative medicine expert, Dr. Greenblatt has published several books discussing the scientific evidence supporting the use of nutritional interventions in psychiatry.

Dr. Greenblatt’s expertise in the areas of biology, genetics, psychology, and nutrition as they interact in the treatment of mental illness has lead to numerous interviews by the media on television as well as in written articles for consumer audiences.

Dr. Greenblatt currently serves as the Chief Medical Officer at Walden Behavioral Care in Waltham, Massachusetts, a treatment facility specializing in the treatment of eating and psychiatric disorders. Dr. Greenblatt also serves as an Assistant Clinical Professor at Tufts Medical School Department of Psychiatry and Dartmouth College Department of Psychiatry.

To learn more about Dr. Greenblatt visit jamesgreenblattmd.com

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