What is a micronutrient?  An essential nutrient, as a trace mineral or vitamin, that is required in minute amounts, for the normal growth and development of living organisms.

How does science support the use of broad-spectrum micronutrient treatments?  The brain is a micronutrient-based organ.  Vitamins and minerals cross the blood-brain barrier to:

• Operate as CNS cofactors of enzymatic reactions and transcription factor conversions.
• Serve as structural components of enzymes involved in neurotransmitter synthesis and metabolism (minerals).
• Help with receptor transformation, transport systems, ion channels, and pump mechanisms.
• Alter membrane fluidity.
• Affect second and third messenger systems, leading to neuron growth and repair, preventing apoptosis.

How do nutrient deficiencies affect the body's systems?  Nutrient deficiencies and genetic variants in cofactors and enzymes can cause oxidative damage to nuclear DNA and mitochondria leading to:

• Inflammation
• Endothelial dysfunction
• Neuronal apoptosis
• Accelerated aging

How does the standard American diet affect micronutrient deficiency rates?  Modern agricultural and food supply practices have reduced micronutrient concentrations.  Naming just the top 4 deficiencies, 92% of Americans do not get enough potassium, 86% do not get enough vitamin E, 69% not enough calcium, and 57% not enough magnesium as per the IOM estimated average dietary requirements.

Nutritional Studies from Australia, Spain, UK, Japan and Canada Show:

• People who eat "traditional unprocessed Mediterranean prudent diets" have lower rates of mood and anxiety symptoms.
• People who eat "Western processed diets" have higher rates of mood and anxiety symptoms.

Should micronutrient supplementation be single nutrient or broad spectrum?  Single nutrient effect sizes for mental disorders are generally small.  Nutrient insufficiencies, deficiencies, and nutrient-based pathway genetic variants are broad and ubiquitous across the population.  Research shows broad-spectrum micronutrients are more likely to be more efficacious in more individuals than single nutrients.

What evidence supports broad-spectrum micronutrient treatments for mental disorders?  Since 2001, studies supporting the safety and efficacy of broad-spectrum micronutrient treatments have been published on:

• Anxiety
• Aggression
• ADHD
• OCD
• Mood disorders/bipolar spectrum disorders
• Behavioral symptoms associated with autism
• Substance abuse
• Acute stress following natural disasters

What studies have been done on using broad-spectrum micronutrients to successfully treat ADHD?  In 2014, Dr. Julia Rucklidge conducted an independent study on broad-spectrum micronutrients in adults with ADHD.  The study targeted 80 adults with ADHD who were medication free, average aged 35.  The study concluded that 30% of the participants experienced mild improvement after just 8 weeks compared to placebo, and and additional 38% were much improved or very much improved in hyperactivity/impulsivity as well as inattention.

What happened to those study participants after one year?
"Those who stayed on the micronutrients for one year following the study fared far better than those who reverted back to their medications or discontinued treatment altogether," shares Dr. Julia Rucklidge (2014, Br J Psychiatry).  [See Figure 1]

More recently, an independent double-blind study was conducted by Dr. Julia Rucklidge, et al., on children with ADHD using Daily Essential Nutrients, an advanced, clinical strength broad-spectrum micronutrient treatment.  

Their findings were published on Oct. 2, 2017, in the Journal of Child Psychology and Psychiatry.

The researchers commented, “This is the first fully blinded randomized controlled trial of medication-free children with ADHD assigned to either micronutrients or placebo…” Half of the ninety three study participants (aged from 7 – 12 years) were randomly assigned Daily Essential Nutrients and the other half were assigned placebo [micronutrient look-alike pills but with no active ingredients] for 10 weeks.” Study participants in the micronutrient group took an average of 11.8 capsules of Daily Essential Nutrients per day.

Here are the key findings from the research:

• Micronutrients significantly reduced impairment and improved overall function.
  
