Much Higher Risk of ADHD in DES GrandChildren

Association of Exposure to Diethylstilbestrol During Pregnancy With Multigenerational Neurodevelopmental Deficits

New research published today, May 21, 2018, shows that prenatal diethylstilbestrol exposure may lead to neurodevelopmental disorders across several generations : DES grandchildren are more likely to be diagnosed with ADHD (36% to 63%).

Key Points

Question
Is exposure to diethylstilbestrol during pregnancy associated with adverse multigenerational neurodevelopmental outcomes?

Findings
A cohort study of 47 450 women in the Nurses’ Health Study II found significantly elevated odds for attention-deficit/hyperactivity disorder in the grandchildren (third generation) of users of diethylstilbestrol, a potent endocrine disruptor.

Meaning
Exposure to endocrine disruptors during pregnancy may be associated with multigenerational neurodevelopmental deficits.

Abstract

Importance
Animal evidence suggests that endocrine disruptors affect germline cells and neurodevelopment. However, to date, the third-generation neurodevelopmental outcomes in humans have not been examined.

Objective
To explore the potential consequences of exposure to diethylstilbestrol or DES across generations—specifically, third-generation neurodevelopment.

Design, Setting, and Participants
This cohort study uses self-reported health information, such as exposure to diethylstilbestrol during pregnancy and attention-deficit/hyperactivity disorder (ADHD) diagnosis, from 47 540 participants enrolled in the ongoing Nurses’ Health Study II. The 3 generations analyzed in this study were the participants (F1 generation), their mothers (F0 generation), and their live-born children (F2 generation).

Main Outcomes and Measures
Participant- and mother-reported exposure to diethylstilbestrol during pregnancy and physician-diagnosed child ADHD.

Results
The total number of women included in this study was 47 540. Of the 47 540 F0 mothers, 861 (1.8%) used diethylstilbestrol and 46 679 (98.2%) did not while pregnant with the F1 participants. Use of diethylstylbestrol by F0 mothers was associated with an increased risk of ADHD among the F2 generation: 7.7% vs 5.2%, adjusted odds ratio (OR), 1.36 (95% CI, 1.10-1.67) and an OR of 1.63 (95% CI, 1.18-2.25) if diethylstilbestrol was taken during the first trimester of pregnancy. No effect modification was observed by the F2 children’s sex.

Conclusions and Relevance
This study provides evidence that diethylstilbestrol exposure is associated with multigenerational neurodevelopmental deficits. The doses and potency level of environmental endocrine disruptors to which humans are exposed are lower than those of diethylstilbestrol, but the prevalence of such exposure and the possibility of cumulative action are potentially high and thus warrant consideration.

DES DiEthylStilbestrol Resources

Prenatal Exposure to Phthalate connected to ADHD in Children

Prenatal Phthalates, Maternal Thyroid Function, and Risk of Attention-Deficit Hyperactivity Disorder in the Norwegian Mother and Child Cohort

Introduction

There is growing concern that phthalate exposures, particularly during the prenatal period, may have an impact on child neurobehavioral development. Prenatal exposure to phthalates has been associated with both externalizing and internalizing  behaviors using validated behavioral screening instruments, as well as with deficits in executive function as measured by both parental report and performance-based assessments , although not all studies have found evidence of associations. Among the neurobehavioral domains identified in multiple studies are inattention , aggression, conduct problems, and emotional reactivity/regulation, as well as impairments in working memory. Sex differences in the associations of phthalates with neurobehavioral end points have often been noted, although some studies have found stronger associations among boys, whereas others have found stronger associations among girls. The constellation of phthalate-associated behaviors highlighted across studies has led many researchers to note overlap with symptoms of attention-deficit hyperactivity disorder (ADHD).

Despite the observed overlap in affected neurobehavioral domains, there is less consensus on the specific phthalate responsible for neurodisruptive effects, and no prior study has accounted for the correlation among phthalates by mutual adjustment. Some studies have reported significant associations with dibutyl phthalates and/or di-2-ethylhexyl phthalate (DEHP) ; others have highlighted butyl benzyl phthalate (BBzP). Moreover, as of now there have been no studies with biomarkers of exposure in the prenatal period and access to clinically confirmed neurobehavioral end points, such as ADHD diagnoses from a clinical provider. Rather, the bulk of the literature relies on parent-reported symptoms. Because the ages of the children examined have varied substantially across and within studies, relying solely on parental reports to identify nonnormative behavior may be problematic.

