Iron deficiency anaemia in children with ADHD

Abstract

Introduction ADHD (Attention Deficit Hyperactivity Disorder) is characterised by age-inappropriate symptoms of hyperactivity, impulsivity and inattention. Iron deficiency anaemia (IDA) is the most common nutritional problem in the UK, affecting 8-13% of children1. Serum ferritin, serum iron and transferrin saturation decrease in IDA. It has been postulated that ADHD is modulated by dopaminergic mesocortical pathways. Iron is a coenzyme in dopaminergic synthesis. Previous research has suggested that low ferritin and IDA may have a role in ADHD2. Objective To determine whether there is an increased prevalence of IDA in children with ADHD Method Review of casenotes of 100 ADHD children. 40 cases were suspected to have IDA from history and clinical findings. 38 were included in the review since lab results of 2 children were not available. We reviewed all electronic record letters and laboratory results. Results 2 children were female and 36 were male, with an age range of 4-14 years (median 7 years). 92% had ADHD and 8% ADD (attention deficit disorder). 17 had poor appetite, 2 had poor weight gain, 1 had food allergy, 1 had nut allergy and 8 of them had significantly reduced appetite with medication. Serum ferritin was low in 50%. The lower limit of the reference range for ferritin in our hospital's lab is 30 ug/ml for males and 13 ug/ml for females; other studies have used a lower limit of 50 ug/ml. Had we used the latter value, more children would have been classified as having a low ferritin. Serum iron and transferrin saturation were low in 32% and 45% respectively. Full blood count was abnormal in 42%, with MCV low in 40% of these children. Conclusion There may be an association between IDA and ADHD. It may be useful to screen children with ADHD for iron deficiency anaemia. However this was a small retrospective review. A larger, well-designed prospective study is required.

The Relationship Between Iron Deficiency Anemia and Sensorineural Hearing Loss in the Pediatric and Adolescent Population

“…Thus, screening and treatment would be part of currently established procedures. Although the link between correcting IDA and improving hearing health is not established, it is known that both IDA and hearing loss have negative effects related to attention and scholastic performance, which are improved with treatment (Abbas & Valli, 2012;Bener, Kamal, Bener, & Bhugra, 2014;Cortese, Angriman, Lecendreux, & Konofal, 2012;Halterman, Kaczorowski, Aligne, Auinger, & Szilagyi, 2001;Konofal, Lecendreux, Arnulf, & Mouren, 2004;Lahat et al, 2011;Millichap, Yee, & Davidson, 2006;Schieffer, Peters, Richter, Loc, & Pawelczyk, 2015).…”

Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors

“…For example, inadequate zinc intake during childhood can lead to detrimental effects on attention and short-term memory (12) . Inadequate iron intake leading to iron deficiency in childhood can negatively impact overall intelligence and cognitive development (13) ; there is growing evidence regarding the prevalence of brain disorders such as Attention Deficit Hyperactivity Disorder and iron deficiency during early life (14,15) . Insufficient vitamin D during childhood has been linked to the onset of various conditions, including rickets, multiple sclerosis (16) and prediabetes (3) .…”

“…Nutrient deficiencies and poor diets have consequences which include various psychological and cognitive challenges (to recap: having a negative impact on brain and cognitive development (5) , cognitive functioning, concentration, memory (6) , attention (12) , intelligence (13) , poor mental health (17) and lower mental well-being (18) , links to Attention Deficit Hyperactivity Disorder (14,15) and lower academic performance (6) ). Hence, healthcare and public health professionals need to consider how they assess these psychological and cognitive needs, and how any challenges associated with such needs are integrated into population based or targeted interventions.…”

Incorporating Informatics for Integrating Biology and the Bedside (i2b2) into Predoctoral Trainee Curriculum to Evaluate Student‐Generated Hypotheses

“…Thus, IDA could contribute to impaired brain development, learning, and memory . Iron is also critical for regulating dopaminergic activity and iron deficiency has been implicated in neurobehavioral disorders such as ADHD …”

“…2,13,19 Iron is also critical for regulating dopaminergic activity and iron deficiency has been implicated in neurobehavioral disorders such as ADHD. [20][21][22][23][24][25][26] ADHD is a complex behavioral disorder, which results in inattention and/or hyperactivity and impulsivity. 27 It is typically diagnosed in school-aged children as the school environment is often particularly challenging for individuals with ADHD symptoms.…”