My Notes From The Children’s and Teen Health Summit
Jacqui Fleury ND
The vast majority of children coming in with ADD or ADHD are boys, I can count on one hand the amount of girls I have seen with this. In many cases it’s a misinformed diagnosis or in some cases a diagnosis of exclusion because they don’t know what’s going on and why these little boys aren’t coping and fitting into the system. Done without proper assessments or screening it’s done with the ADD/HD diagnosis just because they are not fitting in or disruptive without looking at the big picture or the whole child and just looking at the behavior. We look at what’s agitating the child’s nervous system.
The way a small boys nervous system and brain are wired is very different in a boy than a girls brain is wired. The male brain has fewer areas that are wired for language, reading, writing and the early years of school rely heavily on those verbal skills. Rolling around and wrestling is more how boys relate so they might not be sitting down and having a chat with each other, they engage physically as one of the ways they communicate but it’s not socially acceptable to be doing that. That’s one thing you need to understand about boys at a young age they need to move. Boys seem to learn best when there is a mentorship system or attachment system that emphasizes learning. In the old days boys would learn from men in a physical or dynamic way so they would be watching and learning using their muscle groups and moving and learning whether it be carpentry, masonry or mechanical boys learn best when their moving.
We work with the nervous system and make sure their getting good sleep and addressing all aspects of diet and nutrition. We have great success when looking at these boys from all aspects instead of deficient or some disability. With little boys they engage in what appears to be aggressive gestures that are equivalent to a hug because they are more physical. It’s not uncommon to hear “use your words” with boys. Boys develop those language skills later on than girls do, and unfortunately some develop low self esteem because of people calling them stupid when their just not ready yet and it’s sad. These boys all learn to read, write and communicate it just happens at different levels.
With boys often times mood disorders will happen later in the day usually after lunch and we want to know if there is a child with this what time of day is this happening. Those can be early flags that there may be a food sensitivity or a blood sugar dysregulation. If they had rice crispies for breakfast and a grilled cheese for lunch then by one or two in the afternoon they start to act out with aggression or opposition it might be fatigue or their just staring into space and again that’s perceived as a lack of focus or a behavioral issue. These are things I look for in the younger boys, if these symptoms are left unchecked into the teenage years often times they have had many years of blood sugar dysregulation or food sensitivities and now their brains are behaving more in line with irritability or aggression, anger, opposition but of course an oppositional teenager is a little harder to manage than a young boy. Depression or apathy is another way it could look so the teenager doesn’t show much interest in things and doesn’t care much about anything but maybe playing video games and then the hormonal changes amplify everything.
The next common reason for someone to bring their son in to see me would be Asthma. The immune challenges that I see with the boys that generally manifests as respiratory issues Asthma is common, again we look food sensitivities and environmental triggers. Respiratory issues are resolved beautifully to dietary intervention and working with the nervous system and how their bodies handle stress and how their bodies cope with inflammation. With mono and strep that would be the sequela or the way an environmental or food sensitivity or allergy may manifest in a teenager. If they have had a history of allergies, tonsillitis or intestinal issues as a young boy then that might also trigger mono or strep later on as teenagers.
Third most common is skin issues like eczema, psoriasis and skin rashes, if that’s not addressed in later years were going to see it as acne. We can put up with a lot of symptoms we may be constipated, chronic cough or headaches but as soon as the body puts something on the skin it really gets peoples attention. This is all an indication there is something out of balance in the system. When there is something going on with the skin we can pretty much assume there is something going on with the digestive tract. Your skin is your largest organ of elimination after that we can look at the liver and kidneys but usually it’s the digestive tract. Your skin is going to be that last thing to improve so when the skin clears we know were there.
Isn’t acne normal in teenagers? Yes and no, when they are going through a ton of hormonal changes that are going on in their body puts them at an increased risk of developing the oily skin. But acne is really an indication that there is inflammation in the system and often times we look at insulin as being one of those hormones that are the culprit in the inflammation. Going through puberty can amplify other things that are going on in their bodies previous to puberty. If the diet has been high in carbohydrates and sugars your going to have that insulin being high anyway, and that insulin response and puberty thrown in there to aggravate the insulin response.
If the teenager has a pretty clean diet and their low in carbohydrates, low in sugars and higher in protein and healthy fats you will see a little bit of change on the skin but generally it’s not as severe as you see some teenagers with. Pimples are a symptom of something deeper related to digestion and blood sugar.
