This letter is regarding the article by Konofal et al entitled “Iron Deficiency in Children With Attention-Deficit/Hyperactivity Disorder [ADHD].”1 Their conclusion that their results suggest that low iron stores contribute to ADHD seems to possibly be incorrect. In their sample populations they do not distinguish between those who had been taking medicines for ADHD and those who had not. It is possible that the low iron stores of children with ADHD who are taking medications are due to the decreased appetite that these medications can cause (and thus decreased oral intake of iron-rich foods). It is also possible that those with ADHD (whether they’re taking medications or not) have a decreased ability to sit still for a meal and therefore have decreased nutritional intake of iron. Third, the low iron stores in the children with ADHD could be secondary to the medication that they were taking despite the fact that they were reportedly not taking medicines for 2 months. This possibility cannot be further deduced from their data as presented since, as mentioned earlier, they did not distinguish in their sample populations between those who were medicated and those who were not.
D’Amato TJ. Is Iron Deficiency Causative of Attention-Deficit/Hyperactivity Disorder? Arch Pediatr Adolesc Med. 2005;159(8):787–788. doi:https://doi.org/10.1001/archpedi.159.8.788-a
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