ADHD Diagnosis and Misdiagnosis- 176 Problems That Can Look Like ADHD

There are many medical conditions, 176 in fact, that look like ADHD but that are actually caused by another medical problem.

*Academic/Learning Problems:

1. Dyslexia

2. Cognitive impairment

3. Specific learning disability

4. Giftedness

5. Memory discrimination problems

6. Mismatch of behavioral style and environmental expectations

7. Inappropriate educational setting

*Allergy Problems such as: 

8. Allergy induced Asthma

9. Allergic bronchitis

10. Allergic rhinitis, allergic sinusitis, allergic otitis

11. Wheat, lactose, peanut and other food allergies

12. Allergies to food dyes or preservatives

13. Chronic antihistamine use

Autoimmune disorders

14. AIDS

15. Pandas, Pediatric autoimmune neuropsychiatric disorders

16. Disorders or Carbohydrate metabolism

17. Autoimmune neurological disorders and encephalopathy

*Anemias including:

18. B vitamin deficiency anemia

19. Iron Deficiency

20. Sickle Cell Anemia

Biomedical Problems such as:

21. Lead poisoning

22. Arsenic exposure during development

23. Toluene exposure during development

24. Mercury poisoning

25. PCBs exposure

26. Manganese Poisoning

27. Carbon Monoxide Poisoning

28. Prenatal Cocaine Exposure

29. Fetal Alcohol Syndrome

30. Organophosphates intoxication

31. Asthma medication reactions

32. Seizure medication reactions

Chronic Illness

33. Viral Infections

34. Bacterial Infections

35. Parasitic Infection

36. Sequelae (symptoms resulting from) of acute infection/trauma

37. Chronic Asthma

38. Chronic Infections

39. Seizure Disorders

40. Sickle Cell Disease

41. Multiple Sclerosis

*Developmental Problems such as

42. Perceptual/processing disorders

43. Pervasive Normal developmental variation

44. developmental disorders

45. Development Disorders, not otherwise classified

Ear/Nose/Throat Problems such as:

46. Tonsil and adenoid hyperplasia

47. Chronic Ear Infection

48. Chronic Sinusitis

49. Chronic Upper Respiratory Infections

*Emotional Problems such as:

50. Separation anxiety

51. Social Anxiety

52. Generalized Anxiety

53. Attachment disorders

54. Social Skills Problems


55. Traumatic Events (house fires, major motor vehicle accidents)

56. Abuse (sexual, physical or emotional)

57. Loss by separation or death of a loved one

58. Mismatch of behavioral style and expectations

Genetic and or Chromosomal Problems such as:

59. Fragile X syndrome

60. Williams Syndrome

61. Mental retardation

62. Neurofibromatosis

63. XXY syndrome

64. Klinefelter Syndrome

65. XYY Disorder

66. Porphyria

*Hearing Problems such as:

67. Hearing deficits and Hearing loss

68. Auditory Processing problems

69. Auditory Discrimination problems

Infections such as:

70. Parasitic Infections (pinworms, roundworms, tapeworms and hookworm)

71. Untreated or partially treated bacterial infections

72. Viral infections

73. Lingering symptoms of infections


74. Lack of exercise

75. Lack of Green space exposure

76. Poor diet

77. Major life transition (move, change of school)

Metabolic or Endocrine Problems such as:

78. Hypothyroidism

79. Hyperthyroidism

80. Diabetes

81. Hypoglycemia

82. Menopause

83. Hyperbilirubinimia (Gilbert’s Disease, mildly high bilirubin, inattention?)

84. PMS

85. Post Partum Depression

*Neurological Medical Problems Including

86. Tourette's Syndrome

87. Autism Spectrum Disorder

88. Neurodegenerative disorders such as Alzheimer's disease

89. Temporal Lobe seizures

90. Absence Seizures

91. Post traumatic sub-clinical seizure disorder

92. Other seizure disorders

93. Neurodegenerative conditions

94. Choreiform disorder

95. Neurological infections

96. Central Nervous System or Brain trauma

97. Sensory Integration Disorders, Sensory defensiveness

98. Migraine Headaches of all varieties

99. Brain Tumors

100. Brain Cyst

101. ALS (amyotrophic lateral sclerosis)

102. Disorders of the Spine (infection, tumors, trauma)

Nutritional Problems such as:

