Vous êtes sur la page 1sur 41

Attention Deficit Disorder (ADHD/ADD) By

Kyle J.Norton

I. Attention Deficit Disorder (ADHD/ADD) also known as attention deficit


hyperactivity disorder is a chronic disease occurs in certain age and years of
children, defined as a condition with characteristics of co-existence of
attentional problems and hyperactivity. It affects about 5% of the all children
in the world with boys have 3-4 times higher risk than girls. Over one third
of children with ADHD will have continuous symptoms existed into their
adult life.

II. Classification
ADHD is classified with coexistence of Disruptive behavior disorder
Although any disorder can be co-existed with ADHD, disruptive behaviour
disorder is one of most common one, including
a. Oppositional defiant disorder
Oppositional defiant disorder is defined as a behavior of defiance and
disobedience to the authority
b. Conduct disorder
Conduct disorder is defined as long-term (chronic) behavior problems,
including Defiant or impulsive behavior such as aggression, destruction of
property, stealing, etc.
c. Antisocial personality disorder
Antisocial personality disorder is defined as a characteristic of persistently
disregard and violation of the rights of others, such as deceit, manipulation,
etc.

III. Types of Attention Deficit Disorder (ADHD/ADD)


Attention Deficit Disorder (ADHD/ADD) is classified into 3 subtypes
A. Predominantly hyperactive-impulsive
1. Predominantly hyperactive-impulsive is defined as a condition in which a
child has an unusually high activity level impulsively in a short period span.
Children with the disorder usually have behavior and learning disabilities
with (six or more) symptoms in the hyperactivity-impulsivity categories.
Researchers found that Children with the disorder have high levels of
cortisol.

2. Symptoms
2.1. Children who have symptoms of hyperactivity may:
a. Fidget and squirm in their seats
b. Talk nonstop
c. Dash around, touching or playing with anything and everything in sight
d. Have trouble sitting still during dinner, school, and story time
e. Being constantly in motion
f. Have difficulty doing quiet tasks or activities.
g. Sleep Complaints(I)

2.2. Children who have symptoms of impulsivity may:


a. Be very impatient
b. Blurt out inappropriate comments, show their emotions without restraint,
and act without regard for consequences
c. Have difficulty waiting for things they want or waiting their turns in
games
d. Often interrupt conversations or others' activities.

B. Predominantly inattentive
1. Predominantly inattentive is defined as a condition of a child with serious
inattention problems, as they do cause any problem with others, but sit quiet
and ignore others with six or more symptoms in the inattention category.
Researchers found that Children with the disorder have Low levels of
cortisol.
2. Symptoms
a. Be easily distracted, miss details, forget things, and frequently switch
from one activity to another
b. Have difficulty focusing on one thing
c. Become bored with a task after only a few minutes, unless they are doing
something enjoyable
d. Have difficulty focusing attention on organizing and completing a task or
learning something new
e. Have trouble completing or turning in homework assignments, often
losing things (e.g., pencils, toys, assignments) needed to complete tasks or
activities
f. Not seem to listen when spoken to
g. Daydream, become easily confused, and move slowly
h. Have difficulty processing information as quickly and accurately as others
i. Struggle to follow instructions(1)

3. Combined hyperactive-impulsive and inattentive


This a combined subtypes of ADHD with Six or more symptoms of
inattention and six or more symptoms of hyperactivity-impulsivity.
Researchers found that children with the disorder have abnormal levels of
cortisol.

IV. Causes
1. Heredity
ADHD can be an inherited form the parent as a result of abnormal genes,
according to the study of "Quantitative and Molecular Genetics of ADHD"
by Asherson P, Gurling H., researchers indicated that there is consistent
evidence of monoamine neurotransmitter involvement with the best
evidence coming from genetic markers in or near the dopamine D4 and D5
receptor genes. Recent genome-wide association studies have identified new
association findings, including genes involved in cell division, cell adhesion,
neuronal migration, and neuronal plasticity(2)

2. Perinatal factors
Perinatal factors such as miscarriage symptoms, premature delivery
symptoms, severe flu attacks (cold with fever, without virus confirmation),
tobacco abuse, alcohol abuse (to become drunk), minor congenital
malformations, neonatal seizures and hospitalizations may cause ADHD to
the new born, according to the study of "[Perinatal factors associated with
attention deficit/hyperactivity diagnosis in Colombian Paisa children].
[Article in Spanish]" by Pineda DA, Puerta IC, Merchán V, Arango CP,
Galvis AY, Velásquez B, Gómez M, Builes A, Zapata M, Montoya P,
Martínez J, Salazar EO, Lopera F., posted in PubMed(3)

3. Heavy prenatal maternal smoking


Exposure to heavy maternal cigarette smoking in pregnancy and severe
maternal psychosocial stress during pregnancy increase risk of ADHD as a
result of neuropsychological deficits commonly seen in ADHD, according to
the study of "Adverse effects of heavy prenatal maternal smoking on
attentional control in children with ADHD" by Motlagh MG,
Sukhodolsky DG, Landeros-Weisenberger A, Katsovich L, Thompson N,
Scahill L, King RA, Peterson BS, Schultz RT, Leckman JF., posted in
PubMed(4)

4. Environmental influences
In a study of 200 children with ADHD (149 males and 51 females) and 286
healthy controls (135 males and 151 females). The ADHD DSM-IV
diagnosis was obtained using the DICA and BASC evaluation instruments,
and the children's mothers or grandmothers filled out a questionnaire on
each child's exposure to prenatal, neonatal, and early childhood risk factors,
conducted by
University of San Buenaventura, researchers indicated that the risk of
developing ADHD must include these environmental factors as covariates(5)

5. Brain injure
The behavioural and cognitive sequelae of traumatic brain injury (TBI) have
features in common with attention deficit/hyperactivity disorder (ADHD),
according to the study of "Inhibitory control in children with traumatic brain
injury (TBI) and children with attention deficit/hyperactivity disorder
(ADHD)" by Konrad K, Gauggel S, Manz A, Schöll M., PubMed(6)

6. Refined Sugar
In the study of A total of 107 students participated, and eight boys and one
girl (8.4% of the total) categorized as high risk for ADHD according to
diagnostic criteria, conducted by Graduate School of Education, Dankook
University, posted in PubMed(7), researchers indicated that children who
consumed less sugar from fruit snacks or whose vitamin C intake was less
than RI was at increased risks for ADHD (P < 0.05). However, no significant
association was observed between total volume of simple sugar intake from
snacks and ADHD development.

7. Artificial food additives and dyes


Although there is contradictive results of how Artificial food additives
causes of ADHD, Some reserachers do believe that the balance of existing
evidence neither refutes nor supports the link between AFCs and ADHD,
which highlights the need for carefully designed studies to further
investigate the link between AFCs and ADHD, according to the study of "A
research model for investigating the effects of artificial food colorings on
children with ADHD" by Kleinman RE, Brown RT, Cutter GR, Dupaul GJ,
Clydesdale FM., posted in PubMed(8)

8. Toxic Substances
Toxic substances may be considered as a substantial contribution to the
etiology of ADHD, as a result of affecting the dopamine system, according
to the study of "Etiologic subtypes of attention-deficit/hyperactivity
disorder: brain imaging, molecular genetic and environmental factors
and the dopamine hypothesis" by Swanson JM, Kinsbourne M, Nigg J,
Lanphear B, Stefanatos GA, Volkow N, Taylor E, Casey BJ, Castellanos FX,
Wadhwa PD., posted in PubMed(9)

9. Maternal stress during pregnancy


Maternal stress during pregnancy may increase the risk of the development
of ADHD symptomatology after controlling for family history of ADHD
and other environmental factors(36)

10. Etc.

V. Diseases with similar symptoms to ADHD


A number of other conditions and disorders have similar symptoms,
therefore, it is imporant for the doctors to rule out before treating ADHD
1. Visual disturbances
Visual disturbances are defined as a condition of abnormalities of sight
associated with neurological disorders often include double vision
(diplopia), moving or blurred vision as a result of nystagmus, a rapid
involuntary movements of the eyes. Some children with ADHD are
experience the symptoms of visual disturbances as a result of
neuropsychological dysfunction.

2. Thyroid disorders
Children who are experience the symptoms of dementia and depression,
dysfunction of cerebellum and cranial nerves as a result of hypothyroidism
(lacks sufficient thyroid hormone) may be risk of misdiagnosis as the
symptoms are similar of those in ADHD (10)

3. Epilepsy
Epilepsy is defined as condition of chronic neurological disorders
characterized by seizures and with recurrent symptoms as a result of
mutations in several genes. ADHD occurs frequently in children with
epilepsy. The factors associated with increased risk of ADHD include the
onset age of epilepsy, the types of seizures or epileptic syndromes, the
epileptiform EEG discharges, and the effects of antiepileptic drugs(11)

4. Sleeping problems, and attention-deficit/hyperactivity disorder.


Some children with ADHD may be experience the symptoms of childhood
eczema, sleeping problems, but not all of them. Researchers at University
Clinic of Wuerzburg indicated that ADHD and AE appear to be strongly and
independently associated in children with sleeping problems, but not in
children without sleeping problems. A substantial part of diagnoses met for
ADHD might be engendered by the presence of AE and concomitant
sleeping problems.(12)

5. Some genetic disorders


Researchers at the Complejo Hospitalario Universitario de Albacete found
that the X-chromosome-linked ichthyosis is caused by mutation or deletion
of the STS gene as. Depending on its size, it can present as an isolated entity
or combined with a syndrome caused by neighbouring genes, thus
associating itself with other monogenic diseases as well as other mental
disorders. The most relevant findings from the literature review are the
importance of the Xp22.3-pter region and the higher incidence of
neurological disorders among males such as attention deficit hyperactivity
disorder, autism and X-linked mental retardation(13)

6. Eenuresis
Nocturnal enuresis (MNE) or bedwetting is defined as condition of
involuntary urination while asleep inchildren at which bladder control
usually occurs. Researchers at Duzce University School of Medicine said
that monosymptomatic nocturnal enuresis (MNE) and attention deficit and
hyperactivity disorder (ADHD) are multifactorial disorders and biological,
social, and psychological factors may play significant roles in the
development of both. Children with enuresis display a higher prevalence of
ADHD compared to the normal population, in a study of A total of 64
children between the ages of 6 and 13 years (14)

