Can Acidic Foods Affect Stimulant Medications for ADHD?

Can Acidic Foods Affect Stimulant Medications for ADHD?

Can foods—particularly those containing citric acid—affect how well you absorb stimulants, such as Ritalin, Adderall, and Vyvanse?

The question came up again at my face-to-face Silicon Valley Adult ADHD discussion group. So, let’s delve now into answering that question.

In a word, yes. Yes, food can interfere!   Most specifically, an overly acid or alkaline system (ph) can affect some stimulants’ effectiveness.

For example, citric acid and antacids can mean the difference between a stimulant working—or not.  This bears thinking about, because many Americans consume an extremely acid diet (e.g. soda, meat, cheese, chocolate, pasta, beer, wine, most grains, etc.).

But the cautions don’t stop with Ph. Even calcium or ammonium chloride, a food additive to bread and certain types of licorice can reduce stimulant effectiveness.

Grapefruit juice can also create problematic interactions with stimulants and many other medications.  Chemicals in grapefruit can interfere with the enzymes that break down (metabolize) the medication in your digestive system. That means the medication may stay in your body for too short or too long a time. When a medication breaks down too quickly, it has insufficient time to work. A medication that stays in the body too long may build up to potentially dangerous levels.

Unfortunately, many prescribing physicians remain unaware of these interfering factors.

By the way, if you came to this page while searching for hacks to abuse stimulants? For example, downing an orange juice chaser after you take Adderall? You’ll be disappointed.

Ph Spectrum: Acidic to Alkaline

Please keep in mind:  There are many other explanations to explain why a stimulant medication fails—or ceases to work—for an individual. They include genetic and physiologic.

Right now, though, let’s view this issue primarily through the narrow lens of ph (alkalinity and acidity).  Merriam-Webster defines ph this way:

a measure of acidity and alkalinity of a solution that is a number on a scale on which a value of 7 represents neutrality and lower numbers indicate increasing acidity and higher numbers increasing alkalinity and on which each unit of change represents a tenfold change in acidity or alkalinity and that is the negative logarithm of the effective hydrogen-ion concentration or hydrogen-ion activity in gram equivalents per liter of the solution; also: the condition represented by a pH number.

Citric Acid and Stimulant Absorption

Many years ago, I learned that citric acid can reduce the stimulant’s absorption—because it changes the ph of the gut. So, if someone complained to me of reduced effect from the medication,  I would ask about any new habits around citric acid consumption. This might include:

  • Drinking orange juice
  • Eating certain fruits
  • Taking a vitamin C supplement
  • Eating some other food product containing citric acid as a preservative.  (Examples of the latter include soft drinks, fruit-flavor candies, and even some cooking stock/bouillon.)

The general rule, I’d heard: Do not consume citric acid an hour before or after taking the stimulant. I’ve heard the same of a high-fat meal—to avoid it around the time you take stimulant medication, as it can reduce absorption.

This webpage (Citric Acid in Foods) contains a list of foods that contain citric acid naturally or to which it is added. The list is bigger than you might think, including berries, preserves and jams, and mayonnaise that is made with lemon juice. With children, think gummy bears, “fruit” chews, and all the other candy masquerading as fruit items.

Acidic Foods Affect Stimulants

Then again, I’d also heard that this acid/absorption issue applies more to the immediate-release medications. It’s less of a risk with the novel delivery systems for extended-release stimulants such as Vyvanse and Concerta.

One rumor is that citric acid actually improves absorption. As it turns out, that’s not the case.

Moreover, many middle-aged folks with late-diagnosis ADHD—their guts suffering from years of scattershot eating habits and stress—are also taking antacids.  Can that affect stimulant effectiveness, too?  You bet.

Acidic Foods Affect Stimulants

Let’s start solving this puzzle by examining medication label inserts, textbooks, and published literature. Read on.

Paper Inserts Shed Light

I checked the label insert for various stimulants. They offered some information.

