Live a few decades not knowing that you have ADHD, and chances are you’re lugging around not only
emotional baggage but also physical baggage — sleep debt, adrenal exhaustion, off-kilter hormones, allergies, and more. Yet, in our specialist-dominated healthcare “system,” finding a physician who can assemble all the puzzle pieces is a challenge.
When’s the last time your personal physician, not to mention ADHD-treating psychiatrist, closely scrutinized lab results for your: complete blood panel, adrenal function, hormones? How about properly answering your questions about, say, potential gluten sensitivity?
Yet, if you’re suffering from any of these allied health challenges, your brain function could be suffering in ways that will never be sufficiently addressed by psychotropic medications alone. But will your physician understand this?
Unfortunately, I’ve found many ADHD medication prescribers don’t even get the basics right with that. How can they possibly understand the individual factors around drug metabolism, side effects, nutrition, supplements, hormones, and all the rest?
A few years ago, I scoured the Internet for a “big picture and small details” physician. I sought a physician who was sharing information (on a blog or website) not only about ADHD and its commonly co-occurring conditions but also the many other biomarkers that affect brain health.
Fortunately, I found CorePsychBlog , written by physician, author, neuroscientist, and psychiatric consultant Charles Parker, D.O. (pictured, above right). (Regular readers of this blog have seen Dr. Parker’s comments. For the record, he and I have no business association.)
Update: This post dates to 2009
Dr. Parker has since scaled back his blogging and other writing. You can still watch many of Dr. Parker’s videos on Youtube.
On Getting the ADHD Meds Right: “If we start with the right diagnosis, and recognize complexity of the spectrum of ADD, we will be much more capable of finding the right solution,” says Dr. Parker, introducing the first in a three-episode series regarding right diagnosis, right meds, wrong meds, and metabolic issues that encourage a failure of treatment.
Hello, I started on 10 mg Adderall last year and had many negative symptoms such as insomnia, migraines, muscle aches, weakness, after 3 days I developed tinnitus, light headedness, shortness of breathe, hair loss.
I only took the medication for 3 months (not consistently either) and when I went off of it, the symptoms persisted into the summer and actually got worse.
I went crazy on the research and assumed I had glutamate toxicity and or an iron deficiency. I began taking an iron supplement with zinc, folate, and copper. It reduced my tinnitus and shortness of breathe by 90 percent and helped with a lot of my symptoms (this was immediately as well).
I thought it was an iron deficiency and I had fixed the problem, however, my hair loss, muscle aches, and weakness got worse.
I now feel as though I have tennis elbow in both my arms, and sometimes if I don’t take my supplements, I feel like someone is sitting on my chest. My thyroid gland was inflamed a few weeks ago. I went to a Holistic nurse practitioner. My blood tests showed my TSH elevated at 4.4, my T3, T4 were normal. My TPO was 24, and thyroglobulin was 22. My ALP and ALT was lower than optimal. White blood cells were bordering the flagged range.
I have measured with low blood pressure during the morning before but normally its normal, but my blood sugar can be low. She believes it is adrenal fatigue causing issues with my thyroid but I am certain it is my thyroid because I already do much of what she recommended. I am a health nut and eat really well (kale, eggs, or oatmeal in morning w/ protein shake, sweet potato, broccoli, fish, water w/ lemon, apple cider vinegar for supper, etc).
I buy most of everything organic and take many supplements (organic and third party verified) such as vitamins C, D, A, B vitamins, magnesium, omega 3, the basics, alpha lipoic acid, ashwagandha, turmeric, COQ10, L-theanine, chaga extract, etc.
I don’t understand why I am experiencing all of these health affects when I eat so healthy and take the right supplements.
My energy levels fluctuate massively throughout the day and I find myself fighting to maintain them with what I eat, when I eat it, the supplements. I can’t drink tap water without peeing a half hour later and my energy levels will either go higher or plummet. If I eat soy, gluten, eggs, dairy, it is the same thing, my energy levels are unpredictable.
My symptoms are exacerbated on ADHD medication but I cannot stop taking it. The only reason I take it is because I cannot stay awake otherwise while studying, I can sleep 12-16 hours in a day, I normally take naps during.
I personally want to go on the natural thyroid hormone medication and see if it helps me. I don’t know if I will be able to find an endocrinologist or natural path that will do this for me. I know I put a lot of information in here but I am not looking for you to diagnose me, I am wondering from personal experience what you think and am seeking re-assurance. I wanna know from what you know and what you’ve seen, if it could more likely be adrenal fatigue or a thyroid issue. If I should fight this. Would it be beneficial for me to try and find an endocrinologist that will listen to me and help me.
HI Hannah,
I appreciate your struggles.