I didn’t realize how many people had sleep issues until I went into private practice fifteen years ago, recently it’s become an issue with kids and the biggest culprit is screen time. The effect of looking at the screen so many hours of the day is effecting their brain, their circadian rhythms and their pineal gland which is responsible for melatonin their sleep hormone. The light from these screens is being effected in particular by the blue wave length light inhibiting their ability to have a good sleep. We also have kids with a lot of electronics in their rooms causing sleep disturbances. This also effects their ability to sleep through the night and some of the things we talked about before will effect sleep. Lack of protein during the day will effect their ability to settle down and effect their ability to sleep through the night. They fall asleep ok then wake up one to two hours after. That protein is very grounding to the nervous system. When they are eating carbs all day they find they need to be constantly eating or their craving sugars because their eating a bowl of cereal for breakfast, something carbohydrate for lunch, get home from school and have a cookie. Then their not hungry for supper or they just snack and we are expecting their nervous systems to just settle and go to sleep at night, if they do it’s because they crashed. They don’t get a restorative sleep, wake up the next morning and start the cycle over again.
The brain needs a constant source of energy whether your awake or sleeping if it starts to sense your not getting enough energy it will send a message to the liver to release some glycogen, it’s broken down into glycose giving the brain some energy and so does the person waking them up. We see this a lot in adults too where their mind is racing it’s because it just got a quick little burst of glucose.
Now for the girls the number one issue for 0-7 age group is digestive issues and the beginning of irritable bowel. They usually describe it as tummy pain or they have bowel issues, diarrhea, constipation or a history of frequent vomiting, or they catch the stomach flu really easy. Or it will be related to some of the skin issues we talked about with the boys. The girls will have eczema or a history of hives or rashes that present on their face because they have eaten something and develop a hive or contact outside develops a rash. They also report their very sensitive to bug bites, some don’t get bothered much from a mosquito bite and others will get red and inflamed. This is an indication there is a higher level of histamine in the body and also a sign we need to be working on their gut health and immune systems.
I see more boys at the younger ages because their flagged with developmental stuff, the girls I see more of at a later age. I believe it’s a precursor to the later hormonal and menstrual dysregularity at pre-teen and teen or their going to have skin or emotional issues. If you look back in their history there would have been some of those digestive issues of allergies and signs and symptoms of inflammation earlier. I start to see them beginning from 10-14 because their starting their periods and becoming symptomatic now. In naturopathic medicine we like to focus on prevention so the earlier we see them the better because were trained to look for really subtle signs and symptoms that might indicate there’s an imbalance. We can catch these things before the girl starts her period and has full blown acne, intense menstrual cycle, cramping, pain and pre menstrual type symptoms.
If they go the medical route too early their offered very limited resources in terms of dealing with those. One of my concerns is the use of the birth control pill in young girls, girls in general are starting their periods at a younger age than they used to. We are seeing in these young girls the beginning stages of insulin resistance, this is at play because they start to carry more weight around their waist. This is a common issue with women when they are transitioning into menopause and say I used to be able to eat anything and not gain a pound and they hit menopause then all of a sudden they start gaining all this weight around their torso. We are not saying it’s normal but it’s something we have come to expect in women, what concerns me is were starting to see it in younger and younger girls. We should not be seeing the young girls walking around with bellies. Sometimes we will see it in girls who appear to be lean everywhere else with skinny arms and legs but they have bellies. This is a definite change and something we have not seen before in the way these girls are developing hormonally. We think of puberty as being the onset of the menstrual cycle but it also appears to be a time when it seems to be amplifying any hormonal imbalance that’s been going on even two or three years before or more depending on the diet of these girls.
We attribute this to diet as the big one mostly because it’s what we have direct control over. The overall estrogenic effects in our diet from herbicides, pesticides and hormones in our drinking water and food. Also if your carrying any extra weight those fat cells tend to carry more hormones in them and because we are an estrogen dominant society these young girls are getting that estrogen at an earlier age. It’s endogenous which means it’s coming from inside the body and exogenous which means it’s coming from the environment. It gets a little overwhelming when you start to think that every glass of water you drink may have a little estrogen in it from all the birth control pills women are peeing out into the water system. Then there is the hormones that’s being fed to the animals and all this gets into the water supply you start to think were doomed but you can filter your water which makes a big difference.
You need to focus on where you have control it comes back to the diet, we can make changes to our health two to three times a day by the decisions we make around food. That’s where I consistently see the best therapeutic and clinical response is by working with the diet. This brings us back to the young girls that maybe are not given the right tools they need as they transition into their menstrual time because they just don’t know. They may not know their options and then their peers, a lot of socializing revolves around food, it’s difficult to eat differently than everyone else around you. When there is more people doing it it gets easier, you start with yourself making choices that will make you better. It starts with the parents making changes and leading by example, it’s hard to tell the children to make those changes without their mentorship around them and struggling to make those changes yourself.