Basically, yes, the gut ph (alkalinity/acidity) can reduce absorption. But it seems to vary by delivery method. That is, the way the medication travels from the pill (or other) to the bloodstream. For example, Adderall, Concerta, Vyvanse, and Daytrana (the patch) are all delivered via different mechanisms.

To read the product insert for each medication, click on the hyperlinked name.

Adderall:

  • Acidifying agents: 
    • Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, fruit juices, etc.) lower absorption of amphetamines.
    • Urinary acidifying agent (ammonium chloride, sodium acid phosphate, etc.) increase the concentration of the ionized species of the amphetamine molecule, thereby increasing urinary excretion.
    • Both groups of agents lower blood levels and efficacy of amphetamines.
  • Alkalinizing agents
    • Gastrointestinal alkalinizing agents (sodium bicarbonate, etc.) increase the absorption of amphetamines. Coadministration of Adderall and gastrointestinal alkalizing agents, such as antacids, should be avoided.
    • Urinary alkalinizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amphetamine molecule, thereby decreasing urinary excretion.
    • Both groups of agents increase blood levels and therefore potentiate the actions of amphetamines.

Summary: A system that is too alkaline or acid will reduce medication effectiveness.

Adderall XR:

  • Alkalinizing agents (GI antacids, including sodium bicarbonate, and urinary): These agents increase blood levels of amphetamine. (7.1)
  • Acidifying agents (GI and urinary): These agents reduce blood levels of amphetamine. (7.2) One of these acidifying agents is ammonium chloride, also known as sal ammoniac; Wikipedia has this to say about ammonium chloride:

In several countries, ammonium chloride, known as sal ammoniac, is used as a food additive under the E number E510, commonly as a yeast nutrient in breadmaking. It is a feed supplement for cattle and an ingredient in nutritive media for yeasts and many microorganisms.

Ammonium chloride is used to spice up dark sweets called salty licorice (very popular in Nordic countries, especially in Finland), in baking to give cookies a very crisp texture, and in the vodka Salmiakki Koskenkorva for flavouring. In India and Pakistan, it is called “Noshader” and is used to improve the crispness of snacks such as samosas andjalebi

Vyvanse:

  • Urinary acidifying agents may reduce blood levels of amphetamine. (7.1)
  • Urinary alkalinizing agents may increase blood levels of amphetamine. (7.2)

Dexedrine:

Acidifying agents: Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, fruit juices, etc.) lower absorption of amphetamines.

  • Urinary acidifying agents (ammonium chloride, sodium acid phosphate, etc.) increase the concentration of the ionized species of the amphetamine molecule, thereby increasing urinary excretion.
  • Both groups of agents lower blood levels and efficacy of amphetamines.

Daytrana:

[No ph interactions listed, perhaps because Daytrana is a methylphenidate patch worn on the skin and is not absorbed through the gut.]

Concerta:

  • In patients, there were no differences in either the pharmacokinetics or the pharmacodynamic performance of CONCERTA® when administered after a high fat breakfast. There is no evidence of dose dumping in the presence or absence of food.

[The label makes no mention of ph interactions, perhaps due to Concerta’s  novel delivery system.]

Ritalin LA:

  • Especially tell your doctor if you or your child takes stomach acid medicines.

Focalin XR:

  • Antacids or acid suppressants could alter the release of Focalin XR
  • The effects of gastrointestinal pH alterations on the absorption of dexmethylphenidate from Focalin XR have not been
    studied. Since the modified release characteristics of Focalin XR are pH dependent, the coadministration of antacids or
    acid suppressants could alter the release of dexmethylphenidate.

The Literature Tells Us This

Next, I checked the literature (not an exhaustive search at this point) and found this information:

In an in vitro study, the pH-solubility profile of LDX was determined in buffered aqueous solutions using an assay specific for LDX.

The environmental pH did not affect the solubility profile of LDX within the biological pH range (pH, 1–8), suggesting that gastric pH variation does not affect the absorption of LDX.

