Micronutrient Supplementation Linked to Positive Global Effects in Pediatric ADHD

pediatric, child at doctor, primary care provider
Investigators assessed the effect of micronutrients in the form of vitamin and mineral supplementation in pediatric patients with attention-deficient/hyperactivity disorder.

For children with attention-deficit/hyperactivity disorder (ADHD), supplementation was micronutrients was found to have global benefits including height growth. These findings, from a placebo-controlled, randomized trial, were published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Children (N=126) aged 6 to 12 years with ADHD were recruited from Oregon Health & Science University, The Ohio State University, and the University of Calgary between 2018 and 2020. Participants were randomly assigned in a 3:2 ratio to receive either 9 to 12 daily micronutrient capsules consisting of more than the recommended dietary allowance of all vitamins, known essential minerals, amino acids, and antioxidants (n=71) or placebo (n=55). At weeks 4 and 8, the patients were assessed by the Clinical Global Impression (CGI) and the Child and Adolescent Symptom Inventory-5 (CASI-5), and growth was measured.

The mean age of participants was 9.8 (standard deviation [SD], 1.7) years; 73% were boys, and 88% were White. Approximately one-half (56%) of study participants had moderately severe ADHD, and the average composite CASI-5 score was 1.50 (SD, 0.47).

At week 8, compared with placebo, micronutrient treatment was found to be associated with significant improvement in clinician-rated CGI-Improvement (difference, -0.36; 95% CI, -0.54 to -0.18; P <.001) and peer conflict scale (difference, -0.13; 95% CI, -0.26 to -0.01; P =.04).

No children who received the micronutrients experienced worsened severity of ADHD, but 3 of the children who received placebo worsened by 1 category. In addition, illness severity was reduced by at least 1 category among 56% of the intervention and 22% of the control cohorts (P <.001).

The micronutrient recipients grew 6 mm more than the placebo recipients (P =.002).

No evidence of blood or urine abnormalities were detected among the micronutrient cohort. A participant who received the placebo was found to have elevated aspartate aminotransferase and alanine aminotransferase levels.

Adverse events were reported by less than 10% of individuals overall, except for stomach ache (10.9% vs 18.2%) and diarrhea (10.9% vs 3.0%) among the intervention and control cohorts, respectively.

The study authors reported that using CASI-5 as the primary endpoint was a limitation of this study, as this patient population may not have had severe enough symptoms for this particular instrument.

These data indicated that supplementation with micronutrients may improve global symptoms of ADHD and promote growth among children.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Johnstone JM, Hatsu I, Tost G, et al. Micronutrients for attention-deficit/hyperactivity disorder in youths: a placebo-controlled randomized clinical trial. J Am Acad Child Adolesc Psychiatry. 2021;S0890-8567(21)00473-1. doi:10.1016/j.jaac.2021.07.005