Are Micronutrients a Waste of Time? – A Randomized Controlled Trial

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Four years ago, when Julia published her first open-label trial of the mineral/vitamin formula sometimes called EMPowerplus, she received this email: “I am 34 yrs old and have had anxiety/depression/hypo/mood issues for as long as I can remember. The biggest problem I have is constant erratic racing thoughts which never allow me to get proper sleep.  I have seen so many doctors, sleep specialists, Psych’s and tried many drugs. I need to finally fix this as I have a lot to live for. I guess what I am asking is Can we get EMP+ in New Zealand? and do you believe it is worth a try? Or do you think (like a lot of internet discussions) that it is a waste of time?”

Four years later, we can finally and confidently say, they are not a waste of time. Over 20 studies using other experimental designs (within-subject crossover, etc.) had provided extensive preliminary evidence of that, but now Julia’s group has finally completed the type of trial that scientists and physicians pay attention to, which hopefully might filter down to the consumer.

Julia has received a lot of media attention in the last few days as a result of her blinded RCT published in a prominent journal, the British Journal of Psychiatry, showing that micronutrients were better than placebo at improving ADHD and mood symptoms in adults.

But what interests us far more is the amount of emails we get as a result of this work. And the theme running through almost every email is that a child/adult/husband/wife has tried all kinds of medications, and the symptoms are still there and, often, getting worse. Could the micronutrients help?

While they may be a select portion of the population (and to date the two of us have received over 3000 emails from the public), it is a portion of the population we need to listen to. As Bob Whitaker has shown repeatedly and often, we aren’t always helping them with medications or other conventional treatments. Will nutrients help? We hope so, but the messages from the public tell us that medications aren’t working for them and scientists have to try harder to find a different approach for their struggles.

So what did Julia’s RCT find, and were the results important?

This study investigated, using a randomized double-blind placebo-controlled trial, the efficacy and safety of a broad-spectrum mineral and vitamin formula in the treatment of adults with ADHD. The product is sold under various names – including EMPower, EMPowerplus and Daily Essential Nutrients – with some small differences in formulation.

The trial was conducted between May 2009 and July 2012 in Christchurch, New Zealand. Out of 136 community and self-referrals, 80 medication-free adults diagnosed with ADHD (using standardized instruments) were randomly allocated in a 1:1 ratio to receive micronutrients (n=42) or placebo (n=38) for eight weeks. Primary outcomes were the Conners Adult ADHD Rating Scale (CAARS), self, observer and clinician forms, clinical global impression (CGI) and Montgomery-Asberg Depression Rating Scale (MADRS).

The first key finding was of a treatment effect. This means that when we broke the blind, it was clear that overall the group of people who were taking the micronutrients did better than the group who were taking the placebo. This is a remarkable and important finding given there is so much scepticism associated with taking nutrients to treat mental illness. Because no one knew whether they were taking the real thing or the placebo, this outcome is regarded highly in the scientific literature. This is the first trial to show that the benefit of micronutrients for the treatment of ADHD symptoms is not simply due to the placebo effect.

The second key finding was that there were no group differences in reported side effects. This means that there were no adverse effects associated with taking the nutrients. Typical side effects reported were mild nausea or headaches, but as many people in the placebo group reported these side effects as in the micronutrient group. This finding suggests that the side effects were not specific to the nutrients, but may have more to do with taking pills or close monitoring of these types of symptoms over time. We found that as long as the pills were taken with food and water, these problems generally resolved. The lack of side effects is great news, as many of the medications prescribed for ADHD come with side effects that people find intolerable and can often be the reason why people stop medications.

Other notable findings included:

  • There were significant group differences favouring the micronutrient treatment on self-ratings and observer (that is spouse or parent) ratings of ADHD symptoms, but not based on clinician observation. This latter finding isn’t necessarily surprising as clinicians only saw the participants very briefly once every two weeks.
  • Clinician ratings favoured micronutrient treatment over placebo in terms of overall improvement in psychiatric functioning over the 8 week trial.
  • Clinicians rated 48% of those taking the micronutrients as “much” or “very much” improved as compared with 21% of those taking the placebo.
  • Based on an average across raters, micronutrients normalized hyperactivity/impulsivity symptoms.
  • For those who entered the trial with a moderately to severely low mood, we found a greater improvement in mood in those taking the micronutrients as compared with those taking the placebo.
  • Six months after the trial was completed, we observed that those who stayed on the nutrients were doing better than those who chose to come off. We also found continued improvement over time for those who stayed on, suggesting that the benefit of micronutrients takes time to reach its full potential.

