Episode 70 - The Connection between Fibromyalgia, ADHD and Chronic Pain with Dr. Michael Lenz

What if the chronic pain, fatigue, migraines, or fibromyalgia you’ve lived with for years weren’t “just part of getting older” — but connected to undiagnosed ADHD?

In this eye-opening episode of Grandma Has ADHD, Jami Shapiro is joined by Dr. Michael Lenz, physician, author, and host of the Conquering Your Fibromyalgia podcast, for a deep dive into the powerful — and often missed — overlap between ADHD, fibromyalgia, chronic pain, IBS, migraines, and nervous system dysregulation.

Dr. Lenz shares how his early exposure to ADHD research shaped his medical career, why adult ADHD is still widely misunderstood (especially in women and older adults), and how decades of patients struggling with “invisible illnesses” led him to recognize a consistent pattern: a high co-occurrence of ADHD in people with fibromyalgia and chronic pain syndromes.

Together, Jami and Dr. Lenz explore how the ADHD brain processes pain differently, why sensory overload and emotional dysregulation matter, and how properly treating ADHD can dramatically reduce pain, fatigue, overwhelm, and even improve relationships and quality of life. The episode also tackles common myths — including stimulant medication fears in older adults — and offers practical guidance on where to seek help if you suspect ADHD later in life.

This conversation is validating, science-based, and deeply hopeful for anyone who has felt dismissed, misunderstood, or exhausted by chronic symptoms with no clear answers.

Disclaimer: This episode discusses ADHD, fibromyalgia, chronic pain, mental health, and medical treatment options. It is intended for education and awareness only and is not a substitute for professional medical advice, diagnosis, or treatment.

Always consult a qualified healthcare professional before making medical decisions. If you are experiencing emotional distress or a medical emergency, please seek immediate help.

Resources & Links Mentioned:

• Dr. Michael Lenz Book - Conquering Your Fibromyalgia
• Dr. Michael Lenz Podcast & YouTube Channel - Search Conquering Your Fibromyalgia on YouTube and podcast platforms
• Grandma Has ADHD Community & Resources:
  https://grandmahasadhd.com
• Join the Grandma Has ADHD Facebook Community
• Jami’s Website, ADHD Coaching & Sparkler Society Membership:
  https://jamishapiro.me
• Silver Linings Transitions (ADHD-informed organizing & move management):
  https://silverliningstransitions.com

Thank you for joining us for this episode of Grandma Has ADHD! We hope Jami's journey and insights into ADHD shed light on the unique challenges faced by older adults. Stay tuned for more episodes where we’ll explore helpful resources, share personal stories, and provide guidance for those navigating ADHD. Don’t forget to subscribe and share this podcast with friends who might benefit. Remember, Make the rest of your life the best of your life.

