I’m excited to bring you a new video. I know it’s been quite a while since I was able to publish one. All I can say is it’s been an amazing year and we’ve been super busy with lots of growth in our practice and personally as well. But I hope to refocus on this because I have a lot of great information, I’d love to share with you and help him bring some awareness on some important issues. Today’s video is going to be about ADD and low dopamine. And those of you who followed a lot of our work this may be a topic you’ve heard about before but I’m really going to expand on it today in a different way to share with you these ideas.
So, the concept for this talk is that people have predictable symptoms when they have high or low dopamine. This is a model that we’ve developed in our practice, it is based on research and current understanding of neurochemistry. And the idea is that we have a bell curve, or research calls it a U-curve (I use a bell curve because that’s how my brain likes to look at things) and in this red line represents that bell curve.
Today’s video we are talking about the low catecholamine phenotype or, said another way, people who have a tendency to have low dopamine or low norepinephrine, low adrenaline. There are people out there who are suffering because their dopamine is too low and they have a certain set of symptoms that makes them unique and different than people who have high dopamine symptoms. We’ll make a future video and explain how the high dopamine symptoms really work. But for the low dopamine person, the low catecholamine person, ADD and ADHD is a very common symptom in this group.
When looking at genetics, the question is am I sick because of my genes are there or, am I sick because of an environment that is making my body sick? Well, our philosophy at our practice and with all the work we’ve done with Beyond MTHFR is that your genes in fact are not your destiny but they are your tendency when you’re under stress. So, your genetic programming that you’re born with is always changing and adapting to the environment and we have control over the environment.
So, it dawned on me a few years ago that this model for dopamine is a good model for understanding symptoms that I saw in practice. Today’s video, as I said, is about ADD and ADHD but there are quite a few other ones were going to talk about in future videos. So, the moral of the story with this is on this bell curve of dopamine the x-axis is low dopamine moving over to high dopamine levels in the brain. The x axis represents total levels of dopamine activity in the brain, if you will. The vertical axis, the y axis, is brain function. So, you see when your dopamine is low, over here, your brain function is low but as you increase dopamine you get into this “Goldilocks” sweet spot where you have really good brain function. But if you continue to increase dopamine without stopping, you can go down the other side of the curb and have poor brain function again with different symptoms.
So, ADD and ADHD. Why am I talking about this common problem and relating it to dopamine? Lack of dopamine is associated with ADD and ADHD. That is, when people are given medications like Ritalin (methylphenidate as the generic is called), it’s basically a methamphetamine. It’s almost identical to methamphetamines that you go to prison for, yet we’re giving it to our kids to try to improve their focus. When we’re giving kids and adults Ritalin, or methylphenidate, what’s happening is your increasing dopamine and noradrenaline in the brain. And that improves focus. How do I know that? Well, the research that’s published shows that 90% of the time when someone has a diagnosis of ADHD or ADD, they will experience an improvement. So, if raising your dopamine with the drug makes you better 90% of the time, what we conclude is that part of your problem is that you had low dopamine to start with. Pretty basic idea, right?
Now it’s interesting there’s a difference in ADD and ADHD, males to females. So, it’s important to understand first that men have a tendency to have low dopamine and low catecholamines. This movie, Grumpy Old Men, is a great flick. Well it’s not called grumpy old women because that’s not what we observe. We observe that as men go through their life, boys and men, they tend to have more episodes of anger and grumpiness than females. Just in general, it’s been my observation in the clinic and most people I’ve talked to would agree that boys tend to get grumpy. Give him a Snickers bar, hopefully not, but give him something to eat, it raises blood sugar again, and they feel better.
This is part of our biology, it’s how our hormones and our genes interact with our chemistry. So first of all, men are more susceptible to low catecholamines, low dopamine. And when we look at ADD and ADHD the ratio is about 3 to 1. So, boys are much more likely to have ADD and ADHD than girls, and why is that? Well if this model of low dopamine holds any water, then it explains why, right? The low dopamine model explains this because we already know that men and boys are susceptible to lower dopamine. And we know that low dopamine drives the symptoms of ADD and ADHD because when they give them medication to raise dopamine 90% of them get better. That’s all logical and it makes sense. The research just corroborates what we know.
Now, many of you have followed our work on methylation and MTHFR and these are all connected topics. Because a poor MTHFR system, either genetic mutations or you know dietary, environmental problems with that MTHFR system, what that will do is that will lower the level of dopamine that you can make. People with MTHFR are at a much higher risk of depression and that has simply to do with the fact that when your MTHFR is slowed, you do not make as many neurotransmitters as quickly as other people. If you have low dopamine and problems associated with low dopamine, taking activated folate and B vitamins and maybe amino acids like tyrosine will make you better. That’s the beautiful thing, they work.
But the hard part is knowing whether you have high or low dopamine, and that is what these videos are intended to help you figure out. So this is connected to MTHFR from the point of view that boys and girls with ADD and ADHD don’t have enough dopamine and making more dopamine is what MTHFR is involved in. It is heavily involved in how fast and how many neurotransmitters we make.