A number of mechanisms have been proposed to explain how phthalates may negatively affect brain development, although few have been thoroughly examined in humans or in animal models. One prominent concern is phthalate-induced maternal thyroid hormone disruption. Phthalates have been associated with changes in circulating thyroid hormone levels in adults and in pregnant women. The most consistent finding across studies has been an inverse association between metabolites of DEHP and thyroxine and/or free thyroxine. Maternal prenatal thyroid hormone is essential for fetal neurodevelopment, and clinically diagnosed thyroid hormone disorders (hyperthyroidism and hypothyroidism) in the perinatal period have been linked with ADHD in offspring. Additionally, both higher and lower levels of thyroid hormone concentrations, even within population reference ranges, have been associated with ADHD-like behaviors. Perinatal phthalate exposure has also been associated with preterm delivery, which is itself a risk factor for ADHD.

A true causal association of phthalate exposure with child neurodevelopment would have major public health significance. Phthalates are ubiquitous in consumer products, are components of many food processing and packaging materials, and can be found in both pharmaceuticals, and personal care products. Therefore, to address this critically important public health question, we undertook a prospective, nested case–control study in the Norwegian Mother and Child Study (MoBa) to examine the hypothesis that prenatal biomarkers of phthalate exposure are associated with clinical ADHD in offspring. We further considered whether any associations were mediated by maternal thyroid function or preterm delivery or were modified by child sex.

Objectives

We undertook an investigation into whether prenatal exposure to phthalates was associated with clinically confirmed ADHD in a population-based nested case–control study of the Norwegian Mother and Child Cohort (MoBa) between the years 2003 and 2008.

Methods

Phthalate metabolites were measured in maternal urine collected at midpregnancy. Cases of ADHD (n=297) were obtained through linkage between MoBa and the Norwegian National Patient Registry. A random sample of controls (n=553) from the MoBa population was obtained.

Results

In multivariable adjusted coexposure models, the sum of di-2-ethylhexyl phthalate metabolites (∑DEHP) was associated with a monotonically increasing risk of ADHD. Children of mothers in the highest quintile of ∑DEHP had almost three times the odds of an ADHD diagnosis as those in the lowest [OR=2.99 (95% CI: 1.47, 5.49)]. When ∑DEHP was modeled as a log-linear (natural log) term, for each log-unit increase in exposure, the odds of ADHD increased by 47% [OR=1.47 (95% CI: 1.09, 1.94)]. We detected no significant modification by sex or mediation by prenatal maternal thyroid function or by preterm delivery.

Conclusions

In this population-based case–control study of clinical ADHD, maternal urinary concentrations of DEHP were monotonically associated with increased risk of ADHD. Additional research is needed to evaluate potential mechanisms linking phthalates to ADHD.

Early exposure to BPA linked to increased hyperactivity

Prenatal exposure to bisphenol A and hyperactivity in children: a systematic review and meta-analysis

Bisphenol-A, widely used in plastics, receipt paper and canned food linings, is a culprit in some children developing hyperactivity : a July 2017 review, available online 7 March 2018, of more than 30 scientific studies, concludes early life exposure to the endocrine disrupting chemical BPA leaves children more susceptible to hyperactivity later in life.

Study Highlights

  • We used the OHAT systematic review framework to examine if early exposure to BPA has an effect on hyperactivity
  • We found that, in both rodents and humans, early exposure to BPA is linked to increased hyperactivity
  • Integration of animal and human evidence finds that BPA is a presumed hazard to human health
  • We suggest the development of clinical recommendations for avoiding BPA exposure, especially for pregnant women and children

2018 Study Abstract

Background
Attention-deficit hyperactivity disorder (ADHD) has increased in prevalence in the past decade. Studies attempting to identify a specific genetic component have not been able to account for much of the heritability of ADHD, indicating there may be gene-environment interactions underlying the disorder, including early exposure to environmental chemicals. Based on several relevant studies, we chose to examine bisphenol A (BPA) as a possible contributor to ADHD in humans. BPA is a widespread environmental chemical that has been shown to disrupt neurodevelopment in rodents and humans.

Objectives
Using the Office of Health Assessment and Translation (OHAT) framework, a systematic review and meta-analysis was designed to determine the relationship between early life exposure to BPA and hyperactivity, a key diagnostic criterion of ADHD.

Data sources
Searches of PubMed, Web of Science, and Toxline were completed for all literature to January 1, 2017.

Study eligibility criteria
For inclusion, the studies had to publish original data, be in the English language, include a measure of BPA exposure, and assess if BPA exposure affected hyperactive behaviors in mice, rats or humans. Exposure to BPA had to occur at <3 months of age for humans, up to postnatal day 35 for rats and up to postnatal day 40 for mice. Exposure could occur either gestationally (via maternal exposure) or directly to the offspring.

Study appraisal and synthesis methods
Studies were evaluated using the OHAT risk of bias tool. The effects in humans were assessed qualitatively. For rodents exposed to 20 μg/kg/day BPA, we evaluated the study findings in a random effects meta-analytical model.

Results
A review of the literature identified 29 rodent and 3 human studies. A random effects meta-analysis showed significantly increased hyperactivity in male rodents. In humans, early BPA exposure was associated with hyperactivity in boys and girls.

