Causes of ADHD

Causes of ADHD

The superficial answer is more or less simple: ADHD is caused by an imbalance of chemicals called neurotransmitters in the brain. These chemicals, including serotonin, noreipinephrine, phenylethylamine and dopamine are produced by brain cells to act as signals in order for brain cells to communicate between each other. Insufficient production of these chemicals in certain parts of the brain has been shown to be present in patients diagnosed with ADHD. Low production of some of these chemicals is associated with young age, which explains why some of the children outgrow ADHD.
 
The deeper answer is much more complex. In fact, there is no good single explanation why some children have low production of neurotransmitters and others don’t.

Several theories have been developed: 
Digestive: Dysbacteriosis, or in other words, an overgrowth of abnormal intestinal bacteria may lead to absorption of toxins from the intestine.
Environmental: Children whose mothers consumed alcohol, used illegal drugs or smoked during pregnancy have higher frequency of Attention deficit Disorder. Exposure  to toxic metals, such as lead, mercury, and cadmium and synthetic poisons, especially pesticides is associated with an increased risk of developing ADHD. Toxins produced by household mold may also lead to nervous system abnormalities and brain damage, which can manifest as ADHD.
Hormonal: Adrenal hormone imbalances, abnormal (usually high) blood sugar levels and thyroid hormone imbalances can cause ADHD symptoms.
Immune: There is a strong evidence that neurotransmitter imbalances may be caused by inflammation, a basic form of immune response. Inflammatory reactions produce chemicals called cytokines, which alter function of many cells, including brain neurons. Recently studies have suggested the involvement of cytokine pathways in patients with ADHD.
Allergic: Children with attention deficit are several times more likely to have food allergies than the general population. Food allergies, especially allergies to gluten may play a role in the development of ADHD through the production of high amounts of cytokines.
Genetic: Attention disorders have a tendency to run in families. A few genes have been linked to ADHD, making a child with family members with ADHD to be at a greater risk of having ADHD than the general population.
Neurologic and Psychiatric: Neurologic conditions, including traumatic and hypoxic brain injury, seizure, stroke, encephalitis, meningitis, spina bifida and many others are associated with ADHD. Developmental and psychiatric condition associated with ADHD include depression, hearing and visual impairment and conduct disorder. Patients with ADHD may have smaller brain volume and fewer nerve cell connections in the brain, further impairing the ability of the neurotransmitters to function properly.
Nutritional: Dietary deficiencies of amino acids, omega 3 fatty acids, vitamin B6, calcium, iron, magnesium, selenium, iodine and zinc have been found to be associated with ADHD. Excessive amounts of refined sugar and artificial food additives may contribute to the symptoms of ADHD.  
Infectious diseases: Many viruses, including influenza, enteroviruses and varicella can occasionally cause encephalitis (brain infection) with subsequent brain injury, which can lead to the symptoms of ADHD.  Otitis media (ear infection), Lime disease and streptococcal infections have also been found to have association with ADHD, mechanism of which remains unknown.

In summary, it is usually not clear what causes ADHD in a particular case and most often the cause remains undetermined. It is presumed that in most cases genetically determined low dopamine brain production is the primary cause of ADHD with a multitude of other factors being secondary causes. 

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