adhd and Iron

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Iron Supplementation May Help Children With ADHD

Yael Waknine

Dec. 6, 2004 - Iron deficiency may contribute to the physiopathology

of attention deficit-hyperactivity disorder (ADHD) in children, according to the

results of a controlled group comparison study published in the December issue

of the Archives of Pediatric & Adolescent Medicine. Iron supplementation may

benefit this population.

" Iron deficiency has been previously considered a potent cause of

poor cognitive impairment, learning disability, and psychomotor instability, "

writes Konofal, MD, PhD, from Debré Hospital in Paris, France, and

colleagues. " ron deficiency could lead to ADHD symptoms in relationship with

central dopaminergic dysfunction. "

In the study, the investigators found that serum ferritin levels

were significantly lower in children with ADHD (n = 53; mean age, 9.2 ± 2.2

years) compared with age- and sex-matched control subjects (n = 27; mean age,

9.5 ± 2.8 years) with mild reading disabilities (serum ferritin levels, 23 ± 13

ng/mL vs 44 ± 22 ng/mL, respectively; P < .001).

Serum ferritin levels were also abnormally low (< 30 ng/mL) in a

significantly greater proportion of children with ADHD compared with control

subjects (84% vs 18%; P < .001).

In children with ADHD, low serum ferritin levels were correlated

with more severe general symptom scores on the Conners' Parent Rating Scale

(Pearson correlation coefficient [r] = - 0.34; P < .02) as well as greater

cognitive deficits (r = - 0.38; P < .01). A trend toward a correlation with

greater hyperactivity was also observed but did not achieve significance (r = -

0.57; P = .055).

" Only the cognitive subscore correlated significantly with low

ferritin levels, " the authors note. " This correlation suggests that the

iron-deficient children are mainly inattentive and distractable and suffer from

learning disabilities, a finding consistent with the role of iron deficiency in

cognitive defects and mental retardation.

" ron supplementation could be considered a first-line treatment

for children with ADHD and iron deficiency, " the authors conclude, adding that

such therapy may improve central dopaminergic activity and decrease the need for

psychostimulants.

The authors report no pertinent financial conflicts of interest.

Arch Pediatr Adolesc Med. 2004;158:1113-1115

Reviewed by D. Vogin, MD