The ADHD Basics Panel by Access Medical Labs is a comprehensive blood test designed to identify various biomarkers that can indirectly influence or exacerbate symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD).
This panel includes a broad spectrum of tests covering nutritional and metabolic markers, blood cells and hematology, liver function, immune system and allergies, endocrine and hormonal levels, as well as minerals and electrolytes.
By evaluating these diverse areas, the panel aims to uncover underlying conditions or imbalances that might contribute to the severity of ADHD symptoms or affect its management.
This holistic approach to testing underscores the importance of addressing ADHD from multiple angles, considering the interplay between physical health, nutritional status, and brain function. For individuals with ADHD, this panel offers a pathway to identify potential dietary deficiencies, hormonal imbalances, or other health issues that could be impacting their condition.
This panel allows healthcare providers to tailor more effective treatment strategies that not only focus on managing ADHD symptoms directly but also on improving overall well-being, thereby enhancing the quality of life for those affected by ADHD.
The ADHD Basics Panel by Access Med Labs encompasses a broad range of biomarker categories to provide a holistic overview of factors that could influence ADHD symptoms.
These categories include:
This comprehensive panel aims to uncover any underlying health issues contributing to the severity of ADHD symptoms, offering a foundation for tailored and effective management strategies.
Nutritional and metabolic markers offer insights into an individual's overall health, which can influence cognitive function and behavior, making them essential to understand in ADHD.
Glucose and hemoglobin A1C levels are tested to gauge blood sugar regulation, as fluctuations can affect mood, energy, and attention, and exacerbate ADHD symptoms.
The lipid profile including total cholesterol, LDL, HDL, and triglycerides is assessed to understand metabolic health, given that imbalances might indirectly influence brain function and ADHD management. Elevated lipid levels have been correlated with ADHD in children, particularly in obese children. [23.]
One large study of over 26,000 Icelandic women showed that women with both ADHD and metabolic disorders had an increased risk of additional psychiatric diagnoses. Additionally, these women were at increased risk of self-harm and premature death compared to women without cardiometabolic disorders. [16.]
Identifying and providing early interventions for these people may not only increase their lifespan but give them an increased quality of life. [16.]
Iron and ferritin levels are crucial due to iron's role in dopamine metabolism, a key neurotransmitter involved in ADHD. Nonanemic children with ADHD have benefitted from iron supplementation, which is thought to be due to its functions in the dopaminergic system. [21.]
Vitamin D status is commonly and easily assessed by testing blood levels of 25-Hydroxy Vitamin D. Vitamin D deficiency has been linked to cognitive and behavioral issues, and specifically to symptoms of ADHD. [17.]
Additionally, markers like total protein, albumin, and hormones such as testosterone and DHEA-S provide a broader view of nutritional status and hormonal balance, factors that can indirectly impact ADHD symptoms. [13., 14., 19.]
Addressing these underlying health issues through dietary adjustments or supplementation can support better management of ADHD, highlighting the importance of a holistic approach to treatment.
Blood cells and hematology markers provide essential yet underutilized information in diagnosing and understanding various conditions, including their potential impact on ADHD.
These markers, including white blood cells (WBC), lymphocytes, neutrophils, eosinophils, and basophils percentages, along with red blood cell (RBC) counts, hemoglobin levels, hematocrit, and platelet counts, provide comprehensive insights into an individual's immune status, inflammation levels, and overall blood health.
In the context of ADHD, abnormalities in these markers might not directly diagnose the condition but can indicate underlying issues that exacerbate symptoms including low-grade inflammation or anemia, which can affect cognitive function and attention. [2., 15.]
For example, elevated WBC counts could suggest an ongoing infection or inflammation, potentially impacting brain function and exacerbating ADHD symptoms. Anemia, as evidenced by low hemoglobin and hematocrit levels, can lead to symptoms of ADHD including hyperactivity. [2., 21.]
Studies have demonstrated a link between anemia and ADHD. Study findings suggest a potential link between iron deficiency anemia and ADHD symptoms, supported by significant correlations between iron levels and ADHD evaluation scores. [6.]