In my own experience, I’ve found that “truth” lies somewhere between standard MDs and the “alternative” types (naturopaths, etc.). We have to be careful in treading that gray area, because it can be very hard to find solid professional guidance.
A few thoughts:
1. re: endocrinologist.
If you can find a really smart one with a broad understanding of all the issues connected to hormones, maybe that would help. In my experience, those types of specialists are few and far between.
2. re: adrenal fatigue — there is no such diagnosis.
I’m all for “holistic, etc.” medicine — since the 1980s, in fact! — but I do not appreciate the tendency of many “holistic” NDs, etc. to make up terms and their made-up causes…..and treatments.
3. I’m confused…at the beginning you said you went off the Adderall after 3 months. At the end, you said you cannot stop taking it.
4. “All the right supplements and healthy diet.” It sounds like you are making a great effort. But maybe you’re over-doing it a bit?
For example, despite “kale mania” …as promoted on the “health” blogs, etc….you really don’t want to eat too much of it—or any one vegetable, fruit, etc.. Same with fish — given mercury contamination in most fish, it’s really not advised to eat fish more than once a week, and then low-on-the-food-chain fish.
Also, the supplements…why so many supplements? Especially chaga extract and ashwagandha—and why a Vitamin A supplement if you eat so healthily? Why iron and zinc (in particular)? Do you have a known deficiency?
Supplements can be hard on the liver and kidney. And this can affect how a medication is metabolized.
You’re mixing a lot of things — some with no evidence, some with little evidence, and some with no apparent demonstrated need that it is useful to you. And who knows the interactions?
Who says these are all the “right” supplements? I urge caution. There is a lot of nonsense online pitching itself as expert information. It’s getting worse by the day. So be careful.
re: Thyroid, etc.
ADHD itself can create dysregulated adrenal, thyroid, and hormone function. Adderall could be exacerbating that.
One thing to do is stop taking the Adderall — and take a less problematic stimulant. You might try Vyvanse or Concerta — both popular long-acting choices in the two classes of stimulants.
Before you do that, I would also consider cutting back on all the supplements. At least for now. Maybe limit it to a basic multi-vitamin/mineral and fish oil (not too much, though…more is not better).
I hope this helps. good luck!
g
Sorry Gina, I forgot to mention, I stopped taking the medication during the summer time. In September when school came back, I started on medication for ADHD again. I had tried Ritalin, Biphentin, and Vyvanse, however, I feel fatigued and cannot concentrate on those ones. Vyvanse presents the same side effects as Adderall. I was originally on Concerta since I was 13 (on and off for 10 years), however, I could not handle the symptoms of that medication either (bad depression and anxiety), I hardly ever took it regularly. After trying different ADHD medications, Adderall was the ‘better’ pick. I have been on it now for 2 months again and it does exacerbate my symptoms, however, taking away the medication doesn’t eliminate my symptoms. I’m stuck in a pickle.
I recently completed another blood test (while off of my medication) and my TSH was 6.1 and my T3, and T4 were a little lower but normal.
The foods I chose were some examples, I try to make sure that I am switching my diet up lots. I know it may seem like i’m taking a lot of supplements but they are higher quality and of the daily recommended value. The supplements provide a lot of relief to my symptoms and are really the only thing providing relief. My tinnitus and breathing becomes difficult if I do not take copper and zinc, and I may have low vitamin A absorption (according to a genetics test). Blood tests showed that my copper was low in comparison to zinc. Supplements that I notice the biggest difference with are associated with thyroid issues – COQ10, Ashwagandha, omega 3, iron, zinc, copper, quercetin, B complex, pomegranate juice, and Chaga. Those are all supplements associated with beneficial properties to thyroid disorders, except quercetin. Quercetin is associated with histamine intolerance or mast cell activation syndrome. I am going to get tested for this because the symptoms are almost the exact same as hypothyroidism. I think that is so important because most people do not realize allergies can display the same symptoms as Hashimoto’s and even produce antibodies. It can also be associated with Hashimoto’s and increase thyroid anti-bodies. Hopefully, when I do testing for this, I’ll get some answers.