7. Schizophrenic
Schizophrenia is defined as a serve mental disorder characterized by a
breakdown of thought processes and by poor emotional responsiveness,
including symtoms similar to those of ADHD.
and both associated with deficits in inhibition and working memory, but the
hypothesis that working memory is a primary deficit in schizophrenia, but
secondary to the inhibitory deficit in ADHD.(15)

8. Substance Use Disorders


In the replied to the article by Timothy E. Wilens, M.D. in The American
Journal of Psychiatry, VOL. 164, No. 6, the writer wrote that the case
presented does exhibit symptoms typical of marijuana users (4—6).
According to Fletcher et al. (7), long-term cannabis use is associated with
disruption of short-term memory, working memory, and attentional skills, all
of which are exemplified in the case presented in Dr. Wilens’s article (16)

9. Autism and ADHD are characterized with the association of


neurodeficits
Even though there are allots of similar symptom, but children with ASD also
showed slower rates of adaptation compared with both control groups while
children with ADHD did not show this excessive generalization to the
proprioceptive target, but they did show excessive variability in the speed of
movements with an increase in the exponential distribution of responses (τ)
as compared with both TD children and children with ASD.(17)

10. Tourette's Syndrome


Tourette syndrome (TS) is defined as a neurological disorder characterized
by repetitive, stereotyped, involuntary movements and vocalizations called
tics. Some time it is misdiagnosis to children with ADHD or vice versa, but
there are the evident that ADHD are more common in patient with chronic
tics and Tourette's syndrome(18)

k. Oppositional Defiant Disorder (ODD)


ODD is a psychiatric disorder that is characterized as a set of symptoms,
including aggressiveness and a purposefully bother and irritate others. ODD
may sometime associate with ADHD and other neuropsychiatric disorders
including, depression, Tourette's syndrome, etc..and sometime they can be
treated with the same medication and at different improvement rate(19)

11. Anxiety Disorders


Anxiety disorder is defined as a condition of several different forms of a
type of mental illness of abnormal and pathological fear.. In the study of
children (8-17 years) with anxiety disorders (n = 24) and children (8-16
years) with ADHD (n = 23) on neurocognitive tests of both general and
emotion-based attention processes, showed that children with ADHD
demonstrated poorer selective and sustained attention, whereas youth with
anxiety disorders demonstrated greater attentional bias toward threatening
faces on a visual probe task.(20)

12. Depressive Disorders


Depressive disorders is defined as a metal illness of which includes mood,
and thoughts of the patient, affecting their way of eating and sleeping,
feeling, etc. with the prevalence rate for MDD is 6.7%, while the ADHD
prevalence rate in US adults is 4.4%.(21)

13. Etc.

VI. What to avoid


It is important for parent and the benefits of the child avoided intake of food
that promote the brain allergic reaction, impaired social and communication
skill, limited interest, etc.
A. For Children
1. Sugar
Sugar may rob the body of vitamins, minerals, and enzymes and increases
hyperactivity in ADHD as a result of fluctuation of sugar levels. Researchers
found that excessive sugar intake may lead to alterations in mesolimbic
dopamine signaling, which could contribute to the symptoms associated with
ADHD. We recommend further studies to investigate the possible
relationship between chronic sugar intake and ADHD.(28)

2. Artificial ingredients
a. Artificial colors
Food color is any substance added in to the food to preserve its favors or to
simulate a natural state of the foods with an aim to make customers to buy
them. Although, they have been tested by the government food body to
ensure its safety, but unfortunately, it has interfered the neurological
processes, such as the behavior, personality and learning ability of children
with or without autism if taken in high dose.
It is said that some artificial ingredient such as FD & C Red No. 2 dye have
shown to promote cancerous growth. Researcher found that removing the
artificial colors from the autistic children diet, improve in attention deficit
and hyperactivity behaviors dramatically.
b) Artificial flavors
Artificial flavors are any synthesized chemical added to manufactured foods
to change or make its taste better such as banana - isoamyl acetate;
cinnamon - ethyl cinnamate; orange - octyl acetate and pineapple - methyl
butyrate; pear. It causes nervous tension including mental concentration,
behavior, lost of energy and weakened immune response.
It is said that long-term usage can increase your risk of cancer,
cardiovascular disease and other degenerative conditions to children's central
nervous system.

c) Artificial preservatives
Artificial preservatives are a group of chemical substances, such as BHT,
nitrates, sulfites, sulfur dioxide, BHA, etc. added to food, sprayed on the
outside of food, or added to certain medications with the purpose of
preventing food from spoiling or discoloring. It causes allergic reactions in
children, resulting in skin rashes or facial swelling and worsening asthma.

d) Artificial Addictive
Artificial addictive is defined as substances, adding to foods from the
manufacture with the purpose of preservation, coloring, texture and flavor.
Studies found that artificial additive can cause several types of cancer and
tumor. Many of them have negative impacts in children with ADHD.
i) Olestra
Olestra is a fat substitute used in crackers and potato chips. It is type of
additive can not be absorbed by the digestive system, leading to diarrhea,
loose stools, abdominal cramps.
ii) Monosodium glutamate (MSG)
MSG is used as a flavor enhancer in many cooking and preservative foods. It
is said that MSG can cause sensitive neurons to die. leading to headache,
nausea or vomiting.

e) Artificial sweeteners
Artificial sweeteners is a synthesis sugar substituted substance. It has been
used increasingly in replacing natural sugar in a wide range of products
traditionally containing sugar. Studies found that artificial sweetener may
increase risk of bladder and brain cancers.
i) Sucralose
It is 600 times as sweet as sugar and has been used in beverages, frozen
desserts, chewing gum, baked goods, etc. and belongs to a class of chemicals
called organochlorides. Some of them are considered toxic to our health.
ii) Lead acetate
It is an artificial sugar substitute made from lead, it causes lead accumulated
in the body, leading to nervous symptoms.
iii) Aspartame
It is 200 times as sweet as sugar and can be used as a tabletop sweetener,
frozen desserts, gelatins, etc. Researchers found that aspartame may increase
the risk of brain damage and cancer.(26)

3. Trans Fat
Trans fat has been proven to inhibit the function of nerve function as Diets
high in fat, especially trans and saturated fats, adversely affect cognition,
while those high in fruits, vegetables, cereals, and fish are associated with
better cognitive function and lower risk of dementia(29). trans fat is the
hydrogenated oil found in many commercial mayonnaise, margarine, and
peanut butter etc. and can cause cholesterol building up in the arteries,
leading to less blood circulation to the central nervous system.

4. Yeast extract
It is also known as processed yeast products and has been used as food
additives or flavourings under the name of monosodium glutamate (MSG). It
contains glutamic acid which is classified as exitotoxins, and can cause brain
damage in some studies.

5. Casein
Casein is a protein found in milk and foods containing milk, such as cheese,
butter, yogurt, etc. Studies found besides promoting cancer, it also increases
the risk of bad cholesterol building up in the arteries, leading to heart
diseases and stroke. Casein after intake can also be broken down to
casomorphins, an chemical agent which is known to interfere with the
function of neurotransmitter in transmitting information and decrease the
immune response to foreign bacteria and virus invasion.

6. Non organic foods


Non organic foods may contain
i) Pesticides & Herbicides
Pesticides & Herbicides is highly toxic. Because of their value of increasing
the production of foods and prevent insect eating away the profits of the
growers, it have been widely uses in non organic farming. Intake of non
organic foods may weakened the immune system as well as interfering the
liver function in toxic elimination, leading to central nervous tension and
exhibiting the symptoms of ADHD.
ii) Contaminated Sewage Sludge
The increasing uses of contaminated sewage sludge containing human
waste, industrial waste and toxic chemicals as a fertilizer, causes crop
contamination, leading to major chronic health problem, including
increasing the severity of the nervous symptoms for children with ADHD.
iii) Hormones & Antibiotics
Animal fed with fed antibiotics, hormones, ground up remains of other
animals causes hormone imbalance in our body, leading central nervous
disorder, increasing the risk of irregular cell growth, and damaging the
balance of beneficial bacteria in the intestines.

7. Refine products
Refined products with little fiber release sugar in the blood stream quickly,
causing the responses of pancreas to produce high level of insulin to
neutralize it in a short period of time, that interferes with the normal function
of central nervous system in controlling the concentration, focus and
behaviour for children with ADHD.

8. Etc.

B. During pregnancy
1. Alcohol
Moderate in take of alcohol can be helpful in enhancing the circulatory and
nervous functions, but excessive intake of alcohol during pregnancy can
increase the risk of low birth weight and birth defect including ADHD. In
this prospective study of alcohol and other substance use during pregnancy,
a cohort of 650 women was interviewed at each trimester of pregnancy
demonstrated between prenatal maternal alcohol use and growth and
morphologic abnormalities in the offspring. Low birth weight, decreased
head circumference and length, and an increased rate of fetal alcohol effects
were all found to be significantly correlated with exposure to alcohol during
the first 2 months of the first trimester(34). Other sugested that alcohol
consumption during pregnancy may associated to neuropsychological
deficits of the offdpring, as Prenatal alcohol exposure may have its primary
effect on brain growth, reflected by smaller forehead widths, and may
suppress neural crest migration to the branchial arches, reflected by deficits
in ear length and mandibular dimensions(35)

2. Drugs
It is not always possible to isolate the effect of marijuana exposure from
other possible confounders on pregnancy outcome, but some studies
suggested it might have subtle negative effects on neurobehavioural
outcomes, including sleep disturbances, impaired visual problem solving,
hyperactivity, impassivity, inattention, and increased delinquency.(32)
Other researchers point out that Prenatal marijuana use was significantly
related to increased hyperactivity, impulsivity, and inattention symptoms as
measured by the SNAP, increased delinquency as measured by the CBCL,
and increased delinquency and externalizing problems as measured by the
TRF. The pathway between prenatal marijuana exposure and delinquency
was mediated by the effects of marijuana exposure on inattention symptoms.
These findings indicate that prenatal marijuana exposure has an effect on
child behavior problems at age 10.(33)

3. Smoking
Smoking during pregnancy cause the exposure of nicotine to the fetal
neuroteratogen of which may lead to lower executive function proficiency,
according to the Behavioral Rating Inventory of Executive Function(37)