In summary, this study is the first placebo-controlled RCT to investigate the efficacy and safety of a broad-based vitamin/mineral formula in the treatment of ADHD in adults. We demonstrated that micronutrient treatment induced robust improvements in several areas, from ADHD symptoms, to depression, to global assessment of functioning, compared to placebo. Indeed, the effect of micronutrients is comparable, if not better than, other non-pharmacological treatments for ADHD, including omega-3s and food restriction diets, making it a serious alternative for those who choose not to take medications. It now needs further replication in larger samples.

We know we won’t be able to help everyone with these symptoms, but we certainly think that a substantial proportion of the population will benefit from this approach. Let’s hope that this publication moves us in the direction where micronutrients become a part of the mainstream approach to treating mental health disorders. Then the next step would be to tackle the very political challenge, which is that *if* this approach works for you and medications don’t, and your insurance or the government or whoever was willing to pay for the medications, will they be willing to pay for an alternative that actually does work? Can we make that happen?

* * * * *

References:

Rucklidge, J. J., Frampton, C., Gorman, B., & Boggis, A. (in press). Vitamin-mineral treatment of ADHD in adults:  A double-blind, randomized, placebo controlled trial. British Journal of Psychiatry.

Rucklidge, J. J., Johnstone, J., Gorman, B., & Boggis, A., & Frampton, C. (2014). Moderators of treatment response in adults with ADHD to micronutrients: demographics and biomarkers. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 50, 163–171.

52 COMMENTS

  1. Re: “Then the next step would be to tackle the very political challenge, which is that *if* this approach works for you and medications don’t, and your insurance or the government or whoever was willing to pay for the medications, will they be willing to pay for an alternative that actually does work? Can we make that happen?”

    This would be *real* parity, for the first time.

    Unfortunately, I don’t see the federal government here in the U.S. signing on, especially now that ObamaCare has become the law of the land… The drugmakers have yet to get their kickbacks for making sure the law got passed. (Those closed-door meetings during the summer of 2009, for those who may have forgotten).

    Duane

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  2. Duane, big pharma has been a big hindrance and threat to health for years and would have continued to be whether Obama Care came into existence or not. Thanks to that “evil” plan, I will be having surgery that has a a great chance of enhancing my qualify of life. Without it, things would get alot worse.

    Regarding the topic, as usual doctors in general are incapable of thinking outside the box. However, in all fairness, even the ones who want to, are limited by the so called medical standard of care which is usually drugs and could be a target for a lawsuit if something happened.

    As one who is experimenting with a paleo type diet, there is no doubt in my mind that diet can make a different. Previously, at work, I was having trouble motivating myself to do some tasks that weren’t very exciting. With this diet, my motivation was alot better. Doesn’t prove anything obviously but it leads me to believe the role of nutrition is definitely minimized in the medical community.

    AA

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    • I’ve been doing something similar to relatively low carb/high fat, real food, paleo, whatever diet for maybe two years. Besides losing all of the weight I gained while in psychiatry, I think it has had a great effect on my mind and general well-being as well. For instance, it’s much easier for me to maintain a constant focused state of mind throughout the day. This effect also helps with exercise, and those help with some more “advanced” zen practices. For me, these practices seem to boost each other in great ways. I remember being sceptical about diet when I was younger, but I’m not so much anymore. Even still, I haven’t taken or studied much about micronutrients. I do take some fish oil capsules and whatever comes from berries, vegetables, etc. If one eats lots of “toxic” food, I’m not sure loads of micronutrients will do much to fix it. In any case, I’m not sure what all of this stuff has done to my body and brain, maybe it’s something to do with inflammation, cytokines, ketosis-kind metabolism stuff, etc, but it’s working for me.

