Practices

Allergies turn up more often alongside ADHD than chance would predict. Worth mentioning your allergy history at an assessment even when nobody asks, since the two seem to travel together.

The likeliest explanation is not that one causes the other. It is that some of the same underlying wiring makes both more likely in the same person.…

Here is a question that costs nothing: has anyone in your family been told their vitamin D was low? It runs in families through genes, skin tone, where you live and how much time anyone spends outside.

The clinician telling this story found out only afterwards that his mother, father and brother had all been low. Nobody had mentioned it, because it…

Even where a herb has good evidence behind it, that evidence belongs to the plant and not to the bottle in your hand. Testing keeps turning up products that do not contain what the label says.

This part of the argument does not depend on whether herbal remedies work. You could accept every claim made for a plant and still be left with the…

People often turn to herbal remedies hoping to avoid side effects. Plants are chemistry too, and some of them interact with prescribed medication in ways that matter.

A plant extract is not one substance, it is a mixture of many, which gives it more places to interact rather than fewer. Origin has nothing to do…

Around seven in ten people who use herbal products never mention it to their doctor. Not out of secrecy, mostly because a tea or a gummy does not feel like it belongs on a list of medications.

The useful move is to answer a wider question than the one you were asked. When someone asks what medication you take, tell them what else you take…

Skin prick and IgE blood tests find real allergies. The IgG food sensitivity panels sold direct to families have not been shown to measure sensitivity at all, and they tend to come back with a long list of foods to avoid.

IgG antibodies mostly show that you have eaten something, not that it harms you, which is why the results look alarming and change so little when…

Put an actual number on it: how many coffees, teas, energy drinks and colas in a normal day. Without that number, your sleep problems, your anxiety and how well a medication is working are all being read against an unknown.

People underestimate this, partly because it feels embarrassing and partly because a large takeaway cup is often two or three servings. Count across…

Stimulants sharpen focus in almost anyone, so responding well to one does not confirm you have ADHD. The diagnosis comes from your history and how you function, not from a trial of tablets.

This cuts both ways. Someone can be handed a diagnosis on the strength of a good response, and someone else can be doubted because their response was…

Food and movement are powerful, and hardly anyone keeps them up as prescribed. So the question is not what works best on paper. It is what you will still be doing in six weeks.

Roughly a third of people follow a prescription exactly as it is written, and keeping to a diet or an activity plan goes worse than that. Which means…

Working out what you have comes before choosing what to take. The right remedy for the wrong condition is still the wrong remedy, however good the remedy happens to be.

The health food shop route usually starts with a self diagnosis, and that first step is the one worth slowing down. St John's wort will do nothing…

Supplements are regulated as food rather than as medicine. Nobody checks strength or purity before a product goes on sale, and the main rule is that the packet cannot claim to treat a disease.

Most people assume the opposite, that anything on a pharmacy shelf has been through some kind of approval. Regulators here generally act only once a…

When researchers ran DNA testing on 13 herbal products, only 2 contained the plant on the label. Three had none of it at all, and several were padded out with rice, soy or wheat that nobody had declared.

The obvious problem is paying for something you did not get. The quieter problem is the undeclared filler, which matters a great deal if you avoid…

If you are going to buy supplements, look for an independent verification mark: USP Verified, NSF, or a product tested by ConsumerLab. It is the nearest thing available to the check that regulators do not carry out.

Those schemes test identity, strength, purity and how a product was made, and manufacturers pay to take part voluntarily. There are different tiers,…

St John's wort can cut the effectiveness of the contraceptive pill by around a third. If you take both, that is worth knowing today rather than finding out later.

It speeds up the way the liver clears certain drugs, so the pill is not the only thing affected. Warfarin, some HIV medicines, ciclosporin and a…

Some of these do have real evidence behind them. St John's wort has repeated support in mild to moderate depression, SAMe and methylfolate have reasonable backing as additions to treatment, and omega-3 has looked weaker in the larger and better run trials.

That last part is worth sitting with, because it is what usually happens. An early promising effect shrinks as trials get bigger and better…

If you want to use herbal remedies, two things carry most of the risk. Make sure whoever prescribes for you knows what you are taking, and buy from a source that has been independently tested.

That is a short list on purpose. Nearly all the harm in this area comes from an interaction nobody knew about or a product that was not what it…