Dr. James Greenblatt has seen thousands of children and adults struggling with the symptoms of ADHD – hyperactivity, inattentiveness, impulsiveness, and often irritability and combativeness. Rather than simply prescribing medication for their ADHD symptoms, he tailors remedies to his patients’ individual needs, detecting and treating the underlying causes of the disorder.
Finally Focused provides proven natural and medical methods to easily treat problems such as nutritional deficiencies or excesses, dysbiosis (a microbial imbalance inside the body), sleeping difficulties, and food allergies, all of which surprisingly can cause or worsen the symptoms of ADHD. Using Dr. Greenblatt’s effective Plus-Minus Healing Plan, parents will first understand the reasons behind their child's symptoms, and then be able to eliminate them by addressing the child’s unique pattern of biological weakness. Adults with ADHD can do the same for themselves. And if conventional medication is still necessary, this integrative approach will minimize or even eliminate troublesome side effects. Using Dr. Greenblatt’s expert advice, millions of children and adults with ADHD finally will get the help they need to achieve true wellness.
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About the Author
JAMES GREENBLATT, MD, is board-certified in both child and adult psychiatry, and has treated thousands of children and adults with ADHD over the past 30 years, using a unique, science-based approach that combines both natural and medical therapeutics. During his career, Dr. Greenblatt has trained and supervised medical professionals in integrative strategies for depression, anxiety, obsessive-compulsive disorder and schizophrenia, and currently serves as chief medical officer and vice president of medical services at Walden Behavioral Care in Waltham, Massachusetts. Dr. Greenblatt is also on the clinical faculty of Tufts Medical School and Dartmouth’s Geisel School of Medicine. His previous books include Breakthrough Depression Solution, Answers to Binge Eating, and Answers to Anorexia.
BILL GOTTLIEB, CHC, is the author of 16 health books that have sold 3 million copies and been translated into 10 languages, a health journalist whose articles have appeared in Prevention, Men’s Health, Bottom Line Health and many other magazines and periodicals, a health coach certified by the American Association of Drugless Practitioners, and the former editor-in-chief of Rodale Books and Prevention Magazine Books.
Read an Excerpt
The Miracle Mineral
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
• 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.
Table of Contents
Before You Begin 1
The Plus-Minus Treatment Plan: Why It Works - and How to Make It Work for Your Child or for You
Part I The Plus-Minus Treatment Plan
1 The Miracle Mineral 19
2 Balancing Brain Waves for Sharper Focus 34
Plus: OPCs Plus: Neurofeedback
3 Breakthrough Natural Therapy for Irritability, Anger, and Aggression 45
Plus: Nutritional Lithium
4 Balanced Nutrients, Balanced Behavior 59
Minus: Copper Plus: Zinc
5 Heal the Gut, Help the Brain 72
Minus: Intestinal Imbalance Plus: Probiotics
6 These Good Foods May Be Bad for Your Child 93
Minus: Food Sensitivity and Food Allergy Plus: Digestive Enzymes
7 Strengthening Brain Cells, Weakening ADHD 111
8 Solve the Sugar Problem: Just Add Protein 124
Minus: Sugar-Sweetened Beverages Plus: Protein
9 A Natural Alternative to ADHD Drugs 140
Plus: Neurotransmitter Precursors
10 The Finally Focused Lifestyle: Deep Sleep and Regular Exercise 154
Minus: Sleep Problems and Disorders Plus: Regular Exercise
11 Improving Attention, One Breath at a Time 172
Part II The Best of Medical and Behavioral Care
12 ADHD Medication-Minus the Side Effects 189
13 Parenting-Plus: Key Strategies for Better Behavior 209
Appendix: Resources for Parents of ADHD Children and Adults with ADHD 225