Limitations, conclusions, and implications of key findings
We concluded that early life BPA exposure is a presumed human hazard for the development of hyperactivity. Possible limitations of this systematic review include deficiencies in author reporting, exclusion of some literature based on language, and insufficient similarity between human studies. SRs that result in hazard-based conclusions are the first step in assessing and mitigating risks. Given the widespread exposure of BPA and increasing diagnoses of ADHD, we recommend immediate actions to complete such risk analyses and take next steps for the protection of human health. In the meantime, precautionary measures should be taken to reduce exposure in pregnant women, infants and children. The present analysis also discusses potential mechanisms by which BPA affects hyperactivity, and the most effective avenues for future research.

Sources and Press Releases

Root Causes that Can Mimic ADHD Symptoms

There are many other problems that have the same symptoms of ADHD

ADHD is diagnosed by health professionals who form their opinion by observing a child’s behavior. There are no brain scans, blood tests, or anything else definite that is used during diagnosis. The problem with this is there are many other problems that have the same symptoms of ADHD.

Many parents, because of not knowing, settle for ADHD as a diagnosis before looking at everything. For example, any problem dealing with the fuels of the body: water, food, blood and air can cause behavior problems. Water, food, blood and air to the body are just like gas and oil to a car. If you put bad gas or have old or the wrong oil in your car, it will act up just like a child acts up when eating foods they are allergic to, drinking or breathing contaminated water or air or having blood disorders.

There are also many medical, biological, emotional and mental conditions that mimic ADHD also. For those who are searching for reasons behind their child’s behavior, here are some possibilities. Only settle for the diagnosis of ADHD after checking out all of these problems and many more.

50 Conditions that Mimic ADHD

See original publication on ablechild.

Conditions most over looked

  1. Hypoglycemia (Low Blood sugar)
    Low blood sugar can stem from thyroid disorders, liver or pancreatic problems, or adrenal gland abnormalities, or even an insufficient diet. Hypoglycemia can display the same ADHD like sypmtoms.
  2. Allergies
    15 to 20 percent of the world has some type of allergy. A person can be allergic to nearly anything so check for all forms. Food is one of the primary causes of allergic reactions. Just like the Car and human analogy stated above. If a child eats food they are allergic to, the body will not run properly and that may affect behavior. Everyone has different sensitivities to allergens so just because you aren’t affected does not mean your child won’t be also. (Some examples, Allergic reactions to food dye, milk, chocolate, and grains, ect)
  3. Learning disabilities
    If the primary place of behavior problems is at school, learning disabilities may be the cause of ill behavior. One of the main things that affect a child’s self-esteem is how well they do in school. If a child has an undiagnosed learning disorder that makes school much harder and sometimes impossible. Children with undiagnosed learning disabilities are labeled as lazy, stupid, and many other downgrading opinions that affect self-esteem. And many times when a child’s self-esteem is at jeopardy they try to make up for it in other sometimes-nonproductive ways such as acting out, bullying, or becoming the class clown.
  4. Hyper or hypothyroidism
    An imbalance in metabolism that occurs from an overproduction or underproduction of thyroid hormones. This imbalance may cause a variety of behaviors and may affect all body functions.
  5. Hearing and vision problems
    If a child can’t see or hear properly, school and daily things in life are nearly impossible and it may cause ADHD like symptoms especially in educational settings.
  6. Mild to high lead levels
    Even in the absence of clinical lead poisoning: research shows that children with even mildly elevated lead levels suffer from reduced IQs, attention deficits, and poor school performance. Lead is the leading culprit in toxin-caused hyperactivity.