Due to the effect pH has on absorption, amphetamine also interacts with gastric acid reducers such as proton pump inhibitors and H2 antihistamines, which increase gastrointestinal pH (i.e., make it less acidic).

grapefruit and medication

Grapefruit’s Particular Challenges

Now consider a very particular type of citrus: grapefruit. Beyond any considerations about acid and Ph, grapefruit—both the fruit and the juice—can create adverse outcomes when taken with certain medications, including some stimulants.   What’s the culprit here? It seems to be flavonoids called furanocoumarins.

Wikipedia has a very clear entry on this topic, excerpted here:

These active materials inhibit a key enzyme (cytochrome P450 isoform CYP3A4) which is responsible (among other activities) for drug metabolism. The effect happens in two ways.

One is that grapefruit can block the hepatic CYP3A4 thereby affecting the medication metabolism. If the drug is not metabolized, then the level of the drug in the blood can become too high, leading to an adverse effect.

On the other hand, if the medication is provided as a pro-drug [Gina notes: Vyvanse is a pro-drug], compromising its metabolism may prevent the drug from being created, thereby reducing its therapeutic effect.

The other effect is that grapefruit can block the enterocyte CYP3A4 thereby affecting the medication absorption in the intestine. Absorbing the medication to a lesser extent means it may not reach a therapeutic level. Therefore, its effect may be compromised.

In other words, grapefruit juice can be a problem in two big ways:

1. Create a toxic too-high dose of the medication
2. Reduce the medication’s therapeutic effect.

Acidic Foods Affect Stimulants

The list of grapefruit’s potential drug interactions is long. Here is a sampling, again from the Wikipedia entry on Grapefruit-drug interactions:

  • Benzodiazepines
  • All the stimulant medications
  • SSRI antidepressants
  • Statins
  • Anti-Erectile Dysfunction medications
  • Acetaminophen

Cytochrome P450

For more information on cytochrome P450, check this post from the series I wrote with my molecular-biologist husband:  Part 4: Gene-Testing to Inform ADHD Drug Therapy.

The Bottom Line

It should be clear, from this brief examination, that ph can be a factor in stimulant efficacy.  Grapefruit juice has its own particular effect on the absorption of stimulants and other medications. We also touched briefly upon the role of calcium, fat, and food additives such as ammonium chloride.

This is a reminder that stimulants do not act in a vacuum. They act in a highly individual human body.  To be most effective, the stimulants require physiological support, including but not limited to:

  • Adequate sleep: Stimulants cannot compensate for sleep deprivation
  • Good nutrition:  All medication targeting neurochemicals need “helpers”—B vitamins, potassium, magnesium, and other vitamins and minerals that help to fuel neural transmission (“moving messages around”).
  • Adequate protein:  Not “high protein” but rather adequate—because proteins are composed of amino acids. Amino acids are the building blocks of neurotransmitters such as dopamine, serotonin, and the like.

What’s Your Experience?

I’d love to hear your experiences on this topic. For example:

  • Have you found that acidic foods affect your stimulant’s effectiveness?
  • Have you noticed that taking an antacid creates problems with your stimulant being effective?
  • Did your physician ever mention these factors?  If so, what information did you receive?
  • If you have particular knowledge in this area, please write a comment and I will incorporate it into this post for future readers to benefit. Thanks.

—Gina Pera

213 thoughts on “Can Acidic Foods Affect Stimulant Medications for ADHD?”