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      • My son and I both used the Empower Plus vitamins for three months and they did nothing for either one of us. The only effect was that I was $400.00 poorer. He had a serious mental illness and I was suffering anxiety and depression as a result. Neither one of us was helped by any of the many drugs and vitamins we tried.

        Then I read the “Ultra-Mind Solution” and tried eating more whole foods and less processed. The results have been amazing. Like Hermes and AA I noticed many changes including weight loss, better concentration, less anxiety and depression, stronger hair and nails, better digestion, better sleep. I have also received many compliments on my appearance, apparently I look less tired and younger. My son was a lot sicker than I was but he is trying paleo now and he seems to be doing quite a bit better.

        I don’t think that any drug or vitamin supplement can make up for a poor diet. The tremendous importance of dietary fibre is probably the reason. Why would anyone spend $200.00 a month on vitamins when you could buy so many wonderful fruits, veggies, nuts, berries and fish for that amount of money?

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        • It is terrific to hear of the successes of dietary changes, because this of course should be the first step anyone takes: improve your diet. But some of our studies have indicated that even people who eat really excellent diets with lots of fruits and veggies are still symptomatic, and adding vitamins and minerals in pill form benefits them. Why? We have theories, and we have models based on inborn errors of metabolism already demonstrated in the realm of physical health. But there is much research still needed.

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          • I do appreciate the work you and Julia are doing studying nutritional therapies. The theories about inborn errors of metabolism are very important, what works for one person may not work for another because of genetic differences. You are right that much more research is needed.

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      • I have been fascinated with how different diet types affect mental health. Personally I think that it starts with shifting to a whole foods diet. My guess is that most people would find an improvement in their mental health if they simply cut out sugar, processed food, caffeine, alcohol (and for some- wheat).

        When adhering to a Paleo diet, all of these (except for caffeine) are eliminated. I have tried a Paleo diet and found it pretty hard to be that strict. When I added in whole grains and legumes I personally didn’t notice any difference with my well being. I don’t know if you are familiar with Mark Sisson (Primal diet), but his forums are chock full of people exploring the mental health/diet connection. He can be found at http://www.marksdailyapple.com.

        Anyhow, I would love it if doctors talked about diet instead of pills.

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        • Yeah, two years ago or so I decided to go low carb based on just some basic advice I had read, and I studied more here and there while I was at it. I lost maybe a little over 20 kg in a year and now I’ve lost 27 kg. I’m pretty close to my ideal weight right now (BMI 22,5), though I can see a very slight bit of fat around stomach at times. In any case, I think I even heard about this pale stuff just some months ago and my diet was quite much of what that paleo crowd talks about already. Yeah, I’m now following that Mark’s Daily Apple blog with RSS, as well as some other “paleo” blogs. I also haven’t gone too much into details of nutrition, I’m just trying to get at least the macronutrients right and getting rid of too much processed foods. I’ll likely go further to it with time and experience. For me, Peter Attia’s blog has been a great source of info http://eatingacademy.com

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    • AA,

      As I’ve said before, I think it’s great that you now have insurance…. and I mean that sincerely.

      My heart goes out to the (soon to be) tens of millions who will now lose their insurance; to the people on Medicare – seniors and people with severe disabilities… that program will be gutted – close to a trillion dollars.

      I could go on and on, but this is not the time, nor the place.

      Duane

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    • Thank you for raising a common misconception, which enables us to clarify it publicly. Neither Bonnie nor Julia has any financial connection with any company manufacturing a natural health product. Neither of us has ever been employed by or paid by any company, including Truehope Nutritional Support or Nutratek. And by the way, MiA also doesn’t have any financial interest in these companies and they currently do not even accept advertising of any kind.