Looking at the discrepancy between boys and girls, this was a study that showed around puberty boys have a whole lot more receptors for dopamine than girls. So, the male brain has a higher need for dopamine. That’s the moral of the story. I’ll get into that in other videos here in the near future. But really what happens is boys’ brains are sensitive to dopamine levels, more than females, and they need it more than females and so when the dopamine is low it is going to affect boys more. And that may explain why ADD/ADHD is two to four times higher in men than women. Guys just need a steady supply of dopamine or their brain won’t work very well. Women need it too but it seems to hit boys especially teenagers and young adults more than anyone else.
There are lots of neurotransmitters, but in my opinion, dopamine rules the roost. It is the ultimate thing that we are after when we decide to go skydiving, when decide to go rock climbing a thousand feet off the ground, when we decide to do all kinds of crazy dangerous “extreme sports” or even play football; anything that is exciting gives you a bump of dopamine and our brain is programed to seek those things out. So, as we look at dopamine levels and we are able to see who has high dopamine and who has low, we’re able to make changes for people who have been resistant to other treatment, other types of approaches.
But dopamine also has a huge impact on memory, learning, and movement as well. They’re all catecholamine, dopamine dependent. Think about Parkinson’s Disease. It’s a very challenging illness and science, despite its best efforts, hasn’t really broken through to figure out how to turn these people around. And that’s what happens to the body on low dopamine. What happens to a Parkinson’s patient is what happens when you run out of dopamine. It’s a significant problem to the system. Dopamine is needed but it’s hard to keep it in the right Goldilocks position. That’s what our practice and all the research we’ve done on methylation has helped me helped accomplish for people. So, this chart of mine is really just a visual to explain why dopamine is so important for ADD and ADHD.
Years ago, before I was even thought I would become a doctor, I was probably a teenager, I had heard of people who had problems with hyperactivity and they took a stimulant. They took methylphenidate – or Ritalin. And I’m thinking you know just logically why would you give someone who’s already over active a stimulant? And yet it works, in 90% of the cases. That fact makes sense now. The reason you’re seeing Hyperactivity in somebody with ADD and ADHD, and someone with low dopamine is simply this: this green area in the front of brain, it controls your brain function. It’s the big baby sitter that controls all this primitive, emotional stuff that’s happening in our deeper brain center, in our limbic system, and our emotional system. You know this is kind of the human brain, the mammalian brain, and then you have the reptilian brain. But really all that emotional regulation, that seeing the big picture, being a very well-mannered self-controlled, your best personality, your best ability to take test, to achieve in sports, to achieve in life… All that good quality comes from the ability of the frontal lobe to function. And the frontal lobe is run by dopamine. Just that simple.
When you lose dopamine your frontal lobe goes down like this blue arrow shows and now you have escape or expression of these impulses, this irritability, and this lack of focus that comes out from these deeper brain centers. In other words, when you lack dopamine, when you’re low dopamine, the brain isn’t going fast enough and it can’t focus long enough to learn well, to sit in a classroom for 45 minutes and go through a lesson while you sit in your desk. It takes a lot of focus, lot of concentration. Without dopamine in the system the brain is just going to be looking at everything and anything but what it should be looking at. And so I share this picture with you just so you have a model to understand when the frontal lobe goes down these deeper systems erupt.
And again another look at the bell curve this is really my most important piece of functional medicine work or nutritional work, genetic work I’ve ever put together. This model, this picture has helped me help more people than anything else I’ve ever discovered in my own practice. It is the model of the bell curve of dopamine. And what we strive to do for our patients is figure out whether someone is low like this blue star and they need to increase their dopamine levels to get back to the Goldilocks Optimum area; or if they’re like the red star, kind of like this young woman here, and we have to bring their dopamine levels down and that actually helps them. And we’ll talk about that in the future. So, ADD and ADHD is related to low dopamine. We know that because giving people drugs that raise dopamine ninety percent of those kids get better. We don’t have to use medication. There’s no law that says you have to take Ritalin. There are other ways. And that’s what we focus on using MTHFR and B vitamins and methylation Pathways and bh4 levels and amino acid support and really the whole toolbox of functional medicine.
I hope you’ve enjoyed the short video and again my apologies for my sabbatical. But we are back. We are going to make some more videos. It’s going to be a lot of fun sharing the new stuff with you guys. And if you haven’t had a chance to check out the book, Your Genius Body, it’s a great read. It’s a good handbook for all these ideas, a good reference.
And if you happen to be a practitioner, who is interested in this work that I’ve done and we put out over the last few years, we have a coaching program starts in about two weeks. It’s once a week on a Thursday morning and it’s going to walk you through how to implement these ideas in your practice. There’s going to be a lot of hand-holding and really a lot of teaching on how to apply all these ideas of MTHFR, dopamine levels, epigenetics, gut health. And we’re going to take you through 12 weeks and help you implement these in your practice so if that’s something you’re interested and would love to hear from you. We only have a few spots left and you can email us at our office at coaching@RedMountainClinic.Com. And we will give you all the info. And you can learn about the program on the Beyond MTHFR website as well.