  1. So I have GERD and I take pantoprazole. Since concomitant use of gastric ph modulators can change the release profile, shape of pharmacokinetic profile, and exposure to extended release medications like Adderall XR, I believe what is happening is what they refer to as “dose dumping” where the entire dose or a significant fraction thereof is being released too soon. I can’t go off of the PPIs, so I need to figure out what my best option is as far as an extended release medication which will stay in my system longer. I’ve tried Vyvanse, which gave me severe nausea (no other stimulant meds give me nausea so I’m not sure why it did). I’ve looked at Mydayis which contains 3 beads instead of 2 like Adderall XR. Mydayis is formulated to release some beads immediately, some at ph 5.5, and some at ph 7. I’m not sure if this would work any better for me vs Adderall XR, or if it would still result in dose dumping. I couldn’t find any info on what ph the Adderall XR extended release portion of the med releases at for comparison. I looked at Adzenys, which is formulated with a different release mechanism (Adzenys is a XR-ODT tablet not beads in a capsule) but is still ph dependent. However, Adzenys is amphetamine base instead of mixed amphetamine salts like Mydayis and Adderall XR. I don’t know if this would make any difference as far as if it would be more likely to release as intended in my stomach or if it would still result in dose dumping.

    I think that pretty much exhausts the options for amphetamine based medications, but there are of course some options in the methylphenidate category with less ph dependent release mechanisms. It’s fairly easy to find information on the absorption of AMP being ph-dependent, but less info is available on the ph-dependent absorption of MPH. When I was first diagnosed, they tried a methylphenidate first and it helped some but not enough, and that’s why they switched me to Adderall. That was 14 years ago though so I don’t know if maybe the dose wasn’t right or if I would respond more optimally to a MPH based medication now. Concerta appears to be not influenced by stomach ph for its extended release delivery system, which is an osmotic pump in a pill instead of ph-released beads like Adderall XR. Daytrana is of course transdermal, but it is only approved for use in children and so I don’t know if my insurance would cover it, and it is really expensive without insurance. Concerta would be covered by my insurance.

    With all of that said, I’m not sure what the best option would be. Looking for insight.

    1. Hi Leo,

      I think you owe it to yourself to try a MPH product. If you try Concerta, be sure to read my blog post on how to get the authorized generic (brand marketed as a generic).

      It might be that, in the end, one of the “legally bioequivalent but we know otherwise” generics would work better for you. But the idea is controlling for all the variables you can first.

      Sometimes, impatience toward seeing improvement and inability/reluctance to teach new skills mean Adderall. It seems to “work” better. But it also has a higher side effect profile, and many people burn out or develop physical symptoms.

      good luck,
      g

  2. Hello! I am a college student with ADHD and on 15mg of Adderall XR and 10mg IR in the afternoon. Sometimes the medicine works, but recently it has not been working at all. I am completely distracted and all over the place. I usually have greek yogurt with honey in the morning right before taking the medicine and about 10 minutes later have my first cup of coffee. What am I doing wrong? Is it the acidic coffee? I talked to my dr. about it and they didn’t seem to know much and weren’t much help other than upping my dose. I just want to be able to concentrate! Any help you have would be greatly appreciated.
    Thank you!

    1. Hi Michael,

      I can only imagine how disorienting this is for you.

      If that’s been your morning routine (yogurt, honey, coffee) while you’ve been taking the Adderall for a while, it’s probably something else, right?

      Do the pills look different than ones in the past? Can you check your past receipts — or call the pharmacy and ask — to see if maybe your generic manufacturer has changed?

      I assume you mean generic, but maybe you mean brand?

      Nothing else has changed? Not less sleep? Not more demands on your focus/attention?

      Did you ever try Vyvanse? At least you won’t have to deal with generics.

      g

  3. So is Vyvanse made STRONGER or WEAKER by calcium carbonate and proton pump inhibitors? I take both and have recently upped my intake due to worsening GERD/gastritis pain after starting Vyvanse. This stuff must be caustic af because I’m dying. I’m getting an ulcer for sure–you know if you’ve ever had one. When I took couple days off, the pain eased up so it’s definitely the medication causing it. And I’m only on 10mg. I’m a substance user of many years and have (unfortunately) self-medicated with tons of stimulants, both legal and illegal, and NOTHING has burned my stomach like Vyvanse!

