It’s not on you. An enormous amount of stigma surrounds the use of stimulant medication, even if it’s one of the oldest and most studied psychiatric meds there is. And the stigma is continuously reinforced by all the people who don’t need it abusing the meds.

Sure, there’s also some risk for patients using them properly, but for them it does not compare to the sheer benefits provided by the meds.

You are not deficient in stimulants. So using them is not the answer.

Instead, look to nutrition.

https://pubmed.ncbi.nlm.nih.gov/24321736/

That is an interesting paper, as is the co-morbidity of ADHD with epilepsy that they cite. It's also hopeful for some people suffering from ADHD because it is suggestive of the possibility of a more complete treatment for some.

However there's a general understanding of ADHD (and related disorders such as ASD) as a spectrum of conditions with multiple contributing factors. Depending on the person ADHD will manifest with more or less hyperactivity, distractability, working memory issues, and lacking emotional regulation (among other things). Different causes combine to give a somewhat amorphous disorder with a range of common symptoms.

So adding a new treatment with fewer downsides (because stimulants can have a few) is great, especially as it might treat aspects of the disorder that aren't treated by stimulants. But this doesn't mean stimulants won't still be relevant in the future.

There's there's also plenty of research showing specific dopamine receptor dysregulations as contributing to ADHD. See for example https://www.researchgate.net/publication/364120700_Dopamine_...

So unless the research also shows that this is caused by pyridoxine metabolism problems, these hypotheses can both hold at the same time.

Picking some paper that talks about different causes doesn't mean other causes aren't still relevant. It will probably be decades before we can definitively rule out contributing factors.

PS It's generalizations like yours that are very stigmatizing towards stimulant use. We already know many people benefit from them enormously and significant numbers are not getting or taking them due to stigma.

You are making a complicated when it’s effing simple.

Just try taking high dose P5P.

And probably zinc:

https://www.nature.com/articles/s41598-021-94124-5

If you knew the metabolic pathways thus would be as clear as day. We need enzymes to make neurotransmitter and those enzymes need cofactors to work.

If only things were generally so simple. While I'm all for more possible causes that are more easily treated, I’d hardly call this convincing evidence that all we need to treat is zinc deficiencies. But time will tell, as I hope these kinds of research continue.

But did you try it????

Yes, didn't work, stop acting like an asshole. It is very common to check for deficiencies, if people with ADHD had it then likely they wouldn't be prescribed meds before the deficiency is fixed in the first place, you questioning others like this is just making their life worse.

One, I do not beleive you.

Two, If you did, how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?

Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.

And calling me an asshole when I am advocating for better health is making everyone's life worse. I do not mind if people choose to take stimulants, but they are not being advised that there are other options.

> One, I do not beleive you.

That makes you an asshole.

> Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.

Why do you believe this? It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing. Do you have any evidence it isn't common to check for deficiencies, because to me it seems like that is one of the first thing they check.

> Why do you believe this?

Because I have worked with health care professionals for 20 years and they do not test for nutritional deficiencies unless you ask/beg them to. This is even more true with psychiatrists. I am advocating right now for a woman with a serum B6 deficiency that her doctor will not address. She has an actual serum B6 deficiency and anemia and depression and her dopctor thinks it is not importnat. That is why.

> It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing.

There are deficiencies and functional deficiencies. Plus there is serum B6 and RBC B6. Have you had your RBC B6 tested? Nope.

And Homocysteine levels will reveal more than serum B6.

And I do not believe you because you did not answer "how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?"

The pills says just vitamin B6, 1.4mg, more than a year. For zinc I eat way more than I need since I eat mostly vegetarian and legumes contains plenty of it.

Then reason you are an asshole is that you are asking questions that takes a lot of work to answer since most wont know the answer to them on the spot. That is a very common tactic when you try to push your pet theory on others, but you should know that nobody thinks you won the argument when you do that they will just see you as an asshole. Even if you are doing it to be nice, you will be seen as an asshole, so please stop doing that.

THANK YOU for answering. See, this is what I mean. 1.4mg? That is nothing. The dose that use in testing are 50 to 100mg. And you should be taking P5P.

People I know take 30 - 60mg of P5P to feel the effects.

