What You Need to Know About the ‘Natural Remedies’ Marketed for ADHD

Medication is a valuable tool for managing the core symptoms of attention deficit hyperactivity disorder (ADHD). For those people who do not want to take the medication route behavioral therapy, nutrition and lifestyle changes, and/or brain training, among other natural therapies designed to improve focus and impulsivity may help alleviate some ADHD symptoms.

The fact remains: Between 80%-85% of patients with ADHD experience a positive response to methylphenidate and/or amphetamine — the two main classes of stimulant medication. Still, the widely-cited Multi-Modal MTA Cooperative Group Study¹ concluded that medication combined with behavior therapy is the optimal treatment of ADHD in school-age children. Here, we discuss the natural treatments used by many individuals with ADHD to augment medication.

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¹ The MTA Cooperative Group. A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry. 1999;56(12):1073–1086. doi:10.1001/archpsyc.56.12.1073

"There's no way to predict in advance if a child or an adult will be helped by any individual ADHD treatment, even medication," says Duke University's David Rabiner, Ph.D. His advice? It is critical to monitor your ADHD symptoms (and those of your child) to know what's working — and to be open to a variety of changes in nutrition, exercise, sleep habits, and more.

Many experts recommend keeping a symptom log to track improvements, setbacks, and side effects on a daily basis. This can help to pinpoint the areas of greatest need and, when shared with a medical professional, may suggest new strategies or treatment approaches.

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Behavioral therapy for ADHD is a structured discipline strategy that aims to teach children new ways of behaving by rewarding desired behavior, such as following directions, and eliminating undesired actions, such as losing homework. The American Psychological Association says that behavior therapy should be the first line of treatment for children with ADHD under five. It can be effective for older children as well.

Research shows that behavioral parent training (BPT)—which teaches parents skills for effective, productive interactions with their ADHD children— reduces parental stress and instances of non-compliance.¹ BPT programs typically span 12 to 20 sessions, each focusing on teaching parents new, specific techniques for addressing problem behaviors. The ultimate goal of these programs is to strengthen the parent-child relationship while teaching strategies for long-term behavior improvement.

¹ Ciesielski, H. A., Loren, R. E. A., & Tamm, L. (2019) Behavioral Parent Training for ADHD Reduces Situational Severity of Child Noncompliance and Related Parental Stress. Journal of Attention Disorders https://doi.org/10.1177/1087054719843181

The omega-3 fatty acids found in fish oil are important in brain and nerve cell function. The body cannot make omega-3 fatty acids by itself, so people have to get them through food, supplements, and vitamins. There are two types of omega-3 fatty acids in fish oil, EPA and DHA. The best supplements have two or three times more EPA than DHA.

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The Journal of Lipids reported that omega-3 and omega-6 supplements moderately decreased the severity of some ADHD symptoms, such as hyperactivity and impulsivity.¹ Additional studies have found that omegas may improve neural efficiency, improving an individual’s overall cognitive performance.^2, 3

¹ Derbyshire, E. (2017). Do Omega-3/6 Fatty Acids Have a Therapeutic Role in Children and Young People with ADHD? J Lipids. https://doi.org/10.1155/2017/6285218

² Dighriri, I.M., Alsubaie, A.M., Hakami, F.M., Hamithi, D.M., Alshekh, M.M., Khobrani, F.A., Dalak, F.E., Hakami, A.A., et al. (2022). Effects of Omega-3 Polyunsaturated Fatty Acids on Brain Functions: A Systematic Review. Cureus. 14(10):e30091. https://doi.org/10.7759/cureus.3009

³ Veatch-Blohm, M.E., Chicas, I., Margolis, K., Vanderminden, R., Gochie, M., Lila, K. (2021). Screening for Consistency and Contamination within and Between Bottles of 29 Herbal Supplements. PLoS One. 16(11):e0260463. https://doi.org/10.1371/journal.pone.0260463

CBT aims to change irrational or negative thought patterns that interfere with staying on task or getting things done — two obstacles for individuals with ADHD. For a person with ADHD who thinks, "This has to be perfect or it's no good" or "I never do anything right," CBT challenges the truth of those thoughts by getting the patient to examine the evidence.

