Chinese herbal medicine, the perfect ADHD remedy

Ing. Jan Jileček

Oct 13, 2018·9 min read

Herbal therapy can be multiple times more effective than Ritalin, as I found in one scientific paper, which made me delve more into the area and make a thorough research of Chinese herbs as ADHD therapy.

For those unaware, ADHD is divided into 4–7 sub-classes (Dr. Daniel Amen)
Classic
Inattentive
Over focused
Temporal Lobe
Limbic
Ring of Fire
Anxious.

and each has it’s different symptoms and syndromes and thus, treatments. Therapy with Traditional Chinese Medicine (TCM) relies on differentiation of those symptoms and applies different therapy based on it.

ADHD has 5 main syndromes:

1. Heat in heart and liver
2. Internal disturbance of pyrophlegm
3. Deficiency of liver-yin and kidney-yin
4. Heart-spleen deficiency
5. Liver depression and spleen deficiency

For example, the inattentive type, which is characteristic by the heart-spleen deficiency, will be relieved by nourishing the heart and soothing the nerves, invigorating spleen and supplementing chi.

A combined type with liver depression and spleen deficiency (which is characteristic i.e. by impulsiveness, irritability, lack of strength, reduced appetite, pessimism, depression and absentmindedness..) will benefit from soothing the liver and strengthening spleen, tonifying chi and resolving depression.

Another thing to note is that the condition can have it’s root in different organs. If the “disease” (as TCM calls it) is located in the liver, the symptoms will include impulsiveness, hyperkinesia, irritability and lack of self-control.

If it is located in the spleen, the symptoms are inattentiveness and poor memory. And if in kidney, then they include poor academic achievement and memory, enuresis, soreness and weakness of the waist and knees.

Note on Yin-Yang pair organs — Zang Fu

In TCM, every organ belongs to a yin-yang pair. It’s so called “Zang-Fu”.

• Earth (土) = Spleen (脾) and Stomach (胃)
• Metal (金) = Lung (肺) and Large Intestine (大肠)
• Water (水) = Kidney (肾) and Bladder (膀胱)
• Wood (木) = Liver (肝) and Gall Bladder (胆)
• Fire (火) = Heart (心) and Small Intestine (小肠)

If one organ is weak, the another compensates, and vice versa. Just like yin-yang harmony.

There are emotions, tastes and elements associated with each organ, but that is for another article. Each organ has also either yin form or yang function.

Yin is a form, or substance and Yang means a function. The form and function are inter-connected. Substance/Form is an anatomic basis of a function and at the same time its “fuel”. On the other hand, the function activates and motivates the form, and it also replenishes, builds and holds it.

If we were to say it in an analogy, the best suitable would be that of a candle: the function of a candle is to burn. The form of the candle is the wax and the wick (Tao of Healthy eating — Bob Flaws)

I.e. spleen and stomach create a yin-yang pair — the spleen is the yin, and the stomach is the yang. The stomach is at the center of the triple burner, acting as a kettle, under which the “fire” of spleen burns, and makes the digestion possible.

Yin-Yang differentiation

If there is a yin-deficiency, the symptoms are:

• inattention
• poor self-control
• emotional lability
• absent-mindedness

and in case of yang excess

• hyperactivity
• talkativeness
• impulsiveness and willfulness
• irritability

So, first you need to establish which symptoms you have, and then use a corresponding therapy, which is listed below.

Herbal Decoctions and their effectivity

Duodongning granule
Consists of:
Gouqizi (Fructus Lycii)
Shudinhuang (Rehmanniae radix preparata)
Wuweizi (Schisandra chinensis)
Renshen (Ginseng radix et rhizome)
Fuling (Poria cocos)
Gancao (Glycyrrhizae radix et rhizoma)

In invigorates the heart and kidneys, calms the nerves and reinforces intelligence.

In randomized and double-blind clinical trial (Clinical comparative observation on duodongning and Ritalin in treating child hyperkinetic syndrome), children with ADHD (N = 37) treated with Duodongning granule achieved the similar total effective rate (89.2%) as the methylphenidate (MPH) (10mg/day)-treated group (N = 33, 87.9%) after 4 weeks of treatment.

Yizhi mixture
Yizhi is composed of 10 herbs, including:
Lujiaoshuang (Cervi cornu degelatinatum)
Guiban (Testudinis carapacis et plastri)
Shudihuang (Rehmanniae radix preparata)
Gouteng (Uncariaeramulus cum uncis)

It synergistically supplements the liver-kidney yin to tranquilize the liver yang. In a randomized trial of 12 weeks treatment, combined treatment with the Yizhi mixture and MPH group was significantly more effective than the Yizhi mixture or MPH (10–30mg/day) treatment alone (N = 70 each); both the Yizhi-mixture-alone group and the combined group had significantly fewer side effects than the MPH alone.

