Supplements to Support the ADHD Brain in Perimenopause
Navigating perimenopause or menopause when you also have ADHD can feel like being hit from both sides. Hormonal fluctuations, particularly declining and erratic levels of oestrogen, progesterone, and testosterone, can significantly affect cognitive function, mood, sleep, and executive functioning. Research shows that women with ADHD often experience worsening symptoms during hormonal transitions because oestrogen modulates dopamine and serotonin pathways, both of which influence attention and emotional regulation.
While hormone replacement therapy (HRT) is often a key part of managing menopausal symptoms (NICE, 2024), supplements may also offer supportive benefits. They can help regulate the nervous system, stress response, gut–brain axis, and hormone metabolism, all of which affect how ADHD symptoms show up and fluctuate. However, supplements are not a substitute for evidence-based medical treatment, such as HRT or prescribed ADHD medication, and should always be discussed with a qualified clinician.
NHS and NICE guidance
Current UK guidelines highlight that supplements and complementary medicines for menopause lack robust regulation and evidence, and may have significant drug interactions. The NICE Menopause Guideline (NG23) recommends evidence-based use of HRT and cautions that alternative or complementary therapies should be considered only where there is adequate safety data (NICE, 2024).
For ADHD in adults, the NHS recognises lifestyle, medication, and behavioural interventions as core management approaches, but does not include supplements within standard treatment recommendations. Therefore, any supplementation should be considered adjunctive and under clinical supervision.
Before starting anything, it's worth getting blood tests done, checking iron, thyroid function, magnesium, vitamin D, B12 and folate.
Magnesium (glycinate or threonate)
Magnesium supports sleep and nervous system function. Of the two forms, glycinate is the better form of magnesium to take for that. It's well absorbed, gentle on the gut, and the glycine itself has a calming effect on the nervous system. Trials have linked magnesium bisglycinate to improved sleep and reduced anxiety symptoms (Tarleton et al., 2017; Schuster et al., 2025). Magnesium L-threonate works differently, it's aimed at raising magnesium levels in the brain specifically, and has shown some promise for cognitive performance in small trials, though evidence in ADHD populations specifically is still limited (Harris, 2023). Try to get magnesium from food first, from things like leafy greens, nuts, seeds and wholegrains, since these come with fewer side effects than high doses of a supplement. Only add a supplement if a blood test shows your levels are actually low, or you know your diet doesn't include much magnesium rich food.
Caution: high doses can cause loose stools or stomach upset, and magnesium can interact with certain antibiotics and blood pressure medication, so leave a gap between doses and check with a pharmacist if you're on either.
Omega-3 fatty acids (EPA and DHA)
One of the better-evidenced supplements for ADHD. Meta-analyses suggest modest improvements in attention and hyperactivity, particularly with high-EPA formulas (Sinn and Bryan, 2010; Breen et al., 2017). One meta-analysis of ten placebo-controlled trials found that the amount of EPA in a supplement, rather than the DHA, was what predicted how well it worked, with formulas containing an EPA to DHA ratio of around 2:1 showing the most consistent results (Bloch and Qawasmi, 2011). A quality fish oil supplement is a reasonable alternative where oily fish intake is low. Benefits typically take several months to become noticeable, and anyone on blood thinners or ADHD medication should check with a clinician first, since higher doses can have a mild blood thinning effect.
Caution: avoid high doses if you're on blood thinning medication or have a bleeding disorder, and choose a third-party tested brand to avoid contaminants like mercury.
Vitamin D3 with K2
Deficiency in Vitamin D is common in UK women, particularly through autumn and winter. While direct evidence for ADHD improvement is limited, low vitamin D is associated with low mood and fatigue, both of which worsen ADHD and perimenopausal symptoms (Medical News Today, 2024). K2 is a separate vitamin, not a form of D3, and it's usually paired with it because D3 increases how much calcium your body absorbs, while K2 helps direct that calcium to where it's actually needed, your bones and teeth (Maresz, 2015). That's why the two are often taken together. The NHS recommends 10 micrograms of D3 daily for adults in autumn and winter. Avoid high-dose supplementation without blood testing first.
Caution: K2 can interact with warfarin and other blood thinning medication, so this combination needs a clinician's input before starting, and high-dose D3 without testing risks raised calcium levels.
B vitamins (B6, B9, B12)
Essential for energy production and neurotransmitter synthesis, B9 (folate) and B12 in particular are needed to make dopamine and serotonin, and both help protect against raised homocysteine, which is linked to cognitive decline. Deficiency can worsen fatigue and mood instability, and a systematic review found that children with ADHD had significantly lower levels of B9 and B12 than children without (Razavinia et al., 2024). Evidence directly linking B-vitamin supplementation to ADHD improvement in adults is mixed, but low B12 in particular can mimic anxiety, low mood, poor concentration and irritability, symptoms that overlap heavily with both ADHD and perimenopause, so it's worth ruling out a deficiency before assuming a symptom is either of those (Verywell Mind, 2016). Good food sources include leafy greens and legumes for folate, and meat, fish, eggs and dairy for B12, worth prioritising if you follow a plant based diet.