You were not taking high dose B6, just the RDA, and that will not do anything. And it will not correct a deficiency.

You think it takes a lot of work to answer? What about all the work I do looking into this and asking? For who? For you. Instead of calling me an asshole understand that I am helping you, for free, unlike your doctors.

So you cannot say taking B6 did not work for you.

Treatment with stimulants doesn’t treat deficiencies of stimulants. This is immediately obvious with patients who actually benefit from the meds, because they’re generally not stimulated by them. Treatment with many chemicals doesn’t treat deficiencies of those chemicals. In the case of stimulants for ADHD, they help regulate dopamine and norepinephrine intake. In practical terms, results of successful treatment include improved management of executive function, reduced social and sensory stress, and healthier sleep patterns. I can’t say what anyone else’s answer is, but stimulants saved my life because the impact of the things they helped me address were life threatening. Using stimulants as prescribed by my doctor was definitely an answer for me, and I am grateful for the life I kept intact because of that.

Medications saved my life as well. That is not the point. The point is do you keep taking them and not look for the nutritional answer to your problem.

If a B6 deficiency cured your ADHD would you still want to take stimulants?

> If a B6 deficiency cured your ADHD would you still want to take stimulants?

Assuming you mean “if treating a B6 deficiency”, and assuming I had strong expectations that I could expect a cure, I’d consider giving it a try. I’d be cautious about any transition, as it could mean either significant side effects while still taking stimulants, or significant regression without them if the B6 treatment doesn’t work as hoped.

But I don’t even have a strong expectation that I could expect equivalent or better management. The study you linked was conducted with children, and the conclusions based on observations of children’s behavior. Maybe that’s a good indicator that it’s helpful, but I have no clue. I wasn’t diagnosed as a child, my ADHD was noticeable to one adult in my adulthood enough to mention it, and my experienced symptoms are much closer to autism (again as experienced by adults, not as behavior observed in children, although those diverge much less for me). But the things mentioned improving in the study are very much not what I’ve struggled with having ADHD as an adult, nor things for which I sought diagnosis or treatment.

The way diagnosis and treatment saved my life was helping me manage crippling anxiety and helping me make chronic depression manageable. It’s possible that exploring a nutritional deficiency none of my doctors have found with supplements no one has studied for adult ADHD… it’s possible that would benefit me. It’s a very high risk proposition given I have meds which work for me and which present no side effects so negative I’d reconsider.

Moreover I haven’t had a single medical professional raise this possibility and with good reason. My treatment is working. Even if an alternative treatment might be promising… why would any responsible doctor propose disrupting a persistently successful treatment plan?

I don’t know why you’re so motivated to disabuse me of my effective medication, but you’ll have to do better than showing a study which made children more tolerable. I credit my life to the meds that I take now, and there’s very very little I could fault them for. Asking me to reconsider that is asking an AWFUL lot.

You make me assumption that I’m trying to disabuse you of taking your medication. I’m not. I don’t care, take it if you want. But by not being open to other methods of treatment, you aredisabusing people of that choice.

You go on and on about how you don’t think it would work, but have you ever had your B6 level tested never mind your red blood cell B6 levels?

I get it, you don’t care, you found a treatment that works, even though that treatment is not curing the underlying disorder. It’s just a treatment. I get it it works, until it doesn’t. I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.

So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do. That’s OK.

Responding to both your comments in one.

> I mean you did not even bother to search for another paper.

I most certainly did. The search results I got were primarily ads, and few clinical studies I found were, like the one you linked, far less bold in the results they claimed than your claim of a “cure”.

> You make me assumption that I’m trying to disabuse you of taking your medication. I’m not. I don’t care, take it if you want. But by not being open to other methods of treatment, you aredisabusing people of that choice.

Excuse me, how?

> You go on and on about how you don’t think it would work

The studies themselves don’t support your claim of a cure.

> but have you ever had your B6 level tested never mind your red blood cell B6 levels?

No, I haven’t been to a doctor since some person on the internet mentioned this a few days ago. I did have a scheduled psychiatrist appointment in that time, but had to reschedule because il out of state for a family medical emergency.

> I get it, you don’t care

I don’t know where you got that impression. I took the time to reply thoughtfully and, despite your impressions otherwise, to look for other studies more pertinent to my own experience. In my thoughtful response I expressed caution and the reasons for that caution, which you completely ignored.

