By Kim Roy
April 30, 2017
What is ADD/ADHD?
First off, I'm not a doctor of any sort.  I cannot diagnose your child.  All I can do is let you know what ADD/ADHD can look like, and what can be done to help quell the symptoms without medication.  Every child is different, so what might work for one child might not work for another. 
Many times, it is the parents who first notice certain behaviours in their child.  An inability to sit still for periods long enough for average activity, like sitting down to eat a meal.  Or perhaps a child has an idea, and then is off doing it without first considering options, like maybe putting on shoes before running outside on hot pavement, or hitting their younger sibling for taking a favoured toy. 
Perhaps your child spends all day being super active, and you're hoping this activity will help them sleep at night (and you too), but then nighttime comes and your child is still up and showing no signs of approaching tiredness.  No amount of warmed milk, or dull stories, or shutting off lights, or playing soothing sounds will entice your child to attempt sleep.  It's nearing midnight, you have to be up in six hours for your work and to get your child off to school, and the day just won't end. 
What are some options for treatment?
By now you've probably already figured out that your child has something like ADD/ADHD. Even if there's no formal diagnosis, DHA and EPA wouldn't go astray in helping mitigate the often-infuriating behaviours of your child. 
We'll talk about EPA's and DHA's benefits in dealing with symptoms of ADD and ADHD. 
EPA and DHA are both Omega 3s.  They are fatty acids that your body uses to keep itself healthy, or used to try and reclaim its health. 
There is some debate on the merits of DHA over EPA, but I think they are both beneficial.  I used to think that DHA was the thing that really helped ADHD due to its effects on the brain's neurotransmitters, and its concurrent effects on the central nervous system, i.e.: impulse control.  However, I've come to realize that EPA is as important, as it is the EPA that reduces systemic inflammation, which can start the whole roller coaster of symptoms. 
This is how it starts: systemic inflammation affects a whole gamut of processes in the body, one of which is our mental health.  If this systemic inflammation is reduced, so is the incidence and severity of mental health issues.  Systemic inflammation can have many sources, from the overly processed foods that many people consume on a regular basis, which includes margarine, lunch meats, seed oils (canola, sunflower, safflower, vegetable oils), and grains. 
Seed oils contain very high amounts of Omega 6s, which is the main inflammation-causing type of fatty acid.  It isn't a bad, per se, to consume omega 6 fatty acids, as our bodies do need some inflammation-promoting fatty acids in order for our bodies to heal from the transient stress of illness or injury.  I say transient because it is assumed by the body that the current state of inflammation is temporary, and the causative agent will be removed momentarily.  So, a random snack of crackers cooked in canola oil would elicit a mild inflammatory response (most likely in the gut noticeable by a slightly distende abdomen), the body heals the damage done (gut is healed), no more canola oil is consumed, so inflammation disappears (distention disappears).
However, continued consumption of canola oil—or any other Omega 6/PUFA—would then make inflammation systemic, as in it is now throughout the body, and brings with it a host of other symptoms, like brain fog, skin issues, digestive issues. 
As for grains being a culprit, it is well known that gluten in wheat, rye, barley, spelt, can produce inflammation in the body.  This inflammation is usually digestive, but can also manifest as other illness including arthritis, migraines, skin issues, and yes, even mental issues such as depression, bipolar, schizophrenia, and ADD/ADHD.  So elimitating gluten, even all grains, from the diet can be a long way toward eliminating many of the symptoms of ADD and ADHD.  I would also add that the recent (15-20 years) addition of the pesticide glyphosate sprayed on the wheat three weeks before harvesting probably hasn't done anything good for ADD/ADHD. 
The brain fog can be seen as difficulty with decision making, or three-step thinking (thinking ahead), planning and organizing (one's homework from multiple classes, or due dates for projects).  
Digestive issues can manifest as abdominal distention, but can also be the cause of multiple colds and flus, as our immune system originates in our gut.  So a healthy gut bacteria leads to a healthy immune system.  It's not so much what you eat, but what you digest, so a healthy digestive system goes a long way.