Caution: long-term high-dose B6 has been linked to nerve damage, so stick to standard doses and get levels checked rather than self-prescribing high strength versions.
Iron
Iron doesn't always get mentioned alongside the more popular supplements, but it's one of the most directly relevant given how common deficiency is in this exact group. Iron is needed to make dopamine, and low ferritin has repeatedly been linked to worse ADHD symptoms, one study found ferritin levels were abnormally low in 84% of children with ADHD compared with 18% of controls (Konofal et al., 2004). In adult women, heavy periods make iron deficiency more likely, and a 2025 study of over 400 women found heavy menstrual bleeding was significantly more common among those reporting ADHD symptoms, alongside overlapping symptoms like fatigue, brain fog and anxiety, though the study measured haemoglobin rather than ferritin directly, and anaemia status itself wasn't significantly linked to ADHD symptoms (MacLean et al., 2025). It's a reasonable signal rather than proof of a direct link, which is exactly why testing your own ferritin is worth doing rather than assuming. Many women are told their iron is fine because they're not anaemic, when their ferritin is still low enough to affect energy, concentration and mood, so it's worth asking for your actual ferritin number rather than a general iron result, and supplementing only if it's confirmed low, since excess iron carries its own risks.
Caution: excess iron is toxic and can damage the liver over time, never supplement without a confirmed deficiency, and expect possible constipation or stomach upset at higher doses.
Zinc
Zinc supports dopamine regulation and hormone function. Some studies suggest it may help with attention and impulsivity in people with ADHD who are zinc-deficient, though findings are inconsistent and most of the research has been done in children (Verywell Health, 2016). Get levels tested before supplementing. Over-supplementation can cause copper deficiency, so standard doses only are recommended and check with a clinician first.
Caution: long-term high doses can cause copper deficiency and nausea, take with food, and avoid alongside certain antibiotics since zinc can reduce their absorption.
Inositol (myo-inositol)
Less well known than the others on this list but worth knowing about. Myo-inositol has clinical evidence for reducing anxiety and supporting mood, and is increasingly being studied in relation to ADHD. It also has evidence for easing perimenopausal mood changes and hot flushes, which makes it relevant on both fronts. Interaction risks are low and it is generally well tolerated, though it works on the same pathway in the brain that lithium targets, so it can interfere with how well lithium works, and there's some evidence it may enhance the effect of SSRIs rather than cause harm, which can still mean a dose needs adjusting. Worth discussing with your GP if you are on either of these.
Caution: avoid combining with lithium without medical advice, and check in with your prescriber if you're on an SSRI, since a dose adjustment may be needed.
Saffron
Saffron has emerging evidence specific to ADHD. Its active compound, crocin, appears to inhibit the reuptake of dopamine and norepinephrine in a way that mildly resembles how stimulant medication works, alongside a separate effect on serotonin reuptake that may help with the mood and emotional impulsivity side of ADHD that stimulants don't always touch. Clinical trials suggest saffron at 20 to 30mg daily, most commonly split as 15mg twice daily, may reduce inattention and hyperactivity, with some research comparing it favourably to low-dose methylphenidate, though evidence remains preliminary (Baziar et al., 2019; Lopresti et al., 2022). It is recommended to discuss with your prescriber before starting this supplement if you are on antidepressants, since combining saffron's effect on serotonin with an SSRI or SNRI carries a theoretical risk of serotonin syndrome, even though this hasn't been reported in practice so far.
Caution:don't combine with SSRIs or SNRIs without medical advice, and avoid in pregnancy, since safety data is limited.
L-tyrosine
L-tyrosine is the amino acid your body uses to make dopamine and norepinephrine, which is why it gets suggested as a natural alternative to stimulant medication. In reality, the evidence doesn't support that, there's very little clinical trial data in ADHD, and what exists hasn't shown a meaningful benefit compared with the extensive evidence behind actual ADHD medication. It's generally considered safe alongside stimulant medication, though combining the two without medical guidance isn't advised since both act on dopamine pathways, and it must never be combined with MAOI antidepressants due to the risk of a dangerous rise in blood pressure. Given the weak evidence, this isn't one to prioritise over the options above.
Caution: never combine with MAOI antidepressants, and use caution if you have a thyroid condition, since tyrosine is a building block for thyroid hormone.