Other good possibilities to check for

  1. Spinal Problems
    Some spinal problems can cause ADHD like symptoms because if the spine is not connected to the brain properly nerves from the spinal cord can give the brain all of signals at once making a child rambunctious and always on the go.
  2. Toxin exposures
    Children are more vulnerable to toxins than adults. Such as pesticide-poisoning (Eating vegetables and fruit not washed thoroughly, they can be exposed to them by playing outside on the ground), also by gasoline fumes, and herbicides. Inside there are also many toxins. Disinfectants, furniture polishes and air fresheners are toxins that can affect some children’s behaviors. Beds and carpets are one of the most dangerous places in the house because they are full of different types of dust, and other toxins. Toxins can cause hyperactivity, attention deficits, irritability, and learning problems.
  3. Carbon Monoxide poisoning
    Thousands of children each year are exposed to toxic levels of this gas each year. Sources include gas heaters, and other gas appliances such as fireplaces, dryers, and water heaters.
  4. Seizure disorders
    The most overlooked is the absence Seizures. During an absence seizure, the brain’s normal activity shuts down. The child stares blankly, sometimes rotates his eyes upward, and occasionally blinks or jerks repetitively, he drops objects from his hand, and there may be some mild involuntary movements known as automatisms. The attack lasts for a few seconds and then it is over as rapidly as it begins. If these attacks occur dozens of times each day, they can interfere with a child’s school performance and be confused by parents and teachers with daydreaming.
  5. Metabolic disorders
    They reduce the brain’s supply of glucose, the bodies fuel and can cause ADHD like symptoms.
  6. Genetic defects
    Some mild forms of genetic disorders can go unnoticed in children and display some of the same symptoms of ADHD. Mild forms of Turner’s syndrome, sickle-cell anemia, and Fragile X syndrome are some examples. Almost any genetic disorder can cause hyperactivity or other behavior problems, even if the disorder isn’t normally linked to such problems. Many genetic diseases disrupt brain functions directly, through a variety of paths. A simple blood test can rule out genetic disorders.
  7. Sleeping disorders
    Or other problems causing fatigue and crankiness during the day.
  8. Post-traumatic subclinical seizure disorder
    It causes episodic temper explosions. These fits of temper come out of the blue for no reason. Some of these seizures can be too subtle to detect without a twenty-four-hour electroencephalogram (EEG).
  9. High mercury levels
    One of the most interesting things regarding high mercury levels is that it can relate to dental fillings. Children who have mercury amalgam fillings in their mouth and grind their teeth are at risk of high mercury levels. American dental associations are defensive on the subject of mercury fillings but many European countries have discontinued the use of them because of side effects. There are also other causes of high mercury levels.
  10. High manganese levels
  11. Iron deficiency
    Iron is an essential component of hemoglobin, the oxygen carrying pigment in the blood. Iron is normally obtained through the food in the diet and by the recycling of iron from old red blood cells. The causes of iron deficiency are too little iron in the diet, poor absorption of iron by the body, and loss of blood. It is also caused by lead poisoning in children.
  12. B vitamin deficiencies
    Many experts believe that one of the main causes for inattention, hyperactivity, impulsivity, temper tantrums, sleep disorders, forgetfulness, and aggression are caused by faulty neurotransmissions a problem with the neurotransmitters in the brain. Vitamin B-6 is a necessary vitamin used in the making of neurotransmitters that affect behavior. A lack of this vitamin or really any other vitamin can cause a child to act inappropriately.
  13. Excessive amounts of Vitamins
    Excessive amounts of vitamins can be toxic to the body and may cause the same ADHD like symptoms. It is possible to overdose when taking vitamins so make sure you contact a physician and check for vitamin deficiencies before taking extra vitamins.
  14. Tourette’s syndrome
    Tourette’s syndrome is a rare but disruptive condition. It involves multiple tics (small, repetitive muscle movements), usually facial tics with grimacing and blinking. Tics may also occur in the shoulders and arms. This is usually accompanied by loud vocalizations, which may include grunts or noises, or uncontrollable (compulsive) use of obscenities or short phrases. The tics are worse during emotional stress and are absent during sleep. The cause is unknown. It occurs most often in boys, and may begin around age 7 or 8 or not until the child is in his or her late teens or early twenties. It may, at times, run in families. This disorder can be mistaken for not being able to sit still or impulsive behavior.
  15. Sensory Integration Dysfunction
    Sensory Integration Dysfunction is the inefficient neurological processing of information received through the senses, causing problems with learning, development, and behavior. These children are over-sensitive or under-sensitive dealing in touch, taste, smell, sound, or sight. For example, some of these children crave fast and spinning movement, such as swinging, rocking, twirling, and riding the merry-go-round- without getting dizzy. These children may move constantly, fidget, enjoy getting into upside down positions and be a daredevil. These children may become overexcited when there is too much to look at words, toys, or other children. They may cover their eyes, have poor eye contact, be inattentive when drawing or doing desk work, or overreact to bright light. These children often act out in an attempt to cope with their inability to process sensory information such as acting out in crowded or loud places.

Definitely check if there is a family history of the condition

  1. Early-onset diabetes
    Symptoms include aggression, depression, and anxiety. If you have a family history of diabetes checking for this is a must.
  2. Heart disease
    It affects blood and oxygen flow to the brain affecting brain function that in-turn affects behavior.
  3. Cardiac conditions
    It can reduce the supply of blood, oxygen and nutrients to the brain. Defective blood vessels between organs to the brain.
  4. Early-Onset Bi-Polar disorder
    Also know as child-like Bi-polar. The experts state that 85% of children with child-like Bi-polar also meet the criteria for ADHD. The symptoms are extremely close. Most people when they think of Bi-polar disorder, think of Adult like Bipolar which mood swings happen over a somewhat long period of time. In child-like Bipolar, the mood swings can happen many times within a twenty-four hour day, known as rapid cycling. At one moment they’re calm and the next minute they could be in a full fledge temper tantrum. Some of the symptoms are Distractibility, Hyperactivity, impulsivity, separation anxiety, restlessness, depressed mood, low self-esteem, and many more. Early-Onset Bi-polar should be ruled out before ADHD is considered mainly because they are treated with different medications if you choose medications that is. ADHD is treated with stimulant medications which will make a Bipolar child worse possibly psychotic.