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Transcript

0:15

Have you ever thought, is this just me? When struggling to stay organized, start tasks, or manage time, for those of us over 50, these challenges might not be just aging. They could be ADHD hiding in plain sight for decades. I'm Jami Shapiro, host of Grandma has ADHD, and I'm building a community where your experiences matter. Whether you are diagnosed, questioning or simply curious. You are not alone. Our Facebook group is filled with vibrant understanding. People over 50 who share their stories, strategies, and yes, even their struggles with plenty of laughter along the way. Ready to find your people. Join our growing grandma has ADHD Facebook community. Please like and subscribe to the podcast wherever you listen and share it with someone who might need to hear. They're not alone because ADHD doesn't have an age limit and neither does understanding yourself better. Together, we're changing the conversation about ADHD after 50 come be part of the story. Well on the grandma has ADHD podcast. We keep it real. And I also have to say that we are so fortunate to work with and interview some amazing, amazing, just kind and, wonderful people in our field. And one of them is a returning guest to me, but a new guest to you, Dr. Michael Lenz. We did an amazing interview, and I'm using the word amazing a lot because this, topic is one that is near and dear to me. We did the whole interview. It was great. I was listening to it so that I could approve it to go out, and it, just was so bad I couldn't even. Use the perfect as the enemy of done when I put it out there. So he graciously agreed to give us his time because it's so important to him that people understand the connection between fibromyalgia and chronic pain and ADHD. So I'm gonna read his intro back to you for those of you who haven't heard it, I've heard it twice and so has Dr. Lenz. But Dr. Michael Lenz is a physician specializing in pediatrics internal medicine. Lipidology and Lifestyle Medicine. He's the author of Conquering Your Fibromyalgia and host of the Conquering Your Fibromyalgia podcast. Dr. Lenz helps bridge the gap between chronic pain, ADHD, and misunderstood conditions like fibromyalgia, empowering patients and clinicians with science-based insight and compassion. Many people don't realize ADHD and fibromyalgia can overlap. Okay, so before I even get into the questions, thank you again for being with us today. I, so greatly appreciate it. Yeah, it's a pleasure and thanks for having me back. Oh, you're welcome. Well, you know, with an ADHD brain that it's a sieve, but I very, very distinctly remember you talking about how you got into the ADHD world from med school, and I would really like you to share how you ended up here first. Yeah. So I started in my pre-med. I was in early acceptance program called Target MD at University of Milwaukee years ago. I had a mentor there who said, every seven years, half of what you learn changes, you're gonna have to learn a lot from your patients. my first year in med school, we had this lecture by this person named Russell Barkley. He was this optional lunch lecture. We never had any testing on it, but it was about ADHD and how actually ADHD is a real thing and I. Had the, like most people, isn't that just bad parents? An excuse for naughty kids? Of course, my mentor said, you're gonna learn a lot. And I always had a big heart for mental health. So that was the first seed and then basically, I hadn't heard about it. Essentially for four years of my medical school and then I do my combined residency in pediatrics. And I was fortunate enough that my training involved working with ADHD in my pediatric clinic, that my mentors and I realized not everybody in the 1990s who did pediatric residency. Had mentors who were comfortable diagnosing and treating ADHD. So that was just to me, a normal routine care. Somebody has eczema, they have asthma, they have headaches, and ADHD was part of that evaluation in pediatrics. I continued to do that. And then again, my mentor every seven years, half of what you learn changes. Keep that in mind. Lifelong learner. I'm an internist and an adult doing everything that nobody does anymore, which is start the day in the ICU, go to med surg, go to the newborn nursery, go to clinic, see patients. And these patients that I was diagnosing now in practice who were kids were becoming adults. Their ADHD didn't go away when they turned 18. And then, oh, wait, wait, let's pause on that. Their ADHD didn't go away like everyone said, and so you continue to treat them of course. And then you start reading more about adult ADHD and women with ADHD. And I remember diagnosing my first adult with ADHD. And I had diagnosed like a good doctor. We were trained to recognize depression and anxiety, and I put him on Paxil and it helped. And then I saw his kids who were in at age like six or seven with the classic ADHD symptoms and a well child check. And part of my thought is always screening at age six. Your heart or lungs would've figured out if there was a problem by then, but how school And started describing a stereotypical struggle of a couple brothers that were struggling with ADHD and without, me even prompting or probing, dad gets this big smile and he's like, yeah, I was just like them as a kid. I'm like, really? I've been reading about anxiety in the connection with how anxiety is often a presenting symptom in ADHD in adults. And I went on to treat him for the first time starting you know, evaluating him using the World Health Organization version 1.1, diagnosed his ADHD. Had a very good response at continue to see him. And so that just continued lifelong learning as I met Dr. Bill Dotson at the conference in Kansas City where you were and I spoke at and I got a chance to meet with him and he said, yeah, pretty much everybody who does adult ADHD was self-taught, which was really interesting because that was basically me self-taught in adult ADHD, but. I was taught in pediatric ADHD. Many