      It would be lovely if we (Bonnie and Julia) could just provide a description of the various nutrient formulas we have studied with no commercial name, but that would be like publishing an article examining the effects of ‘a stimulant’ without specifying that it is methylphenidate. It just makes no sense. So we specify the commercial name(s), but always state the fact that we are not in a conflict of interest. Also, it makes sense to name the formula being evaluated; in this case, a package of micronutrients that are, in fact, being offered for the specific purpose being tested and therefore warrants investigation as to the legitimacy of the claim. This also allows people to know the specific nutrients that were used.
      As for your accusation that EMPowerplus is excessively costly, that concern is best raised with the manufacturer. We would just point out that there are many formulas that you can buy at a lower cost, but to the best of our knowledge none of them has been shown to have significant mental health benefits. Perhaps they do, but there is no way to know. Ultimately, it’s up to you to decide for yourself what evidence you need to be satisfied that it is worthwhile making a purchase.

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  3. There has been at least one trial of adding micro-nutrients to prisoners diets and observing positive changes in behavior in the UK in recent years. I remember The Food Programme on BBC Radio 4 doing a feature on one such experiment in a young offender unit a few years ago.

    Here is an article on one of those experiments: http://www.bbc.co.uk/learningzone/clips/prisoners-given-dietary-supplements-to-improve-behaviour/6003.html

    Here is another: http://bjp.rcpsych.org/content/181/1/22.full

    Here is the conclusion to that study: “Antisocial behaviour in prisons, including violence, are reduced by vitamins, minerals and essential fatty acids with similar implications for those eating poor diets in the community.”

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    • Here is a newspaper report on one of those studies:

      http://www.independent.co.uk/life-style/health-and-families/health-news/prison-study-to-investigate-link-between-junk-food-and-violence-775176.html

      Here is a quote from the article: “In a pilot study of 231 prisoners by the same researchers, published in 2002, violent incidents while in custody were cut by a more than a third among those given the supplements. Overall, offences recorded by the prison authorities fell by a quarter.

      John Stein, professor of physiology at Oxford University, said: “If you could extrapolate from those results you would see a reduction of a quarter to a third in violent offences in prison. You could reduce violent offences in the community by a third. That would have a huge economic benefit.”

      “Our initial findings indicated that improving what people eat could lead them to behave more sociably as well as improving their health. This is not an area currently considered in standards of dietary adequacy. We are not saying nutrition is the only influence on behaviour but we seem to have seriously underestimated its importance.”

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      • They are talking about omega 3 fatty acids and the effect on the brain of a lack of these. They are also talking about other micro nutrients but seems to be the core of their theory. So the theory is much the same as the author of the above’s article, the effect on attention span and irritability is similar, though the observed behaviors are different.

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        • Omega-3s are considered macronutrients. The original article states:

          “Indeed, the effect of micronutrients is comparable, if not better than, other non-pharmacological treatments for ADHD, including omega-3s and food restriction diets, making it a serious alternative for those who choose not to take medications. It now needs further replication in larger samples.”

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  4. hello Bonnie and Julia,

    Thanks a lot for your work! I really appreciate that. I’m taking the complex and I’m slowly improving and getting healthier!

    I was wondering, why did you choose ADHD group for research? Why not mood disorders? it is because it’s much more difficult to work with nutrients, when the people are taking also psychiatric drugs, so you need to have a group without drug use?

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  5. Hi good question. It all has to do with how likely it is to get a sample to study. So many people with depression or other mood disorders are medicated and we certainly don’t advocate for someone to come off a treatment to be in a trial. So it makes it really hard to study depression. In christchurch, the diagnosis of ADHD in adults has been controversial and so many go untreated, hence why we had a population of people who might not be receiving care in the community…someone really needs to study it in people with just depression…

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  6. thank you for your answer, Julia! That’s what I thought – it’s difficult to find unmedicated people with depression. I’m in the process of reducing meds and it totally blurs the picture, because of withdrawals.

    wow, internet is amazing! I have been following your work for some time, and been really excited about it – and now I can actually ask questions directly from you, from another part of the world. amazing! 🙂

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  7. Natasha Tracy (a pseudonym) has been blogging about her use of EMP/Truehope.

    http://natashatracy.com/topic/bipolar-blog/

    In the past I never read her blog closely because it was dismissive of the pain of survivors and she was virulently pro medication and pro medical treatment. My understanding is that she recently stopped all medication because it was not relieving her symptoms and started EMP/Truehope. (She also has an implant of some sort in her brain to theoretically help control her symptoms. I don’t know much about the science / terminology regarding this.)