General problems you can think about yourself and check if you see fit

  1. CAPD
    (Central Auditory processing Disorder) will sometimes occur in children who have had a history of ear infections and/or PE tubes. Symptoms include distractibility, inability to follow a set of verbal instructions, “space out”, etc.
  2. Worms
    Such as Pinworms lay their eggs in the anal area, causing tickling and itching, which are most bothersome at night. The lack of sleep from this type of infestation can cause crankiness or bad behavior during the day. When asleep, nightmares may be present. This problem is mostly found in very young children preschool to kindergarten because of primitive toileting skills, they tend to put their fingers in their mouths, and they participate in a lot of hands-on activities with other kids and with pets. Roundworms, hookworms, and tapeworms are other examples that can make a child display ADHD like symptoms. Worms cause hyperactive behavior, learning problems, depression, or attention deficits by making children miserable on the inside.
  3. Viral or bacterial infections
    When a child is affected by an infection that might cause problem behavior.
  4. Malnutrition or improper diet
    Many children in the United States do not eat a well balanced diet. A proper diet is necessary to growing children. An improper diet can affect a child’s behavior in an ill way.
  5. Head injuries
    Such as the postconcussion syndrome. Some of the symptoms include Irritability, emotionality, memory problems, depression, and sleep disturbances. A concussion can disrupt brain functioning causing ADHD like symptoms.
  6. Dietary Factors
    (For example to much caffeine and sugar) At doses as low as 250 milligrams a day, a level many American children exceed- caffeine can cause rambling speech, attention and concentration problems, agitation, heart palpitations, insomnia, and hyperactive behavior. In a way, it is true we are what we eat.
  7. Some disorders such as anemias reduce oxygen to the brain causing disturbance in the brains chemistry causing ADHD like symptoms.
  8. Fetal alcohol syndrome (FAS) or Fetal alcohol effects (FAE)
    FAS is a name that doctors use to describe the damage done to children’s brains and bodies when their mother drink heavily during pregnancy. It is the leading form of mental retardation today. Prenatal alcohol impairment, however, also comes in a milder form called fetal alcohol effects (FAE). Children with FAE often don’t look disabled, and they tend to score in the low-normal or even normal range of intelligence. But these kids arent normal. Their mal-developed brains cause them to exhibit a wide range of behavior problems, including hyperactivity, attention problems, learning disorders, and ethical problems such as stealing, lying, and cheating.
  9. Intentionally or unintentionally sniffing materials such as modeling glue or other house hold products.
  10. Some drugs
    (both prescription and illegal) can cause the brain to atrophy, leading to disturbed cognition and behavior. If your child routinely takes prescription or over-the-counter medications for asthma, hay fever, allergies, headaches, or any other condition, consider the possibility that the drugs are causing or contributing to behavior problems.
  11. A beta-hemolytic streptococcus:(better known as “strep.”)
    Although these bacteria are most commonly thought of as the cause of strep throat. Left untreated, strep can cause rheumatic fever and a movement disorder called Sydenham’s chorea. Moreover, recurrent infections can lead, in susceptible children, to a group of symptoms collectively known as PANDAS (Pediatric autoimmune neuropsychiatric disorders) Some symptoms of PANDAS include obsessive-compulsive behavior, Tourette’s syndrome, hyperactivity, cognitive problems, and fidgeting.
  12. Lack of exercise
    “Hyper Couch Potatoes” are children who aren’t moving enough. Some children because of lack of exercise may seem as though they are always in motion, but often that motion is in fits and spurts: leaping up from a chair, spinning around in the lunch line, bouncing in a chair while watching TV. Quite a few hyperactive children actually do not get enough sustained, strenuous exercise to stay healthy mentally and physically. Exercise can make people happier, less anxious, less hyperactive, and less depressed. One reason is that exercise increases serotonin levels in the brain exactly what Prozac, Elavil, and similar drugs do.
  13. Gifted Children
    Gifted children often display ADHD like symptoms because most of the time they are bored with what other kids their age are doing. Behaviors associated with Giftedness are poor attention, boredom, daydreaming, low tolerance for persistence on tasks that seem irrelevant, their judgment often lags behind their development of intellect, their intensity may lead to power struggles with authorities, and they may have a high activity level. They may need less sleep compared to other children, and they may question rules, customs, and traditions. If your child scores above average on IQ tests, aces exams, has no trouble with homework, has no apparent learning disabilities, and primarily exhibits his or her problems mostly at school, maybe seeking a more challenging class or school would help.
  14. Emotional problems
    Kids who are experiencing emotional problems most often display ADHD like symptoms. For example, kids who are constantly subjected to bullying at school can display ADHD like symptoms. These are normal kids that act out because they are scared. They experience sleeping problems, sadness, and they develop physical symptoms, especially if they think those symptoms will keep them home from school. Often they can’t concentrate in class, partly because they are worried and partly because they are suffering from sleep deprivation. Really any emotional problem at school or home in which a child is having trouble coping with can result in ADHD like symptoms.
  15. Some kids are spoiled and undisciplined
    A number of children labeled hyperactive are merely under-disciplined children. They tend to run their household and get away with anything. Dr Syndey Walker stated this problem best of why parents under-discipline their children. He stated that he blamed not the parents but on the psychological experts who have counseled parents for several decades that children are fragile, easily traumatized little flowers who could be ruined for life by a cross look or a scolding which is very untrue. Children need firm discipline and strict rules not abuse but setting rules and standards and demanding those standards be met, and giving consequences when your rules are broken. Labeling undisciplined kids as ADHD who are not gives them an excuse for their misbehavior, which will often make it worse.
  16. Spirited children
    When dealing with spirited children the problem usually does not lie with the child but with society’s perception of what normal childhood behavior is. Many normal children, according to some people, display ADHD like symptoms not because they are hyperactive or lack sufficient attention spans but because the person forming the opinion has unrealistic standards of how a child should behave.
  17. Lack of understanding and communication skills
    One of the main reasons why a child acts out and throws temper tantrums when they have a problem is because of their lack of understanding of a problem and lack of expressing how they feel. Children do not have the vocabulary or know how to express their emotions like adults do, that’s why many act out when they are in a difficult situation. They are not able tell you something is wrong so they show you instead. This is one reason why any emotional or medical problem can cause acting out behavior in children.