Iron is important for several steps in dopamine production, a crucial neurotransmitter for attention and focus. Iron deficiency may alter dopamine levels, affecting the manifestation of ADHD symptoms. [8.]
Examining mean platelet volume and red cell distribution width can offer clues about the body's response to stress and inflammation, which may provide insight into the pathogenesis of ADHD. [22.]
Understanding these hematological parameters allows for a more nuanced approach to managing ADHD, highlighting the importance of addressing any underlying conditions that may contribute to the severity of its symptoms.
Liver function markers including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, and albumin are crucial in assessing liver health, which is vital for detoxifying the body, metabolizing drugs, and synthesizing proteins essential for blood clotting and other functions. [10., 18.]
These markers are not directly used to diagnose or understand ADHD itself but are important in monitoring the liver's ability to process medications prescribed for ADHD, such as stimulants, which can have hepatic metabolism pathways.
Elevated levels of ALT and AST often indicate liver damage or inflammation, potentially affecting medication metabolism and overall health, which can then influence ADHD management. Similarly, abnormal ALP and bilirubin levels can signal bile duct issues or liver dysfunction.
Monitoring albumin levels helps assess the liver’s synthetic function and nutritional status. Ensuring liver health is paramount in individuals with ADHD, especially those on medication, to avoid complications in drug processing and to maintain overall well-being.
Total IgE is a significant indicator for allergies. IgE, or Immunoglobulin E, plays a pivotal role in allergic reactions including common allergies to foods, dust, pollen, and other substances.
Elevated IgE levels can suggest an atopic or allergic condition which could exacerbate behavioral and cognitive issues associated with ADHD. For instance, allergic reactions often lead to symptoms like irritation, discomfort, and sleep disturbances, which can further impair concentration, mood, and overall cognitive function in individuals with ADHD. [20.]
Both allergic diseases and neurodevelopmental disorders including ADHD and ASD share immune dysregulation and inflammation as hallmark features, suggesting overlapping pathophysiology.
Epidemiological studies have provided compelling evidence linking allergies to neurodevelopmental disorders, possibly influenced by factors like maternal health, environmental exposures, and early-life disturbances. [5.]
In addition to inflammation, epigenetics, gene expression, and mitochondrial dysfunction may contribute to the development of both conditions, highlighting the need to explore these shared factors for a better understanding of their comorbidity.
The Endocrine and Hormonal category, including markers such as thyroid-stimulating hormone (TSH), sex hormone-binding globulin (SHBG), prolactin, testosterone, and DHEA-S (dehydroepiandrosterone sulfate), offers insights into the complex interplay between hormones and ADHD symptoms. [19.]
Hormonal imbalances can significantly affect mood, energy levels, concentration, and overall brain function, which are critical areas of concern in ADHD.
TSH levels are particularly relevant because thyroid hormones directly impact metabolism, brain development, and neurological function. Both hyperthyroidism and hypothyroidism can mimic or exacerbate ADHD symptoms, making thyroid function tests essential in the comprehensive assessment of ADHD.
In one study, the relationship between serum TSH and hyperactivity in children was highlighted by positive correlations between TSH levels and both the Conners 3 scale scores and hyperactivity severity. [4.]
Additionally, ADHD children with hyperactivity exhibited significantly higher TSH levels compared to those without hyperactivity. Further analysis indicated that TSH independently correlated with hyperactivity severity, and TSH showed moderate accuracy in discriminating ADHD children with hyperactivity from those without. [4.]
SHBG can affect the availability of sex hormones, including testosterone, which influences mood and behavior. Elevated or reduced levels of testosterone and DHEA-S may also impact energy levels, attention, and mood stability. [19.]
Hormonal fluctuations significantly influence ADHD symptoms, with transitions like puberty, pregnancy, and menopause exacerbating the condition. Gender differences in ADHD manifestation highlight the need for increased awareness among healthcare professionals, as symptoms in girls often differ from those in boys, with girls more prone to internalizing symptoms such as anxiety and depression. [1.]