4. Etc.

VII. Diet for ADHD


Diet can affect cognitive ability and behaviour in children and adolescents.
Nutrient composition and meal pattern can exert immediate or long-term,
beneficial or adverse effects. (40)
1. Black bean
a. Antioxidant effect
In the evaluation of the indigestible fraction (IF)of the cooked seeds of three
pulses (black bean, chickpea and lentil) and their antioxidant effect found
that Condensed tannins were retained to some extent in the IF that exhibited
significant antioxidant capacity. The total IF of the three pulses produced
short chain fatty acids (SCFA) after 24 h of in vitro fermentation by human
colonic microflora. IF from black bean and lentil were best substrates for the
fermentative production of butyric acid, according to "In vitro
fermentability and antioxidant capacity of the indigestible fraction of
cooked black beans (Phaseolus vulgaris L.), lentils (Lens culinaris L.)
and chickpeas (Cicer arietinum L.)" by Hernández-Salazar M, Osorio-
Diaz P, Loarca-Piña G, Reynoso-Camacho R, Tovar J, Bello-Pérez LA.(46)

b. Nervous system
Protein is essential for the brain in transmitting information between
themselves and cells in the other parts of the body, thus reducing the blood
sugar levels from rising too rapidly after a meal, reducing the risk of nervous
symptoms cause of anxiety, stress and depression, etc., according to the
study of "The planar polarity protein Scribble1 is essential for neuronal
plasticity and brain function" by Moreau MM, Piguel N, Papouin T, Koehl
M, Durand CM, Rubio ME, Loll F, Richard EM, Mazzocco C, Racca C,
Oliet SH, Abrous DN, Montcouquiol M, Sans N.(47)

c. Tryptophan
Tryptophan is one of the 10 essential amino acids which the body uses to
synthesize the proteins for brain cells need, thus enhancing the nerve cells in
information transmitting between themselves and cells in the parts of the
body that reduces the risk of anxiety and depression, according to the study
of "The effects of tryptophan depletion on neural responses to emotional
words in remitted depression" by Roiser JP, Levy J, Fromm SJ, Nugent
AC, Talagala SL, Hasler G, Henn FA, Sahakian BJ, Drevets WC.(48)

2. Buckwheat
a. Antioxidant activity
in the investigation of buckwheat samples (Xingku No.2 and Diqing) grown
at three locations were analyzed for free and bound phenolic content and its
antioxidant effects found that additionally, growing conditions and the
interaction between variety and environment may have more contribution
than variety to individual phenolics and antioxidant properties of tartary
buckwheat. Environmental parameters such as higher altitudes may also
have an increasing effect on rutin and phenolic acids. according to
"Phenolics content and antioxidant activity of tartary buckwheat from
different locations" by Guo XD, Ma YJ, Parry J, Gao JM, Yu LL, Wang M.
(49)

b. Anti-fatigue properties
In the evaluation of tartary buckwheat extracts (TBE) and its anti-fatigue
effect found that tartary buckwheat extracts had anti-fatigue properties,
which extended the exhaustive swimming time of mice, effectively
inhibiting the increase of BLA, decreasing the level of BUN, increasing the
tissue glycogen content and the activities of SOD and GPx of mice,
according to "Anti-fatigue properties of tartary buckwheat extracts in
mice" by Jin HM, Wei P.(50)

c. Tryptophan
Tryptophan is one of the 10 essential amino acids which the body uses to
synthesize the proteins for brain cells need, thus enhancing the nerve cells in
information transmitting between themselves and cells in the parts of the
body that reduces the risk of anxiety and depression, according to the study
of "The effects of tryptophan depletion on neural responses to emotional
words in remitted depression" by Roiser JP, Levy J, Fromm SJ, Nugent
AC, Talagala SL, Hasler G, Henn FA, Sahakian BJ, Drevets WC.(51)

3. Lentils
a. Omega 3 fatty acid
The omega 3 fatty not only helps to maintain the ratio of Omega 6 fatty acid
that reduces the risk of over production of prostaglandin hormones
(according to the study of "Effect of Clupeonella grimmi (anchovy/kilka)
fish oil on dysmenorrhoea" by Moghadamnia AA, Mirhosseini N, Abadi
MH, Omranirad A, Omidvar S.(52), it also helps to prevent of oxidation bad
cholesterol (LDL), thus reducing the risk of free radical cause of
cardiovascular disease, according to the study of "Fish oil for the treatment
of cardiovascular disease" by Weitz D, Weintraub H, Fisher E, Schwartzbard
AZ.(53)

b. Folate
Folate beside is important for the production of red blood cells, and for the
proper development of the brain, it also helps to enhance the replication and
maintain DNA and RNA, thus reducing the risk of birth defects, in a study of
"Go folic!" by Bland J.(54) researchers state that in order to prevent neural
tube defects (NTDs), and proactively prevent new cases of spina bifida and
hydrocephalus, it is essential that women take folic acid well before
becoming pregnant. Through the use of social networks, and the voice of
healthcare professionals, it is hoped that more women than ever before will
receive the Go Folic! message and start taking the 400mcg/day required to
ensure the development of a healthy brain and spine.

4. Tomato
a. Lycopene
Lycopene, one of the powerful antioxidant in tomatoes, not only helps the
immune system in neutralizing the forming of free radicals in the body and
according to Harvard investigation as it found that men who ate more than
10 servings tomato-based foods daily (like cooked tomatoes and tomato
sauce,) had a 35 percent lower risk of developing prostate cancer than those
who ate the least amount of these foods. The benefits of lycopene was more
pronounced with advanced stages of prostate cancer. Also according to the
study of "Chemoprevention of prostate cancer with lycopene in the TRAMP
model" by Konijeti R, Henning S, Moro A, Sheikh A, Elashoff D, Shapiro A,
Ku M, Said JW, Heber D, Cohen P, Aronson WJ.(55)

b. Detoxification
Liver is a second defense that helps to clean out the toxins accumulation in
the blood body. If the liver is over work, it can cause liver congestion,
leading to lower of bile production or weaken carbohydrate metabolism.
Since tomato contains high amount of Vitamins A and C, it not only supports
liver function but stimulates the liver's function in detoxification of toxins.,
according to the study of "Effects of dried fish on antioxidant levels in rat
liver" by Anilakumar KR, Khanum F, Krishna KR, Viswanathan KR. (56)

5. Lean meat (Beef)


a. Protein
In the research of the importance of dietary proteins influence body weight
by affecting four targets for body weight regulation: satiety, thermogenesis,
energy efficiency, and body composition, found that Ingestion of dietary
proteins in diabetes type 1 exerts a delayed postprandial increase in blood
glucose levels due to protein-induced stimulation of pancreatic glucagon
secretion. Higher than minimal amounts of protein in the diet needed for
nitrogen balance may play an important role for the increasing number of
elderly obese subjects in our industrialized societies, since proteins exert
beneficial effects in the conditions of overweight, metabolic syndrome,
cardiovascular risk factors, bone health, and sarcopenia. Adverse effects of
increased dietary proteins have been observed in subjects with renal
impairment- this problem is frequently observed in the elderly, hypertensive,
and diabetic population. Nevertheless, dietary proteins deserve more
attention than they have received in the past, according to "Dietary proteins
in obesity and in diabetes" by Keller U.(57)

b. Vitamin B complex
Beef contains high levels of vitamin B complex, including niacin, thiamin,
riboflavin and B6, which aid each other for the body's metabolism,
according to the article of "Vitamin B Complex", posted in the American
cancer society, the author wrote that B vitamins are essential for growth,
development, and a variety of other bodily functions. They play a major role
in the activities of enzymes, proteins that regulate chemical reactions in the
body(III), the formation of red blood cell formation and promoting the
effectiveness of nervous system, according to the study of "The effect of 90 
day administration of a high dose vitamin B-complex on work stress" by
Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA., posted in
PubMed (58).

c. Zinc
In the assessment of zinc and its effect on thyroid hormone and testosterone
levels found that exercise decreases thyroid hormones and testosterone in
sedentary men; however, zinc supplementation prevents this decrease.
Administration of a physiologic dose of zinc can be beneficial to
performance, according to "Effect of fatiguing bicycle exercise on thyroid
hormone and testosterone levels in sedentary males supplemented with
oral zinc" by Kilic M.(59)

6. Chicken
6. 1. Vitamin B complex
a) Vitamin B2 or Riboflavin is one of very important vitamin in
metabolism of energy by helping the transforming of fats, proteins and
carbohydrates and high dose riboflavin appears to be useful alone or along
with beta-blockers in the prevention of migraine, according to the study of
"Effectiveness of high-dose riboflavin in migraine prophylaxis. A
randomized controlled trial" by Schoenen J, Jacquy J, Lenaerts M. (60)

b) Vitamin B3
Vitamin B3 or Niacin is essential for lowering high cholesterol levels,
according to the study of "Cholesterol efflux potential and antiinflammatory
properties of high-density lipoprotein after treatment with niacin or
anacetrapib" by Yvan-Charvet L, Kling J, Pagler T, Li H, Hubbard B, Fisher
T, Sparrow CP, Taggart AK, Tall AR., posted in PubMed
(http://www.ncbi.nlm.nih.gov/pubmed/20448206), forming the components
of cells' genetic material DNA during excision repair, according to the study
of "Niacin deficiency delays DNA excision repair and increases spontaneous
and nitrosourea-induced chromosomal instability in rat bone marrow" by
Kostecki LM, Thomas M, Linford G, Lizotte M, Toxopeus L, Bartleman AP,
Kirkland JB., posted in PubMed
(http://www.ncbi.nlm.nih.gov/pubmed/17618655) and treating diabetes and
high blood sugar levels, according to the study of "Treatment of
dyslipidemia in patients with type 2 diabetes" by Vijayaraghavan K., posted
in PubMed (http://www.ncbi.nlm.nih.gov/pubmed/21172030), researcher
indicated that a number of lipid-lowering agents, including statins, fibrates,
niacin, and bile acid sequestrants, are available to target normalization of the
entire lipid profile.