Ningdong granule
Includes these herbs:

• Gastrodiae rhizoma / elata — Tian ma
• Condonopsis radix — Dang shen
• Ophiopogonis radix — Mai dong
• Paeoniae alba radix — Bai shao
• Uncaria rhyncophylla — Gouteng — gambir plant
• Ligusticum — Chuan xiong

It synergistically nourishes the heart and liver, calms endogenous wind and relieves convulsion. Eight weeks of treatment in a randomized and double-blind trial showed that Ningdong granule is more effective and safer than MPH (1mg/kg/day) treatment (N = 36 each) and could increase serum homovanillic concentration, suggesting that Ningdong granule treatment could regulate dopamine metabolism.

(Ningdong granule: a complementary and alternative therapy in the treatment of attention deficit/hyperactivity disorder.)

Several other studies then showed that Chinese herbal medicine increases the serum concentration of calcium and zinc in children with ADHD (Zinc helps with dopaminergic neuro-synaptic pathways signal transmission).

In other words, for 80kg man the ningdong granule is more effective than 80mg of Ritalin a day, that is 8 pills (!!) and it also increases zinc.

Zinc is the only co-factor necessary for adenosine deaminase activity, so adequate zinc is needed for the enzyme to work well — Adenosine Deaminase converts adenosine to inosine, inosine then acts as a competitive inhibitor to adenosine → reduction in adenosine activity leads to increased activity of dopamine (Adenosine is a neurotransmitter that reduces dopamine’s actions).

The two main prescriptions for ADHD, methylphenidate (Ritalin) and amphetamine both target dopamine (stimulating its release into and inhibiting its re-uptake from the synapse). Also, caffeine has similar structure to adenosine, so it binds to adenosine’s receptors in the synapse, effectively keeping the adenosine from inhibiting dopamine’s actions.

Final: Recommended formulas and herbs

Other therapies in the paper included tai chi, acupuncture and of course meditation, where all aforementioned showed significant improvements of the condition, but let’s stick to the herbs for now — after all, they are the best for jump-starting an ADHD brain. It is hard to introduce an exercise routine into your life without the much needed support, in this case herbal.

As I stated earlier, each syndrome needs a different treatment. These are recommended formulas for each (listed with main symptoms — keep in mind this is in terms of traditional Chinese medicine):

Heat in heart and liver — Anshen Dinghzi Decoction
talkativeness, over-activity, impulsiveness and willfulness, explosiveness, irritability, talks back to authority, loses temper, inattention

Internal disturbance of Pyrophleghm — Huanglian Wendan decoction
extremely arrogant and restless, talkative and noisy, talking nonsense, smashing objects

Deficiency of Liver-Yin and Kidney-yin — Qiju Dihuang wan
restless and unsettled, impatience and tantrums, inattention and poor memory, poor academic achievement

Heart-Spleen deficiency — Guipi decoction + Ganmai Dazao
absentmindedness, inattention, fickle interest, dilatoriness, hyperactivity, no bad temper, reckless speech, impulsiveness, fatigued spirit and lack of strength, poor memory, slowness of thinking, poor sleep, reduced food intake

Liver depression and spleen deficiency — Xiaoyao powder
absentmindedness, inattention, impulsiveness, irritability, fatiqued spirit and lack of strength, abdominal fullness and distention, reduced appetite and slow intake, pessimism, depression, frequent sighing

Herbs

Schichangpu (Rhizoma acori tatarinowii) and Yuanzhi (Polygala tenuifolia) are the 2 most frequently used herbs and have long been used to treat psychotic illnesses for hundreds of years in TCM. The extracts from both herbs can easily pass through blood-brain barrier, improve memory and reduce the hyperactivity (PAP 9704, a Korean herbal medicine attenuates methamphetamine-induced hyperlocomotion via adenosine A2A receptor stimulation in mice)

Let’s have a look at them.

Schigangpu — Rhizoma Acori Tatarinowii

This herb showed in 25 ADHD studies. Normal dosage ranges between 3 and 10 grams. It enters the meridians of heart and stomach. Schigangpu tranquilizes the mind, promotes intelligence and removes dampness to regulate stomach.