doctors who are just psychiatrists and adults had to be self-taught. Many family practice doctors have little pediatric experience and all internal medicine doctor has no pediatric experience. So for me, it was just a continuation. And so being a double boarded doctor, I see the whole lifespan. So I recognize and treat kids who have diabetes and have high cholesterol, so it's no. Different, the same medicines, different dosing and et cetera. So that's kind of a quick summary. Right. Well I also wanna highlight one other important thing that you said that first of all, you said that you happen to attend an optional luncheon in med school. And I can't imagine that there were many doc, you know, medical students who were going to optional lunches.'cause I don't know, I didn't go to med school, but I've heard it's not so easy. So that also just right there highlights that, you know, all of these doctors that were trained in the nineties or before probably have like zero to no awareness or training to look for adult ADHD. So I just wanna. Plug that one. Really, really most importantly, and I wanna thank you because the fact that you took an interest in it is helping further the work that needs to be done in our community. So thank you for that. and I'm glad you pointed out what Dr. Dodson said about most physicians who know about ADHD or because they self-train. And so thank you. Then I remember, and I don't wanna interrupt you, but I also want to get into the story of how that fibromyalgia connection came to be. But I wanna share, if I can, my personal, the reason that I was so excited to have you on and how I even got into this ADHD thing. So I discovered like many adults, that I had ADHD when my oldest child was 13, 14, and being evaluated for ADHD by their psychiatrist. And I remember my oldest child coming to me and saying, mom, I wanna be evaluated for ADHD. my child is non-binary, so I'll use they them pronouns. I said, you, don't have ADHD. You've been reading since you were three. Because I could not sit still in school to learn to read until second grade. Nobody ever diagnosed me with ADHD. Well, you can't possibly have ADHD. Well, sure enough, as the doctor, as the psychiatrist is asking those questions, I'm answering more yeses for me, and I looked at him and I said. Do I have ADHD? Like I really had no idea. and from there I was like, okay, I have ADHD, I'm 45 years old. I've started a business, I've graduated college with high honors. I have three children. So what I have ADHD and I sort of just left it there. And it wasn't until I heard a podcast about eight years later where they were talking about fibromyalgia and migraine headaches in. Adults with ADHD that this light bulb went off because my mom had struggled with fibromyalgia and migraine headaches most of the life that I could remember with her. And my mom had a lot of clutter. And I called my mom, I said, mom, I want you to listen to this podcast. So had I not heard that podcast, I don't think I would be in this space. I think I would've also been one of those people who was just ignoring, I have ADHD. So what? And honestly, it's so much bigger than Then we realize, which is why I am now committed to writing books, doing podcasts, and getting the word out and meeting people like you Dr. Lenz. So thank you. Yeah, you're very welcome. And I think the more you start, once you start seeing this, it's hard to not see that. I think you were asking about connections with chronic pain syndromes, and it was just the pattern recognition, I think recognizing that. You treat somebody who has ADHD and their migraines may improve, or people who had IBS may have had higher rates of having ADHD. And then you, I was very fascinated as a separate silo, the whole concept of fibromyalgia kind of as a personal note. I came into med school also with this bias that hypochondria wasn't real. Meaning the labeling somebody as a hypochondriac or hysterical wasn't a fair diagnosis, but they were mystery people. Now, what we'd call invisible illnesses, and probably most people listening probably can relate to a relative or somebody at a family gathering who may not always have shown up. And they may have had some struggles. You may not have understood it. I recall somebody who said, oh, they have agoraphobia. I'm like, what's agoraphobia to a 7-year-old? Oh, they don't like going out with a lot of people around or somebody struggling. I know that. My mom's in heaven now, but she, right before she died, she read my book and said, oh, I'm pretty sure that her sister-in-law had it when she described this, and she struggled with a lot of fatigue and chronic pain and et cetera. And so my heart always went out to people who are struggling with these often misunderstood invisible type illnesses, but. What was the cause, and I remember not offering great care because you don't understand it. I remember in the year 2000, after my first year out of residency, I'm eager to learn everything. And one of the physical medicine rehab doctors, though, they're often the pain doctors in a clinic. They do some often pain injections, but they're there to manage chronic pain. Well, they have these monthly pain. Patient discussions where they talk about difficult patients, kind of like tumor board except for chronic pain patients did. He said, Hey Michael, do you want to come and learn? And, and it was a pain psychologist and been discussing these patients and I remember they would talk and they go, well, what they really need is a really good primary care doctor and I'm like I don't want to take care of these complicated patients.'cause I didn't have any training in that. And that is right when Oxycontin was being pushed. And I always felt uncomfortable about using opioids for a chronic pain syndrome that I didn't get. So I did that for a few, you know, I got some exposure, but. Then what is the real answer? What is the real hope? And then there were people like Dr. Daniel Claw from the University of Michigan who started talking on this. If you research