c) Vitamin B6
c. 1. Vitamin B6 or Pyridoxine beside is important in enhancing the
developing red blood cells by stimulating the production of hemoglobin, it
also helps to keep blood sugar levels steady during the process of breaking
down stored energy in gestation pregnancy, according to the study of
"Improvement of oral glucose tolerance in gestational diabetes by
pyridoxine" by Bennink HJ, Schreurs WH., posted in PubMed
(http://www.ncbi.nlm.nih.gov/pubmed/1131652)

c.2. It also plays a pivotal role as a methyl donor in the basic cellular process
of methylation, through which methyl groups are transferred from one
molecule to another, resulting in the formation of a wide variety of precess,
including regulation of gene expression, protein function, and RNA
metabolism. When levels of B6 are inadequate, it may cause faulty
Methylation with high levels of homocysteine that can cause variety of
disease, including cervical dysplasia, faulty detoxification and impaired
DNA repair, etc., according to the study of "Back To Life Natural Health
Center - Healthcare Through Natural
Methods"(http://www.backtolifehealth.com/Methylation.htm)

d) Vitamin B12
In the evaluation of vitamin B12 in Turnip greens found that vitamin Bi2
was present in the
leaves of a higher plant in amounts. there is no evidence supporting the
synthesis of vitamin Bi2 by a higher plant. Was it produced by soil
microorganisms and subsequently absorbed via the plant roots? There is
ample proof of such synthetic activity by certain microorganisms and of
vitamin B12 activity in soil , but no evidence that the vitamin B]2molecule
is absorbed by the plant from the soil. Could it have been produced by
bacteria living epiphytically
on the turnip leaf? Ericson and Lewis ('54) postulated such a relationship in
their studies of vitamin Bt2 compounds found in certain algae, according to
"STUDIES OF VITAMIN B12IN TUENIP GREENS" by LOUISE F.
GEAY ANDLOUISE J.
DANIEL(http://jn.nutrition.org/content/67/4/623.full.pdf)

6.2. Protein
Protein beside is important building block of bones, muscles, cartilage, skin,
and blood, it also enhances the nervous system in information transmitting
between cells and cells of the other parts of the body, thus reducing the risk
of nervous tension, (according to the study of "The planar polarity protein
Scribble1 is essential for neuronal plasticity and brain function" by
Moreau MM, Piguel N, Papouin T, Koehl M, Durand CM, Rubio ME, Loll
F, Richard EM, Mazzocco C, Racca C, Oliet SH, Abrous DN, Montcouquiol
M, Sans N, posted in PubMed
(http://www.ncbi.nlm.nih.gov/pubmed/20660256)

6.3. Iron
Beside as a mineral in carrying life-giving oxygen to human blood cells and
maintaining robust health as an essential protein component for metabolism,
it also helps in synthesis of a number of essential neurotransmitters like
dopamine, nor-epinephrine, along with serotonin. acccording to the study of
"Brain Iron Dysregulation and the Risk of Ageing White Matter
Lesions" by Gebril OH, Simpson JE, Kirby J, Brayne C, Ince PG., posted in
PubMed, researchers found that The mRNA expression using QPCR
suggests a pattern that favours decreased intracellular iron influx, increased
ferrous oxidation and increased iron export from the cells. Iron metabolism
seems to be changed in brains with WML, increased elemental iron in these
brains and in turn increased production of free oxidative radicals could
represent a potentiating factor for the development of ageing WML.

7. Flaxseed
a. Omega 3 fatty acids
Besides well known for its benefits for the maintenance of a healthy cardio-
vascular system, according to the study of "Omega-3 Fatty acids for
cardiovascular disease prevention" by Defilippis AP, Blaha MJ, Jacobson
TA, posted in PubMed(I) and proper ratio of Omega 3 and 6 fatty acid and
prevent blood clotting, it also extends the portion of your cycle in which you
are fertile, by promoting natural ovulation, according tothe study of
"Postpartum ovarian activity in multiparous Holstein cows treated with
bovine somatotropin and fed n-3 fatty acids in early lactation" by
Carriquiry M, Dahlen CR, Weber WJ, Lamb GC, Crooker BA., posted in
pubMed (61)

b. Tryptophan
Tryptophan is one of the 10 essential amino acids which the body uses to
synthesize the proteins for brain cells need, thus enhancing the nerve cells in
information transmitting between themselves and cells in the parts of the
body that reduces the risk of anxiety and depression, according to the study
of "The effects of tryptophan depletion on neural responses to emotional
words in remitted depression" by Roiser JP, Levy J, Fromm SJ, Nugent
AC, Talagala SL, Hasler G, Henn FA, Sahakian BJ, Drevets WC.(62)

8. Salmon
a. Protein
In the research of the importance of dietary proteins influence body weight
by affecting four targets for body weight regulation: satiety, thermogenesis,
energy efficiency, and body composition, found that Ingestion of dietary
proteins in diabetes type 1 exerts a delayed postprandial increase in blood
glucose levels due to protein-induced stimulation of pancreatic glucagon
secretion. Higher than minimal amounts of protein in the diet needed for
nitrogen balance may play an important role for the increasing number of
elderly obese subjects in our industrialized societies, since proteins exert
beneficial effects in the conditions of overweight, metabolic syndrome,
cardiovascular risk factors, bone health, and sarcopenia. Adverse effects of
increased dietary proteins have been observed in subjects with renal
impairment- this problem is frequently observed in the elderly, hypertensive,
and diabetic population. Nevertheless, dietary proteins deserve more
attention than they have received in the past, according to "Dietary proteins
in obesity and in diabetes" by Keller U.(63)

b. Omega 3 fatty acids


Omega 3 fatty acids is necessary to maintain the ratio of good and bad
cholesterol, thus reducing the risk of cholesterol inflammation according to
the study of "In vitro fatty acid enrichment of macrophages alters
inflammatory response and net cholesterol accumulation" by Wang S,
Wu D, Lamon-Fava S, Matthan NR, Honda KL, Lichtenstein AH., posted in
PubMed (64) and forming of free radical in the heart cells, leading to heart
diseases. It also reduces the risk of plaque forming in the arterial wall, thus
also decreasing the risk of stoke, according to the study of "N-3 vs.
saturated fatty acids: effects on the arterial wall" by Sudheendran S,
Chang CC, Deckelbaum RJ., posted in PubMed (65)

9. Etc.

VIII. ADHD in conventional medicine prospective


1. Diagnosis
Diagnosis depending to the observation of the symptoms of the children
with ADHD and answering to questions about past and present problems,
and a medical exam is also important to rule out other causes for symptoms.
The diagnosis of children with development A is always a stressful and time
consuming road for both parent and children, because each doctor in
conventional medicine mostly specializes in one field and can not make any
suggestion outside of his or her professional judgement. You may be
recommended to see other specialists if one found to be necessary. Since
ADHD is complex disease, it requires a team of doctor before it can be
diagnosed correctly and many wrong diagnosis have been done, leading to
overwhelming pressure and time wasting to the parent and their children.
Fortunately, many cases of ADHD have been correctly diagnosed and are
treated accordingly.
To avoid wasting your time, here is the basic list of doctors and specialists
who have been required for all children with development disorder to be
diagnosed correctly.
1. Development and behaviour pediatrician
2. Paediatric neurologist
3. Children psychiatrist
4. Children psychologist
5. Developmental/Behavioral Pediatricians
6. Occupational therapist
7. Neuropsychologists
8. Behavioral therapy
9. Social worker
Some children may require more or less specialists than the list above in
their road to find a cure, but we believe the list is a basic team for fast and
corrected diagnosis.

2. Treatments
Cognitive behavioral therapy and medication may be at least partially
helpful in the treatment of children with ADHD or with ASD, if it is not
accompanied with diet and nutrition as in Children with Autism, researchers
said, according to the study "Effectiveness of nutritional interventions on
the functioning of children with ADHD and/or ASD. An updated review
of research evidence" by Martí LF., posted in PubMed(a)
2.1. Cognitive behavioral therapy
The aims of behaviour theory is to help the ADHD children to overcome the
emotional, behavioural and cognitive dysfunction through a goal-oriented,
systematic procedure. It is said that this types of treatment have proven to be
successful in treating mood, anxiety, personality, eating, substance abuse,
and psychotic disorders in some degrees.

2.2. Exercise
Research is demonstrating that acute exercise facilitated performance in the
Stroop Test, particularly in the Stroop Color-Word condition. Additionally,
children in the exercise group demonstrated improvement in specific WCST
performances in Non-perseverative Errors and Categories Completed (10)

2.3. Parental Training


Parental Training in early alliance and change in alliance over time predicted
improvements in several parenting behaviors and child outcomes, including
peer sociometrics in a lab-based playgroup. These preliminary findings lend
support to the importance of examining the parent-therapist alliance in
parent-training groups for youth social and behavioral problems (11). Even
though it is always difficult for parent to try them in the beginning, but be
consistent. follow through on punishments and rewards. Keep rewards
frequent and short-term, etc.

2.4. Occupational therapy


Occupational therapy is a type of program, helping to compromise
physically, intellectually or emotionally to integrate coping skills into their
lives in order to perform necessary tasks. but for children with ADHD, the
main goal of occupational therapy is to integrate sensory perception through
recognition and interpretation of sensory stimuli based chiefly on memory,
therefore it helps the child to gain a more peaceful frame of mind and
concentrate on certain tasks.