    Mind you, I already have severe GERD due to a hiatal hernia so it doesn’t take much to tip over into ulcer territory. But jeez. Whatever’s in this pill must be pure fire. I’m hoping Adderall or Dexedrine doesn’t cause the same symptoms because I need these meds to function. They help so much, both with my ADD and sobriety from other substances 🙁

    Awesome site, btw.

    1. Hi Barbie,

      I’m glad you like my blog, thank you! It’s the first website of any kind of Adult ADHD—with never any pharma support of any kind. (Pretty rare these days!)

      Here’s what I wrote in the post, drawing from the FDA-mandated product insert:

      Vyvanse:

    2. Urinary acidifying agents may reduce blood levels of amphetamine. (7.1)
      Urinary alkalinizing agents may increase blood levels of amphetamine. (7.2)
    3. So, the answer to your question (is Vyvanse made stronger or weaker) is……BOTH? 🙂

      It’s impossible to say for any individual, but the general idea is: The medication will behave differently in the presence of these other factors (e.g. proton pump inhibitors, etc.).

      It’s not that the Vyvanse itself contains “pure fire”. It’s that it changes your physiology, including gastric movement, etc..

      If you haven’t tried a methylphenidate option, you might want to start there (e.g. Brand Concerta, Ritalin, etc.). Or maybe Strattera.

      Definitely, if I were you, I wouldn’t stay on the Vyvanse. The sooner it’s out of your system, the sooner you can begin healing.

      Good luck sorting this out.
      g

  4. Great article. I’ve had acid reflux on and off for a few years. A year ago I started on vyvanse for adhd and binge eating disorder, it did not work for adhd but worked well for bed. I had bad reflux but it seemed normal for me and so didn’t connect them. Had a break from vyvanse then went back to it where I then began huge relux worse than ever before, now believing its silent reflux going by symptoms but also a feeling of constant hunger which should be the opposite as it was when I took it before, I was eating but couldn’t get the feeling gone so upped my protein which didn’t help if anything was worse. Stopped vyvanse again 3 months ago but severe acid symptoms still here including severe hunger feelings, nothing is taking it away. Could it have been the vyvanse? What can I do? Thank you for any help

    1. Hi Harry,

      Apologies for the delay. Life has been extra busy this week.

      That is a bit of a mystery.

      Does your prescriber have a clue? (Silly question…. lol)

      Are there any other variables? Have you changed your diet, supplements, sleep patterns, etc.?

      Many people with ADHD will experience an uptick in anxiety from a stimulant, perhaps especially the amphetamines.

      For some, this means that the anxiety merits medication treatment, too.

      It can be a delicate balance, as stimulants boost certain neurotransmitter transmission at the price of back-suppressing others.

      Have you tried a low dose of Strattera with the Vyvanse — or perhaps a methylphenidate stimulant?

      The only reason that Vyvanse is used for BED over the other stimulants is because Shire paid for a study that showed effectiveness.

      But really, the main thing is that ADHD itself is associated with obesity, including not “putting the brakes” on eating, in some cases due to not noticing being full.

      It might be that another type of stimulant, along with a low dose of Strattera or an anti-depressant/anxiety medication might work better for you.

      good luck,
      g

    2. Yeah extra protein prob wont help. try eating alkaline foods (fruits and vegetables) only for a week and see if that’s helps. Btw it should fix your overly acidic stomach. Take Care !

    3. Hello Gina,

      Sorry to resurrect an ancient thread. I just wanted to address something here in regards to LDX.

      “…One paper (Lisdexamfetamine Dimesylate (Vyvanse), A Prodrug Stimulant for Attention-Deficit/Hyperactivity Disorder) offers information about Vyvanse that, if I’m reading this correctly, seems to contradict the official information”

      This doesn’t contradict the official information that you quoted before. The above quote is in reference to gastric pH, while the other quote is in reference to urine pH. So LDX isn’t gastric pH-dependent like many other stims, but during the excretion stage, it is highly dependent on urinary pH which can result in dramatic differences in d-amphetamine exposure times—as it often does with other drugs. This is the reason why drug-dosages must be carefully considered among populations with impaired renal function.