Let's focus on DHA/EPA... and if they can help your child
EPA is the part of Omega 3 fatty acid PUFA (Poly Unsaturated Fatty Acid) complex that helps with systemic inflammation that can cause joint pain, muscle pain (twitching and spasming muscles), and inflammation in the gust, as well as foggy brain (originating from gut health issues).  Because foggy brain has as one its hallmark manifestations the symptoms of ADD and ADHD, reduced systemic inflammation helps ease the final symptoms of ADD and ADHD. 
Also, it has been found that children who have symptoms of ADD and ADHD have lower levels of omega 3 in their body. 
Enter DHA.
DHA  helps increase the receptors in the brain for the neurotransmitters dopamine and serotonin. 
When receptors are created with substances from real food, their effects are superior to the synthetic versions created with man-made trans-fats (ie: seed oils like canola, sunflower, safflower, margarine).  The reason these receptors are of an inferior quality is that the fats from which they created are shaped differently than actual DHA from fish.  DHA is a curved trans-fat whereas mad-made trans-fats are straight.  This makes deformed receptors that do not work very well, and lead to deficiencies in dopamine and serotonin, among other neurotransmitters.  Lowered dopamine and serotonin lead to mental illness like ADD and ADHD. 
Strong serotonin levels are known to have an effect on feelings of contentment and lowered anxiety, and strong dopamine levels lead to feelings of self-control and capability.  When we do something that makes us feel good, it's the higher level of dopamine coursing through our bodies.  It's the “reward” hormone.
When these two neurotransmitters are negatively affected (meaning reduced), the symptoms are fatigue, loss of motor control (parkinsonism; feeling like you need to move), foggy brain, depression, myalgia (pain in muscles), neuralgia (nerve pain), insomnia, mood swings (which are usually misdiagnosed as bipolar), memory loss (child has trouble remembering parental admonitions), and can also be attributed to eventual drug addiction that synthetically raises dopamine levels in order the help the now-teenager feel good/competent/etc.  So, dealing with too-low dopamine levels through administration of DHA can help offset current ADD/ADHD symptoms, as well as extenuate any future propensity toward truly artificial feel-good drugs. 
Where to get them (not enough in food)
Because of the current state of fishing, and the high levels of mercury and PCBs in the oceans, being able to eat enough fatty fish to satisfy our bodies' need for DHA and EPA is virtually impossible without poisoning ourselves through mercury and PCBs, with only by a slight increase in DHA and EPA.  Because of this conundrum, external supplementation is required to help our afflicted children. 
So where do you get good supplements, what kind, and how much?
FISH OIL
A good omega 3 supplement will come from fish oil, preferably from cold arctic water.  North Atlantic or Norwegian sources are best.  It is the bottom-dwelling fish, the herring, mackerel, sardines that are the best source, as they eat the foods found on the bottom of the ocean, and not the mercury-laden food-sources found living closer to the surface of the ocean.  And most companies will further purify their oils by removing what little mercury might creep into the fish. 
Cod Live Oil (CLO)
While Cod Live Oil is a good source of omega 3 fatty acids, it is not the preferred source due to its high vitamin A content.  (More on that in a future post, hopefully.)
Fermented Cod Liver Oil (FCLO)
The fermenting of cod liver oil makes it slightly more bioavailable due to its naturally occurring vitamin A and D, not synthetically added.  However, the taste is usually a deal-breaker for kids. 
Krill Oil
Krill oil contains astaxanthin which works as an antioxidant, keeping the krill oil from going rancid giving a longer shelf life.  Also, the omega 3s in krill oil are bound to a phospholipid structure which ensures its immediate, almost 100% bioavailability.  This is vastly different from fish oils which can have an bioavailability of 20%, in that the dose on the bottle of krill oil is what the body will actually absorb and use due to the presence of the phospholipids.  For these reasons, krill oil works at a lower dose due to its higher bioavailability.
DOSAGES
There really is no magical dose amount.  It depends on the age and weight of the child in question.  In other words, testing is in order.  This is where it can get complicated.  You can either do this with the assistance of a knowledgeable doctor, or on your own.  Either way, it's a good idea to keep a log book detailing dates of administration, dose given, and any subsequent reactions good and bad.  Also good to jot down food consumed (even including tasting on tip of tongue), sleep habits (start and duration of sleep time). 