The resources are there and available, that’s what we do as naturopathic doctors and lifestyle coaches, educators and functional diagnostic nutritionists, that’s what we do and were passionate about it. When you seek out these resources your better able to make those changes and make them stick. I’m concerned about young girls being given birth control pills with the intension of regulating their cycle, for the life of me I don’t understand using artificial hormones to regulate something that shouldn’t be regulated at that stage of their life. The bottom line is their still hormonally immature for the first and up to five more years after beginning their menstrual cycle.
Women need to understand that no matter what age you are while your on the pill your not having a menstrual cycle, your having a withdrawal bleed. They start the pill and stop it for seven days and what they get is an endocrine withdrawal from stopping the pill and they bleed from not having that pill but their not having a menstrual cycle. This creates a whole collection of challenges when they finally decide to have a family down the road. The pill was designed as a birth control method you took it when you didn’t want to get pregnant and there is a narrow window of safety with the pill. The longer your on it the more you increase your risk with a lot of different issues with one being breast cancer. Anything over five years on the pill is risky, I think it’s risky no matter what. You don’t want to start it too early just to regulate your period especially young teens.
Other side effects of the pill are nutrient depletion this increases your bodies requirement for B and C vitamins and these are the nutrients that help stabilize symptoms like premenstrual syndrome. They can also decrease the amount of clotting with the period, pain and cramping that you get if you don’t have these nutrients and the pill further depletes them. If you corrected and balanced them in the first place you wouldn’t need the pill. The pill also creates hundreds of endocrine reactions in the body, the liver has to process the pill putting increased stress and demand on the liver creating an estrogenic effect. In many ways the pill has been touted as cancer protective more from the perspective of uterine cancer but it’s hardly talked about the risk to breast health especially in a young girl whose breast tissue is very immature it really doesn’t fully develop until you have lactated. If your taking artificial hormones and you have never lactated it really is messing with your breast tissue.
We are already low in B vitamins their really hard to get in your diet so unless your supplementing B vitamins these girls are going into puberty already deficient, you throw puberty into the mix and it’s the perfect storm. This can lead to antidepressants and often times we see depression is linked to the menstrual cycle. We see this in women in their twenties and thirties and all of a sudden were starting to see it in our teenage girls. We are seeing this more and more but I wonder how much of this is exclusion. Antidepressants are being thrown out to teenagers without a second thought, without looking at the neurotransmitter in the brain what’s off there. Again is there a food sensitivity or a blood sugar imbalance, how’s the social structure, what’s the peer situation, how are things at home, how are you moving your body everyday, how much sleep are you getting. All of that plays into how we interface with our day and the people in our lives.
It’s never too late to change things around.
We are also seeing a lot of girls with immune problems hitting around puberty as well with the strep and mono and fatigue, it’s amazing the fatigue I see. Part of that when were talking teenagers is an application of some of these subtle underlying issues that have been percolating since they were small kids. You can definitely see the difference with the kids you caught early with things like food sensitivities or just imbalances. They seem to navigate puberty much easier than the teenagers who come in later, prevention is the key.
Puberty, menopause and pregnancy are all natural hormonal transitions but for whatever reason we feel the need to medicate menopausal women and now were medicating our young daughter’s, it’s very unsettling. Taking care of this early sets the stage for the rest of their life. If I can start working with kids when their in their teens fertility would be enhanced, pregnancies would be symptom free, go with ease for the most part and menopause would be exactly what menopause is a transition. These are not medical conditions but they could be medicalized when they involve so many symptoms. Medicalized implies a medicine or a drug we can take can fix the issue, it went from premenstrual symptoms to premenstrual syndrome that of course there are medications for. So many of us walk around feeling broken or dysfunctional or there’s something wrong because we have these symptoms and there’s probably something out there that would fix this rather than look at it as symptoms. These collection of symptoms whether it’s something going on in your digestive track, skin or your moods. As naturopathic doctors we spend a lot of time digging under all of that to figure out what is the imbalance here and how can we correct it. For five people with these symptoms they are all going to get treated differently based on what their underlying imbalance might be. Treat the foundations and a lot of symptoms will take care of themselves.
Start with yourself, get support the coaching is there . Don’t focus on what you need to restrict instead look at new ways to expand onto your diet and into your lifestyle. Never feel like your being limited or restricted, that doesn’t work for our kids and it doesn’t work for adults. Find someone who can help with expansion instead of restriction and elimination. If your lactose or gluten intolerant those changes have to be made but it needs to be done in a place where what else can be done rather than eliminating. We as naturopathic practitioners want you to succeed. Lead by example, people will see that your looking and feeling better.
Jacqui Fleury web page
Disclaimer: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.
M. Scherker medical researcher