fibromyalgia, he's done tons of work. He actually, I think in 2002, brought to a big study that showed differences in functional MRIs showing that people with fibromyalgia experience and process pain differently. People who with fibromyalgia had pain at a lower pressure when they did. Thumbnail testing compared to those without about half the pressure. And these are different wiring within the brain, how the brain and, and blood flow and brain activity is different. So that added the legitimacy and it just kind of built from there. Wow. Okay. So how did you recognize the connection between fibromyalgia and ADHD? Well, again, I was just pattern recognition and seeing it in patients. Oh, my patients who have migraines have more. Chances of ADHD and IBS and I'm like, oh, these are common. And I felt I was regularly diagnosing fibromyalgia. Then I started evaluating, do they have coexisting ADHD? These are things that I was very comfortable with. And then you know, you go. Well, does everybody recognize this? I wonder if there's other research. And then I found that there were case reports, and then Dr. Joel Young, who had some case reports on this, and Joel Young, who wrote the foreword to my book, and he's got out research. I just had a video on YouTube interviewing him, talking about this research. But he showed the connection with ADHD and chronic fatigue syndrome, which is to me essentially the same thing as fibromyalgia and showing up to 70 to 80% of his patients now in a research, very careful research setting. Showing the connection with. ADHD. And so it just validated my observations of this high co-occurrence as well that I was seeing in more of the science. Other research out there had supported it as well. This is going back before COVID and now bringing up into the present time, these high co-occurring rates and also looking at other syndromes like migraines and IBS for example, that have. Higher rates, and then that doesn't even get into the last three or four years of my own Personal growth is a high co occurrence of autistic. Being autistic and having chronic pain syndromes and the connection with fibromyalgia and IBS and all of the other, you know the other standalones, hypermobility syndromes, all of that kind of gets blended together. Well, so interesting. First of all, I wanted to ask you, is it pretty common that someone would come to you for fibromyalgia and then you would say, oh, by the way, let's get into the ADHD conversation that maybe hadn't considered it. Oh, so if it's, well, you know, if you have something where 70 to 80% of people have something, it's just standard you'd screen for, for an example. Many people are familiar, especially if you're listening to this podcast, you probably know somebody with atrial fibrillation. Half of people with atrial fibrillation have sleep AP. You have a very low threshold to get a home sleep study. Unless somebody can strongly say, my spouse does not snor or stop breathing, then I won't. But otherwise, I'm like, let's just do a home sleep study. It's a simple test that's rule it out. and that's only half of people? Well, we're talking 70 to 80%. So part of my initial intake is doing the World Health Organization version 1.1 screener in the clinic, if I have time, usually that day. And then I have them take home the diva diagnostic interview for ADHD 5.0 and bring that back and discuss that. So that, is a very common part and. Most people don't know there's that connection unless it's, I see a lot of families, somebody like you, if you were seeing me, Jami sends your brother or sister over and says, well, my sister's got fibro and and ADHD, and she told me to come and see you. And I guess it makes sense 'cause she's talked about how it's affected. So as you've been doing this, a lot of times you end up seeing lots of the family tree because it's so genetic. So is it common for you to inform that patient, Hey, I think you've, you know, you've got ADHD as well here, or do they usually know? Oh yeah, no, I mean, so part of it is asking probing questions when you're doing an in history and my history, when you look at this. Is a longitudinal history, right? So when you get to what is your pain and the classic fibromyalgia symptoms, widespread pain index and the symptoms severity score. And then you, I ask questions like, what were your strengths and struggles and any social life stressors when you were in elementary school, middle school? And often there's stuff like, well, I remember I talked a lot in class. I had a lot of energy. I never really liked homework. Can I share a, cute success story in, this? Please. No, we love, you know, that's the other thing. People with ADHD do really well with stories. We, okay, I'm gonna tell you a quick story. this is a real patient and it's cute in lots of ways, but this is a patient, her sister is a nurse practitioner, retired and. Found me within our healthcare system.'cause I'm one of like two or three doctors that actually wants to put fibromyalgia on their things. They see, nobody wants to see this. It's the most stigmatized problem. So she found me and I sent them the questionnaires including the ADHD stuff. So this woman came to me partly because she never was diagnosed with fibrology. She had chronic pain, her older doctor retired. She was on methadone for chronic pain, and the new young doctor was not wanting her on it and was trying to wean her off, which is, most doctors would be like that. And so I'm asking her during the interview, going through all of this, and I said, well, what were you like in school? What were your strengths? She's like. I don't know why you're asking me about school. I didn't like school. I didn't complete high school. I didn't like doing homework. What does this have to do with anything? I just wanna know, are you gonna give me my methadone or not? Why do you even, what does this have to do with anything? I didn't like homework. I never really, you know? without me having to do extra, you know, that pretty strong indicator of a Yeah. She