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ADD and Naturopathic Medicine
©Dr. Kevin Passero 2004
Dr. Kevin Passero, N.D
203 Ridgely Ave
Annapolis, Md 21401
443-433-5540
Naturopathic Medicine
What is it?

Naturopathic Medicine blends centuries-old
natural, non-toxic therapies with current
advances in the study of health and human
systems.
The Six Principles
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1) The Healing Power of Nature.
Naturopathic Doctors believe that the natural
state of the body is to be healthy. Our jobs are
to help the patient identify and remove obstacles
to healing and allow the body to heal itself.
The Six Principles
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2) Identify and Treat the Causes. The
Naturopath seeks to identify and remove
underlying causes of illness, rather than to
merely eliminate or suppress symptoms.
Symptoms as messengers

Naturopathic Medicine attempts to find the
underlying cause of the patient’s condition.

Much of modern medicine, conventional and
alternative is focused on symptom management.
Often this means neglecting the possibility of an
underlying cause.
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Symptoms are messengers, and what happens
when we shoot the messenger? We don’t know
from where the message came.
The Six Principles
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3) First Do No Harm.
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The Naturopathic Doctor implements this third
rule with the following precepts
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Utilize methods and medical substances which minimize the risk
of harmful side effects.
Avoid when possible the harmful suppression of symptoms.
Acknowledge, respect and work with the individual’s self-healing
process.
The Six Principles

4) Doctor As Teacher.
As Doctor’s we not only believe it is our job to help
people improve their health, it is also our job to
educate them so they can be responsible for their
own health as well.
 Encouraging self-responsibility for one’s health is a
major goal for the Naturopathic Doctor.
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The Six Principles
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5) Treat the Whole Person

This is achieved by taking into account individual physical,
mental, emotional, genetic, environmental, social and
spiritual factors.
The Six Principles
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6) Prevention
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Prevention involves assessing individual risk factors,
heredity and susceptibility to disease and making
appropriate interventions in partnership with the patients
to prevent illness.
How are ND’s trained?

Naturopathic Medical colleges are four-year,
graduate level medical schools with admission
requirements comparable to those of other
medical schools. The Doctor of Naturopathic
Medicine degree (ND) is awarded after
classroom, clinic and practical study.
ND’s are trained in medical sciences
including
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Anatomy
Neurology
Pathology
Obstetrics
Pharmacology
Lab diagnosis
Cardiology
Biochemistry
Minor surgery
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Immunology
Pediatrics
Clinical and physical
diagnosis
Physiology
Radiology
Microbiology
Gynecology
Dermatology
What NDs do

Clinical Nutrition

This refers to both the practice of using food to heal
people and using food to maintain optimal health.

Nutritional supplements are often employed to further
help people optimize nutritional intake for their particular
needs.
What NDs Do

Homeopathy

Homeopathy is a form of medicine that uses
extremely diluted preparations of substances to cure
illness.

As a medicine, it is unparalleled in its ability to effect
people on a physical, mental and emotional level
while at the same time having virtually no side
effects or drug interactions.
What NDs Do

Botanical Medicine
 Plant
substances are safe and powerful tools
in the treatment of many illnesses.
 Most
modern pharmaceuticals are originally
derived from plant compounds.
The Egg of Health
ADD/ADHD
And Naturopathic Philosophy
ADD/ADHD- What is it?

ADD/ADHD is classified by the Diagnostic and
Statistical Manual of Mental Disorders – Fourth
Edition as a mental disorder primarily characterized by
a “persistent pattern of inattention and/or hyperactivity
– impulsivity that is more frequent and severe than is
typically observed in individuals at a comparable level
of development.”

ADD/ADHD can be considered as a broad collection
of processing errors and disorders in the nervous
system.

The part of the brain controlling focus and
concentration is slowed down or dysfunctional.
ADD/ADHD
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1 in 5 U.S. boys takes a controlled stimulant
medication for the management of
ADD/ADHD symptoms

Between 9 and 12 million children currently are
diagnosed with ADD or ADHD

Over 350 million doses of Ritalin are distributed
each day in the United States
Why Boys?

It is speculated that boys are more susceptible to
conditions like ADD/ADHD and Autism
because of the interaction between testosterone
and mercury
Why Boys?

The main routes of exposure to mercury are via
thimerisol containing vaccines and mercury found in
food.

The CDC recently released data showing a 2.4%
increase in the risk of Autism if you have received
thimerisol containing vaccines.

The government considers anything that results in a 2%
increase in the chance of getting a condition to be
causal.
Central Issues in ADD/ADHD
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The Adrenal Glands and Cortisol Regulation
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Blood Sugar Regulation
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Gastrointestinal Health and Function
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Proper Elimination and Detoxification
The Adrenal Glands
and Cortisol
Cortisol, What is it?