I personally don’t like or trust multi-vitamins as they can contain unnecessary or harmful supplements (depending on the person) such as Rhodiola, iodine, estrogen supporting herbs. They are less likely to be best sourced or obtain highly bioavailable ingredients such as methylfolate, magnesium bisglycinate chelate, zinc picolinate, ubiquinol (COQ10), and more. I tested positive for the folate gene (MTHFR) and was on the path to an iron deficiency 4 months ago, methylfolate is more bioavailable and regarded as safer. Many multivitamins do not contain it. There is a large percentage of people with an iron deficiency who cannot sufficiently increase their blood levels with iron supplements alone. Up to 60% of the European population has this gene. The zinc to copper ratio is another parameter most often not accounted for in multi-vitamins. High levels of zinc can lead to a copper deficiency (25 mg of zinc needs to be supplemented with 2 mg of copper). I feel you have so much more freedom with individual supplements and can tailor them to your needs. I just recently purchased organic watercress and moringa liquid extract for my smoothies. The capsules and powdered forms are not as superior. I also have turmeric (curcumin), Ashwagandha, and milk thistle tinctures in the best/optimal dose. The capsules do not provide relief to my symptoms, but the tinctures make a huuuge difference. My muscles feel softer, head pressure decreases, and anxiety goes down, etc.
HI Hannah,
I understand your concern about standard multi-vitamin/mineral. I’m very particular with mine.
It’s interesting that you have low copper relative to zinc. So many people now have the opposite, as they avoid red meat and other sources of zinc and overload on copper-containing cereals and bread.
Copper-zinc and magnesium-calcium..both pairs need to be in balance.
Preliminary research showed that stimulants increased iron uptake in some people with ADHD. I haven’t followed the topic since this post but maybe there is follow up by now.
https://adhdrollercoaster.org/tools-and-strategies/can-stimulants-normalize-iron-uptake-in-individuals-with-adhd-maybe/
If you had bad depression and anxiety on the Concerta, is it possible that you have co-existing depression and anxiety? Many times, ADHD is mistaken for depression and anxiety but those conditions can also co-exist — and be exacerbated by a stimulant.
I wish we had better ways to assess what a specific person needs.
best of luck to you!
g
Sounds like you have Hypothyroidism and Hashimotos disease. The natural (NDT) are not working anymore so you’d need synthetic hormone replacement. I suggest you join anFB group called Adrenal a fatigue and a thyroid Care. You will get AMAZING advice there. You need to see a Functional Medicine Doctor who specialises in thyroid and autoimmune. You’ll be able to get Dr recommendations there too. They will advise the tests you need to do. TSH is not a good number to go by. You need a full thyroid panel (including Reverse T3). Free T3 and Free T4 are really important numbers. You’ll also need a full iron panel (not just ferritin) and will need to do a saliva cortisol test (ZRT is the best brand). These will be the tests they recommend. You’ll then need to be on T4 and T3 thyroid hormone treatment. You CAN feel better. Tiredness is a very very common symptom.
Thanks, Sar.
g
Thank you for the response!
I was told I may have hyperthyroidism before starting Adderall XR about a year ago but it was not significant enough for that doctor to want to act on it.
I do exercise a few times a week and eat fairly well and that hasn’t changed too much in the last year. Actually the only change would be that I started exercising more in these recent months.
When the Adderall XR stopped working it was the first day on the first pill from the new prescription and I noticed the difference. They are the same Shire brand 100 capsule bottles.
Maybe a bad batch? I called Shire to report the LOT number with my issue and also the FDA to see if there were any recalls, but there are not.
This is the first time my new physician has gotten bloodwork done on me. And actually this new bottle that isnt working is the first one I’ve ever filled with him… hm.
I’m no doctor but could my hyperthyroidism spike up to the point where it’s breaking down the Adderall XR faster so suddenly?
Hi Alfred,
Darn, I was hoping there was a simple answer: a generic.
I don’t hear about “bad batches”. These brand medications are very tightly regulated in their manufacture.
Sorry I can’t even hazard a guess with the thyroid issues. I have known more than a few people with ADHD, however, who have had benign tumors on their thyroid.
If you’ve started exercising more, maybe you have also made dietary changes? See my post on citric acid+ and stimulants. Maybe you are taking a protein powder or other supplements?
Lots of sleuthing again for you. good luck!
G
Adderall can DEFINATELY have “bad batches” and different manufacturers that produce different medications. Please DO NOT ever let someone tell you that “generics are just the same as brand” or “all the pills are the same, regardless of manufacturer.”
I almost ended in in the hospital from a “generic” brand of adderall from Mylan manufacturer!! I used TEVA 20mg and 10 mg adderall for years and nothing happened. I was once switched to Mylan due to pharmacy being out of TEVA and BAM! 1 day, sick as a dog. 2 day, migraines like crazy, sick to stomach, hot flashes, was about to go to hospital for the pain. Day 3 I threw out the entire script because I knew it was the pills. I went without medication until TEVA were available and then I was perfectly fine again. Never happened again.
Check the manufacturer on the bottle. Request that the pharmacy only order you a certain brand. Check that bottle before leaving pharmacy. Don’t let anyone tell you it isn’t the pills.
Hi Dani,
Thanks for supporting the message I’ve been blogging about for years.