Rare conditions but still good to check for and know about

  1. Early stage brain tumors
    Found rarely in children but should still be considered. Statistically, this diagnosis may not be important but to individual families, they assuredly are.
  2. Brain cysts
    Another rare cause of hyperactivity but should still be considered when searching for the reasons behind displayed ADHD like behavior.
  3. Temporal lobe seizures
    The Temporal lobe is a part of the brain. Any brain malfunction can cause inappropriate behavior. That’s why conducting brain scans is a must when trying to figure out behavior problems.
  4. Klinefelter syndrom
    A Genetic disorder in which a male has an extra X chromosome (XXY). Many individuals experience learning, behavior, and social problems. A degree of subnormal intelligence appears in some affected individuals. Many affected individuals are skinny and taller than most of their peers. A simple blood test can rule this disorder out.
  5. Genetic Disorder XYY
    The extra Y chromosome has been associated with antisocial behavior.
  6. Porphyria
    A hereditary enzyme-deficiency disease. Enzymes are very important to our body’s chemical reactions. Really nothing occurs in our body without enzymes. A lack of enzymes causes body malfunctioning which can cause ill behavior.
  7. Candida Albicans infestation (Yeast Infection)
    Candida infestations cause hyperactivity in children. Most children who do suffer from Candida infestations have some underlying problem frequently an immune disorder, or a disorder affecting carbohydrate metabolism and thus altering blood sugar levels. So immune disorders can cause other problems that also have the same symptoms of ADHD.
  8. Intestinal parasites
    Parasites rob the body of needed nutrients which in-turn affects behavior.

Long-term use of ADHD drugs impair fertility in mammals

Impaired reproduction after exposure to ADHD drugs : Nordic Cochrane Centre systematic review of animal studies

Researchers from the Nordic Cochrane Centre have reviewed animal studies for effects of long-term use of drugs against Attention Deficit Hyperactivity Disorder (ADHD). The findings show that long-term use may impair the reproductive system, with some studies showing delayed sexual maturation. There were a total of 17 studies available, published between 1975 and 2016, where 13 were rat trials.

2017 Study Abstract

BACKGROUND
Few studies have reported on long-term harms caused by ADHD drugs but they are known to impair growth.

OBJECTIVE
To assess whether ADHD drugs impair reproduction in mammals.

METHODS
Systematic review of reproduction in studies of animals treated with ADHD drugs.

DATA SOURCES
PubMed, Biosis and EMBASE.

RESULTS
We included 17 studies. The studies were generally of poor quality or poorly reported. Two studies reported the use of one of three advised randomisation methods. Fifteen studies used placebo which suggested blinding. On clonidine, the ability to produce offspring was reduced for male rats, which approached two females each. In one study, 10 treated rats produced no offspring while all four controls did. In another study, 10 treated rats impregnated nine females while 10 controls impregnated 16. On methylphenidate, vaginal opening was delayed in two studies (in one, the mean difference was 4.0 days, 95% CI 2.5 to 5.6, and number of estrous cycles was halved; in the other, the minimum delay was 6 days), while in two other studies no difference occurred. Generally, the impairments improved after a drug-free period and were less pronounced when treatment started later in life.

