Latest posts by Dr. Erika Krumbeck (see all)
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I have been working with a lot of kids with ADHD this year. It is the most common problem I see in my pediatric practice. It is also the most common misdiagnosis I see in my practice!
Last year the CDC estimated the prevalence (number of kids) with ADHD to be between 8.7-10.6%, with up to 10% of children (at least in one of the states studied) taking ADHD medication. Worse, up to a 1/3 of kids who were taking stimulant medications did not meet diagnostic criteria for ADHD!
Anyone else find this disturbing?
ADHD is supposed to be a diagnosis of exclusion. This means that a child who has a medical condition that looks like ADHD should not be given the diagnosis of ADHD. I can’t tell you the number of times a simple screening test has determined that a child with “ADHD” actually has iron deficiency anemia, or vitamin D deficiency, or a thyroid problem. Many of these children are given stimulant medications rather than a cheap, simple lab test to rule out another cause. Please, let’s STOP misdiagnosing ADHD! Even when a child technically meets the diagnostic criteria for ADHD and doesn’t have another medical condition I still don’t jump the gun to medications.
There is one simple question that everyone should ask when it comes to their health or the health of their child: WHY? There is no child who has a deficiency of Ritalin or Adderall or Strattera. The imbalance is in the brain and I want to know WHY.
Most of my patients by now know that I like to be very systematic with the way I approach healing. Remember that rebuilding health is not the same as taking a pill and having your symptoms go away! Symptoms are the message the body gives us that something is wrong! Removing a symptom is not removing a disease – it is ignoring the cause of the disease!
When I work with my patients one-on-one we go through each possible cause of the disease and eliminate them one by one. It can take time! But the reward is permanent restoration of health. That is a beautiful thing, let me tell you!
It means no more reliance on prescription drugs, gizmos, gadgets or surgeries. It even means no more reliance on “natural” substances like supplements and herbs to alleviate symptoms! Watching patients go from symptomatic to permanently healed is by far the most rewarding part of my job.
This last year I have developed what I like to call the “3 step” or “3-tiered” approach to ADHD. It starts with eliminating medical conditions that could look like ADHD but actually aren’t. (These are things like iron-deficiency anemia, thyroid disease, lead toxicity and others.)
The 2nd step involves asking the question WHY? It rules out, step-by-step, things that could be irritating the nervous system or causing pain and behavioral problems. (I have a hunch that a subset of kids with “ADHD” are actually in chronic but mild pain – either from headaches, digestive disturbances, joint aches or other problems. A lot of kids have a hard time telling you when they are feeling uncomfortable, since they don’t have a firm grip on their own body’s sensations. A classic example of this is a toddler who acts out right before having a large bowel movement.)
The third step is the last resort: test the biochemistry and alter it if necessary. Many children have abnormal lab values of their neurotransmitters – too few of some, too many of others. Balancing these neurotransmitters can make a HUGE difference in the lives of these children. I do this as a last resort, though, because it doesn’t give us the answer to the question: WHY?
So that is my 3-tiered approach! I find it is by far the most thorough evaluation that investigates the cause of ADHD. After using this approach with so many ADHD kids this year I thought I would share the knowledge with you. (In case you don’t live in the Missoula, MT area!)
So here is my entire brain’s worth of ADHD knowledge for you, in e-book format. I have included all the steps under each Tier of evaluation and treatment so that you can do them with the help of your own physician. (Or, perhaps, you are a physician yourself and need some more ideas about how to evaluate the kids in your own practice.) You can Preview the e-book here!
The cost is $15. Trust me, that’s an unbelievable steal, and is a fraction of the cost of an office visit. (Let alone many office visits!)