The active constituents of the herb, asarones, promote brain cell proliferation (neurogenesis) (some species of the herb contain high amount of asarones, which are carcinogenic. Chinese only use acorus in acute conditions and for short periods). It should not be used in cases of yin deficiency and yang excess.

In combination with Radix Ginseng, Radix Polygalae and Poria cocos this herb may reduce alcohol induced memory loss.

Yuanzhi — Polygalae Radix

This herb was used in 20 studies. Dosage 3–10g, Enters heart, kidney and lung. Calms the mind and reinforces intelligence, induces resuscitation by dispelling phlegm. Also called Polygala tenuifolia, this herb is used for treating Alzheimer patients, because it also promotes nerve growth factor.

Fuling — Poria cocos

18 studies, dosage 10–15 grams. Enters heart, spleen and kidney. Removes dampness and promotes diuresis, invigorates the spleen and tranquilizes the mind.

Shudihuang — Rehmanniae radix preparata

Also in 18 studies, the normal dosage for this herb is 9–15 grams. Enters liver and kidney, nourishes yin and blood, replenishes vital essence in kidneys and benefits marrow.

Gancao — Glycyrrhizae radix et rhizome — Licorice Root

Evaluated in 15 studies, this herb has a dosage of 2–10 grams. It enters heart, lung, spleen and stomach meridians. It has great effects — it invigorates the spleen, replenishes chi energy, expels phlegm, relieves spasm and pain, clears heat and detoxicates. It is so powerful, it is used even in heroin addiction withdrawal therapy.

Shanzhuyu — Corni fructus — Cornus officinalis — Dogwood

12 studies, dosage 6–12 grams. Enters liver and kidney. Invigorates the kidney and liver, relieves and restores depletion.
You can buy a Cornus officinalis syrup/juice :)

Wu wei zi — Schisandrae fructus chinesis

Schisandrae was in 12 studies and the dosage ranges from 2 to 6 grams. It enters lung, heart and kidney meridians and nourishes the chi, generates body fluid, tonifies kidneys and calms the heart.

It is hepatoprotective (liver protective), immuno-modulating and adaptogenic. It increases brain efficiency, work capacity and builds strength. Useful also for insomnia and immunodeficient states.

Bai Shao — Paeoniae Radix Alba

Present in 10 studies. Normal dosage is 6–15 grams. Meridians of liver and spleen. The herb nourishes blood and retains yin, smooths the liver to stop pain and subdues the hyperactivity liver-yang.

Hong Jing Tian — Rhodiola Rosea

Rhodiola is a very powerful adaptogenic anti-inflammatory agent, which should help with ADHD, because as some research shows, that people with ADHD have a major inflammation of the brain. By this logic, every herb that relieves inflammation could help with the symptoms.
It replenishes chi energy, activates blood circulation, unblocks blood vessels and smooths asthmatic conditions.

Dang shen — Condonopsis pilosula

Dang shen is a dried root used for invigorating the function of the spleen and stomach and to replenish the vital energy. Its pharmacological effects include helping to increase red and white blood cell count, anemia, improve blood sugar and stimulate the nervous system. It regulates gastrointestinal motility, fight against ulcer and enhances immunity.
This herb is good at tonifying chi of spleen and lung and it enriches the blood.

Maitake — Grifola Frondosa

Maitake is a mushroom with amazing qualities. It replenishes the spleen and its chi, drains moisture, tones the kidneys and liver, cleanses hear and calms the mind.
It has also anti-inflammatory properties, which may be helpful, as mentioned above.

Gou qi zi — Goji berry — Lycium chinense

Unlike the other herbs, these are the berries of the plant, so you can just throw them in with your breakfast oat-flakes, and they taste bloody amazing.

It is a known superfood, which has been eaten in Asian countries for over 2000 years as a remedy for almost any disease. 1 ounce, a handful of Goji also contains Vitamin A (50% of daily recommended dose) and Riboflavin (28% DRD).

It soothes the liver and lowers blood bilirubin concentration, which is known to slow down neuro-synaptic signaling. (Bilirubin occurs during catabolism)

Wolfberry nourishes the liver, promotes vision, invigorates the kidneys and replenishes essence.

Coffee

Coffee also lowers brain inflammation but drains the kidney yin (Tao Of Healthy eating, page 108), so use in moderation. And as mentioned, the caffeine also blocks adenosine receptors, which in turn enables your brain to have more dopamine.

Honourable mentions for another article:
Gotu Kola, Ashwaganda, Horny Goat Weed, Angelicae, Ginseng, Kratom, Matcha, Moringa, Morinda and Reishi.

See you next time!