Higher prolactin levels are also associated with ADHD symptoms. In one study, patients with higher prolactin exhibited slower reaction times and altered event-related potentials indicative of attentional and conflict monitoring deficits. [3.] Moreover, a significant correlation was found between PRL levels and cognitive function, suggesting potential cognitive toxicity associated with elevated PRL levels in prolactinomas.
By assessing these hormonal markers, healthcare providers can identify potential endocrine issues that might contribute to the severity of ADHD symptoms or complicate its management.
Addressing these hormonal imbalances through medication, lifestyle changes, or both can help improve ADHD symptoms and enhance the effectiveness of ADHD treatments, highlighting the importance of a holistic approach in managing the condition.
The Minerals and Electrolytes category of biomarkers encompasses essential markers such as calcium, zinc, sodium, potassium, magnesium, and chloride. These minerals play critical roles in various bodily functions, including nerve transmission, muscle contraction, hydration, and maintaining the body's acid-base balance. Imbalances in these electrolytes and minerals can affect cognitive function, mood, and overall neurological health, which are areas of concern for individuals with ADHD.
Calcium and magnesium are particularly noteworthy for their roles in nerve function and neurotransmitter release. Imbalances can lead to symptoms like hyperactivity, difficulty concentrating, and increased stress responses, which overlap with ADHD symptoms.
Calcium is intimately related to parathyroid hormone, or PTH; low calcium levels stimulate PTH release to maintain adequate blood levels of PTH, and high calcium levels in blood cause a low PTH level.
One study found that ADHD patients had significantly lower levels of parathyroid hormone (PTH), phosphorus (P), and alkaline phosphatase (ALP), and higher levels of Vitamin D, calcium (Ca), and magnesium (Mg) compared to healthy controls.
Interestingly, there was a negative correlation between serum PTH levels and ADHD symptom severity, suggesting that lower PTH levels might be associated with more severe ADHD symptoms. [9.]
Magnesium, the second most abundant intra-cellular cation in the body, plays a crucial role in enzyme regulation, membrane stabilization, and maintaining ion gradients. While magnesium deficiency is linked to various conditions including cardiovascular issues and neuromuscular excitability, there's emerging evidence suggesting its involvement in neurological disorders like ADHD.
Studies indicate potential associations between magnesium deficiency and ADHD symptoms, with supplementation showing promise in improving behavior and reducing symptoms. [11.]
Magnesium's role in neurotransmitter release and membrane stability highlights its significance in brain function and cognitive processes, suggesting a potential avenue for therapeutic intervention in ADHD management.
Zinc is crucial for neurotransmitter synthesis and brain function, and deficiencies have been linked to attention and cognitive difficulties.
While its etiology is complex, involving genetic, environmental, and perinatal factors, studies have suggested a link between ADHD and zinc deficiency or excess. Zinc plays a crucial role in the dopaminergic and adrenergic systems, which are disrupted in ADHD, and is involved in melatonin production, modulating dopamine function.
Zinc deficiency has been implicated in various neurological disorders, and its role in ADHD may involve modulation of dopamine levels, antioxidant properties, and enzymatic functions. The mechanisms underlying this relationship and the impact of zinc supplementation on ADHD symptoms require further investigation, given the heterogeneity among studies and potential confounding factors such as dietary intake and methodological differences in zinc assessment. [7.]
Sodium and potassium are vital for action potential generation and propagation in neurons, affecting brain activity and cognitive functions. While the relationship between electrolytes and overall health, and particularly neurological and behavioral health, is complex and nuanced, some compelling connections have been established.
Children with ADHD exhibit increased drinking behavior, potentially linked to dysregulation in neurotransmitters like norepinephrine (NE) and neuropeptide Y (NPY), which also play roles in thirst regulation and cardiovascular control.
Studies on spontaneously hypertensive rats, considered a model for ADHD, and hypertensive adults have shown parallels in NE and NPY activity, suggesting a shared physiological basis.
ADHD children demonstrate elevated NPY levels and altered electrolyte balance, including decreased urinary excretion of sodium, phosphate, and calcium, which may reflect disturbances in metabolic homeostasis and contribute to increased drinking behavior. [12.]