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  8. I must say i don t like this article. It sounds like a hidden commercial. Please somebody responde to my question “What should make the EMPowerplus better than other ordinary mutlimineral-vitamin?? Is it maybe ‘magical’? To me it looks just a bad quality mutli-formula. One of the hundreds of garbage sold in the web with wonderful claims!
    Furthermore it does actually contains the worst form of Folate (that is the folic acid instead of 5mthf) and the worst b12 wich is cyanocobalamin when there are others like xydroxy, adenosyl or methyl b12.
    Is it Folic acid safe??? Where?? And the studies that point to the role of sinthetic B9 in cancer?
    Should this be a serious, critical and neutral piece or just a commercial? The web is full of this stuff, and i’m trired of it. They play with our lifes!

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    • Thanks for your comments. It is a reasonable question to know how this product compares with other micronutrient formulae. There is virtually no research that has compared different micronutrient formulae to see if one might be better than another. There is some research that suggests that dose is important. And that is probably one distinction between this product and those purchased over the counter as well as probably the breadth of nutrients used. While we have to study one product to study an idea, we can’t extrapolate these data to other micronutrient formulae unless they have been directly compared. So it is important, in order to make an informed decision about how to treat psychiatric symptoms, to know what nutrients we used and in what dose they were given (and the only way to do that it to name the product!). If you read our other blogs, we do discuss these issues in great depth. Please also see Bonnie Kaplan’s comment addressing the issue you raise about conflicts of interest. As for the safety of the individual ingredients – most of the studies that report safety concerns, tend to study the one ingredient on its own so we don’t know if we can extrapolate those concerns to multi-ingredient formulae. It is something we need to continue to research. In the end, this study is discussed and made available to the public to evaluate and consider the risks and benefits within the context of their situation. However, I urge you to read the entire article published in the British Journal of Psychiatry before drawing conclusions about the science and how seriously you should take it. Your concerns about the specific ingredients chosen should be taken up with the manufacturer although I believe that the more recent changes to the formula have addressed the concerns you raised.

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  9. Well, almost every vitamin-mineral formula with big claims has at least one or more studies with it. And this make me deduce that probably producing at least one study with it could be part of the mechandising strategy. Isn’t iceland the happy land because they eat lot of fish? Well i assumed the strongest EPA fish oil for monthes and my depression symptoms didn’t change at all.

    Please can you explain to me this: in the EMPowerplus site they claim that it is effective against almost all psychiatrich disorders exept schizofrenia. How is it possible, if DOSES are so important as you say, that a single formula could be effective with a variety of cases, each with different symptoms and combinations of symptoms? Shouldn’t they have each one special, personalised needs for nutrients and minerals? So that particular formula should be useful for you but not for me.

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    • I agree, Trollo. This study is already used by Truehope for marketing (it is featured on their start page). 18 from 22 studies linked on their Research page are from Rucklidge and/or Kaplan.

      The biggest problem with EMP+ is the aggressive marketing: “Can EMPowerplus™ Cure ADHD & Depression?”. If I were a professor I would do everything to not get associated with this company.

      They also claim that it works for “severe schizophrenia”:
      http://youtu.be/CneVcqGiHnU?t=8m46s

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    • I would love it if every big vitamin mineral complex had a study associated with it but that simply isn’t the case. Especially for treating symptoms of mental illness. Sadly many people market their products without any published research on it. We reviewed this literature in another blog and there are only about 20 products give or take that have had at least one study done on it for the treatment of mental health symptoms. That’s it…and some of those studies aren’t RCTS.