When it comes to stimulant medications, the generics can vary a lot from the brand. AND the generics vary amongst themselves, manufacturer to manufacturer.
Different colorants, binders, and fillers. Different release rate (for example, dumping a lot of the medication at once).
Here’s the latest post, on the slew of inferior generics for Concerta.
https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update-6-1-19/
g
Hi, I was diagnosed with ADHD and have been taking Adderall XR for about a year now and it has done wonders for me. That is, up until about a week ago when after filling a new prescription, it just stopped working. I still take it but it literally does nothing for me. I was and am still a little concerned with it possibly being something with the medication has changed. After a few visits with my doctor and an embarassing conversation with the pharmacy, they all say that it is the exact same medication I’ve always taken. Today my doctor told me, after having labs done, I have hyperthyroidism and that may be why the Adderall has stopped working. “A spike in my thyroid” as he worded it. Is that really a thing? Can my thyroid problem cause my Adderall to just completely stop working?
Hi Alfred,
It’s complicated. 🙂
In brief, the brain pretty much controls everything that happens in the body, including hormone production.
So, yes Adderall could be affecting your thyroid function. Especially if you are not getting enough good sleep, aren’t eating well, exercising, etc.
On the other hand, you say that it worked until about a week after filling a new prescription.
Was that the same exact pill you’ve been taking or was it a generic—or a new generic?
Sorry to say, you can trust neither the average pharmacist or the average doctor when it comes to generic medication.
They are NOT the same as brand. PERIOD.
For some medications, the differences aren’t significant.
For others, such as the stimulants, they are.
Has your physician been checking thyroid function regularly — or only now in light of the medication not working? In other words, thyroid might not be a factor in the rx no longer working.
g
Hey, it seems you may work some with children. We are working with a pediatrician and endocrinologist to help my seven year old daughter. She has gained 40 pounds in one year and 11 months in the month of Jan. The pediatrician ran some blood work and found that her insulin level was double but everything else was normal. We went to the endocrinologist. She ordered more blood work and a twenty four hour urine test. They all came back normal. She had an MRI two weeks ago and the thyroid and pituitary gland was normal. The endocrinologist is now “fishing.” My daughter is scheduled for a sleep study in July. We have meet with a nutritionist and my daughter is now on a low carb, low sugar, high protein diet but it’s not affecting her weight at all. We are most worried about pains in her legs/feet and her feet go to sleep. I found your site because I also think that she is ADD but was trying to figure out the other stuff first. Now I’m wondering if it’s all related? I am also ADD and suffer from fatigue along with leg pain and swelling ( I’m her mother.) I have been to countless doctors about my leg pain and fatigue but nobody can find anything wrong. I am on Adderall. Just wondering your thoughts. Holly
Hi Holly,
I’m not sure if Dr. Parker is still following this thread.
I’m sorry to hear your child is having such problems, and I hope that the endocrinologist can figure it out soon. One thing I’ve found with some endicrinologists: They completely ignore the role of the brain in the endocrine system. That is, it is signaling from the brain that controls much of hormone function and action.
I wonder what your pregnancy was like? Were you taking Adderall then, or you hadn’t yet been diagnosed? Were you eating a lot of sugar or a high-carb diet? That can affect the fetus and then the child’s insulin function, as more and more research is showing.
As for the diet, I can see the low carb and low sugar, but high protein can be hard on a body, too. I hope the nutritionist emphasized vegetables as part of your daughter’s nutrition.
Adderall is not my favorite stimulant; it has a high side effect profile. I would look into other, long-acting options, such as Vyvanse or Concerta.
As for your leg pain and swelling, do you get exercise? Are you on your feet a lot? Seem like obvious questions, but they do have relevance. But how is your glucose level? That can affect circulation, too.
Wish I could be more help. Mainly, what I have are more questions.
best,
g
I’m not sure if it could be this but it could be a histamine intolerance. Histamine intolerance depending on the severity (active receptors) can present with many of the same symptoms as hypothyroidism. You can have a histamine intolerance without conventional allergic symptoms (runny nose, itchy eyes, hives, throat swelling). It most often encompasses inflammation, muscle pain, weakness, fatigue, brain fog, gut issues, weight gain or weight loss, dry skin (psoriasis), blood sugar control issues, and more.