Due to the higher need for anti-inflammation, a higher EPA is required, so a good starting dose for a child of 50lbs would be 500mg EPA, and 250mg DHA.  Or a 2:1 ratio.  This can be continue for about two weeks, at which point a reassessment is in order.  If the sought-for amelioration did not appear, upping the EPA dose to 1,000mg daily for another two weeks, and leaving the DHA dose the same, would give results indication whether a higher EPA is needed.  If, after that second two-week period, nothing had changed, you can reduce the EPA to its original 500mg/day, and then increase the DHA to 500mg/day for another two weeks.  In the fourth two-week period, further alterations can be tested to see if the new doses are what is needed.
So, it'll look like this:
(dosages are daily, preferably with a meal, one that includes fat)
Week 1-2 500mg EPA  250mg DHA
Week 3-4 1,000mg EPA  250mg DHA
Week 5-6 500mg EPA  500mg DHA
Week 7-8 1,000mg EPA   500mg DHA
 
By this time, a total of 8 six weeks (two months) will have passed.  A long time, I know, but these kinds of causation healing take time.  A lot more time than a quick “fix” with a pill, or two.  However, when a deficiency is fixed, the symptoms usually disappear.  But, as eating has to be done several times a day, for the rest of a person's life in order to ensure continued living, so does supplementing with omega 3 for the purpose of ameliorating socially disrupting symptoms, and allow the child to continue progressing with a better mental and physical state. 
In essence, like any attempt to externally rebalance intrinsic hormones or neurotransmitters that aren't entirely measurable, testing is the key. Trying various combinations to see which one fits the individual's needs. 
In short, getting rid of systemic inflammation does a long way toward ameliorating many illnesses, whether physical (pain) or mental (clarity, focus, etc.).  EPA deal with inflammation (similar to curcumin), and the DHA helps heal the brain from the punishing levels of inflammation in the body.
In conclusion, I would like to add that France has much fewer ADD/ADHD diagnoses mainly due to their differing description.  Whereas the US and Canada like to describe it as a neurological disorder requiring neuroleptics to control the symptoms, France describes ADD/ADHD as a sociological disorder  caused by a set of social situations requiring perhaps a different mindset when interacting with such children.  Social situations with expectations of self-control in the form of immobility is not best for all children, and understanding this distinction helps many children deal with certain situations.  If a child is allowed to move during an educational episode (aka: class), it has been observed that the child learns better, as he is a “kinesthetic learner” who needs to move in order for his brain to accept new information, and deposit it into the correct “compartment” of his brain for later retrieval.  Stultifying this innate need through mind-numbing neuroleptics can have future deleterious repercussions in the form of extreme learning difficulties, and a stagnant interest in future pursuits. 
It is in the best interests of the child to look at the whole picture of the child's life, and figure out what might need changing, or outright eliminating. 
References used for this article:
Almost No Children In France Are Medicated For ADHD: Here’s How They Define & Treat It. (2016,  November 07). Retrieved April 30, 2017, from http://www.collective- evolution.com/2016/10/28/almost-no-children-in-france-are-medicated-for-adhd-heres-how- they-define-treat-it/
Bélanger, S. A., Vanasse, M., Spahis, S., Sylvestre, M.-P., Lippé, S., l’ Heureux, F., … Levy, E. (2009).  Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A  randomized, double-blind, placebo-controlled study. Paediatrics & Child Health, 14(2), 89–98.
Could a Daily Fish Oil Supplement Help Curb Symptoms of ADHD? (2005, September). Retrieved April  30, 2017, from https://www.additudemag.com/fish-oil-for-adhd-symptoms/
Mercola, J., MD. (2010, December 20). Omega-3 Essential Fatty Acids from Krill Oil Fights ADHD.  Retrieved April 30, 2017, from  http://articles.mercola.com/sites/articles/archive/2010/12/20/omega3-fat-useful-to-improve- adhd.aspx
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