      As for your question about how could it be that one product can be effective for so many different disorders. Great question and I can only speculate as to the answer. We have come to believe because of the DSM that psychiatric disorders are discrete entities with different causes for each one of them. But that hasn’t yet been proven. Yes they talk about genetics but that research is very weak and hasn’t been able to find a specific gene for a specific disorder. If we turn it upside down and consider that perhaps we all express vulnerabilities differently then we can be open to the idea that one treatment might actually have an effect on many different symptoms. We certainly have seen in our work a over and over that when someone gets better it isn’t specific to a disorder, anxiety gets better, mood gets better. So I think this belief that each disorder is going to have a specific treatment may be propagated by our one drug one disease model of thinking. And let’s face it, that hasn’t actually been that successful. Think about when your body gets run down, you express that differently from your spouse, friends, children. Some get headaches, others sore throats, others irritable. But the treatment of the run down immune system could have benefit on all those different symptoms.

      I agree that different people have different nutritional needs and therefore there is a bit of a shot gun approach to this. We would love to be at the point of individualized health care but it is just not that easy. For this work, first we see whether it does actually work, then start figuring out whether it can be fine tuned. We aren’t there yet.

      As for the comment that a professor should stay away from doing this work…who else is going to do it? We are independently assessing claims. Surely that is the role of the scientific community. Just because it is controversial, doesn’t mean we should stay away from it! Otherwise we will only have safe science and how much progress will we make then?

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      • Uhmm… i think the studies should be on nutrients not on the brand of the product. You say you proved those nutrients are effective for mental health? Well i can find the same nutrients in better forms for a more reasonable price. As you surely know (i hope so) some of the nutrients on EMP+ which are already known to be helpful in some cases of cronic illnesses are Folic acid and b12. But it s widely known that the sintetic form of folic acid can create some problems and is less effective than methylfolate and that cyanob12 as well isn’t effective as other more active forms. Did you actually discovered WHY this particular formula should be helpful? If not, HOW did you arrive to select those particular nutrients and those particulr doses?

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      • I comment to each paragraph

        1) Sounds like an advertisement for EMPowerplus again.

        2) I agree. It seems that many of the “psychiatric disorders” defined by the DSM have some connection to trauma, stress, social relationships, nutrition (intolerance and deficiencies), gut microbiome and the immune system (inflammation, autoimmunity). I can understand that psychiatry distinguish between depression and psychosis, because they only want treat the symptoms with some psychoactive drugs. If you are looking for the cause of the symptoms, the psychiatric diagnoses are not very helpful anymore.

        3) We already know that Vitamin D and B12 and folate could be helpful. Which new knowledge do you generate by a study with a multi-vitamin/mineral supplement?

        4) I didn’t mean you shouldn’t do studies about vitamin / mineral supplements for mental health. But if I were at your position I would stay away from a company which such horrible marketing.

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        • 1) we are going to have to disagree on that one. “Trollo” commented that all products have research, I replied.
          2) sounds like we share some similar perspectives.
          3) The single ingredient method of treating mental illness hasn’t actually yielded huge benefits in the ADHD world (see Rucklidge, J. J., Johnstone, J., & Kaplan, B. J. (2009). Nutrient supplementation approaches in the treatment of ADHD. Expert Review of Neurotherapeutics, 9(4), 461-476.). Hence why a different approach is required. Of course maybe not all these ingredients are necessary, but we need to start somewhere, I would love to see other researchers tackle this issue and certainly different doses and products and more comparison studies. This is actually far more challenging to do that it sounds. Imagine the number of studies you would need to do! It sounds like you are quite passionate about the problems, be a part of the solution.
          4)Thanks for the advice. They don’t control my research (no input into design, data analysis, writing it up…the first copy of the study that the company would have seen was the final version that is available through the BJP website) and equally I can’t control what they post on their website.

          In reply to Trollo: I am a psychologist keen to study existing treatments and evaluate their effectiveness for mental illness, not a manufacturer of nutrients. I am not in a position to put together a formula for research. Figuring out why something works is certainly an area of research I am keen to see explored. These studies take time. If you can receive benefit from cheaper sources of nutrients, that’s fantastic. I am delighted to hear you are using nutrients to alleviate suffering. Please do let us know what you have been using so that we can study it!