I loved finding this as I was blessed to be a patient of Dr Parker when my hubby was stationed in Virginia Beach. To say he changed the lives of my 2 daughters that also saw him would be an understatement! He took my daughter who had been diagnosed with Aspergers with severe social anxiety from being paralyzed outside the house to a talkative and bubbly little girl who now even has a best friend, and is the first to offer telling a joke. She is just on supplements right now, but I trust if she ever needs more than that Dr Parker will look at everything and help find the right medication. He is not your average doctor. He listens. He is very good at showing my children he wants to hear from them too. His book is well written and his videos are the perfect length for those of us with ADHD. He offers great supplements but was not offended when I wanted to purchase a different brand that was cheaper. He simply looked over the amounts on the bottle so he could suggest appropriate dosing. He is not pushing an agenda to simply pad his pockets- he cares about his profession and helping the people who come to him. I wish more doctors would take his approach, be willing to work outside the box in order to find the answers their patients need to feel better. I just wanted to give firsthand experience to his credibility. Thank you Gina for bringing awareness to his amazing work and helping people connect so they can find answers! 🙂
Hi Ginger,
What a wonderful testimony about my longtime friend and online ally, Chuck Parker.
I’m so pleased to know that your daughter was lucky enough to have him as her doctor.
And yes, if only we had more physicians like him, who asks the big questions and examines the tiny details. He’s made so much important information available freely to the public. It’s an immense service.
I will be posting an excerpt from his book here soon.
Thanks so much for your comment.
best,
g
I live in Mass, getting ‘Crisis’ help for someone who has been on Meds 15 yrs, effectively,(Never pushing the dose, btw), is a (6) SIX month waiting period for meds from intake to issuance of a Pyschiatrist. That in itself is mind boggling to me, but there are no (very few) direct patient/Pyschiatrist relationships anymore.
Mass has a System where because, ” I don’t want to hurt myself”, I get basic insurance that only Behavioral Health Mgmnt Agencies accept. PC Dr ‘s ‘I was Told’ the DEA prohibits writing scripts for chronic issues, only Pyschiatrists can, but directly, don’t accept my ins., cannot take cash, nor can I legally pay in cash. This leaves me with a PCA, & still a 5-6 month wait ,(My dr of 10 yrs retired btw,) E-Room refuse to write scripts, and my Wife’s PCA, (For reference) the. 4 th in 12 months , has written scripts for meds she already had severe adverse reactions to. So even when or if I get a PCA, scares the H #%^ out me , as I suffer from specific Adult ADHD,& Anxiety Disoder- complexities. The major one is the Metabolic coding for ADHD, (I don’t keep it in my body as long as other people it just gets expelled through. ” Ive been told is ‘renal Discharge /cleansing of the med’, so a 30Mg IR tab (Which gives me NO ROCKET effect, in fact if I don’t spread my doses right I get groggy, only lasts 2-3 hrs!). That’s my base story, my question is I take 90mg IR 30×3 a day (I work for a huG e..co, as a Photographer/ & cannot NOT complete work, so I work. 10-12 hr days. When Vyvanse 70mg was out I went from 90Adderall XR to 70mg Vyvanse & it was a wonder drug. 6 months later I saw the rocket effect & asked to go back, I did for 23 days. Even calling Shire for help, finally called my Dr.(On Vacation-He was pissed) put me back on Adderall and wouldn’t discuss how to transition. I feel like 3weeks should have been plenty for me to be able to function, but I couldn’t. My anxiety has increased and I’m counting my pills all the time, remembering the misery of those 3 weeks, do I have any chance? ThankYou
Ach, I’m sorry it’s so hard, MJ!
I’m not sure of your question, though.
I’m not sure why you stopped the Vyvanse (“I saw the rocket effect” – what? dimninish? At any rate, you don’t want a rocket effect; you want a steady effect).
You asked to go back to Adderall, to get the “rocket effect”? (Again, bad idea.)
What kind of transition, from vyvanse to Adderall?
In general, you just can’t burn the candle at both ends. So, if you are using these medications as one would “speed,” it’s just not going to work over time. You will become depleted, in many ways.
Most adults with ADHD have a co-existing condition — including anxiety. And that can be exacerbated by the stimulants if it is neurogenetic anxiety and not anxiety from untreated ADHD. Many people take a medication for anxiety in addition to the stimulant. For some, Strattera plus a stimulant fulfills that dual-goal.
Obviously, creating better efficiency at work should be a top priority. Can you get some help with that?
g
Hi MJH,
Bless your heart!
If you quit the Vyvanse because of cost, did you know there are patient assistance programs? Call the Shire Cares folks to see if you might qualify.
https://www.shire.com/patients/patient-services/shire-cares
Vyvanse is a very different medication than Adderall IR. Different medication (Vyvanse is essentially Dexedrine) and different delivery system.
I’d try to get back on that PRONTO and see which issues are left.
