Attention Deficit Disorders

The biochemistry of the human body is intricate and inter-related.  We take a Functional Medicine approach to assessing biochemical disorders, which means that we analyze metabolic components and correct imbalances using integrative therapies.  What this means is that we look at each person as a whole being on all levels, including biochemical (physical), energetic (including emotional), and spiritual. 

If you are having difficulty concentrating, the first step is to fill out the medical questionnaire and fax it to us.  This information is on the home page of our website.  Dr. Diehl will then review your personal history at no cost, and determine your options.  In general, she will start with a comprehensive blood evaluation, including routine testing as well as thyroid and adrenal testing. 

In addition to thyroid and adrenal measurements, you will be tested for inflammation, a process which frequently triggers disorders of attention and concentration.  Inflammation is easy to quantify in the blood, and we have used C-Reactive Protein testing for decades to monitor inflammation.   We routinely measure cardiac C-Reactive Protein and serum homocysteine in order to assess inflammation. It is likely that insurance will NOT pay for you to have these simple blood tests, but it is well worth your money to learn whether you have elevated inflammation, which in fact, damages the lining of your blood vessels and interferes with nitric oxide metabolism, resulting in the development of plaques which can then trigger heart attacks.

While homocysteine is an inverse measure of folic acid metabolism, methylmalonic acid measurement is inverse to Vitamin B 12 levels, and must be assessed when one is having difficulty concentrating.  We measure MMA routinely in serum, although the test is available in urine.  Deficiencies of the B vitamins can cause severe disease, including inflammatory conditions such as demyelination.

Sometimes we also measure other less known inflammatory markers in the blood when assessing cognitive dysfunction, including Tumor Necrosis Factor alpha Interleukins 1, 6, and 18, and Fas (APO 1). For further information, you can access the New England Journal of Medicine, volume 358; 20; May 15 2008.

Oxidative stress markers may be measured in the blood, also, including myeloperoxidase, plasma-oxidized low density lipoproteins, and plasma isoprostanes.  Insurance will not cover these tests, so we do not yet order them routinely for cognitive dysfunction.

In assessing attention deficit complaints, the neurohormones must be measured.  We offer both 24 hour comprehensive urinary levels as well as single urinary sampling of adrenaline (epinephrine), noradrenaline (norepinephrine), dopamine, cortisol, GABA, glutamine, glutamine, PEA, and other chemicals responsible for metabolic function.  Insurance will not likely cover these tests.

Heavy metal toxicities such as mercury and lead are contributing more frequently to attention disorders, and we utilize 12 or 24 hour urinary testing to measure body stores of both toxic and beneficial metals.  Heavy metal toxicities are treated routinely in emergency medicine, and deserve better attention in the health practitioner’s routine practice.

The above information is just a drop in the bucket when it comes to approaching attention disorders. We will address dietary and lifestyle changes that can be implemented immediately to help relieve inflammation, at your appointment.