      Also, worth nothing that PPIs don’t affect urine pH, however Calcium Carbonate certainly does.

    4. Dear Niels,

      Thank you so much for supplying that info nugget!

      I knew enough to hedge my statement (“if I’m reading this correctly”) but not enough to explain.

      This might be an “ancient” thread but it’s one of my most popular blog posts.

      g

  5. Hello,

    I am 24 years old, and I have been taking aderall for about 3 years now. About two years ago I started experiencing EXTREME acid reflux. I tried switching to extended release, which made it worse, so I moved to Vyvance, and that was also much worse. So I have been back on my regular 18mg Aderall. I have to sleep sitting up, and I have to eat oatmeal first thing in the morning, otherwise I am in excruciating discomfort. I mean I can’t bend over without feeling like I’m going to throw up acid. About six months ago I was prescribed 20mg of Famotidine to take every night before bed, and I haven’t noticed any change at all. I am plant based, I eat tons of veggies and clean foods, and I am in great shape. Please let me know what I can do to stop this terrible acid reflux!

    1. Hi Sophia,

      I am not a physician — but I sort of know more about this than most prescribers. 🙂

      But that doesn’t mean I know a lot.

      Here’s the thing: Stimulants target dopamine, a neurotransmitter. Dopamine affects more than brain functions such as focus, distractibility, etc.. It is involved with many physiological processes, including those of the respiratory and digestive systems.

      Specifically, dopamine transmission (that is, dopamine molecules sending messages along neural pathways) can affect “gastric motility.” That is, the involuntary muscle movements that move food through our digestive system. That MIGHT be a factor in your “EXTREME acid reflux.”

      More potential factors:

      —Adderall might be acting as a vaso-constrictor — that is, contracting/narrowing the smooth muscle in blood vessels, which causes the vessels to constrict.

      —Many people with ADHD have a co-existing condition, such as depression or anxiety. Stimulants can exacerbate those conditions by back-suppressing the neurotransmitter serotonin in parts of the brain.

      —If you are taking generic, there might be problems you might not experience with the brand (different colorants, fillers, etc.).

      I guess the main thing is to see how you might do off a stimulant or on the other class of stimulant, methylphenidate (e.g. Concerta, Ritalin, etc.).

      If I was in your shoes, I’d try one of those or maybe even Strattera (with might help with anxiety, too) with a low dose of stimulant.

      These acid-reflux-type problems can cause real damage, so I would not risk my good health by continuing the Adderall.

      That’s great that you focus on a healthy diet and staying fit.

      But just know that “tons of veggies” might be hard on your digestive system, too. And of course you’ll want to pay attention to vitamins and minerals that are not found sufficiently in a plant-based diet, such as zinc. We need those vitamins and minerals to metabolize medications and to support neurotransmitter function.

      I hope this helps. Good luck!
      g

    2. Hello Sophia,

      From what you shared it sounds like you might have LPR (laryngopharyngeal reflux) also known as silent reflux.

      It’s very different from the more well known acid reflux. Alot of doctors aren’t well versed in it, prescribe medications that target the acid in the stomach which actually do little to nothing for LPR, hence no change in your symptoms.

      I recently developed LPR and noticed an increase in symptoms when I was taking my daily Vyvanse.

      I did a ton of research and found holistic ways to cope with the symptoms. I recently read a book by Jonathan Aviv called The Acid Watcher Book. I found it incredibly helpful as it explains so much about the issue plus ways to cope with the symptoms.
      I hope this info is helpful to you, that you are able to find some relief soon.