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          • 1) I never said that “all products have research”, i said that researches should be done on the substances not on branded products. Vitamins and mineral are always vitamins and minerals irrespective of the brand and commercial name. I know quality may change but this is another matter.
            3) Why should somebody assume a nutrient if he s not deficient in that? There exist already tests to deduce that, why shooting in the dark with a one fits all approach?
            4)I never said i m receiving benefits, i’m just trying.

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  10. Well i had a EPA deficiency for sure as it showed blood tests on fatty acids. But fish oil didn’t help the same. It is also incredibly difficult to find fish oil high in EPA. Also fish oil ruts very easily. I don’t use sources of Omega 6 cause the only oil i use for food and cooking is olive oil. I don’t eat processed foods.
    Still it s absurdly simplicistic thinking that one simple formula could help everybody. IF nutrients can improve mental health the amount type and number of nutrients you need should be quite subjective and not one for everybody.
    I assumed many supplements, recently i assumed Doctor’s best multi wich is quite similar to EMP+ but has 5 mthf instead of folic acid and methylb12. Anyway for what i know b12 cannot be absorbed by ingestion but only by injection or sublingually.
    Also, chelated minerals if not specified could contain glutamate. All EMP+ minerals are ‘chelated’ without specification.

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  11. In response to the desire for researchers to study nutrients and not brands…that would be an ideal situation but not one that I have come across yet. I can envision that being achieved if one had massive amounts of grant funds and could invest in the development of the nutrient complex alongside developing the best way to ensure maximal absorption etc. wouldn’t that be nice if that kind of money was available for nutrition research?

    As for using serum blood markers to determine whether someone is deficient in a nutrient to prevent them from consuming nutrients unnecessarily, again, ideal but we have shown that not having a deficiency doesn’t actually mean you won’t benefit from a nutrient. See a related paper http://www.ncbi.nlm.nih.gov/pubmed/24374068 on moderators of treatment outcome using micronutrients. Scientists wonder if we all have our own individual nutrient requirements such that those levels aren’t always useful to determine what one person might need for optimal functioning. Also serum nutrient levels don’t tell us what a metabolically active organ like the brain is actually using and requiring. I encourage you to read the article I just referred to so you can read at great depth some of the limitations of using serum markers to determine what someone might require nutritionally.

    I am sorry I misunderstood your comment about benefiting from nutrients, I am delighted you are trying to figure out whether these nutrients can be helpful.

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  12. Just about Folic acid: last year i assumed as part of a therapy suggested by an orthomolecular doctor 2,5 mg of folic acid x day.
    I must admit i felt a good mood for the first weeks but right 1 week after i began this supplements i got a flu that lasted for 5 and half monthes. Tried to stop everything one by one without success after it turned out my flu was without any apparent cause. Just after i stopped folic acid (wich casually i kept for last) the flu ceased in a pair of weeks.
    I have read that folic acid is believed by some to create problems on conversion to 5-mthf. As i am a1298cMTHFR homozigous maybe this could be an explanation for my bad experience.
    That’s just to say something about folic acid.

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  13. I suspect an even more useful question would be: “Are micronutrients a waste of time if you’re already consuming a healthy diet?” It would be interesting to know what proportion of the study participants might have had some nutritional deficiency to begin with or what kinds of diets were the people on who responded positively to the supplements.

    As to the issue of side effects, many/several prominent diet doctors advocating diets of the whole foods, plant-based type (John McDougall, T. Colin Campbell for instance) do caution against the use of multivitamins due to possible harm from long-term use.

    Anyway, it’s an interesting article. As a diagnosed “schizophrenic” not too impressed by the current state of psychiatry, I certainly appreciate any efforts to find better alternatives.

    I do hope that further research into supplementation aims to determine the role of dietary factors (but I’m not holding my breath). Obviously what constitutes a “healthy” diet is not
    agreed upon, but people who are serious about their health and are only hearing “Paleo”/low-carb should at least be aware that there are other (better? I think so) approaches.

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    • “Obviously what constitutes a “healthy” diet is not agreed upon, but people who are serious about their health and are only hearing “Paleo”/low-carb should at least be aware that there are other (better? I think so) approaches.”