A steroid hormone released from the adrenal glands to
increase energy in response to stress.

Under times of stress the body needs more energy.
Cortisol is released in an effort to provide this energy.

The energy derived from cortisol is a result of its ability
to stimulate the body to release glucose into the blood.
Cortisol and Daily Rhythms
What does Stress Mean

A stress related rise in cortisol can be triggered
by physical stress (strenuous exercise, surgeries
and physical trauma), mental stress (school,
work, money), and emotional stress
(relationships, family etc.)

Large fluctuations in blood sugar also elicit a
cortisol response
Cortisol and ADD

Is it high or is it low?
Cortisol and ADD
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Many children with ADD already have a
significant physiologic stress that predisposes
them to the condition. Coupled with daily stress
of family life and school these kids are usually in
a state of cortisol imbalance.

Overall Adrenal function is not optimal due to
overexertion. The situation can be likened to
burning a candle at both ends.
The Adrenal Gland
The Adrenal Connection

Cortisol is essential for normal functioning of human
physiology. Without proper cortisol regulation energy
levels, sleep cycles, immune function and mental
capabilities will all be compromised.

Secondly, as chronic stress persists the portion of the
adrenal gland responsible for cortisol production can
hypertrophy in an effort to keep up production. This
in turn compromises the ability of other areas of the
adrenal gland to function at optimal levels.
The Adrenal Connection
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It is hypothesized that Ritalin’s therapeutic effect
results from it’s ability to increase availability of
dopamine levels.
Dopamine is a precursor to important
neurotransmitters like epinephrine and
norepinephrine.
A major producer of epinephrine and
norepinephrine is the inner medulla of the
adrenal gland.
The Adrenal Connection
Cortisol and ADD
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Many people wonder why a stimulant
medication like Ritalin helps calm an already
hyperactive person
It is because there adrenal function is low to
begin with and their natural physiologic stimulus
is already low
The hyperactive behavior observed is a
compensatory mechanism in an effort to reach a
normal functioning state
Blood Sugar and
ADD/ADHD
Simple Carbs and Simple Sugars
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Breads
Potatoes
Pasta
Processed Grains
Some Fruits
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Refined Sugar
Juice
Candy
Junk Foods
Soda
Simple Carbs
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Simple carbohydrates are almost immediately
broken down by the body into simple sugars
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This results in a rapid influx of sugar into the
blood stream
The Physiology
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The sudden increase in blood sugar triggers a
sharp increase in insulin secretion, which in turn
rapidly lowers the sugar level in the blood
Blood Sugar and Insulin
Blood Sugar and ADD
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High sugar levels can itself be activating and can
trigger hyperactive behavior.
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Secondly, the quick release of insulin that leads
to low sugar levels worsens low brain arousal
levels of ADD subjects and aggravates
behavioral problems.
Take Home Message
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EAT MORE PROTIEN, BENEFICIAL FATS
AND FRESH VEGEATABLES
Optimal Blood Sugar Curve
Back to Cortisol
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We know cortisol is the key hormone that
triggers the body to increase blood sugar levels.
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So this pattern of hypoglycemia serves as a
further stress on the adrenal glands.
The Gastrointestinal
System
What does our GI system have to do
with our brains?
Our GI System
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Our GI system is our barrier to the outside
world
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It’s job is to act as a selective filter
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Something does not truly enter our body until it
passes the cells of the intestinal walls
Our GI System
Digestion
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Incomplete digestion of proteins can result in
the production of large molecular by-products.
Incomplete vs. Complete
Digestion
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Some of these more complex structures are not easily
utilized by the body and have a difficult time passing
through the cell membrane.
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This means less absorption of nutrients.
Dysbiosis
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Our GI tract is normally inhabited by more than 500
species of micro-organisms.
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These micro-organisms play a large role in the defense
of our GI system and in the breakdown of food
products.
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They also metabolize food products into vitamins and
amino acids that feed the cells of the intestine.
Dysbiosis
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Incompletely digested structures, like the one in
my diagram, can not be easily utilized by our
beneficial gut bacteria.
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However, bad bacteria have special urase
enzymes that can break these structures down.
The Problem
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The break down of these structures by urase enzymes
cause ammonia by-products to be produced.
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Elevated ammonia blood levels have been measured in
children with Autism, ADD and ADHD.
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Ammonia is a neurotoxin and further impairs
neurological function.
Dysbiosis
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Supplementation with beneficial gut flora and
the use of digestive enzymes help to optimize
gastrointestinal function.
Diet and Food Sensitivities
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A large body of medical literature has indicated that
hidden food allergy is a frequent cause of a wide range
of physical and mental conditions.
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Furthermore, although the concept of hidden food
allergy remains controversial, the evidence strongly
suggests that identification and avoidance of allergenic
foods can relieve a number of common and difficult to
treat medical problems.
Common Allergens
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Common foods that cause reactions are dairy
