Is it neurodivergence or a health condition?

When Neurodivergent Traits Are Actually a Medical Issue: Avoiding Misdiagnosis

Many individuals seek evaluations for ADHD, autism, or other neurodivergent conditions due to persistent challenges with attention, mood, energy, or behavior. While these traits can be indicative of neurodivergence, they can also be caused—or significantly influenced—by medical conditions, hormonal imbalances, chronic illnesses, or food sensitivities. Misattributing these symptoms to neurodivergence can delay appropriate treatment and create unnecessary confusion.

1. Food Sensitivities and Allergies

Certain food reactions, like gluten or dairy intolerance, can lead to symptoms that mimic ADHD or autism traits, including irritability, difficulty focusing, anxiety, or “meltdowns.” For example, research suggests that children with undiagnosed celiac disease may exhibit behavioral issues that resemble ADHD, which often improve when the underlying dietary problem is addressed.

2. Hormonal and Thyroid Imbalances

Thyroid dysfunctions, such as hypothyroidism, share several symptoms with neurodivergent traits, including fatigue, mood swings, and concentration difficulties. A study highlighted that individuals with ADHD often have overlapping symptoms with thyroid disorders, leading to potential misdiagnosis.

3. Chronic Illness and Nutritional Deficiencies

Chronic conditions like anemia, autoimmune disorders, or sleep apnea can impair cognitive function, emotional regulation, and energy levels. Similarly, deficiencies in nutrients like B12, iron, or vitamin D can present as attention difficulties, low motivation, or mood dysregulation—symptoms often misinterpreted as neurodivergence.

4. Importance of Comprehensive Assessment

Before confirming a neurodivergence diagnosis, clinicians recommend ruling out medical, nutritional, and environmental factors that could explain symptoms. This approach avoids diagnostic overshadowing, ensures correct treatment, and helps clients receive the right interventions—whether that’s dietary support, medical care, or true neurodivergence-focused strategies.

Case Studies

Case Study 1: Misdiagnosis of ADHD Due to Hypothyroidism

A 35-year-old woman presented with symptoms of inattention, forgetfulness, and low energy. She had been diagnosed with ADHD in her youth and was on medication. However, after experiencing worsening symptoms, she sought a second opinion. Thyroid function tests revealed hypothyroidism. After initiating thyroid hormone replacement therapy, her cognitive and emotional symptoms improved, suggesting that her ADHD diagnosis was a misinterpretation of underlying thyroid dysfunction.

Case Study 2: Food Sensitivities Mimicking Autism Traits

A 10-year-old boy with a history of behavioral issues, including irritability and difficulty focusing, was referred for an autism evaluation. His parents reported that his symptoms worsened after consuming certain foods. Allergy testing revealed sensitivities to gluten and dairy. Upon eliminating these foods from his diet, his behavioral issues significantly decreased, indicating that his symptoms were related to food sensitivities rather than autism.

What to Discuss with Your Doctor: Steps Toward Clarity

If you’ve been considering a neurodivergence diagnosis but suspect your symptoms might stem from other causes, it’s important to have an open conversation with your healthcare provider. Here are some key areas to explore:

1. Understanding Brain Fog

Brain fog refers to a collection of symptoms affecting cognitive function, including difficulty concentrating, memory problems, and mental fatigue. It's often associated with various conditions such as chronic fatigue syndrome, hormonal imbalances, and certain medications. If you're experiencing brain fog, consider discussing the following tests with your doctor:

• Complete Blood Count (CBC): To check for anemia or infections.

• Thyroid Function Tests: To assess for hypothyroidism or hyperthyroidism.

• Vitamin B12 and Vitamin D Levels: Deficiencies can lead to cognitive issues.

• Comprehensive Metabolic Panel (CMP): To evaluate kidney and liver function, as well as electrolyte and fluid balance.

• Celiac Disease Screening: If you suspect gluten sensitivity.

2. Evaluating Attention Issues

Attention difficulties can arise from various medical conditions, not just ADHD. Conditions such as sleep disorders, anxiety, depression, and certain types of learning disabilities can present with similar symptoms. Discussing the following with your doctor may be beneficial:

• Sleep Studies: To rule out sleep apnea or other sleep disorders.

• Psychological Evaluation: To assess for underlying mental health conditions.

• Neuropsychological Testing: To evaluate cognitive function and identify any learning disabilities.

3. Assessing for Learning Disabilities

Learning disabilities can sometimes be mistaken for neurodivergent traits. It's crucial to differentiate between the two to ensure appropriate interventions. Your doctor might recommend:

• Psychoeducational Testing: To assess intellectual capabilities, academic skills, and processing abilities.

• Speech and Language Evaluation: To identify any communication disorders.

• Behavioral Observations: To understand how symptoms manifest in different settings.

4. Considering the Impact of Childhood Trauma

Experiencing trauma during childhood can lead to symptoms that mimic those of neurodivergent conditions. These may include difficulties with attention, emotional regulation, and social interactions. Discussing your personal history with your doctor can help in:

• Trauma-Informed Assessments: To differentiate between trauma-related symptoms and neurodivergent traits.

• Therapeutic Interventions: Such as trauma-focused therapy, to address underlying issues.

5. Investigating Nutrient Absorption and Gut Health

Poor nutrient absorption and gut health issues can lead to symptoms like brain fog, fatigue, and mood disturbances. Conditions such as celiac disease, irritable bowel syndrome (IBS), and small intestinal bacterial overgrowth (SIBO) can impact nutrient absorption. Your doctor may consider:

• Comprehensive Stool Analysis: To assess gut microbiota and digestive function.

• Food Allergy Testing: To identify sensitivities or intolerances.

• Nutrient Level Testing: To check for deficiencies in vitamins and minerals.

By discussing these areas with your healthcare provider, you can work together to identify the root cause of your symptoms and develop an appropriate treatment plan. Remember, it's essential to consider all potential factors to ensure accurate diagnosis and effective management.