      This obviously referred to what I wrote above. Going low carb benefited me greatly, and as I said, I only heard about “paleo” some months ago. I’ve never said this approach works with everyone, I’ve only talked about my own experiences. I think that in my case going low carb was the most crucial thing at least in losing weight. In my case! I never said it’s good for everyone. What is your “better” approach, going vegan?

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      • Essentially, yes (or at least very low meat (/dairy/eggs/added fats)). And I don’t want to veer way too far off the topic of the article (or claim any expertise for myself), but there is a lot of information about diets which have actually been shown to consistently reverse disease (heart disease, type-2 diabetes) so I guess they can’t be too unhealthy, right? If I’m allowed to mention the following names here (all physicians), I think they’re worth checking out:

        John McDougall
        Neal Barnard
        Caldwell Esselstyn

        I especially like John McDougall who has a pretty interesting book called “The Starch Solution” and a lot of free presentations on youtube, many where he rails against ineffective/harmful/questionable (but highly profitable) practices in today’s medicine. Actually, Robert Whitaker was recently a speaker at one of his (McDougall’s) conferences, so I guess it all ties together somehow:).

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        • I’m not trying to get in the nutrition debate that is all over the place. I still think that in my personal case, going low carb/sugar helped me to at least lose those fats I gained from, well, basically modern psych meds which often mess up with with the metabolism of glucose/fat. I’m not everyone, but in my case, if I was still eating, for instance, the typical atypical drugs, I’d go very low carb/sugar just to save my body.

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          • Yeah, I certainly don’t know all the implications for glucose/fat metabolism on Zyprexa, for instance. I gained about 30 or 40 lbs in 3 months on Zyprexa at a dose of 15mg. I then changed to essentially an ultra-low fat vegan diet while still on the Zyprexa and was able to lose weight. But, soon after that, I was also reducing my dosage and lost all of the weight/fat pretty easily once I got down to a very low dosage. I don’t know how much to attribute to the diet change or the Zyprexa reduction. I guess I could be pioneering and restart the Zyprexa at 15mg to do an experiment, but… no.

            I guess we can at least agree that getting rid of the processed junk food is a good first step for anyone.

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          • chris12345, yeah, what I’m saying is just my personal report. I know I’m biased because of my personal experience, and I partly tell about people and studies than fit my experience, etc. Why do drugs such as Zyprexa actually cause weight gain, and how to stop it? It’s nice that you tell about your own experience as well.

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    • The Paleo vs. Vegan debate has really been raging hard for the past few years. I think its first important to acknowledge what they agree on first. They both agree that the Standard American Diet (SAD) is making us sicker and more mentally/emotionally unwell. Though a Vegan diet can theoretically include sugar and processed junk food, I think most people who talk about this diet promote eating primarily whole foods in the form of vegetables, legumes, grains and fruit. And certainly a Paleo diet does not allow for processed foods, sugar, as well as legumes and grains.

      I personally think that starting either of these diets can be very healthy depending on the person. Both have their strengths and weaknesses. Paleo seems to be really helpful for people with sensitivity to wheat and grains, helps with blood sugar balance and can impart an overall sense of vigor and calm mood. At the same time, it is also very expenisve (if you but free range and organic only) and not very environmentally sustainable.

      Veganism is much cheaper, more enviro sustainable, but some people have a problem with feeling deficient and weak after a while. The plant based diet seems to be really helpful for improving health at an organic level, helping to reverse many disease processes.

      However, some vegans also lapse into eating a lot of processed “fake meat”, peanut butter and jelly sandwiches and vegan cookies. Obviosuly this is just as bad as eating a SAD diet- just has a “vegan” spin.

      Personally, since we’re talking mental health here- I have seen a lot more improvement for people with a Paleo/Primal diet than Vegan. But I think it just requires personal experimentation to see how one reacts to each diet type. Bioindividuality.

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  14. So please….tell me where I can get these micronutrients you speak of? It sounds like it’s some sort of a mix rather than a bunch of separate supplements.

    And do I need a spectracell micronutrient test first?

    Pretty desperate for answers to help with this depression and Adult adhd….before my insurance runs out since I lost my job! Thanks!!

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