Introduction: “The Meds Help… But I Don’t Feel Like Myself Anymore”

Many children, teens, and adults in St. Louis are prescribed medication for ADHD. For many, these medications can be life-changing, helping with focus, school or work performance, and daily function.

At the same time, some patients share concerns like:

• “I’m not hungry during the day.”
• “I don’t sleep as well at night.”
• “I feel flat or anxious.”
• “I’m worried about being on this long-term.”

This blog is not about telling anyone to stop medication.
Instead, it’s about education: how common ADHD medications (especially stimulants) work, what potential long-term considerations exist, and why it is important to pay attention to the whole person, not just symptoms on paper.

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Learn more about our functional and integrative approach to brain and metabolic health at our St. Louis clinic.

How Stimulant ADHD Medications Work

Most common ADHD medications are stimulants that impact levels of:

• Dopamine
• Norepinephrine

These neurotransmitters influence:

• Focus
• Motivation
• Reward pathways
• Impulse control

By increasing the availability of these neurotransmitters in certain brain regions, stimulants can improve:

• Attention
• Task completion
• Classroom or workplace performance

Short-Term Benefits vs. Long-Term Considerations

Short-term, many patients notice:

• Improved focus
• Reduced hyperactivity or impulsivity
• Better productivity

However, over time, some individuals experience side effects such as:

• Appetite suppression
• Difficulty sleeping
• Increased heart rate or blood pressure
• Mood changes or irritability
• Emotional “flattening”
• Rebound symptoms when medication wears off

These effects are not guaranteed or universal, but they are important to monitor.

Impact on Sleep

Sleep is foundational for:

• Brain development
• Memory and learning
• Hormone regulation
• Mood stability

When stimulant medications are taken too late in the day, or when sensitivity is high, they may:

• Delay sleep onset
• Reduce sleep depth
• Shorten total sleep time

Over the long term, poor sleep can worsen:

• Anxiety
• Mood disorders
• Hormone imbalance
• Metabolic health

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Read more about sleep, hormones, and metabolic health in our St. Louis practice here.

Impact on Appetite and Growth (for Children and Teens)

One of the most commonly reported side effects of stimulant ADHD medications is reduced appetite.

In younger patients, this can:

• Lower overall calorie intake
• Reduce nutrient intake
• Potentially affect weight gain or growth patterns if not monitored carefully

From a functional standpoint, we are always interested in:

• Whether the child is eating enough protein, healthy fats, and micronutrients
• Whether growth charts are stable over time
• Whether the family has strategies to support nutrition around medication timing

Emotional Health and the “Flat” or “Not Myself” Feeling

Some patients describe feeling:

• Less spontaneous
• Less emotionally connected
• More anxious or tense
• Emotionally “flat”

Others feel perfectly themselves on medication.
Responses are highly individual.

When someone reports not feeling like themselves over time, it is a prompt to re-evaluate:

• Dosing
• Timing
• Overall stress levels
• Sleep and nutrition
• Coexisting mood or anxiety symptoms

Stress, Cortisol, and Stimulants

Stimulants increase alertness and focus — which, physiologically, is not far removed from a stress response. Over time, especially when life is already high-stress, some patients may experience:

• Worsened anxiety
• Restlessness
• Elevated heart rate
• Signs of sympathetic nervous system overactivation

Layer that on top of a high-demand school or work environment, and the result may be a chronically “amped” system.

From a functional medicine perspective, we are interested in balancing:

• The benefits of improved focus
• The cost to the nervous system and stress physiology

Cardiovascular Considerations

Because stimulant medications can increase heart rate and blood pressure, it is important to monitor:

• Blood pressure trends
• Heart rate
• Family history of cardiovascular disease

Most patients tolerate medications well, but clinicians should periodically reassess risk, especially as patients age or if additional risk factors develop.

The Role of Nutrition, Sleep, and Environment

Whether or not someone uses ADHD medication, the brain still needs:

• Stable blood sugar (protein, healthy fats, fiber)
• Micronutrients (iron, zinc, magnesium, omega-3s, B vitamins)
• Adequate sleep
• Movement and exercise
• Reasonable screen exposure and downtime

Unfortunately, many individuals on ADHD medications are:

• Eating less during the day
• Sleeping less at night
• Dealing with the same or higher life stress
• Exposed to constant digital stimulation

This combination can, over time, increase the risk of burnout, mood shifts, and physical symptoms.

Internal link prompt:
Learn more about how we evaluate nutrition, sleep, and stress in patients with attention concerns at our St. Louis clinic.

Functional Medicine Perspective: Looking Beyond the Prescription

A functional medicine approach does not necessarily mean “no medication.”
What it does mean is asking:

• What are the underlying contributors to this patient’s symptoms?
• How is sleep?
• How is nutrition?
• Are there gut, hormone, or nutrient issues that make focusing harder?
• Is anxiety being addressed?
• Is the nervous system constantly in fight-or-flight mode?

We see ADHD less as a single diagnosis and more as part of a larger brain–body pattern that can be supported from many angles.

When to Reassess ADHD Medication Use and Overall Health

It may be time to step back and reassess the bigger picture if:

• Side effects are persistent or worsening
• Appetite is chronically low
• Sleep is consistently poor
• Anxiety or mood issues are escalating
• The person feels “numb” or unlike themselves
• Physical symptoms like palpitations, headaches, or weight changes become significant

These are signals to talk openly with the prescribing clinician and possibly integrate a broader functional evaluation.

Conclusion: Medication Is One Tool — Not the Whole Story

ADHD medications can be immensely helpful and appropriate for many people. The goal is not fear, but awareness.

From a functional medicine point of view, we want to support:

• Brain health
• Nervous system balance
• Sleep
• Nutrition
• Hormones
• Long-term well-being

Medication is one piece of a much larger puzzle.

Internal link prompt:
Schedule a functional brain and metabolic health consultation at Sheen Vein Aesthetics & Functional Medicine in St. Louis.

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