103. Iron Deficiencies

104. Zinc Deficiencias

105. Protein Deficiencies

106. B vitamin Deficiency

107. Omega-3 Fatty Acid deficiency

108. Diets high if food colorings, flavorings and preservatives

109. Malnutrition

*Parenting Problems Such as:

110. Inadequate Parenting

111. Child abuse or neglect

112. Inconsistent expectations

113. Developmentally inappropriate parenting

114. Chaotic home environment

115. Stressful home environment

116. Cultural factors

117. Parental psychopathology

118. Parental chemical dependency

119. Parental Substance abuse

120. Exposure to Domestic Violence

Prescription Medication Problems caused by:

121. Asthma Medication

122. Allergies Medication

123. Headache Medication

124. Seizure Disorder Medication

125. Other Medication

*Psychiatric Problems such as:

126. Depression

127. Anxiety

128. Post Traumatic Stress Disorder

129. Bipolar Disorder

130. Conduct Disorder

131. Oppositional Defiance Disorder

132. Childhood Mania-Juvenile Bipolar Disorder

133. Dysthymia

134. Psychosis

135. Adjustment Disorder

    136.  Obsessive Compulsive Disorder

*Psychosocial Problems such as:

137. Abuse (sexual, physical or emotional)

138. Exposure to Traumatic Events (house fires, major motor vehicle accidents)

139. Domestic Violence

140. Loss by separation or death of a loved one

*Speech and Language Problems such as:

141. Expressive/Receptive language disorder

142. Phonological disorder

143. Dyslexia

144. Dysfluency

145. Apraxia

146. Central auditory processing disorder

*Sleep Disorders such as:

147. Insomnia

148. Breathing related sleep disorders and Sleep Apnea

149. Night Terrors

150. Delayed sleep Onset

151. Sleep Motor Restlessness (Restless Leg Syndrome, Sleep Leg Discomfort)

152. Sleep walking

153. Confusional arousals

154. Snoring

Substance Abuse Disorders

155. Illegal drug use

156. Inadvertent drug intoxication (glue sniffing)

157. Prescription drug abuse

158. Ethanol abuse

*Vision Problems such as:

159. All Vision Impairments

160. Near sightedness

161. Convergence Insufficiency

162. Visual discrimination problems


163. Mold Neurotoxins

164. Lyme Disease

165. Ciguatera Neurotoxins

166. Adrenal Fatigue

167. Estrogen Dominance [PCOS, etc.]

168. IBS - Constipation, Diarrhea [Transit Time under 18 hr or over 24 hr]

169. Hashimoto's Autoimmune Thyroiditis

170. Parasitic Lung Diseases

171. Primary antiphospholipid antibody syndrome

172. Argininosuccinate Lyase Deficiency. Genetic disorder. Neonatal form is fatal.

173. X-Linked ichthyosis, or Steroid Sulfatase (STS) Deficiency

174. Panayiotopoulos syndrome (PS)

175.  Increased levels of Urinary phthalates

176.  DiGeorge Syndrome

It is imperative that a correct diagnosis is made before medicating a child or an adult for ADHD. Medicating a person for ADHD when the problem is actually something different is not only a waste of time; it can be dangerous as well.

The list of medical problems that are ADHD-like is long. The 175 problems included here are actually only the tip of the iceberg. Before a diagnosis of ADHD can be made, clinicians must perform a thorough history and physical to rule out other medical issues that may be causing the ADHD like symptoms. The diagnosis of ADHD can be difficult to pin down for other reasons as well. Medical problems that co-exist with ADHD can be the primary diagnosis causing the ADHD.