Creatine
A randomised controlled trial in perimenopausal and menopausal women found that medium dose creatine hydrochloride improved reaction time, increased frontal brain creatine levels, and showed a possible edge in reducing the severity of mood swings compared with placebo, with no serious side effects reported (Korovljev et al., 2026). The thinking is that as oestrogen declines, mitochondria run less efficiently, and creatine supports the brain's energy production to help offset that.
For ADHD specifically, there is less evidence. There are no randomised trials in ADHD populations, though a broader meta-analysis found creatine supplementation improved memory, attention and processing speed in adults generally, albeit with low certainty (Xu et al., 2024). Worth considering, but framed as promising for perimenopause rather than proven for ADHD.
Caution: drink plenty of water alongside it, and check with a clinician first if you have any kidney condition, since creatine is processed by the kidneys.
Ashwagandha
An adaptogen with a longer track record than most on this list. A meta-analysis of 15 studies found ashwagandha significantly reduced anxiety compared with placebo, and a separate placebo-controlled trial found it lowered morning cortisol alongside reducing stress and anxiety (Chandrasekhar et al., 2012). There's no direct evidence yet for ADHD specifically, though lower cortisol and better stress resilience may indirectly support focus and emotional regulation in people whose ADHD gets worse under stress. It can interact with thyroid medication, so it's particularly worth checking with a clinician given how common thyroid issues are in perimenopause, as well as with antidiabetic, antihypertensive and sedative medications.
Caution: avoid if you have an autoimmune condition, since it can stimulate immune activity, and avoid in pregnancy.
Rhodiola rosea
Another adaptogen, best evidenced for fatigue rather than ADHD directly. A trial in physicians working night shifts found rhodiola reduced mental fatigue and improved performance by around 20% (Darbinyan et al., 2000). It doesn't raise dopamine directly the way stimulants do, it appears to make existing dopamine more effective and has some effect on norepinephrine, which is why there's interest in it for ADHD, though controlled trials in ADHD populations specifically don't yet exist. It can interact with antidepressants, stimulant medication and other medications that affect serotonin or dopamine, so check with whoever manages your prescriptions before adding it in.
Caution: can be overstimulating for some people, take earlier in the day to avoid disrupting sleep.
N-acetylcysteine (NAC)
NAC works on glutamate, a brain chemical that's often found at higher levels in people with ADHD and is linked to poorer impulse control. Trials in related conditions have shown NAC can reduce irritability and impulsivity, in one trial in autism it cut irritability by 27% compared with 10% on placebo (Ghanizadeh and Moghimi-Sarani, 2013). Direct trials in ADHD are still lacking, so this is based on a plausible mechanism rather than proof it works for ADHD symptoms specifically. It's generally well tolerated, but check with a clinician before combining it with other medication, particularly if you're on anything else that affects glutamate or is used for mood.
Caution: avoid combining with nitroglycerin medication, and check with a clinician if you have asthma, since NAC has rarely been linked to bronchospasm.
Probiotics and fibre
The gut-brain axis matters more than most people realise, and it shifts further during perimenopause. As oestrogen drops, the gut microbiome tends to lose diversity, with helpful bacteria like Lactobacillus and Bifidobacterium declining while less helpful strains increase. Specific strains including Lactobacillus rhamnosus and Bifidobacterium longum have been associated with improved mood and reduced stress (Bagga et al., 2018). Fibre matters here too, aiming for around 25g a day supports what's sometimes called the estrobolome, the group of gut bacteria that helps process and clear used oestrogen, which is directly relevant in perimenopause. This is one of the lowest-risk places to start, through food first, oats, lentils, vegetables and fermented foods like yoghurt or kefir, with a supplement added only if your diet falls well short.
Caution: introduce fibre and probiotics gradually to avoid bloating, and check ingredient lists if you have any known sensitivities.
Others you may come across
You may also come across Lion's Mane mushroom, CoQ10, phosphatidylserine, and ginkgo biloba in conversations about cognitive health and ADHD. All four have some interest in this space but the evidence specific to ADHD and perimenopause is limited at this stage. None are harmful in themselves, but there is not yet enough research to prioritise them over the supplements listed above.
Key considerations
Always test for deficiencies (iron, magnesium, vitamin D, B12, folate, thyroid) before supplementing.
Some supplements, such as tyrosine and adaptogens, can interact with ADHD medication or HRT, it is therefore recommended to seek clinical advice first.
Use high-quality, third-party tested products.
Supplements can complement, but not replace, medical treatments like HRT or ADHD medication.
Lifestyle factors such as sleep, balanced nutrition, stress management, and movement remain foundational.