2.5. Social skill training


Social skill training plays an important role for many children with ADHD
to learn social skills for improving relationships with peers for the child and
formed part of the ADHD treatment.
2.6. Make Environment ADHD Friendly
Some researchers suggested that making environment friendly may be
essential for children with ADHD such as reduce distractions and strategies
for keeping attention for the ADHD children

2.7. Medication
Stimulants are used to treat and manage ADHD. All stimulants involved the
increasing levels of dopamine, a neurotransmitter in the brain associated
with pleasure, movement, and attention.
a. Methylphenidate , including Biphentin®, Concerta® or Ritalin®)
a. 1. Methylphenidate is a piperidine compounds used to treat ADHD by
increasing the levels of dopamine and norepinephrine in the brain
byreleasing medication in the body over a period of time to prvide a
paradoxically calming and attention effect on individuals with ADHD. Some
researchers have found the beneficial effects of methylphenidate for both
boys and girls. Methylphenidate therefore would appear to be as useful a
treatment for ADD girls as for ADD boys.(22)
a.2. Side Effects are not limit to
a.2.1. It can be addictive
a.2.2. the medication of can cause nervousness including dizziness,
agitation, anxiety and irritability
a.2.3. It may also cause gastrointestinal disorders including stomach ache,
nausea, decreased appetite, vomiting, etc.
a.2.4. Do not use the medication if you have high blood pressure or any form
of heart disease
a.2.5. The medicine is easy to abuse and toxicity
As therapeutic use increases, the risk increases of unintentional overdoses,
medication errors, and intentional overdoses caused by abuse, misuse, or
suicide gestures and attempts. Side effects during therapy, which include
nervousness, headache, insomnia, anorexia, and tachycardia, increase
linearly with dose. Clinical manifestations of overdoses include agitation,
hallucinations, psychosis, lethargy, seizures, tachycardia, dysrhythmias,
hypertension, and hyperthermia(23)
a.2.6. Etc.

b. Dextroamphetamine (Dexedrine®, amphetamine mixed salts


(Adderall XR®)
b.1. Dextroamphetamine used as part of a treatment program to control
symptoms of attention deficit hyperactivity disorder (ADHD, is a central
nervous system stimulants used by changing the amounts of certain natural
substances in the brain in which involved the effect in wakefulness and
focus as well as decreased fatigue and decreased appetite.
b.2. Side Effects are not limit to
b.2.1. Prolonged period of use may decrease the effectiveness of the
medicine
b.2.2. Over doses or using can cause cause serious heart problems or sudden
death.
b.2.3. The medicine can cause nervous tension, including restlessness,
difficulty falling asleep or staying asleep, headache, uncontrollable shaking
of a part of your body , etc.
b.2.4. Dextroamphetamine can also cause digestive
disorder, including diarrhea, constipation loss of appetite, etc.
b.2.5. abuse, misuse, and diversion
Although, evidence on abuse, misuse, and diversion was limited, if compare
to the use of Methylphenidate. But misuse and diversion rates varied by age
and were highest among college students, and rates of diversion were
highest with amphetamine-based products but similar among
methylphenidate products. Evidence of effects in important subgroups of
patients with ADHD (e.g. comorbid anxiety) was not comparative.(24)

c. Lisdexamfetamine (Vyvanse®)
c.1. Lisdexamfetamine dimesylate (LDX) is the medicine used in children
with and without previous exposure to stimulant medication in the treatment
of attention-deficit/hyperactivity disorder (ADHD) as a significantly less
active form to dextroamphetamine. As LDX reduced the core symptoms of
ADHD with more severe adverse events in stimulant-naïve than previous-
exposure subjects. Future controlled studies with larger samples should
address the impact of previous stimulant exposure on other ADHD
treatments(25)
c.2. Side effects are not limit to
c.2.1. The medication can cause nervous tension, including mild irritability,
nervousness, restlessness, dizziness, trouble sleeping, etc.
c.2.2. Lisdexamfetamine dimesylate can also cause digestive disorders,
including, constipation, decreased appetite, diarrhea, dry mouth, nausea,
stomach pain; vomiting, etc.
c.2.3. It may be subject to abuse cause as increased risk for impairment in
driving behaviors.(26)
c.2.4. Etc.

2.8. Etc.
IX. In Nutritional Supplement perspective
1. Caffeine (Adult only, please)
Some researchers suggested that caffeine administration cause a significant
improvement in the attention deficit of the 6-OHDA in lesioned rats(30) and
demonstrate a selective spatial learning deficit in SHR which can be
attenuated by pre-training administration of caffeine. In addition, the present
findings indicate that the spatial learning deficit in SHR is not directly
related to hypertension(31)

2. Omega 3 fatty acid


High intake of Omega 3 fatty acid has been associated with a reduced risk of
Alzheimer's disease (AD) and enhanced neuroprotective effect, including
mild form of cognitive impairment(39)
researchers found that lower levels of long-chain polyunsaturated fatty acids,
particularly omega-3 fatty acids, in blood have repeatedly been associated
with a variety of behavioral disorders including attention-
deficit/hyperactivity disorder (ADHD)(38).

3. Antioxidants
Antioxidants have been proven to be effective in fighting against the
forming of free radicals of which can damage to the DNA of the cells,
particular to brain cells. Some researchers suggested that oxidative stress
may be a factor underlying the pathophysiology of bipolar disorder (BD),
major depressive disorder (MDD), and schizophrenia (SCZ) as a result of of
reduced levels of Glutathione (GSH), a major free radical scavenger in the
brain(41)

4. Vitamin B complex
It is also known as B vitamins (vitamins B1, B2, B3, B5, B6, B7, B9, and
B12). B vitamins beside play a major role in regulating chemical reactions in
the body, it also have been linked to improve neurodegenerative and
cerebrovascular disease. Study showed that B-vitamin deficiency and/or
hyperhomocysteinemia can cause a variety of neurological and vascular
deficits in animals.(45)

5. Protein
Proteins beside serve as a fuel source, they also are essential nutrients for
the human body and as one of the building blocks of the body, protein
deficiency can lead to variety of ailments including mental retardation,
including learning disability.

6. Calcium and magnesium


Calcium beside is best known for helping build strong bones, it also
enhances the durable process cell membranes and promotes the nervous
system, especially in neurotransmitter release, triggered by the arrival of a
nerve impulse of which could improve a child's behavior.
Magnesium beside maintains normal muscle and nerve function, keeps heart
rhythm steady, it also promotes a healthy immune system, and maintains
bones strong. some reserachers suggestedthat symptoms of hyperexcitability
(physical aggressivity, instability, scholar attention, hypertony, spasm,
myoclony) were reduced after 1 to 6 months treatment. Other family
members shared similar symptoms, had low ERC-Mg values, and also
responded clinically to increased Mg(2+)/vitamin B6 intakes.(44)

7. Trace minerals
Trace minerals are micronutrients that have played a vital role in the body's
function but with a small amount. Zinc is an essential mineral that is
naturally present in some foods and as an essential cofactor of more than 100
enzymes, including metalloenzymes and metalloenzyme complexes, which
are necessary in the metabolism of carbohydrates, fatty acids, proteins and
nucleic acids. In recent studies estimate its prevalence to three of ten
hyperactive children, and there are data that about 4% of children have the
complete frame of the disorder, researchers suggested that children with
ADHD have low levels of zinc in their bodies compared to children without
ADHD may be a result of zinc deficiency (42). In a controlled comparison
group study, (Konofal et al. 2004) showed that iron deficiency was
correlated to ADHD symptoms severity, hypothesizing that iron
supplementation may improve symptoms of ADHD in those subjects with
low ferritin levelsmitter dopamine of which may help children with ADHD.
(43)

X. In Herbal medicine perspective


Herbal medicine believe ADHD is a result of coordination failure in the
reticular activating system of the brain. Therefore, herbs used to treat ADHD
are those improves concentration, attention, motivation and performance,
promote the stay on task and normal energy levels and particular enhance
the flow of oxygen and nutrients to the brain and supports brain functions in
information processing and memory, etc.
1. Ginkgo Biloba
a. Brain-cognition effects
Ginkgo Biloba extract (GBE) have exhibited the function of alleviating
symptoms of cognitive impairment in aging populationby increasing the
SSVEP(state visually evoked potentia) amplitude at occipital and frontal
sites and SSVEP latency at left temporal and left frontal sites, according to
the study of "Examining brain-cognition effects of ginkgo biloba extract:
brain activation in the left temporal and left prefrontal cortex in an
object working memory task" by Silberstein RB, Pipingas A, Song J,
Camfield DA, Nathan PJ, Stough C., posted in PubMed(67)

b. Acute cognitive effects


Administration of GBE complexed with phosphatidylserine have exerted the
results of improingsecondary memory performance and speed of memory
task performance, according to the study of "Acute cognitive effects of
standardised Ginkgo biloba extract complexed with phosphatidylserine"
by Kennedy DO, Haskell CF, Mauri PL, Scholey AB., posted in
PubMed(68)

c. Tardive dyskinesia
Extract of Ginkgo biloba (EGb) has exerted the activity as an antioxidant in
scavenging free radicals for tardive dyskinesia (TD) in in schizophrenia
patients by significantly decreased the AIMS(Abnormal Involuntary
Movement Scale) total score in patients with TD, according to the study of
"Extract of Ginkgo biloba treatment for tardive dyskinesia in
schizophrenia: a randomized, double-blind, placebo-controlled trial" by
Zhang WF, Tan YL, Zhang XY, Chan RC, Wu HR, Zhou DF., posted in
PubMed(69)

d. Etc.

2. Panax ginseng
a. Antioxidant activity
In the evaluation of the extraction conditions of polysaccharides from the
rhizomes of Panax japonicus C.A. Meyer and its antioxidant effect found
that antioxidant activity exhibited Panax japonicus polysaccharides (PJP)
had a good potential for antioxidant, according to "Optimization of
polysaccharides from Panax japonicus C.A. Meyer by RSM and its anti-
oxidant activity" by Wang R, Chen P, Jia F, Tang J, Ma F.(70)
b. Antipsychotic effect
In the investigation of Panax quinquefolium (PQ) and its significant
neuroactive properties for its antipsychotic potential found that PQ blocked
ketamine induced memory impairment in the passive avoidance paradigm.
In the chronic studies, PQ reduced the ketamine induced enhanced
immobility in the forced swim test and did not show extra-pyramidal side
effects in bar test and wood block test of catalepsy. These behavioural effects
were compared with standard drugs haloperidol and clozapine. Further PQ
reduced DA and 5-HT content after chronic treatment, but not after acute
administration, according to "Evaluation of the Antipsychotic Potential of
Panax quinquefolium in Ketamine Induced Experimental Psychosis
Model in Mice" by Chatterjee M, Singh S, Kumari R, Verma AK, Palit G.
(71)

c. Neuroprotective effect
In the analyzing Panax ginseng C.A. Meyer and its beneficial effects in
cerebral ischemia and inhibition of the inflammatory cascade in sepsis found
that Ginsenoside Rb1 (GRb1) partially inhibited the activation of nuclear
factor-κB (NF-κB) pathway from 6 h to 72 h after ischemia and reperfusion
onset, as determined by the expression of total and phosphorylated NF-
κB/p65, inhibitor protein of κB (IκB)-α, and IκB-kinase complex (IKK)-α.
All these results indicate that suppression of local inflammation after
cerebral ischemia might be one mechanism that contributes to the
neuroprotection of GRb1, according to "Suppression of local inflammation
contributes to the neuroprotective effect of ginsenoside Rb1 in rats with
cerebral ischemia" by Zhu J, Jiang Y, Wu L, Lu T, Xu G, Liu X.(72)