CONCLUSION
ADHD drugs impair the reproduction in animals.

Sources, More Information

  • Impaired reproduction after exposure to ADHD drugs: Systematic review of animal studies, IOS Press, International Journal of Risk & Safety in Medicine, vol. 29, no. 1-2, pp. 107-124, DOI: 10.3233/JRS-170743, 2 September 2017.
  • New systematic review links long-term use of ADHD drugs to impaired fertility in mammals, Cochrane Nordic, Oct 11 2017.
  • Featured image The Cochrane Collaboration on Facebook.

Air Pollution and Poverty Stack the Deck for ADHD

Combined effects of prenatal exposure to polycyclic aromatic hydrocarbons and material hardship on child ADHD behavior problems

Scientists at the Columbia Center for Children’s Environmental Health (CCCEH) at the Mailman School of Public Health report the first evidence that prenatal exposure to polycyclic aromatic hydrocarbons (PAH)—carcinogenic and neurotoxic combustion byproducts commonly found in urban air—combines with material hardship to significantly increase ADHD symptoms in children.

2017 Study Highlights

  • PAH are common carcinogenic and neurotoxic combustion-related air pollutants.
  • Exposure to PAH tends to be disproportionately high in low income communities.
  • Prenatal PAH exposure was measured by PAH-DNA adducts in maternal blood.
  • We evaluated the combined effects of prenatal PAH and material hardship on ADHD.
  • We observed significant effects of combined exposures on ADHD behavior problems.

2017 Study Abstract

Importance
Polycyclic aromatic hydrocarbons (PAH) are carcinogenic and neurotoxic combustion by-products commonly found in urban air. Exposure to PAH is disproportionately high in low income communities of color who also experience chronic economic stress.

Objective
In a prospective cohort study in New York City (NYC) we previously found a significant association between prenatal PAH exposure and Attention Deficit Hyperactivity Disorder (ADHD) behavior problems at age 9. Here, we have evaluated the joint effects of prenatal exposure to PAH and prenatal/childhood material hardship on ADHD behavior problems.

Materials and Methods
We enrolled nonsmoking African-American and Dominican pregnant women in New York City between 1998 and 2006 and followed their children through 9 years of age. As a biomarker of prenatal PAH exposure, PAH-DNA adducts were measured in maternal blood at delivery and were dichotomized at the limit of detection (to indicate high vs. low exposure). Maternal material hardship (lack of adequate food, housing, utilities, and clothing) was self-reported prenatally and at multiple time points through child age 9. Latent variable analysis identified four distinct patterns of hardship. ADHD behavior problems were assessed using the Conners Parent Rating Scale- Revised. Analyses adjusted for relevant covariates.

Results
Among 351 children in our sample, across all hardship groups, children with high prenatal PAH exposure (high adducts) generally had more symptoms of ADHD (higher scores) compared to those with low PAH exposure. The greatest difference was seen among the children with hardship persisting from pregnancy through childhood. Although the interactions between high PAH exposure and hardship experienced at either period (“persistent” hardship or “any” hardship) were not significant, we observed significant differences in the number of ADHD symptoms between children with high prenatal PAH exposure and either persistent hardship or any hardship compared to the others. These differences were most significant for combined high PAH and persistent hardship: ADHD Index (p < 0.008), DSM-IV Inattentive (p = 0.006), DSM-IV Hyperactive Impulsive problems (p = 0.033), and DSM-IV Index Total (p = 0.009).

Conclusion
The present findings add to existing evidence that co-exposure to socioeconomic disadvantage and air pollution in early life significantly increases the risk of adverse neurodevelopmental outcomes. They suggest the need for multifaceted interventions to protect pregnant mothers and their children.

More Information
  • Combined effects of prenatal exposure to polycyclic aromatic hydrocarbons and material hardship on child ADHD behavior problems, sciencedirect, 4 October 2017.
  • Air Pollution and Poverty Stack the Deck for ADHD, ccceh, 4 October 2017.
  • Research in New York City, ccceh.
  • Toxic Combination of Air Pollution and Poverty Lowers Child IQ, sciencedirect, 4 October 2017.
  • Featured image credit parents.

The Toxins that Threatens our Brains

UCSF Program on Reproductive Health and the Environment, 2017

The University of California San Francisco (UCSF) Program on Reproductive Health and the Environment (PRHE)’s mission is to create a healthier environment for human reproduction and development through advancing scientific inquiry, clinical care and health policies that prevent exposures to harmful chemicals in our environment.