products, sweeteners, corn, wheat, yeast, orange,
soy, peanut, beef and chicken.
Wheat and Casein
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Some incomplete digestion by-products, like the ones
from wheat and casein, have molecular structures that
mimic opiod like molecules in the body. These opiod
like structures can exert effects on the neurological
system and aggravate symptoms of ADD/ADHD
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Some trials show as much as an 80% improvement in
ADD/ADHD symptoms with just the elimination of
wheat and casein from the diet.
Inflammation and Food Sensitivities
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Low level allergic reactions to food serve as a
constant source of inflammation in the GI tract.
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Inflammation of the GI tract causes a
compromise in the tight junctions of cells. This
allows for the easy passage of large molecules
directly into the circulatory system.
Our GI System
Consequence
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This constitutes a compromise of our selective
filter and barrier.
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We now have environmental toxins, mercury,
digestive waste and large proteins passing
directly into the circulatory system.
Food Sensitivities
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The elimination of irritants is essential in the
restoration of tight junctions and GI integrity.
Recap
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Eliminate food allergies and inflammation to restore
integrity of filter
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Improve digestion to enhance nutrient absorption and
eliminate incompletely digested protein by-products
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Establish strong colonization of beneficial microorganisms like acidophilus and bifidus species
Essential Fatty Acids
Omega 3 and Omega 6
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Essential Fatty Acids are compounds in our
body essential for proper functioning.
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They can not be synthesized by the body so they
must be obtained via the diet
Essential Fatty Acids
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All cells in our body are enveloped by
membranes primarily composed of essential
fatty acids.
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Proper functioning of this membrane is
necessary for the health of our cells.
The American Diet
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The average American Diet provides a ratio of
about 300:1 Omega 6 to Omega 3 fatty acids.
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The ideal ratio for our bodies in about 5:1.
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Omega 3 acids are severely lacking in an average
diet.
Omega 3
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Some of the highest concentrations of Omega 3
fatty acids are found in the brain and nervous
system.
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There has been encouraging research revealing
improvement of ADD/ADHD symptoms with
proper Omega 3 supplementation.
Where are the good fats found?
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Cold water fish is the best source of Omega 3
fatty acids.
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Beneficial fats are also found in freshly shelled
nuts, flax seeds, and avocadoes.
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Ample sources of these fats should be a part of
every diet.
A Case Study
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14 year old male presenting to the clinic with a
pervious diagnosis of ADD
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Mom reports problems at home with fighting
with siblings, not staying on task and lots of
mouthing off
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School reports slipping grades, not staying
focused during class and problems with teachers
Initial Treatment Plan
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Modify diet to eliminate all dairy products and
sources of refined sugar. This meant no juice,
soda pop or candy.
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Coached mom about cooking with more whole
foods like fresh organic vegetables, whole grains
and quality meats
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Also discussed importance of a good breakfast
Initial Treatment Plan
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Support Adrenal Glands. This was done with
a multiple B-vitamin complex and a regime of
going to bed at the same time every night and
waking up at same time every morning.
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Further support for cortisol rhythms was
achieved with an essential fatty acid supplement
that help modulate the growth
hormone/cortisol interaction.
Treatment Plan Cont..
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150 mg of magnesium once a day.
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Daily supplementation with beneficial GI microorganisms.
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Homeopathic Remedies to aid the body in the
breakdown and elimination of toxins.
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We also advised mom to discontinue topical cortisone
cream for a small patch of eczema on his leg.
1 month follow-up
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Little change in overall behavior. Things still seem to
be getting worse
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The child was very good about taking the supplements
and adjusting to the new diet without much complaint
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Patch of eczema getting slightly worse
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Homeopathic remedies changed and patient advised to
continue protocol for 1 more month
2 month follow up
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Behavior starting to improve. Mom notices
better ability to stay on task at home and less
talking back
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Child comments that he feels he can now think
before he speaks or acts.
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Treatment protocol continued for 1 more
month
3 month follow up
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Mom can not believe it is the same child. Home
life dramatically better, school life greatly
improved.
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Child feels it is easier to concentrate and does
not feel as agitated as he used to. Overall feels
calmer and in more control.
Dr. Kevin Passero, N.D
203 Ridgely Ave
Annapolis Md 21401
443-433-5540