d. Immunological activities
In the study of Water-soluble ginseng oligosaccharides (designated as
WGOS) with a degree of polymerization ranging from 2 to 10 were obtained
from warm-water extract of Panax ginseng roots, found that WGOS were
potent B and T-cell stimulators and WGOS-1 has the highest
immunostimulating effect on lymphocyte proliferation among those purified
fractions. It is hoped that the WGOS will be developed into functional food
or medicine, according to "Structural characterization and
immunological activities of the water-soluble oligosaccharides isolated
from the Panax ginseng roots" by Wan D, Jiao L, Yang H, Liu S.(73)

e. Etc.
3. Skullcap
a. Liver diseases
In the evaluation of the anti-proliferative effects on human hepatoma HepG2
and Hep3B cells of each fraction of Pheophorbide a, a major antitumor
component purified from Scutellaria barbata, found that pheophorbide a
induced apoptosis in Hep3B cells, a viral-induced hepatoma cell line.
However, it was found to be non-toxic in normal human liver cells WRL-68.
DNA fragmentation, sub-G1 cell cycle arrest, as well as suppression of the
anti-apoptotic protein Bcl-2, release of cytochrome c to the cytosol, and
activation of pro-caspase 3 and pro-caspase 9 were observed when Hep3B
cells were treated with 40 microg/mL (i. e., 67.5 microM) pheophorbide a
for 48 hours, according to "Pheophorbide a, a major antitumor
component purified from Scutellaria barbata, induces apoptosis in
human hepatocellular carcinoma cells" by Chan JY, Tang PM, Hon PM,
Au SW, Tsui SK, Waye MM, Kong SK, Mak TC, Fung KP.(74)

b. Antioxidants
In the Comparisons of Scutellaria baicalensis, Scutellaria lateriflora and
Scutellaria racemosa: genome size, antioxidant potential, found that
Antioxidant potential studies showed that there were no significant
differences in the 3 Scutellaria species. Phytochemical analyses detected and
quantified the flavonoids baicalin, baicalein, scutellarin, and wogonin as
well as the human neurohormones melatonin and serotonin in leaf and stem
tissues from S. baicalensis, S. lateriflora, and S. racemosa, according to
"Comparisons of Scutellaria baicalensis, Scutellaria lateriflora and
Scutellaria racemosa: genome size, antioxidant potential and
phytochemistry" by Cole IB, Cao J, Alan AR, Saxena PK, Murch SJ.(75)

c. Neurodegeneration diseases
In the study of flavones isolated from Scutellaria baicalensis root exhibit
strong neuroprotective effects on the brain, found that Baicalein, the main
flavone present in Scutellaria baicalensis root, strongly inhibited aggregation
of neuronal amyloidogenic proteins in vitro and induces dissolution of
amyloid deposits. It exerts strong antioxidative and anti-inflammatory
activities and also exhibits anti-convulsive, anxiolytic, and mild sedative
actions. Importantly, baicalein, and also another flavone: oroxylin A,
markedly enhanced cognitive and mnestic functions in animal models of
aging brains and neurodegeneration, according to "Flavones from root of
Scutellaria baicalensis Georgi: drugs of the future in
neurodegeneration?" by Gasiorowski K, Lamer-Zarawska E, Leszek J,
Parvathaneni K, Yendluri BB, Błach-Olszewska Z, Aliev G.(76)

d. Anxiolytic activity
In the investigation of the phytochemistry and biological activity of
Scutellaria lateriflora L. (American skullcap) which has been traditionally
used as a sedative and to treat various nervous disorders, found that these
compounds may play a role in anxiolytic activity since baicalin and
baicalein are known to bind to the benzodiazepine site of the GABAA
receptor and since GABA is the main inhibitory neurotransmitter, according
to "Phytochemical and biological analysis of skullcap (Scutellaria
lateriflora L.): a medicinal plant with anxiolytic properties" by Awad R,
Arnason JT, Trudeau V, Bergeron C, Budzinski JW, Foster BC, Merali Z.
(77)

e. Etc.

4. Gotu Kola
a. Locomotor activity
In the investigation of the asiatic acid, a triterpenoids isolated from Centella
asiatica and its inhibitory effect on acetylcholinesterase (AChE) properties,
excitatory post synaptic potential (EPSP) and locomotor activity. found that
asiatic acid having an effect on AChE, a selective GABA(B) receptor
agonist and no sedative effect on locomotor, according to "Inhibitory effect
of asiatic acid on acetylcholinesterase, excitatory post synapticpotential
and locomotor activity" by Nasir MN, Abdullah J, Habsah M, Ghani RI,
Rammes G.(78)

b. Cognitive effects
In the assessment of the role of "Brahmi" (Bocopa monnieri and Centella
asiatica) and its effect on the loss of memory, cognitive deficits, impaired
mental function found that both plants possess neuroprotective properties,
have nootropic activity with therapeutic implications for patients with
memory loss. The field has witnessed exciting patent activity with most
inventions aiming at either (i) improving the methods of herbal extraction or
(ii) enrichment and purification of novel compounds from brahmi or (iii)
providing novel synergistic formulations for therapeutics in various human
ailments, according to "Exploring the role of "Brahmi" (Bocopa
monnieri and Centella asiatica) in brain function and therapy" by
Shinomol GK, Muralidhara, Bharath MM.(79)
c. Antioxidant capacity
In the identification of antioxidant effects of C. asiatica was exposed to
various fermentations: no fermentation (0 min), partial fermentation (120
min) and full fermentation (24 h). Total phenolic content (TPC) and ferric-
reducing antioxidant power (FRAP) of C. asiatica, found that C. asiatica
herbal teas should be prepared at 100 °C for 10 min to obtain the optimum
antioxidant capacity. Multiple brewing steps in C. asiatica herbal tea are
encouraged due to the certain amount of antioxidant obtained, according to
"Antioxidant capacity and phenolic composition of fermented Centella
asiatica herbal teas" by Ariffin F, Heong Chew S, Bhupinder K, Karim AA,
Huda N.(80)

d. Etc.

5. Chamomile
a. Anti-allergic activity
The methanol extract of Matricaria recutita L. has shown anti-allergic
activity by inhibition of histamine release from mast cells, according to the
study of "Anti-allergic activity of German chamomile (Matricaria
recutita L.) in mast cell mediated allergy model" by Chandrashekhar VM,
Halagali KS, Nidavani RB, Shalavadi MH, Biradar BS, Biswas D,
Muchchandi IS.(81)

b. Neuroprotective activity
German chamomile methanol extract (GCME) has shown shown the ability
to treat neuroprotective activity by significant decrease in lipid peroxidation
(LPO) and increase in the superoxide dismutase (SOD), catalase (CAT),
glutathione (GSH), and total thiol levels, against AlF₄⁻- and may be used to
treat oxidative brain damage, according to the study of "Neuroprotective
activity of Matricaria recutita against fluoride-induced stress in rats" by
Ranpariya VL, Parmar SK, Sheth NR, Chandrashekhar VM.(82)

c. Anxiety
Matricaria recutita (chamomile) extract therapy has exerted the modest
anxiolytic activity in patients with mild to moderate generalized anxiety
disorder, according to the study of "A randomized, double-blind, placebo-
controlled trial of oral Matricaria recutita (chamomile) extract therapy
for generalized anxiety disorder" by Amsterdam JD, Li Y, Soeller I,
Rockwell K, Mao JJ, Shults J.(83)
d. Etc.

6. Hawthorn
a. Neuroprotective effects
In the investigation of the neuroprotective effects on PC12 cells from the
methanol extracts of Spatholobus suberectus, Uncaria rhynchophylla,
Alpinia officinarum, Drynaria fortunei, and Crataegus pinnatifida found that
The CPE, SSE, and URE presented neurogrowth effects and neuroprotective
activities on H(2)O(2)-induced PC12 cell death at 0.5-5.0 μg/mL. The CPE
represents a promising medicinal plant source for the treatment of H(2)O(2)-
induced neurodegenerative disease, because of its useful phytochemical
characteristic, according to "Phytochemical characteristics, free radical
scavenging activities, and neuroprotection of five medicinal plant
extracts" by Chang CL, Lin CS, Lai GH.(84)

b. Immunomodulatory effect
In the determination of sheds more light on the extract's mechanism of
neuroprotection, especially its immunomodulatory effect found that
Hawthorn extract helped alleviate pro-inflammatory immune responses
associated with I/R-induced injury, boosted IL-10 levels, and increased
Foxp3-positive T(regs) in the brain, which may have aided in suppression of
activated inflammatory cells. Such treatment also minimizes apoptotic cell
death by influencing STAT-3 phosphorylation and Bcl-xL expression in the
brain. Taken together, the immunomodulatory effect of Hawthorn extract
may play a critical role in the neuroprotection observed in this MCAO-
induced stroke model, according to "Immunomodulatory effect of
Hawthorn extract in an experimental stroke model" by Elango C,
Devaraj SN.(85)

c. Prevention and treatment of cataracts


In the evaluation of the anticataract potential of Crataegus pinnatifida
(hawthorn tree) leaves and its extract in selenite-induced cataract in vivo and
antioxidant effects in vitro, found that administration of C. pinnatifida leaves
extract eye drops alternately three times a day in rat pups with selenite-
induced oxidative stress significantly increased serum SOD and CAT
activities, and tended to reduce MDA level compared with control group.
The antioxidant enzyme SOD, CAT, and GSH activities in lens showed a
significant increase. These results may be applied in the future for the
prevention and treatment of cataracts, according to "Prevention effect in
selenite-induced cataract in vivo and antioxidative effects in vitro of
Crataegus pinnatifida leaves" by Wang T, Zhang P, Zhao C, Zhang Y, Liu
H, Hu L, Gao X, Zhang D.(86)