A 2024 meta-analysis published in the Journal of Attention Disorders found that CBT plus medication is more effective than medication alone in improving adult ADHD symptoms and maintains an advantage for at least three months¹

¹Li, Y., & Zhang, L. (2024). Efficacy of Cognitive Behavioral Therapy Combined with Pharmacotherapy Versus Pharmacotherapy Alone in Adult ADHD: A Systematic Review and Meta-Analysis. Journal of Attention Disorders, 28(3), 279-292. doi.org/10.1177/10870547231214969

An ADHD diet rich in proper nutrition is a powerful tool for managing ADHD symptoms. Studies by Massachusetts Institute of Technology neuroscientist Richard Wurtman,Ph.D.¹, and others have shown that protein triggers neurotransmitters responsible for inducing alertness while carbohydrates trigger drowsiness. Protein also prevents surges in blood sugar that may increase hyperactivity. High-fiber foods such as fruits and vegetables, whole grains, and legumes can help stabilize energy levels. If you or your child is taking a stimulant medication, a low-fat breakfast will maximize its effectiveness. Fats can cause the body to absorb the medication more slowly, delaying the drug’s effectiveness.

"Protein is a satiating macronutrient that helps maintain stable blood sugar levels, which is important for regulating appetite and energy levels," says Roberto Olivardia, Ph.D., a Clinical Psychologist and Clinical Instructor of Psychology at Harvard Medical School.

Start the day with a breakfast comprising a balance of complex carbohydrates and protein, such as eggs with whole wheat toast or whole grain pancakes with yogurt.

¹ Wurtman, Richard J. “Nutrients That Modify Brain Function.” Scientific American, vol. 246, no. 4, 1982, pp. 50–59., doi:10.1038/scientificamerican0482-50.

Several ADHD vitamins and minerals are key to producing and regulating neurotransmitter levels in the brain, especially when a child or adult is deficient in one of them. Vitamin C is a building block of neurotransmitters, while iron and vitamin B6 increase dopamine levels. Zinc regulates dopamine, and may help alleviate ADHD symptoms in some children when used with conventional medication and treatments.¹

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One small study² showed ferritin levels (a measure of iron stores) to be low in 84% of children with ADHD, compared to 18% of a control group. Low iron levels — and low zinc levels, as well — correlate with severe ADHD, however, patients should not begin using supplements without the supervision and direction of their doctor.

¹ Akhondzadeh, Shahin. “Zinc Sulfate as an Adjunct to Methylphenidate for the Treatment of Attention Deficit Hyperactivity Disorder in Children: A Double Blind and Randomized Trial.” BMC Psychiatry, vol. 4, no. 9, 2004, doi:10.1186/isrctn64132371.

² Konofal, Eric, Michel Lecendreux, Isabelle Arnulf, and Marie-Christine Mouren. “Iron Deficiency in Children With Attention-Deficit/Hyperactivity Disorder.”Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 12, 2004, pp. 1113.

Exercise helps the ADHD brain function more effectively and efficiently. One well-known benefit of exercise is an increase in endorphins, which can improve mood. Exercise also elevates the brain’s levels of dopamine, norepinephrine, and serotonin, which increases focus and attention.

Studies have shown¹ that short-term aerobic exercise, including yoga, has positive effects on attention, hyperactivity, impulsivity, executive function, and other ADHD symptoms. Walking for 30 minutes four times a week will also do the trick, and skill-based exercises like martial arts or ballet are especially effective for those with ADHD.