Good luck!
g
Hi,
I am a 37 year old mother of 2 (3 and 5 year old). I’ve been on antidepressant meds since I was diagnosed at 16 and since then have learnt the hard way that I should not go without it. About 2 years ago I suggested to my psychiatrist (I’ve been a patient of hers for about 7 years now) that I suspect I have ADHD and she agreed that she’d noticed the symptoms. She put me on Concerta which worked wonders, like Michelle said using a stimulant really was like putting on glasses!
I currently work as a process engineer and wish a had the help of a stimulant during my studies – I really had a very difficult time with my symptoms back then. That said, it was as if becoming a mother (pregnancy, sleep deprevation, added responsibilities and worries etc) caused the ADHD symptoms to really crystallize out into something that couldn’t be missed.
My question is about fatigue. Even with 36mg of Concerta per day I still suffer from chronic fatigue and after a day at the office/on site I have trouble facing my family with all their needs – this makes me feel extremely guilty. I love them to bits but I also enjoy my job (and we really do need the income) but it feels like it is all just too much for me. I’m not sure if I’m depressed because I’m tired or tired because I’m depressed! ADHD is OK as long as I take my Concerta.
I went to see a medical doctor in February this year and she had some blood work done. Consultation fees plus cost of the blood work was about half a month’s salary (!), even if I have health insurance, just because it is not considered as conventional medical expenses. The doc said my blood serotonin is severely low, and something called a Braverman assessment indicates very low serotonin, GABA and dopamine. I haven’t gone for the cortisol test but she highly suspects my adrenals not working well also. She gave me a script for supplements (which she sells) costing another 15% of my monthly pay check for a month’s worth, nothing covered by medical insurance because of its alternative nature. I felt distressed and simply freaked out about all that was now wrong with me and the cost to make it better.
Before filling the script I asked my trusted psychiatrist’s opinion, she said looking at blood serotonin is useless and she is very skeptical. After considering a few things we decided to try switching to Sertraline as an alternative antidepressant. I was on Cipralex/Lexamil before but we thought it may have been making the fatigue worse. The Sertraline is working OK (I am still deciding about this) but even with that change I would not possibly be able to cope without the Concerta, and this concerns me.
I read Dr Parker’s book on ADHD meds and I think I’ve got my dosage right now. I have eliminated gluten from my diet and mostly stick to a low carb, high protein diet, with lots of healthy fats. It helps, but it didn’t solve the problem (I have committed to this way of eating in any case, I find it very beneficial on many levels).
Do you think I am missing something here, some reason for the chronic fatigue which may or may not be linked to my depression and ADHD also? Is there any hope of treatment which is actually effective and affordable? I am so done with everyone offering so called solutions! I can’t afford to “play around” anymore but I really need to be healthy for myself and my family.
Sorry for the long letter, that’s just typically me. Any advice?
Thanks 🙂
Hi Sunette,
It’s hard to say what is causing your chronic fatigue. There could be many things, including your diet. High protein is not typically a healthy diet. You should not eat more protein than you need, and the rest of your diet should include healthy fats, complex carbs, and some fruits. Are you getting enough sleep? The fact that you don’t even mention sleep suggests that this might not be a priority?
I don’t know the Braverman test, but you can’t measure serotonin. Only biomarkers for serotonin can be assessed, to varying degrees of accuracy.
I’d say your psychiatrist should be working with you to tease out the issues. Do you really have chronic fatigue or are you overwhelmed with all of the tasks on your plate? Your psychiatrist or therapist should be working with you on organizational strategies.
I know that when I am overwhelmed and feeling I’m not up to the task of all that must be done, I too can feel exhausted.
Developing a monthly schedule to tackle domestic tasks might help you to feel less stressed and overwhelmed.
Good luck!
Gina
Michele,
Gina does a great job of breaking down much of the complexity – and she’s right on about the various AMP and MPH meds.
Some notes:
1. Right: no evidence of problems with stimulant meds of any kind with hypothyroidism… except the following:
a. Meds may cover an underlying adrenal or thyroid problem by pushing the person through real medical symptoms that require more deliberate medical attention.
b. With associated medical problems meds are oftentimes difficult to adjust because the energy issues and cognitive issues [that the ADHD meds are designed to treat] often overlap.
c. Most often thyroid issues occur downstream from other metabolic issues, and, as one person commented above, associated additional adrenal issues, [though not considered real in the subtle presentation of “fatigue”] do respond to precise diagnosis and treatment even though traditional medicine, focused more on life and death than brain function, may disagree.
d. I also agree with the concept that longer acting meds would likely prove helpful, but the everyday reality of managed care with their pervasive lack of appreciation for the nuances of medication compliance with multiple dosings add further treatment complexity.
Adrenal problems with both thyroid problems and ADHD further complicate the complexity and require more comprehensive, coordinated diagnostic and treatment efforts.