  • Clinician ratings identified that “...47% of those on micronutrients [were] ‘much’ to ‘very much’ improved versus 28% on placebo.” (Overall Clinician Global Assessment Improvement, p=0.029)  The study authors reported: “Many parents commented that...their child was calmer, more able to be reasoned with, and happier.”
    
    
• Micronutrients significantly improved inattention.
  • Researchers found that “Inattentive symptoms appeared to be improved more than hyperactive-impulsive symptoms… 32% of those on micronutrients versus 9% of those on placebo showed a substantial change (30% drop) in inattentive symptoms.” (Clinician ADHD - attention sub-scale, p=0.005)
    
    
• Micronutrients dramatically improved emotional regulation and aggression.
  • Researchers found that “Twice as many of the children who entered the trial with severe mood dysregulation, and were randomized to micronutrients, showed a clinically significant improvement in emotional dysregulation compared with placebo (41% vs. 20%)… These measures tapped into behaviours including hot tempers, fights with other children, explosive angry outbursts, and moods changing rapidly for no reason. These improvements on emotional control were consistent across the three raters (clinician, parent and teacher).”  (Parent Conduct Problems ratings, p=0.015; Teacher Emotional Control ratings, p=0.009) 
  • Researchers acknowledged that “Management of emotional dysregulation presents a considerable therapeutic challenge for parents, teachers and clinicians…” and were very encouraged by what the study results meant for the lives of the children involved, concluding that “These improvements bode well for improving life outcomes.”
    
    
• Daily Essential Nutrients was safe: there were no differences in side effects between the micronutrient and placebo group.
  • Researchers concluded the study by commenting, “In addition to conferring the symptom improvements, the micronutrients were safe and well-tolerated over the course of the 10-week trial and as such, they may have an important role in the treatment of childhood ADHD, particularly in cases where conventional stimulant medication is not viable, either due to ineffectiveness, poor tolerability or parental preference.

Randomized, placebo-controlled double blind studies are the gold standard of scientific rigor, and across multiple disorders and different supplement formulas, micronutrient therapy is being proving to be effective and reliable.

The study authors commented that “There are now a number of double-blind randomized controlled trials (RCT) supporting the positive effect of broad-spectrum micronutrients for the treatment of symptoms associated with clinical conditions, including autism, ADHD, conduct disorder and depression.” And the results of this study were not biased by selecting for kids that were more likely to respond. The authors emphasized that “A strength of this study was that participants [were] typical of children seen in clinical practice.”

_{Useful References
• Kaplan, B. J., Rucklidge, J. J., McLeod, K., & Romijn, A. (in press). The Emerging Field of Nutritional Mental Health: Inflammation, the Microbiome, Oxidative Stress, and Mitochondrial Function. Clinical Psychological Science. DOI: 10.1177/2167702614555413
• Sarris, J. et al. (2015). Nutritional Medicine as Mainstream in Psychiatry: A Consensus Position Statement from The International Society for Nutritional Psychiatry Research (ISNPR). Lancet Psychiatry, 2, 271-274.
• Popper, C. W. (2014). Single-Micronutrient and Broad-Spectrum Micronutrient Approaches for Treating Mood Disorders in Youth and Adults. Child and Adolescent Psychiatric Clinics of North America, 23(3), 591-672. doi: 10.1016/j.chc.2014.04.001
• Rucklidge, J. J., & Kaplan, B. J. (2013). Broad-spectrum micronutrient formulas for the treatment psychiatric symptoms: A systematic review. Expert Review of Neurotherapeutics, 13(1), 49-73.]}

_{The information presented in this article include excerpts from a presentation given by:
Barbara L. Gracious MD, Jeffrey Research Fellow, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital, Associate Professor of Clinical Psychiatry and Nutrition in association with Ohio State University.}

About Hardy Nutritionals®

Hardy Nutritionals® multivitamin-mineral products are powered by our proprietary NutraTek™ mineral delivery technology, which combines each mineral with specialized organic molecules—just like nature—to optimize absorption and distribution to body cells. Our flagship supplement, Daily Essential Nutrients, is widely considered to be the most research-backed micronutrient treatment.