Monitoring and correcting imbalances in these minerals and electrolytes can contribute to better management of ADHD. Adequate levels support optimal brain function and may mitigate some ADHD symptoms, underscoring the significance of a comprehensive approach to treatment that includes monitoring nutritional status and metabolic health alongside direct ADHD interventions.
[1.] Antoniou E, Rigas N, Orovou E, Papatrechas A, Sarella A. ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period. Mater Sociomed. 2021 Jun;33(2):114-118. doi: 10.5455/msm.2021.33.114-118. PMID: 34483739; PMCID: PMC8385721.
[2.] Bener A, Kamal M, Bener H, Bhugra D. Higher prevalence of iron deficiency as strong predictor of attention deficit hyperactivity disorder in children. Ann Med Health Sci Res. 2014 Sep;4(Suppl 3):S291-7. doi: 10.4103/2141-9248.141974. PMID: 25364604; PMCID: PMC4212392.
[3.] Chen A, Cao C, Liu B, et al. Hyperprolactinemia Associated with Attentional Processing and Interference Control Impairments in Patients with Prolactinomas. Brain Sciences. 2022;12(8):1091. doi:https://doi.org/10.3390/brainsci12081091
[4.] Chen G, Gao W, Xu Y, Chen H, Cai H. Serum TSH Levels are Associated with Hyperactivity Behaviors in Children with Attention Deficit/Hyperactivity Disorder. Neuropsychiatr Dis Treat. 2023 Mar 7;19:557-564. doi: 10.2147/NDT.S402530. PMID: 36915908; PMCID: PMC10007977.
[5.] Chua RXY, Tay MJY, Ooi DSQ, et al. Understanding the Link Between Allergy and Neurodevelopmental Disorders: A Current Review of Factors and Mechanisms. Frontiers in Neurology. 2021;11:603571. doi:https://doi.org/10.3389/fneur.2020.603571
[6.] Demirci K, Yildirim Baş F, Arslan B, Salman Z, Akpinar A, Demirdaş A. The Investigation of Symptoms and Diagnoses of Adult-Attention Deficit/ Hyperactivity Disorder in Women with Iron Deficiency Anemia. Noro Psikiyatr Ars. 2017 Mar;54(1):72-77. doi: 10.5152/npa.2016.12464. Epub 2016 Mar 4. PMID: 28566963; PMCID: PMC5439476.
[7.] Ghoreishy SM, Ebrahimi Mousavi S, Asoudeh F, Mohammadi H. Zinc status in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis of observational studies. Sci Rep. 2021 Jul 16;11(1):14612. doi: 10.1038/s41598-021-94124-5. PMID: 34272450; PMCID: PMC8285486.
[8.] Hare D, Ayton S, Bush A, Lei P. A delicate balance: Iron metabolism and diseases of the brain. Frontiers in Aging Neuroscience. 2013;5. doi:https://doi.org/10.3389/fnagi.2013.00034
[9.] Kaypakli G, Varmiş D, Tahiroğlu A, et al. Role of calcium metabolism in ADHD: The relationship between parathyroid hormone and ADHD symptom severity. Indian Journal of Psychiatry. 2022;64(3):257. doi:https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_484_21
[10.] LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Methylphenidate. [Updated 2021 Aug 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547941/
[11.] Mousain-Bosc M, Siatka C, Bali JP. Magnesium, hyperactivity and autism in children. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507249/
[12.] Oades RD, Daniels R, Rascher W. Plasma neuropeptide-Y levels, monoamine metabolism, electrolyte excretion and drinking behavior in children with attention-deficit hyperactivity disorder. Psychiatry Res. 1998 Aug 17;80(2):177-86. doi: 10.1016/s0165-1781(98)00064-x. PMID: 9754697.