You are not damaging your adrenals or thyroid unless you simply use ADHD meds to get through the day and overlook treatment of the other conditions. They will likely evolve if not correctly addressed.
Testing proves useful, and a commonplace oversight is missing immunity issues such as food sensitivities which leading authorities internationally, and at, for example, Harvard, consider essential to review.
Testing will provide additional maps for these new territories.
Best of luck in your next steps.
cp
Thanks for weighing in, Dr. Parker!
g
Wow thanks g for your helpful comments. Regarding my iodine levs, I supplemented with it for a while hence the elevated levels. I avoid it now and would never supplement with it again – in fact I feel no one should without first testing their levels – and have learned high iodine levels may in fact throw one into hypothyroidism! Slow thyroid does run in my family and being a high energy person I am sure I have contributed to it with my habits.
Regarding vivance – yes I have tried it. I feel an unbelievable calm on it; I did like it and yes it could be better for me – only one big problem – it constipated me! It was the vivance and do not think it’s an issue that I could deal with. I can try to take it again – you are right – it’s definitely not the rocket fuel feeling and I find I really like that feeling – that may be a huge issue with me and again, one that has led to the hypothyroid.
I thank you again for your thoughts, I will consider the vivance again. And yes try to slow down, get more sleep ( close to impossible with 4 kids) and rest more… Also hard for me!
Hi Michele,
Constipation, eh? That’s a new one!
You could try taking some magnesium citrate while you’re taking the Vyvanse. Probably would help you feel calmer, too.
The “rocket-fuel” feeling is how many people with ADHD who take Adderall know that it’s “working.” At least they think they do. Actually, I consider that a huge problem with Adderall; the visceral “it’s working” feeling. It’s better to use more objective criteria regarding your functioning and thinking, now just feeling that someone lit a rocket under your behind. 🙂
g
Hi Michele,
I am not a physician, so I cannot offer medical advice. Of course neither can a physician without examining you.
But I will share my thoughts, based on what I know of these issues.
1. I’ve never heard that Adderall (or any other stimulant) causes hypothyroidism. Perhaps that doctor is unfamiliar with ADHD-related neurobiology.
2. Many women develop hypothyroidism in the 40s (sometimes higher). In other words, this could have happened independently of the Adderall. You are the mother of four and a personal trainer; is it possible that you are pushing yourself too hard? It might not feel “normal” to you to be a little more sedate than you were in your youth, but it might merit some thought.
3. The amphetamine class (AMP) of stimulants do operate a little differently than the methylphenidate (MPH); there is an extra mechanism that serves to sort of “squeeze out” more from the cell. I’ve known many people to feel exhausted after 2 months on Adderall, perhaps for that reason. Or the next.
4. It’s very important not to mistake the “rocket fuel” that Adderall can be for some people with your natural energy levels. In other words. some people with ADHD finds that Adderall makes them super-productive and so they go into over-drive. Ideally, stimulants should work to help you balance your life, not be a super-charged Energizer bunny. It’s important to rest, to get plenty of sleep.
5. If you haven’t tried Vyvanse, you might want to. From many reports, it seems to work better than Adderall for the people who like Adderall (and even some who don’t), but the delivery is more smooth and sustained, less exhausting. (For others, of course, this is not true.)
6. The brain sends signals to the other organs to produce hormones, etc. In other words, the brain regulates other physiological processes. It makes sense to me that the brain of person with ADHD would be better able to regulate these process when medication is in the system. Because the medication helps to regulate the brain function itself.
If it were me, I’d monitor my thyroid levels and see if the Adderall worsens/improves.
Oh, one more thing: You said your iodine was high. Most people have iodine deficiency. So, perhaps there is some risk to thyroid function of having too much iodine. And you could try laying off whatever you are eating that contains iodine?
good luck!
g
Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term often shows up in popular health books and on alternative medicine websites, but it isn’t an accepted medical diagnosis.
Adrenal fatigue is real I have it along with Hashimoto’s and leaky gut . I’m so weak I can’t function. I’ve seen a md who also does the natural route With supplements. I’ve gone gluten free dairy free the whole 9 yards I still feel like terrible. I take armour thyroid meds . This is going on 11 months with very little improvement .
Hi Terry,
I’m sorry that you’re struggling physically. I know what that feels like.
Yes, the feelings associated with so-called “Adrenal Fatigue” are real. But that is not a diagnosis.
https://www.health.harvard.edu/blog/is-adrenal-fatigue-real-2018022813344
I’ve found the term used more by “alternative” healthcare providers—and often with a ton of supplements and all the usual remedies du jour (e.g. methylated folic acid, gluten-free, etc.).
If over 11 months you have little improvement, I hope you can change tactics.