      J

    3. Have you tried hot water with liberal amount of pieces of fresh ginger until the water is yellow? Drink it before eating, after eating, always abt 30min before going to bed, sip on it through out the day etc… Maybe you’ve already tried it, If you have not, you should go to the store and get the fresh ginger ASAP. So many of my American colleagues and friends who have suffered from extreme GERD don’t take my suggestion seriously, to the point that I have to go out and get the ginger and make the drink for them when I realize they just ignored my suggestion(probably sounds too simple, when they’ve already tried every advanced medication out there). I have never meet a person who it didn’t help and often times makes the symptoms go away completely over time.
      But you must use fresh ginger, not one that’s already pre shopped, you must peel and chop it yourself, and NEVER add any other ingredient, it will be a bit bitter at first but you will get used to it and the relief will be worth it. Good luck, and if you’ve already tried it, ignore this message.

    4. Thanks, Sarah.

      I found this:

      Ginger has been used worldwide as a natural cure-all for everything from malaria to baldness, but it is most commonly celebrated as a remedy for digestive problems. Because of the vast range of gastrointestinal issues, researchers continue to “dig deeper” to find more uses for this spicy, fragrant root (Source: Web MD).

      Scientists are especially curious about whether ginger can relieve acid reflux and symptoms of heartburn. A 2011 study found that participants who took ginger supplements showed reduced levels of inflammation within one month. This could be due to the phenolic compounds in ginger, which can ease stomach irritation. Phenols are also known to reduce gastric contractions that might allow acid from the stomach to flow up into the esophagus (Source: Healthline).

      Currently, most studies on ginger are limited to its nausea-reducing effects, so there is certainly room for more research on ginger’s effectiveness against acid reflux and heartburn. However, there is no denying that cultures worldwide have been using ginger to soothe digestive conditions for generations. According to Home Remedies for Life, ginger can also help:

      https://westonoutpatient.com/news/the-power-of-gingertorelieveheartburn

  6. Hi! What a fascinating article to read!

    I have a question for you, as you seem to be quite an expert on the subject!

    Is there anything that comes to mind or any reason at all why all types of stimulants have slim to no effect at all on someone? Adderall XR(60mg) ,Dextroamphetamine(Dexedrine spansule XR 60 mg)
    methylphenidate (Ritalin) Modafinil(up to 400mg).

    All of the above were prescribed to me for their wakefulness properties, because I have severe hypersomnia and also ADD.

    Is there a protein, or anything, that could be “not binding” properly on something else in my brain and therefore, making all stimulants useless?

    I’ve been tested for anti-lgi1, anti-ma2 and anti-nmda.

    They did found elevated Beta-2 glycoprotein 1 IgG and I’ve tested positive for antinuclear antibodies. I am getting a full body PET-SCAN on Monday..
    Could that explain why all stimulants don’t work on me? Caffeine and energy drinks are useless..

    Thank you very much.

    1. Have you’ve recieved any awnsers about your questions yet?.. I’m curious to know because I have pretty much the same symptoms you mentioned.

    2. Hi Eric,

      Thanks for bringing my attention to not replying to Patricia. It was a tough question, so I needed to think awhile. Then it got away from me. I just responded.

      g

    3. Dear Patricia,

      Any revelations from your PET SCAN?

      I am so sorry to have forgotten to attempt answering your question. I read it when you sent it, but then I needed time to ponder. 🙂

      I could ask some questions, though.

      1. Are you confident of your diagnoses — ADHD (inattentive presentation) and severe hypersomnia? Is it possible there is a mood disorder?

      2. How long have you had these problems? Was there any time when you did not?

      3. When you tried the stimulants, were you consuming citric acid, drinking caffeine, or on a restrictive diet?

      4. Is your diet good, with enough (not too much) protein and you’re getting enough vitamins and minerals?

      5. What is your age?

      One tidbit: Generally speaking, the stimulants are not “wakefulness” medications. Especially not for people with ADHD. (ADD is the old term. Today all presentations are called ADHD.)

      In fact, I’ve seen some folks with late-diagnosis ADHD and with lifelong sleep deficits actually become sleepy on the stimulants. That’s because, I presume, the stimulant is helping them to “focus” on sleep and relax — and pay off sleep debts. At least in some that’s how it’s turned out. With some patience. Does that sound like a possibility?

      Gina

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