7. Green oat (Avena sativa)


a. Magnesium
Magnesium not only important for bone health, according to the study of
"Magnesium, zinc, copper, manganese, and selenium levels in
postmenopausal women with osteoporosis. Can magnesium play a key
role in osteoporosis?" by Odabasi E, Turan M, Aydin A, Akay C, Kutlu
M(87) but also play and important role in protecting against Alzheimer's
disease, according to the study of "Altered ionized magnesium levels in
mild-to-moderate Alzheimer's disease" by Barbagallo M, Belvedere M, Di
Bella G, Dominguez LJ.(88)

b. Avenanthramides
The ingredients of avenanthramides and phenolic acids in oat protect the
LDL cholesterol against the forming of free radicals by inducing the
functions of copper and selenium against oxidation, according to the study
of "Avenanthramides and phenolic acids from oats are bioavailable and
act synergistically with vitamin C to enhance hamster and human LDL
resistance to oxidation" by Chen CY, Milbury PE, Kwak HK, Collins FW,
Samuel P, Blumberg JB., posted in PubMed(89)

c. Immune system
Selenium in Oat improves the immune system in fighting the foreign
invasion of virus and bacteria causes of infection and inflammation,
according to the study of "Selenium in the immune system" by Arthur JR,
McKenzie RC, Beckett GJ., posted in PubMed(90)

8. Etc.

XI. In traditional Chinese medicine perspective(66)


Although there are no condition known as ADD, in the history of Chinese
medicine, but some TCM practictioners defined ADHD as result as follow
A. Predominantly hyperactive-impulsive as of result of Kidney Yin
deficiency cause of hyperactivities of liver Yang
1. Symptoms
Beside the symptoms mentioned above, TCM also describes the physical
appearance of the patient as follow
a. Thin body
b. Thristy
c. Desire to cold
d. night sweat
e. Red tongue with less coating
f. Etc.

2. Treatment
Qi Ju Di Huang Wan, the TCM formula with main function in nourishing the
kidney and liver, improves vision used for patient with above symptoms and
for deficiency of both liver Yin and kidney-Yin. Ingredients include
a. Shu Di Huang
The bitter, sweet, bitter and warm herb has been used in as diuretic agent and
to enhance heart function (small doses constrict the blood vessels and large
doses dilate the blood vessel), decrease blood sugar, etc., as it clears Heat
and cools the Blood (Sheng) as it nourishes Yin and Blood, tonifies the
Essence, strengthens the Marrow, etc., by enhancing the functions of heart,
kidney, and liver channels.

b. Shan Zhu Yu
Shan Zhu Yu or Shan Yu Rou is also known as Asian Cornelian Cherry Fruit.
The sour, acrid and slightly warm herb has been used in TCM to treat
impotence, spermatorrhea, instant sweating, sore or week knees, chronic
lower back pain, frequent urination, incontinence, etc., as it tonifies the
Liver and the Kidneys, benefits the Liver and the Kidneys, etc., by
enhancing the functions of kidney and liver channels.

c. Shan Yao
Shan Yao or Huai Shan is also known as Dioscorea. The sweet and neutral
herb has been used in TCM as antibiotic , anti-inflammatory and anti aging
agent and to lower blood sugar, improve digestive system, promote
urination, etc. as it tonifies the spleen and stomach and kidney yang and yin,
etc., by enhancing the functions of kidney, lung and spleen channels.

d. Ze Xie
Ze Xie is also known as Alism. The sweet, bland and cold herb has been
used in TCM as anti-pyretic, diuretic, anti-bacterial, hypoglycemic,
hypotensive agent and to lowers blood lipids: total cholesterol, inhibits
hardening of main artery, etc., as it drains deficient kidney fire, promotes
urination, drains damp-heat, etc., by enhancing the functions of kidney and
bladder channels.
e. Fu Ling
Fu Ling, fu shen or fu ling pi is also known as Poria. The bland, sweet and
neutral herb has been used in TCM as as diuretics and to treat urinary
difficulty, diarrhea, water retention, headache, dizziness, palpitations, etc., as
it eliminates Water, strengthens the Spleen, calms the Mind, etc., by
enhancing the functions of heart, spleen, lung and kidney channels.

f. Mu Dan Pi
Mu Dan Pi or Dan Pi is also known as peony bark. The acrid, bitter and
mildly cool has been used in TCM as anti micro organism, anti
inflammatory agent and to enhance circulation, CNS as it clears heat, fire of
yin deficiency, blood stasis and cools the blood, etc., by enhancing the
functions of heart, liver and kidney channels.

g. Gou Qi Zi
The sweet and neutral herb has been used in TCM as anti aging and anti
cancer agent and to enhance the immune system, lower blood lipids, elevate
level of testosterone, protect the liver function, prevent fatty liver, simulate
estrogens, etc., as it nourishes and tonifies the liver, lung and kidney, etc., by
enhancing the functions of liver, lung and kidney channels.

h. Ju Hua
Ju Hua is also known as chrysanthemum flower. The nsweet, bitter and
slightly cold herb has been used in TCM as anti inflammatory, antibiotic,
anti Antipyretic agent and to treat liver and kidney deficiency resulting in
dizziness, blurry vision, pain and weakness in lower back and knees, tears
induced by wind blowing, as it disperses wind, clears heat and wind-heat,
et., by enhancing the functions of liver and lung channels.

B. Predominantly inattentive as of result of Qi and blood deficiency of


Spleen and Heart causes of failing to nourish the heart Mind
1. Symptoms
Beside the symptoms mentioned above, TCM also describes the physical
appearance of the patient as follow
a. Pale face and lips
b. Overactive with low energy
c.Poor memory
d. Pale tongue and weak pulse
f. Etc.
2. Treatment
Gui Pi Tang helps to strengthens the spleen and the heart, nourishes blood
and Qi, calms the mind. Ingredients include
a. Fu Ling
Fu Ling, fu shen or fu ling pi is also known as Poria. The bland, sweet and
neutral herb has been used in TCM as as diuretics and to treat urinary
difficulty, diarrhea, water retention, headache, dizziness, palpitations, etc., as
it eliminates Water, strengthens the Spleen, calms the Mind, etc., by
enhancing the functions of heart, spleen, lung and kidney channels.

b. Bai Zhu
Bai Zhu is also known as Bighead atractylodes rhizome. The aromatic,
slightly acrid and sweet herb has been used in TCM to treat children
drooling, Meniere's disease, constipation, chronic back painm, acute
infection of intestine, dizziness, palpitation, edema, instant sweating, etc., as
it tonifies the spleen, augments qi, dries dampness, atabilizes the exterior,
etc., by enhancing the functions of spleen and stomach channels.

c. Suan Zao Ren


Suan Zao Ren is also known as Sour jujube seed. The sweet, sour, neutral
herb has been used in TCM to treat abnormal sweating, anxiety, insomnia,
excessive dream, palpitation, weak memory, dizziness, night sweating, etc.,
as it nourishes heart and liver, calms spirit, etc., by enhancinf the functions
of gallbladder, heart, liver and spleen channels.

d. Huang Qi
Huang Qi or Bei Qi is also known as Astragalus root. The sweet herb has
been used as diuretic agent and to lower blood pressure, increase blood
pressure, lessens proteinuria, improve endurance, protect liver function,
regulate blood sugar, etc. as it tonifies Qi, raises Yang, strengthens the
Defensive-Qi and the Exterior, expels toxins, etc. by enhancing the functions
of lung and spleen channels.

e. Dang Shen
Dang Shen is also known as codonopsis root. The sweet and neutral herb
has been used in TCM to enhance the immune and cetral nervous systems
and blood coagulation, reduce fatigue, increases red and white blood cells,
white blood cells, raise blood sugar, etc., as it tonifies the Middle,
strengthens Qi, promotes generation of Body Fluids, nourishes Blood, etc.,
by promoting the functions of lung and spleen channels.

f. Long Yan
Long Yan or Long Yan Rou is also known as Longan. The aromatic and
neutral herb has been used in TCM to treat neurasthenia, forgetfulness,
palpitation, insomnia, etc., as it tonifies heart and spleen, nourishes blood,
calms spirit, etc., by enhancing the functions of heart and spleen channels.

g. Da Jiao
Da Jiao or Da Zao also known as black jujube. The sweet and warm herb
has been used in TCM to treat improves cAMP(cyclic adenosine mono
phosphate) and strength of muscles, calms the central nervous system,
inhibits histamine, IgE, and 5-HT, cell mutation and cancer cells, etc., as it
tonifies the Middle Burnner, strengthens Qi, nourishes Blood, calms the
Mind, regulates the nature of other herbs, etc., by enhancing the functions of
stomach , spleen channels.

h. Dang Gui
Dang Qui is also known as Angelica Root. The sweet, bitter, acrid and warm
herb has been used in TCM to regulate the menses, lower lipids, reduce
platelet coagulation and swelling, expel pus, relieve pain, etc/, as it tonifies
and moves Blood, calms pain, moistens the Intestines, etc., by enhancing the
function of heart, liver and spleen channels.

i. Yuan Zhi
Yuan Zhi is also known as Turkey Tails. The sweet, bland and slightly cold
herb has been used in TCM as antibiotic property, anti-viral property, and
anti-tumor agent and to get rid of dampness, transform phlegm, treat lung
disease, insomnia, mental confusion, seizures, palpitations, anxiety,
restlessness, etc., as it calms the spirit, quiets the heart, expels phlegm, clears
the heart orifices, etc., by enhancing the functions of liver, spleen and lung
channels.

j. Gan Cao
Gan Cao is also known as Licorice root. The sweet and neutral herb has
been used in TCM as anti allergy, anti inflammation, anti ulcer, anti
convulsion and to treat stomach weakness, tired and lack of strength,
palpitation and short of breath, cough with abundance of phlegm, stomach
and solar plexus pain, etc., as it tonifies the Spleen, benefits the Qi, moistens
the Lungs, calms cough, deaf or acute pain, by enhancing all 12 channels.
k. Sheng Jiang
Sheng Jiang is also known as Fresh Ginger root. The acrid and cool herb
has been use in TCM as an anti inflammation, anti coagulation of platelets,
anti allergy, anti tumors, etc, and to promote flowing of bile, protect liver,
stimulate cardiac function, inhibit platelet coagulation, prevent dizziness,
improve auto-immune function,etc., as it promotes sweating, releases the
Exterior; warms the Middle Burner and the Lungs, stops vomiting, calms
cough by enhancing the functions of lung, spleen and stomach channels.

l. Mu Xiang
Nu Xiang is also known as costus root. The acrid, bitter and warm hrtb has
been used in TCM to treat flatulence and pain in the abdomen, diarrhea,
bronchitis, digestive tract infection: yeast infection, dysentery, and lack of
appetite, etc,, as it promotes the movement of Qi, alleviates pain, regulates
stagnated Qi in the intestines, strengthens the spleen and prevents stagnation,
etc., by enhancing the functions of gallbladder, large intestine, spleen and
stomach channels.