You don’t mention if you have ADHD and, if so, you are taking medication. It might make a big difference for you.
Good luck sorting this. I know it’s hard to have to manage one’s own healthcare when feeling so non-functional.
gina
Wow, thanks for the response. I will forward this to my MD who happens to be a holistic doctor. She recommended the no-carb diet (as did several others) due to metabolic syndrome. I gain a lot of weight when eating refined carbs and even fruits. Thanks again!
I’m confused as I come across this post and have found nothing with Dr. Parker that clarifies. Are you (him) saying that ADHD can be the cause of the other conditions, or the other way around? I have been diagnosed with gluten sensitivity, metabolic syndrome, low thyroid, and estrogen dominance, and adrenal exhaustion (extreme fatigue). 2 of my children have been diagnosed with ADHD, therefore I’m wondering if it came from me–but I don’t fit the classic symptoms of ADHD more than just mildly. Nothing seems to be working to help the other conditions (progesterone cream, compounded thyroid meds, no carb/sugar diet) and I’m wondering if a stimulant will help.
Hi Danelle,
I understand your confusion. We humans are complex creatures, and the brain is the most complex part of us!
I have an ongoing bone-problem in my foot, and I cannot find two specialists who can agree on what to do next. The orthopedic surgeon has one idea. The Podiatric Surgeron has another. The physical therapist still another opinion. And on and on. With none of them seeming to even “talk the same language.”
If it’s this bad with a simple, mechanistic problem, think about the brain =- and all the possible conditions that can affect brain problems. Shew!
If you have two children with ADHD, chances are good that if the biological father doesn’t have it, you do. If the physician who prescribed the progesterone, the thyroid medication, the diets, etc. doesn’t know about ADHD, it won’t even come up as a possibility.
But yes, living a few decades with untreated ADHD can also create “side effects” in hormone and thyroid function (from the stress, from the lack of sleep, from the erratic diet, from lack of exercise). So, it’s a big complicated ball of wax!
Some people find that only after starting on a good regimen of ADHD medication can they start untangling the rest of these issues. So, maybe it’s time for you to pursue an evaluation for ADHD and try treatment for that. Especially if nothing else has worked. (Then again, there is no reason to think that a no carb diet will work for ADHD, and can even make symptoms worse. Perhaps this is something you decided upon yourself and not with the help of a physician.)
Good luck,
Gina
Danielle, read the site of Mensah Medical-www.mensahmedical.com
Your symptoms are in line with copper
Toxicity: possibly also
Pyroluria and a methylation issue has
Well. The two
Doctors at Me say can tie things in – they are brilliant. And you can start
With
Getting
Tested
At
Home and having a phone consult. Believe me
– they are your
Answer and only hope! They have greatly helped so many with. Issues like yours…
Hi Michele,
Thanks for your comment. I’ve been interested in the work of the docs at Mensah Medical. Their philosophy is largely in line with Bill Walsh, I think. Food for thought.
There are so many things standard psychiatrists and MDs miss. When symptoms elude standard treatments, we must dig deeper.
g
Go Gina Go!!!
Thanks so much for digging until you found a doctor who is writing and blogging about ADHD and its traveling companions. I have long struggled with this issue with close to no help from my doctors.
I have done my own research and tentatively begun to solve my own physical problems with ADHD, thyroid insufficiency, allergies, asthma, fibromyalgia and rheumatoid arthritis. All those conditions are related, who knew? Certainly not my esteemed docs.
Glenna
Hi Gina and Dr. Parker,
Gina referred me to Dr. Parker’s blog a couple years ago. As if it’s not hard enough to have ADHD and to deal with (mis)managed care in trying to get ADHD treatment, it’s IMPOSSIBLE to find one physician who could “connect the dots” between my low thyroid, heart arhythmia, itchy skin and more. Reading Dr. Parker’s CorePsychBlog validated many of my concerns and motivated me to keep looking for answers. Thanks to both of you!
David
Gina,
Early this morning up to find your kind piece on my mission over at CorePsych [actually mine is very close to your objective over here] – and am so appreciative of your taking the time to send this note to your crew. It’s been most reassuring out on my perch to listen to your exceptional voice, your keen insights, and your engaging sense of humor about matters that are so regularly misunderstood out on the ADHD road to recovery.
Confusion often prevails where common sense and the evolution of mind science appear to have taken a vacation.
Most of all I appreciate your fresh, uncomplicated take on matters that may at first appear just too complex – and, even though we have never met, it seems like we have been friends for many years. In speaking with Russell Barkley at a recent meeting I quickly discovered you have that effect on many of your colleagues – and I thought it was just me 😉
Thanks so much – look forward to our evolving conversations!
Chuck