ADD and Iron Deficiency

Attention Deficit Disorder is primarily inherited but many cases are made worse, or even may be due to, simple deficiencies like iron, B12, sex hormones, thyroid, and other rare conditions. 


I am always looking for simple, safe, quick, cheap, and natural solutions to help or even fix ADD. 

Iron deficiency is second-most common deficiency I diagnose after sex hormone deficiency. Iron deficiency is almost always associated with “slowing” of mental acuity, even if subtle.  


Iron deficiency is common in women due to menstrual blood loss. If found in men, it is considered a dangerous sign of intestinal blood loss—an ulcer or cancer until proven otherwise.  Women are more difficult to diagnose and manage because they also can have intestinal blood loss in addition to an expected monthly loss of blood with menstruation. 


Iron is an essential component of brain cell neuron function.  More specifically, disruption of iron homeostasis in the brain can affect neurophysiological mechanisms, cognition, and social behavior, which eventually contributes to the development of a diverse set of neuro-pathologies.


The causes underlying iron deficiency are diverse and include inadequate oral iron intake, resulting from poor diets, excessive milk intake or vegetarian diets, inadequate iron absorption, as a result of Celiac disease and others, or excessive iron loss, mainly occurring via blood loss or as a result of parasitic infection. Although individuals can suffer from iron deficiency at any stage in life, the most severe consequences of iron deficiency are present in early childhood, which is a period of rapid growth and high needs for iron intake. These range from the disruption of neurophysiological mechanisms, to impaired cognitive and altered social behavior. Most importantly, iron deficiency has been reported in low-income, even in high-income countries, with increased prevalence of iron deficiency in lower socio-economic groups. These have been concomitantly characterized by worse eating habits, lower levels of education, and acknowledgement of the impacts of nutritional patterns in physical and cognitive development and health. 


On the opposite pole of iron deficiency, we have iron overloading in the aging population and in neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease (AD and PD). AD and PD progression are associated with depression, anxiety, psychotic symptoms, and sleep disturbances likely impacted by a dysregulation of neural circuitries. This dysregulation can be triggered by the brain iron accumulation present in some cases, including hemochromatosis, a relatively common hereditary condition.  


Whether in children or adults, seniors with other diseases, or a healthy woman, iron is easy to measure with a simple blood test. Often there is concomitant anemia (low blood count) but, as I saw in two cases this week, the blood count has not yet fallen while the iron level is never the less low. One case was a menstruating woman who has ice chewing (PICA) and was constantly cold—two common symptoms of iron deficiency. The other is a male who was inexplicably tired but also had a normal blood count with low iron levels—certainly from intestinal loss of blood. He thought the fatigue was from low testosterone. These blood tests are very inexpensive. 


Someone must deplete every ounce of iron stored in their liver, bone marrow, or muscle to become anemic (low blood count). To replace that iron may take a year or longer, as iron is absorbed very slowly, in small amounts in the stomach and intestine. High doses of iron are damaging to the intestine and associated with cramping and pain. Hence, in severe cases, intravenous or intramuscular shot of iron can be given. 


It is a travesty to overlook something so simple yet so vital to our health. Iron levels should be part of every check-up and physical throughout life. It certainly should be part of any tests evaluating neurocognitive or behavioral abnormalities, like ADD.


Stanford A. Owen, MD practices in Gulfport, MS. He is Certified by the American Board of Internal Medicine, the American Board of Physician Nutrition Specialists, and the Neuroeducation Institute as a Master Psychopharmacologist. 

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