[13.] Öz, E., Parlak, M.E., Kapıcı, Y. et al. Pre- and post-treatment evaluation of routine blood analysis in patients with attention deficit hyperactivity disorder and comparison with the healthy control group. Sci Rep 13, 16233 (2023). https://doi.org/10.1038/s41598-023-43553-5
[14.] Rogne, A., Hassel, B. Improvement of attention deficit/hyperactivity disorder (ADHD) in three adult men during testosterone treatment: a case series . J Med Case Reports 16, 425 (2022). https://doi.org/10.1186/s13256-022-03651-w
[15.] Saccaro LF, Schilliger Z, Perroud N, Piguet C. Inflammation, Anxiety, and Stress in Attention-Deficit/Hyperactivity Disorder. Biomedicines. 2021 Sep 24;9(10):1313. doi: 10.3390/biomedicines9101313. PMID: 34680430; PMCID: PMC8533349.
[16.] Smari, U.J., Valdimarsdottir, U.A., Aspelund, T. et al. Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD: a population-based study. BMC Med 21, 450 (2023). https://doi.org/10.1186/s12916-023-03160-7
[17.] Trivedi C, Rafael J, Bui S, et al. 2.41 The Intriguing Interplay of Vitamin D Deficiency, ADHD, and Major Depression in Inpatient Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. 2023;62(10):S193-S194. doi:https://doi.org/10.1016/j.jaac.2023.09.128
[18.] Vyvanse TM (Lisdexamfetamine Dimesylate) C-II Rx Only AMPHETAMINES HAVE a HIGH POTENTIAL for ABUSE. ADMINISTRATION of AMPHETAMINES for PROLONGED PERIODS of TIME MAY LEAD to DRUG DEPENDENCE. PARTICULAR ATTENTION SHOULD BE PAID to the POSSIBILITY of SUBJECTS OBTAINING AMPHETAMINES for NON- THERAPEUTIC USE or DISTRIBUTION to OTHERS and the DRUGS SHOULD BE PRESCRIBED or DISPENSED SPARINGLY. MISUSE of AMPHETAMINE MAY CAUSE SUDDEN DEATH and SERIOUS CARDIOVASCULAR ADVERSE EVENTS. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021977lbl.pdf
[19.] Wang LJ, Lee SY, Chou MC, Lee MJ, Chou WJ. Dehydroepiandrosterone sulfate, free testosterone, and sex hormone-binding globulin on susceptibility to attention-deficit/hyperactivity disorder. Psychoneuroendocrinology. 2019;103:212-218. doi:https://doi.org/10.1016/j.psyneuen.2019.01.025
[20.] Wang LJ, Yu YH, Fu ML, Yeh WT, Hsu JL, Yang YH, Chen WJ, Chiang BL, Pan WH. Attention deficit-hyperactivity disorder is associated with allergic symptoms and low levels of hemoglobin and serotonin. Sci Rep. 2018 Jul 6;8(1):10229. doi: 10.1038/s41598-018-28702-5. PMID: 29980754; PMCID: PMC6035203.
[21.] Wang Y, Huang L, Zhang L, Qu Y, Mu D. Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. PLoS One. 2017 Jan 3;12(1):e0169145. doi: 10.1371/journal.pone.0169145. PMID: 28046016; PMCID: PMC5207676.
[22.] Wu J, Huang L, He H, Zhao Y, Niu D, Lyu J. Red Cell Distribution Width to Platelet Ratio Is Associated with Increasing In-Hospital Mortality in Critically Ill Patients with Acute Kidney Injury. Dis Markers. 2022 Jan 17;2022:4802702. doi: 10.1155/2022/4802702. PMID: 35082929; PMCID: PMC8786548.
[23.] Xu Y, Bao L, Liu C. The Relationship Between Blood Lipid and Attention-Deficit/Hyperactivity Disorder (ADHD) in an Obese Population of Chinese Children: An Obesity-Stratified Cross-Sectional Study. Int J Gen Med. 2021 Dec 30;14:10503-10509. doi: 10.2147/IJGM.S333247. PMID: 35002306; PMCID: PMC8722542.
The ADHD Basics Panel offers a comprehensive assessment of health parameters related to ADHD, including nutritional status, hormonal balance, and environmental toxins. It provides key insights for understanding ADHD-related health concerns.
.svg){kind=small}
.svg){kind=small}
On December 11th, join Dr. Terry Wahls in a 