PRHE is housed within the Department of Obstetrics, Gynecology and Reproductive Sciences, in the UCSF School of Medicine, one of the nation’s most prestigious medical schools. The Department is renowned for promoting cutting-edge reproductive science research, extending the frontiers of multidisciplinary women’s health care and professional education, advocating for women’s health at local, state and national levels, and engaging community involvement.

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60 MiNueTs : Toxic Bodies

UCSF Program on Reproductive Health and the Environment, 2017

The University of California San Francisco (UCSF) Program on Reproductive Health and the Environment (PRHE)’s mission is to create a healthier environment for human reproduction and development through advancing scientific inquiry, clinical care and health policies that prevent exposures to harmful chemicals in our environment.

PRHE is housed within the Department of Obstetrics, Gynecology and Reproductive Sciences, in the UCSF School of Medicine, one of the nation’s most prestigious medical schools. The Department is renowned for promoting cutting-edge reproductive science research, extending the frontiers of multidisciplinary women’s health care and professional education, advocating for women’s health at local, state and national levels, and engaging community involvement.

More Information

The BMJ Research looks at prenatal antidepressant use and risk of ADHD in children

Prenatal antidepressant use and risk of attention-deficit/hyperactivity disorder in offspring: population based cohort study

Previous reports might have overestimated the association between gestational use of antidepressants and ADHD in offspring because they have failed to control for shared family factors. Although we cannot completely discount the possibility that gestational use of antidepressants is a causal factor, our findings raise the possibility that confounding by indication might at least partially explain the observed association. We propose that if a causal association exists, then the size of the effect is probably smaller than that previously reported. However, decision making about antidepressant use in pregnancy remains important and requires an assessment of the risks and benefits in the context of the individual woman and family.

What is already known on this topic

  • Whether to prescribe drugs for depression during pregnancy is a complex decision
  • Prenatal use of antidepressants is considered a risk factor for attention-deficit/hyperactivity disorder (ADHD) in children, but evidence is inconclusive
  • The negative consequences of untreated maternal depression might also affect childhood development

What this study adds

  • The risk of ADHD was similar between the offspring of mothers who used antidepressants during pregnancy and those who used before pregnancy only, whereas the risk was higher for offspring of mothers with psychiatric disorders irrespective of whether antidepressants were used
  • Evidence suggests that the association between prenatal antidepressant use and risk of ADHD may at least partially be explained by confounding by indication of antidepressants
  • If there was a causal association; then the size of the effect is probably smaller than what has been reported previously

2017 Study Abstract

Objective
To assess the potential association between prenatal use of antidepressants and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring.

Design
Population based cohort study.

Setting
Data from the Hong Kong population based electronic medical records on the Clinical Data Analysis and Reporting System.

Participants
190 618 children born in Hong Kong public hospitals between January 2001 and December 2009 and followed-up to December 2015.

Main outcome measure
Hazard ratio of maternal antidepressant use during pregnancy and ADHD in children aged 6 to 14 years, with an average follow-up time of 9.3 years (range 7.4-11.0 years).

Results
Among 190 618 children, 1252 had a mother who used prenatal antidepressants. 5659 children (3.0%) were given a diagnosis of ADHD or received treatment for ADHD. The crude hazard ratio of maternal antidepressant use during pregnancy was 2.26 (P<0.01) compared with non-use. After adjustment for potential confounding factors, including maternal psychiatric disorders and use of other psychiatric drugs, the adjusted hazard ratio was reduced to 1.39 (95% confidence interval 1.07 to 1.82, P=0.01). Likewise, similar results were observed when comparing children of mothers who had used antidepressants before pregnancy with those who were never users (1.76, 1.36 to 2.30, P<0.01). The risk of ADHD in the children of mothers with psychiatric disorders was higher compared with the children of mothers without psychiatric disorders even if the mothers had never used antidepressants (1.84, 1.54 to 2.18, P<0.01). All sensitivity analyses yielded similar results. Sibling matched analysis identified no significant difference in risk of ADHD in siblings exposed to antidepressants during gestation and those not exposed during gestation (0.54, 0.17 to 1.74, P=0.30).

Conclusions
The findings suggest that the association between prenatal use of antidepressants and risk of ADHD in offspring can be partially explained by confounding by indication of antidepressants. If there is a causal association, the size of the effect is probably smaller than that reported previously.

Many children with bi-polar and ADHD symptoms can be helped without the use of dangerous off-label drugs

Let’s try to find ways to relieve illness without the use of drugs

Video by dr rapp, published on 22 February 2008.

Many children with bi-polar and ADHD symptoms can be helped without the use of dangerous off-label drugs.

There are fast, easy and inexpensive answers available.

Each individual is different and the treatment is rarely identical.

Dr. Doris Rapp has dedicated her life to identifying and providing simple solutions to these and other behavior problems.

Our challenge for physicians is to find fast, easy, safe, effective and inexpensive ways to heal.