For kids with ADHD, when do you usually consider starting medication?

When kids struggle with focus, impulsivity many parents assume that the only thing that will help is mediation. In my practice, I have seen children transform simply by modifying what they eat, how their gut works, and how they handle blood sugar- without medication. Many parents are hesitant about relying on lifelong medication and I advise them of the lifestyle and environmental factors that could be adjusted to support good brain health. We have this conversation in our initial consult. I advise parents to remove many of the levers found in many kids diets. To start, getting rid of artificial dyes and added sugars in morning cereals is a great start. Improving the quality of meals by adding more protein to each meal can help as well. Within weeks you could start noticing dramatic changes in your child: fewer outbursts, better focus during homework and an overall calmer mood. Many children are sensitive to certain dietary or environmental triggers, and when those factors are addressed, the kids baseline regulation often improves. Sometime these small changes are enough to change the trajectory of their treatment. In many cases I will still prescribe medication. I like to start off kids with diets low in refined carbohydrates and sugary drinks. These products can overstimulate dopamine release, leading to short bursts of alertness followed by depletion, much like a roller coaster that leaves the brain exhausted.