"Exercise is particularly relevant to growing the parts of the brain that strengthen self-regulation and executive function, and can help to counteract or improve ADHD," says Joel Nigg, Ph.D., clinical psychologist and a professor in the departments of psychiatry and behavioral sciences at Oregon Health & Science University ²

¹ Cerrillo-Urbina, A., García-Hermoso, A., & Sánchez-López, M., et.al. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials: Exercise and attention deficit hyperactivity disorder. Child Care Health and Development. 2015. doi: 10.1111/cch.12255

² Liu, C., Liang, X., Sit, CHP. (2024). Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis. JAMA Pediatr; 178(3):247-257. https://doi.org/10.1001/jamapediatrics.2023.6251

Brain training for ADHD is growing in popularity and availability. Programs can be found for smartphones, computers, tablets, and beyond. Various brain training systems claim to improve common executive functioning challenges among people with ADHD, such as attention, impulsivity, and working memory. Many of the programs have layouts that look and feel like video games but are designed to exercise these specific brain functions.

Programs generally fall under neurofeedback training — which aims to change physiological activity by monitoring brain waves — and cognitive training, which focuses on improving specific brain skills like problem-solving and reading comprehension mainly through games and other exercises.

Whether brain training definitively works to improve ADHD symptoms, however, is still being researched. Some studies have demonstrated improved brain functioning in users. Critics, however, question how much users are actually benefitting. “Existing research does suggest that neurofeedback can result in improved attention, diminished hyperactivity, and enhanced executive functions, including working memory, for some patients,” said David Rabiner, Ph.D., and Ed Hamlin, Ph.D., in a 2017 ADDitude webinar. “However, some of the most important researchers in the ADHD field would argue that the efficacy of neurofeedback for ADHD has not been conclusively established. The bottom line is that research support for both stimulant medication therapy and behavior therapy is stronger than it is for neurofeedback at the moment.”

One brain training program, Play Attention, bills itself as a learning system that uses both neurofeedback and cognitive training to help users boost focus, refine memory skills, ignore distractions, and finish tasks. A series¹ of² randomized, controlled studies by Tufts University School of Medicine found that its users showed greater improvements in attention, hyperactivity, and executive functioning than students who used other programs.

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"If you are considering any of these approaches for yourself or your child, remember that the placebo effect can be potent, meaning that a program may work simply because you expect it to work, at least initially," says Stephanie Sarkis, Ph.D. and Ari Tuckman, Psy.D. "Keep in mind that any proposed intervention that is expensive and/or time-consuming must be able to make a much stronger case about its effectiveness."

¹Steiner, Naomi J., et al. “Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial.” Clinical Pediatrics, vol. 50, no. 7, 10 May 2011, pp. 615–622., doi:10.1177/0009922810397887.

² Steiner, Naomi J., et al. “Neurofeedback and Cognitive Attention Training for Children with Attention-Deficit Hyperactivity Disorder in Schools.” Journal of Developmental & Behavioral Pediatrics, vol. 35, no. 1, Jan. 2014, pp. 18–27., doi:10.1097/dbp.0000000000000009.

Green time is especially effective in helping kids recover from attention fatigue, which occurs after a long school day. Gardening, biking to school, and walking the dog in the park are all good ways to incorporate green time into the day.

Neurofeedback is a high-tech way, which claims to ease ADHD symptoms. During a session, the patient dons an electrode-lined cap and is asked to perform a complex cognitive task. The aim is to teach patients to produce brain-wave patterns associated with focus. Sessions are brief (30 minutes) and painless, but expensive. A course of treatment can range from $2,000 to $5,000.

Neurofeedback’s efficacy in treating ADHD symptoms is not conclusive, with multiple studies and reviews revealing opposing or weak evidence for the treatment.

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Mindful meditation for ADHD is attention/awareness training that helps manage stress, develop positive emotions, and strengthen self-regulation skills. It involves silent meditation and becoming more aware during daily activities. In other words, you stay "in the moment" as much as possible. Researchers wrote in a 2015 review¹ of multiple, similar studies that mindfulness provides “promising preliminary support for its efficacy” in treating ADHD symptoms. More research, however, is needed to definitively prove its effectiveness.

¹ Mitchell, J. T., Zylowska, L., & Kollins, S. H. (2015). Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions. Cognitive and behavioral practice, 22(2), 172–191. doi:10.1016/j.cbpra.2014.10.002