C. Anxiety, vexed, easily forgetful as of result of deficiency of Kidney


essence causes of failing to nourish heart and Brain
1. Symptoms
a. Insomnia
b. Easily forgetful
c. Sores tongue
d. Red tongue
e. Rapid pusle
f. Etc.

2. Treatment
Kong Sheng Zhen Zhong Dan
A formula from Confucius to treat students with above symptoms and
enhance education achievement by tonifying kidney, heart and benefiting the
brain.
a. Shi Chang Pu
Shi Chang Pu is also known as Sweetflag Rhizome. The pungent, aromatic
and warm herb has been used in TCM to treat deafness, dizziness, poor
memory, dulled sensation, seizures, etc., as it opens orifices,expel phlegm,
quiets spirit, -harmonize middle burner, etc., by enhancing the functions of
heart ans stomach channels.
b. Yuan Zhi
Yuan Zhi is also known as Turkey Tails. The sweet, bland and slightly cold
herb has been used in TCM as antibiotic property, anti-viral property, and
anti-tumor agent and to get rid of dampness, transform phlegm, treat lung
disease, insomnia, mental confusion, seizures, palpitations, anxiety,
restlessness, etc., as it calms the spirit, quiets the heart, expels phlegm, clears
the heart orifices, etc., by enhancing the functions of liver, spleen and lung
channels.

c. Long gu
Long gu is also known as keel. The sweet, sour and neutral herb has been
used in TCM to treat mood, palpitation, excessive dreams, irritability,
seizures, dizziness, insomnia, forgetfulness, etc. as it calms spirit/heart and
calms liver, anchors floating Yang, etc., by enhancing the functions of heart,
liver, large intestine and kidney channels.

d. Baked Gui Ban


Gui Ban, Giu Jia or Gui Ban Jiao Is also known as Fresh Water Turtle
Shell. The salty, sweet and neutral herb has been used in TCM to treat hot
flashes with night sweating, chronic ache in loin and knees, spermatorrhea,
chronic cough, palpitation, insomnia and forgetfulness, excesive bleeding
during menses, etc., as it nourishes Yin, subdues Yang, tonifies the Kidneys
and Heart, strengthens the Bones, Nourishes Blood, etc., by enhancing the
functions of liver, kidney and heart channels.

Recommended E books
Dr. Joseph Mercola's Complete Guide
To Weight Loss, Preventing Diseases, Premature Aging,
And Living Healthy And Longer

For other children health articles, please visit


http://medicaladvisorjournals.blogspot.ca/p/children-health.html
other health articles, please visit
http://medicaladvisorjournals.blogspot.com/

Author notes: All articles written by Kyle J. Norton are for information
and education only, please consulting with your doctor or related field
specialist before applying.
Sources
(I) http://www.ncbi.nlm.nih.gov/pubmed/20451036
(1) Attention Deficit Hyperactivity Disorder (ADHD), posted in National
Institute of Mental Health,
http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-
disorder/complete-index.shtml
(2) http://www.ncbi.nlm.nih.gov/pubmed/21989848
(4) http://www.ncbi.nlm.nih.gov/pubmed/20616372
(5) http://www.ncbi.nlm.nih.gov/pubmed/17487441
(6) http://www.ncbi.nlm.nih.gov/pubmed/11076133
(7) http://www.ncbi.nlm.nih.gov/pubmed/21779528
(8) http://www.ncbi.nlm.nih.gov/pubmed/21576306
(9) http://www.ncbi.nlm.nih.gov/pubmed/17318414
(10) http://www.ncbi.nlm.nih.gov/pubmed/17344150
(11) http://www.ncbi.nlm.nih.gov/pubmed/22357462
(12) http://www.ncbi.nlm.nih.gov/pubmed/19220770
(13) http://www.ncbi.nlm.nih.gov/pubmed/22314765
(14) http://www.ncbi.nlm.nih.gov/pubmed/22122653
(15) http://www.ncbi.nlm.nih.gov/pubmed/10904121
(16) http://ajp.psychiatryonline.org/article.aspx?
Volume=164&page=973&journalID=13
(17) http://www.ncbi.nlm.nih.gov/pubmed/22359275
(18) http://www.ncbi.nlm.nih.gov/pubmed/22292574
(19) http://www.ncbi.nlm.nih.gov/pubmed/22375727
(20) http://www.ncbi.nlm.nih.gov/pubmed/22417186
(21) http://www.ncbi.nlm.nih.gov/pubmed/19773716
(22) http://www.ncbi.nlm.nih.gov/pubmed/2676966
(23) http://www.ncbi.nlm.nih.gov/pubmed/11981294
(24) http://www.ncbi.nlm.nih.gov/pubmed/22420008
(25) http://www.ncbi.nlm.nih.gov/pubmed/22372513
(26) http://www.ncbi.nlm.nih.gov/pubmed/22277301
(27) http://www.ncbi.nlm.nih.gov/pubmed/22232312
(28) http://www.ncbi.nlm.nih.gov/pubmed/21904085
(29) http://www.ncbi.nlm.nih.gov/pubmed/17986600
(30) http://www.ncbi.nlm.nih.gov/pubmed/21362462
(31) http://www.ncbi.nlm.nih.gov/pubmed/15877934
(32) http://www.ncbi.nlm.nih.gov/pubmed/11228023
(33) http://www.ncbi.nlm.nih.gov/pubmed/10840176
(34) http://www.ncbi.nlm.nih.gov/pubmed/2771556
(35) http://www.ncbi.nlm.nih.gov/pubmed/22404085
(36) http://www.ncbi.nlm.nih.gov/pubmed/22299010
(37) http://www.ncbi.nlm.nih.gov/pubmed/22039071
(38) http://www.ncbi.nlm.nih.gov/pubmed/16962757
(39) http://www.ncbi.nlm.nih.gov/pubmed/22305186
(40) http://www.ncbi.nlm.nih.gov/pubmed/15522161
(41) http://www.ncbi.nlm.nih.gov/pubmed/20633320
(42) http://www.ncbi.nlm.nih.gov/pubmed/20034331
(43) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1940080/?tool=pubmed
(44) http://www.ncbi.nlm.nih.gov/pubmed/15466962
(45) http://www.ncbi.nlm.nih.gov/pubmed/22419558
(46) http://www.ncbi.nlm.nih.gov/pubmed/20549791
(47) http://www.ncbi.nlm.nih.gov/pubmed/20660256
(48) http://www.ncbi.nlm.nih.gov/pubmed/19539268
(49) http://www.ncbi.nlm.nih.gov/pubmed/22117174
(50) http://www.ncbi.nlm.nih.gov/pubmed/21954324
(51) http://www.ncbi.nlm.nih.gov/pubmed/22072339
(52) http://www.ncbi.nlm.nih.gov/pubmed/20795425
(53) http://www.ncbi.nlm.nih.gov/pubmed/20699674
(54) http://www.ncbi.nlm.nih.gov/pubmed/21853697
(55) http://www.ncbi.nlm.nih.gov/pubmed/20687227
(56) http://www.ncbi.nlm.nih.gov/pubmed/12597022
(57) http://www.ncbi.nlm.nih.gov/pubmed/22139563
(58) http://www.ncbi.nlm.nih.gov/pubmed/21905094
(59) http://www.ncbi.nlm.nih.gov/pubmed/17984944
(60) http://www.ncbi.nlm.nih.gov/pubmed/9484373
(61) http://www.ncbi.nlm.nih.gov/pubmed/12870295
(62) http://www.ncbi.nlm.nih.gov/pubmed/19539268
(63) http://www.ncbi.nlm.nih.gov/pubmed/22139563
(64) http://www.ncbi.nlm.nih.gov/pubmed/19660150
(65) http://www.ncbi.nlm.nih.gov/pubmed/20207121
(66) ACAOM, Baisong Zhong LAc, PhD, MD (China), www.
easternbalancetcm. com
(67) http://www.ncbi.nlm.nih.gov/pubmed/21941584
(68) http://www.ncbi.nlm.nih.gov/pubmed/17457961
(69) http://www.ncbi.nlm.nih.gov/pubmed/20868638
(70) http://www.ncbi.nlm.nih.gov/pubmed/22214823
(71) http://www.ncbi.nlm.nih.gov/pubmed/22189635
(72) http://www.ncbi.nlm.nih.gov/pubmed/22173011
(73) http://www.ncbi.nlm.nih.gov/pubmed/22183124
(74) http://www.ncbi.nlm.nih.gov/pubmed/16450292
(75) http://www.ncbi.nlm.nih.gov/pubmed/18484546
(76) http://www.ncbi.nlm.nih.gov/pubmed/21222632
(77) http://www.ncbi.nlm.nih.gov/pubmed/14692724
(78) http://www.ncbi.nlm.nih.gov/pubmed/22112723
(79) http://www.ncbi.nlm.nih.gov/pubmed/22074576
(80) http://www.ncbi.nlm.nih.gov/pubmed/21987075
(81) http://www.ncbi.nlm.nih.gov/pubmed/21651969
(82) http://www.ncbi.nlm.nih.gov/pubmed/21599496
(83) http://www.ncbi.nlm.nih.gov/pubmed/19593179
(84) http://www.ncbi.nlm.nih.gov/pubmed/21845204
(85) http://www.ncbi.nlm.nih.gov/pubmed/21192826
(86) http://www.ncbi.nlm.nih.gov/pubmed/20596791
(87) http://www.ncbi.nlm.nih.gov/pubmed/21967159
(88) http://www.ncbi.nlm.nih.gov/pubmed/21951617
(89) http://www.ncbi.nlm.nih.gov/pubmed/15173412
(90) http://www.ncbi.nlm.nih.gov/pubmed/12730442