Gut microbiome this, gut microbiome that - I’m sure you’ve heard all about the cool new science of how our gut impacts our mental health. It’s one of the many reasons why fiber is one of the most important nutrients we can get! Fiber is the food for our microbiome. While we ourselves don’t process fiber well, the microscopic flora inside of us thrive off it. Not eating enough fiber is like being a CEO who doesn’t pay their workers well. The company might still stay afloat, but it isn’t going to be that happy about it.

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Before I get into more about the ADHD gut microbiome, I want to remind you that my work is 100% supported by my Patreon members and people who purchase my digital collections. This collection is the one I’m most proud of, and it is available for only $33! 👇️ 

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At the Gut of Our Issues

The gut microbiome is such a new area of study, and we’re getting new information nearly every day. There’s a lot of confusing and conflicting evidence out there - essentially this whole field is one of the weirdest spaces in human science currently. I start with this because I want you to know that most of what I’m going to chat about might be really confusing. I tried my best to make the language as accessible as possible without compromising the nuance and complexity of the subject!

Before we get into the nitty-gritty, I want to quickly explain the basics of the gut-brain-axis. Recently we discovered that the gut microflora communicates with our brains bidirectionally. This means that not only does the brain influence what our guts experience, but our guts influence the way we experience life. There are three major pathways that this communication occurs: the enteric nervous system via the vagus nerve, the immune system pathways via cytokines, and the endocrine system via the hypothalamus–pituitary–adrenal (HPA) axis and gut-formed hormones. If any of these pathways are dysregulated or unable to communicate effectively, people tend to have both gut dysbiosis and a mental health condition. Working to improve these pathways is typically an important step in healing comorbid gut and mental health difficulties.

So how does ADHD fit into this?

Regarding the specific microbiota, researchers have found that people with ADHD tend to have higher levels of the genus Odoribacter and lower levels of the genus Faecalibacterium in their gut. Odoribacter has been linked to dopamine metabolism, indicating that higher levels in the gut could possibly lead to too little dopamine due to the dopamine being metabolized more quickly. Faecalibacterium, on the other hand, has been associated with inflammation. This gut bug helps stimulate the production of a few specific anti-inflammatory cytokines. When we don’t have enough of it, we can end up having an imbalance of the different cytokines, leading to inflammation. Inflammation affects our entire body - even our brains. The ADHD brain is especially susceptible to inflammation, so it makes sense that less Faecalibacterium is associated with more severe ADHD symptoms. 

Scientists also uncovered that despite having more species in the genus Bifidobacterium on average compared to controls, the Bifidobacterium species in those with ADHD have fewer significant connections to the species in the genus Firmicutes. This is perhaps a large reason why, even though there are no found significant differences between neurotypical and ADHD Bifidobacterium-Firmicutes ratios, people with ADHD may experience more inflammation and gastrointestinal disorders. After all, if they aren’t communicating effectively, then dysbiosis is bound to happen. Both the Bacteroidetes-Firmicutes ratio and the Bifidobacterium-Firmicutes ratios are important markers of obesity, inflammation, and gastrointestinal issues, with a higher proportion of Firmicutes being associated with those. 

There is also evidence that people with ADHD have elevated levels of the protein/cytokine TNF-α. In regulated amounts, this protein is important in inflammation management. However, too much of this actually worsens inflammation. In people with ADHD, higher levels of TNF-α were associated with lower levels of gut microbial diversity, which further emphasizes the importance of addressing our gut.

So how do I “address the gut?”

Honestly speaking? One of the most important things to do is work on stress management. Chronic stress is perhaps one of the most influential things on our gut microbiome and diversity. Beyond that, there’s a few other things we can do:

1. Increase our fiber intake

Fiber is what we call “prebiotics,” or food for our microbiome. In the literature, we actually see that the ADHDers who eat the most plants (AKA, fiber) have the least severe symptoms! Please note that if you do not eat much fiber currently, slowly increase your intake over many weeks. If you don’t, you may experience gastrointestinal distress. One important thing to do here is to also increase your water intake as you increase your fiber intake - being adequately hydrated can decrease the likelihood for constipation.

2. Increase our probiotic intake

Probiotics are the actual gut bugs themselves. We find them in fermented foods such as kefir, Greek yogurt, kombucha, and kimchi. Eating at least one serving a day is associated with a better functioning gut flora system! If you’re curious about probiotic supplementation, our current evidence indicates that the over-the-counter probiotics have no impact on ADHD symptoms. However, keep your eyes peeled in the future for a high-dose probiotic that could be prescribed for ADHD! There was a study that came out recently (November 2024) on a high-dose targeted probiotic supplement that significantly improved hyperactivity symptoms compared to a placebo pill! Now, it didn’t impact inattentiveness, attention, or impulsiveness, but a win is a win!

There’s a few more things you can do, including:

1. Practicing mindfulness

2. Exercise

3. Reduce microplastic exposure

(other things include having more money and better genetics . . . hello social determinants of health!)

Thanks for reading!

If you have any thoughts, questions, or comments, be sure to shoot me a DM on Instagram @Nutrimindcoach or simply reply to this email. I LOVE hearing from you!

This week on the Nutritional Mental Health Podcast: Is Your Gut Making You Anxious? Real Talk with a Dietitian and Neuronutrition Expert. Today's interview is with  @dietitian.gabrielle  - one of many people's favorite gut health dietitian content creators! We get into some of both of our favorite topics, such as how to help your gut, what role mental health plays, and some of our current knowledge on the gut microbiome research. I hope you enjoy it as much as we did! Don’t miss it!

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