> you found a treatment that works, even though that treatment is not curing the underlying disorder

That’s right. And it’s important. It’s the reason I’m still alive. I’m cautious about upsetting treatment that works because I would very much like to remain alive.

> I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.

I don’t know if you mean the disorder is new in the world (it’s not) or in me (it’s also not).

> So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do.

I don’t know where you got that impression. An open mind isn’t characterized by immediately accepting life changing “solutions” proposed by random people on the internet, regardless of whether they cite medical studies. I expressed an open mind, I said I’d consider giving it a try.

> That’s OK.

In your own words, I don’t believe you. You have talked past me and several others in this thread, and you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes. You have even suggested that I’m preventing other people from treatment (or a “cure”) you think more appropriate simply because I haven’t dropped everything to try your preferred treatment. If this is how you “work with” other people who are hoping to treat their ADHD effectively, god help them. And it has nothing to do with the particular treatment, I felt the same way about my first psychiatrist who was just as zealous about stimulant treatment.

> The search results I got were primarily ads..

Maybe use PubMed and not google?

> you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes.

I NEVER SAID THAT ONCE. Take stimulants if you want, but just because that is your choice do you need to be so outraged by the idea that B6 might work just as well?

>> But by not being open to other methods of treatment, you are disabusing people of that choice.

> Excuse me, how?

YOU: Moreover I haven’t had a single medical professional raise this possibility and with good reason.

You: But I don’t even have a strong expectation that I could expect equivalent or better management.

You: I don’t believe you.

This negative stance only feeds on this idea that medications are the only choice, the only answer, and that nutrition never works becasue "there are no studies" or "My doctor did not recommend it".

You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance. Have you worked in Nutritional Genomics? Do you even know why treating a B6 deficiency might be important not just for your behavior but your over all health? If you have a B6 deficiency and take stimulants to cover up the symptoms, what about all the other enzymes that need B6 to function?

Over and over they find B6 deficiency in ADHD. There will be no studies showing the efficacy of B6 because there is no funding for products that do not make a profit. You are on stimulants because they work and they are profitable.

Next thing they will get you to take will be Metadoxine. Ha!

https://pubmed.ncbi.nlm.nih.gov/25295645/

https://pubmed.ncbi.nlm.nih.gov/23290324/

Hmmmm...I wonder why they were trying out Metadoxine for ADHD, and wonder why it failed...oh....Metadoxine, also known as pyridoxine-pyrrolidone carboxylate. So they made a funked up version of B6? Why would all these smart science people want to make a funked up version of B6 if B6 was not linked to ADHD?

Do you think maybe they know something they do not want you to know? And maybe that is because ADHD meds brings in about $20 Billion for these companies?

Have you thought you do not want to hear anything but stimulants are the only answer for you? And that I am not talking past you but that there is no one there who wants to listen?

> so outraged

I normally hate to quote this but it fits: calmer than you are.

> You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance.

My gosh, you’re being a jerk. I haven’t had my B6 levels tested in the last few days because it’s in the last few days and my medical appointment was canceled because I’m out of state for a family medical emergency! Have you thought about the fact that I literally physically cannot meet your expectations of an open mind and that your expectations are totally unreasonable?

> I haven’t had my B6 levels tested in the last few days because it’s in the last few days

I was asking if you had your B6 levels tested ever, not in the last few days.

You’re reading what I wrote much more dramatically than it is implied. The fact you think I am really telling you to run out right now and get your B6 tested is distorted.

I mean you did not even bother to search for another paper. And there are more than these two.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153567/

I’m exactly the same. I knew 40m in, right when it started to take effect. It was night and day. Like I’d just walked from a raging thunderstorm into a quiet sunny meadow, but I’d thought that I was in a quiet meadow my whole life. It was profound.

There was a decade between me first seriously suspecting it, and that.

Information about it is much easier to come by now, and more people talk openly about it. Without that, I probably would have struggled for much longer.

'Like I’d just walked from a raging thunderstorm into a quiet sunny meadow, but I’d thought that I was in a quiet meadow my whole life. It was profound.'

That is profound. Also says a lot about us as humans. Glad it's not raging anymore