References
Bagga, D., Reichert, J.L., Koschutnig, K., Aigner, C.S., Holzer, P., Koskinen, K., Moissl-Eichinger, C. and Schöpf, V. (2018) 'Probiotics drive gut microbiome triggering brain connectivity changes in healthy humans', Nature Microbiology, 3(1), pp. 64–73.
Baziar, S., Akhondzadeh, S., Mohammadi, M.R., Jazayeri, S., Aghili, M. and Mokhber, N. (2019) 'Comparative efficacy of saffron and methylphenidate in children with attention-deficit/hyperactivity disorder', Journal of Child and Adolescent Psychopharmacology, 29(4), pp. 270–277.
Bloch, M.H. and Qawasmi, A. (2011) 'Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis', Journal of the American Academy of Child & Adolescent Psychiatry, 50(10), pp. 991–1000.
Breen, C., Cooney, J. and Dempsey, S. (2017) 'Omega-3 benefits to ADHD brains', ADDitude Magazine, 23(2), pp. 12–15.
Chandrasekhar, K., Kapoor, J. and Anishetty, S. (2012) 'A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults', Indian Journal of Psychological Medicine, 34(3), pp. 255–262.
Darbinyan, V., Kteyan, A., Panossian, A., Gabrielian, E., Wikman, G. and Wagner, H. (2000) 'Rhodiola rosea in stress induced fatigue, a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty', Phytomedicine, 7(5), pp. 365–371.
Ghanizadeh, A. and Moghimi-Sarani, E. (2013) 'A randomized double blind placebo controlled clinical trial of N-Acetylcysteine added to risperidone for treating autistic disorders', BMC Psychiatry, 13, 196.
Harris, M. (2023) 'Should you take magnesium L-threonate?', Health.com, 17 June.
Konofal, E., Lecendreux, M., Arnulf, I. and Mouren, M.C. (2004) 'Iron deficiency in children with attention-deficit/hyperactivity disorder', Archives of Pediatrics & Adolescent Medicine, 158(12), pp. 1113–1115.
Korovljev, D., Ostojic, J., Panic, J., Ranisavljev, M., Todorovic, N., Nedeljkovic, D., Kuzmanovic, J., Vranes, M., Stajer, V. and Ostojic, S.M. (2026) 'The effects of 8-week creatine hydrochloride and creatine ethyl ester supplementation on cognition, clinical outcomes, and brain creatine levels in perimenopausal and menopausal women (CONCRET-MENOPA): a randomised controlled trial', Journal of the American Nutrition Association, 45(3).
Lopresti, A.L., Smith, S.J. and Drummond, P.D. (2022) 'A randomised, double-blind, placebo-controlled trial examining the effects of saffron extract in adults with ADHD', Journal of Psychopharmacology, 36(3), pp. 340–350.
MacLean, B., Buissink, P., Louw, V., Chen, W. and Richards, T. (2025) 'Women with symptoms suggestive of ADHD are more likely to report symptoms of iron deficiency and heavy menstrual bleeding', Nutrients, 17(5), 785.
Maresz, K. (2015) 'Proper calcium use: vitamin K2 as a promoter of bone and cardiovascular health', Integrative Medicine, 14(1), pp. 34–39.
Medical News Today (2024) 'Vitamin D and mood: what's the link?', Medical News Today, 15 February.
National Institute for Health and Care Excellence (NICE) (2024) Menopause: identification and management (NG23). Available at:https://www.nice.org.uk/guidance/ng23 (Accessed: 6 July 2026).
Razavinia, F., Ebrahimiyan, A., Faal Siahkal, S., Ghazinezhad, N. and Abedi, P. (2024) 'Vitamins B9 and B12 in children with attention deficit hyperactivity disorder (ADHD): a systematic review', International Journal for Vitamin and Nutrition Research, 94(5-6), pp. 476–484.
Schuster, J., Cycelskij, I., Lopresti, A. and Hahn, A. (2025) 'Magnesium bisglycinate supplementation in healthy adults reporting poor sleep: a randomized, placebo-controlled trial', Nature and Science of Sleep, 17.
Sinn, N. and Bryan, J. (2010) 'Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behaviour problems associated with ADHD', British Journal of Nutrition, 103(8), pp. 1160–1166.
Tarleton, E.K., Littenberg, B., MacLean, C.D., Kennedy, A.G. and Daley, C. (2017) 'Role of magnesium supplementation in the treatment of depression: a randomized clinical trial', PLOS ONE, 12(6), e0180067.
Verywell Mind (2016) Natural remedies for ADHD. Available at:https://www.verywellmind.com (Accessed: 5 November 2025).
Xu, C., Bi, S., Zhang, W. and Luo, L. (2024) 'The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis', Frontiers in Nutrition, 11, 1424972.