A good example of this would be problems that cause sleep disorders. Sleep disorder problems will cause ADHD like symptoms because fatigue and lack of sleep leads to inattention, disorganized thinking, working memory problems and a host of other psychological and medical problems but the appropriate treatment for sleep disorders is not ADHD medication. The appropriate treatment is the treatment of the underlying sleep problem.

Pediatricians, Psychiatrists, Internist, and Neurologist can make a correct diagnosis of ADHD by ruling out these medical conditions that can look like ADHD but that are NOT ADHD. The conditions list below can cause the same symptoms that are associated with ADHD. They can look like ADHD. Some of the conditions cause hyperactivity, some cause inattention, some cause impulsive behavior, some cause memory and cognitive deficits and some cause all of the above.

Based on the patient’s history and physical examination, further workup with diagnostic and/or laboratory studies as well as a specialist evaluation may be required to avoid making an ADHD misdiagnosis. This list is comprehensive and includes many ADHD-like symptom causing problems but I am certain that there are other ADHD misdiagnosis medical problems that I have left out. The list is in alphabetical order by category, not by the frequency that these conditions are mistaken for ADHD. I have placed an asterisk nest to the categories that have problems that are most commonly mistaken ADHD-like conditions.

This post was written because a reader commented here on having been diagnosed as having Gilbert's 
Disease and wondering if his fatigue and inattention could be related to that diagnosis. I set out to find a 
comprehensive list of the ‘Differential Diagnosis' of ADHD. Differential Diagnosis is a medical term that refers 
to all the other medical conditions that a physician or health care provider should consider and rule out before 
deciding on the ultimate diagnosis. I found in my research that most websites with a comprehensive differential 
diagnosis list make you pay to see the list and I thought this was preposterous.  Here it is for you, free of 
charge as always. Let me know if I missed anything.

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  1. Tess,
    This is an outstanding review of ADHD "appearances" - a frequent subject over at CorePsych Blog - and I applaud your deep efforts in this regard. I look forward to linking to this piece and copying with full attribution for a handout for the many folks who can't see past 'hyperactive' and 'inattentive.'

    The evolution of good care for ADHD is significantly encouraged by pieces such as this one!

  2. Thanks Dr. Parker! Coming from you that is a huge compliment.


  3. Hey this is a great post, thanks alot! But you forgot to include Mold poisoning/fungi infection hahahahahaahaha

    and you should exclude ASD that's sort of an insult of how poorly you understand it. I've worked extensively and studied Aspgergs/ASD and their inattention is nowhere similar to ADHD and is not easy to confuse. I have heard though of many individuals who are diagnosed of ADHD and ASD. However although this is probaly wrong I would think that's extremely unlikely or impossible due to the fact that both syndromes involve different damaged areas of the brain and the inclusion of both would be highly unusual or detail a much more severe problem.

  4. Hey I did include ASD.

    *Neurological Medical Problems Including:
    86. Tourette's Syndrome
    87. Autism Spectrum Disorder

    Thanks for your comments!

  5. Tess - really helpful post. thanks!


  6. Oddly enough this article gives some hope and is comforting that there is more to ADHD than just being linked with a disorder that is primarily linked to the brain and helps dispel the fear of isolation due to social stigma involved in neurological and brain disorders.

  7. I couldn't agree more. There are lots of cases out there that most of us think is ADHD. If you feel like your children have that kind of disease, you should probably ask your doctor first.

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  8. GREAT list, Tess. I found you thru cp's CorePsych Post and have backlinked this page to an article on my main blog: Differential Diagnosis (part 2)

    I'll be back!!

    Madelyn Griffith-Haynie, SCAC, MCC - (blogging at ADDandSoMuchMore and on ADDerWorld - dot com!)
    "It takes a village to transform a world!"


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