Effects of Zinc and Ferritin Levels on Parent and Teacher Reported Symptom Scores in Attention Deficit Hyperactivity Disorder

Abstract

Objective It has been suggested that both low iron and zinc levels might be associated with Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, the association of zinc and iron levels with ADHD symptoms has not been investigated at the same time in a single sample. Method 118 subjects with ADHD (age = 7–14 years, mean = 9.8, median = 10) were included in the study. The relationship between age, gender, ferritin, zinc, hemoglobin, mean corpuscular volume and reticulosite distribution width and behavioral symptoms of children and adolescents with ADHD were investigated with multiple linear regression analysis. Results Results showed that subjects with lower zinc level had higher Conners Parent Rating Scale (CPRS) Total, Conduct Problems and Anxiety scores, indicating more severe problems. CPRS Hyperactivity score was associated both with zinc and ferritin levels. Conners Teacher Rating Scale (CTRS) scores were not significantly associated with zinc or ferritin levels. Conclusions Results indicated that both low zinc and ferritin levels were associated with higher hyperactivity symptoms. Zinc level was also associated with anxiety and conduct problems. Since both zinc and iron are associated with dopamine metabolism, it can be speculated that low zinc and iron levels might be associated with more significant impairment in dopaminergic transmission in subjects with ADHD.

Effectiveness of Methylphenidate Supplemented by Zinc, Calcium, and Magnesium for Treatment of ADHD Patients in the City of Zahedan

“…Oner reported that ferritin and zinc deficiencies were associated with symptoms of hyperactivity in children (32). These results are consistent with our study.…”

Vitamin B12 and haemoglobin levels may be related with ADHD symptoms: a study in Turkish children with ADHD

“…We found a positive correlation between psychosomatic subscale of CPRS and ferritin. Other studies reported the relationship between the ADHD hyperactivity scores on Conners scale and low ferritin levels in their ADHD group [15][16][17]. Moreover, the results of the case control studies searching ferritin levels differ from each other.…”

Assessment of Biometal Profile in Children with Autism Spectrum Disorder, with Attention Deficit Hyperactivity Disorder, or with Other Psychiatric Diagnoses: A Comparative Outpatient Study

“…Several researchers reported a link between zinc levels and ADHD symptoms [21]. Although the exact mechanism of how zinc may contribute to symptoms of ADHD is not known, there is evidence that zinc assists in both the production and regulation of melatonin, which is an important factor in the pathophysiology of ADHD due to its modulation of dopamine.…”