was the ADHD poster child, right? as she's a 60 some year old woman, pacing back and forth angry as I, you saw the JD Vance movie with his grandmother who had the coke bottle glasses, blue collar look, and she was a very thin version, just pacing back and forth. And I was like, you know. I just know that I got one chance. I hope Ritalin works because if, you know, sometimes Adderall works and Ritalin doesn't and you don't know, but I'm like, if I don't get this on the first one, you'll probably say that. Why did this is stupid. short of it is we just dialed from five milligrams twice a day of Ritalin to 10 milligrams. And I do the short acting 'cause she was insurance and Medicare. I think she was probably in her early sixties that she was on Medicare and cost of, you know, meds. Sometimes they don't always cover it and she's on 10 milligrams twice a day. Completely reversed her fibromyalgia. Wow. She has no pain, no fatigue. Now granted, she was doing lifestyle things with it, so she was a gardener. She was always a busy body and it's very satisfying to see that. Well, this nurse practitioner who, that's the sister brought her in, was at church and was saying, yeah, there's this doctor who cured my sister of fibromyaglia, and so this. Friend from church now sees me and now it's getting the same kind of help who's neurodivergent and getting all of those kind of things. and the original patient though, gets along with her family better. She had a cantankerous relationship with much of her family, including her daughters and was kind of hard to be around. And now she's obviously emotionally regulated. Not in pain and fatigue and able to have a good life as you nod your head, but just a feel good story of a real patient. I, I am because I mean, we are changing lives. I mean, the work that we are doing to spread awareness, I know, I'm living it because my relationship with my mom has completely transformed with both of our understanding. So I love it. Like I said, I was so excited to interview you again. I wanna take a pause. I need to take a sip of water. And also as an opportunity for me to have our listeners learn more about something that I didn't even have when you and I talked Dr. Lenz, and that's the Sparkler Society. So I'm actually creating a membership group for older, you know, 45. older women who are discovering ADHD and we're putting scaffolding in place to do life. On an easier level. So helping to stop the impulsive spending working on the clutter together, that self-talk and shame and like what, you know, so I'm really excited. So you're gonna hear a message about that in this commercial. and then of course, as I always like to tell people, it's so important that you like this podcast, that you share this podcast because that is how the attention will grow and this is a message that needs to get out there. And definitely especially this message with Dr. Lenz, which I'm also, when we come back, gonna have you talk about your podcast and your book, but also more about the why that link might be there. So we're gonna pause and come right back. You know that feeling when Monday rolls around and you have all the plans, but by Tuesday you're already behind. Yeah, me too. That's the ADHD brain doing its thing. I'm Jami Shapiro and I'm launching something I Wish had existed when I first discovered my ADHD. Grandma has A-D-H-D a membership community. For women who found out later in life that they have ADHD and have spent way too long feeling like they don't quite fit in. Here's the thing, going it alone doesn't work for ADHD brains. We need accountability without judgment. We need people who get it. We need structure that actually sticks. That's why I'm kicking things off with Monday Momentum and make it happen. Sessions one year of ADHD coaching followed by body doubling where we actually do the things together. No more lonely to-do lists. No more starting strong and fading by Wednesday. If you join the founder circle, you'll lock in this low rate for life as long as you keep your yearly membership. Plus, you'll get quarterly private sessions with just me and the other founders as we build this community together. This isn't just another membership created to take your money. This is the support system we've been looking for. Head to Jamie shapiro.me to add your name to the interest list. Let's stop going it alone. That's Jami Shapiro. J-A-M-I-S-H-A-P-I-R-O.me. Moving can feel overwhelming. Whether you are downsizing, relocating, or helping a loved one transition. There are so many decisions to make, details to handle and emotions to navigate. At silver linings, transitions, we believe every move should be magical, not stressful. We are more than movers. We expertly guide you through the entire process and do our best to alleviate your concerns. From the moment we meet, you'll feel comfortable because we will listen to your needs and wants and work together to create a personalized plan that honors your memories and your cherished belongings while helping you embrace your next chapter. We visit your new space and create a detailed floor plan, ensuring your furniture and treasure belongings will fit safely. We handle the logistics so you don't need to worry about anything from sorting and packing to coordinating the sale and donation of unwanted items. 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So I just did what people with ADHD do best, and I interrupted Dr. Michael Lenz because we took that sip of water and he started to, I just told him how much I love the story, and then he started to talk more about it. I said, no, no, no, no. You've gotta share that with, people who are listening. so if you, I don't know if you remember what you were saying, but Yeah. So, you know, I would probably say that 95% of my patients when I bring this up, are so. Happy, especially as they get better and it makes sense. Often there's a grieving process, like why didn't anybody, other doctors that I've seen for sometimes decades struggling with this, ever connect the dots. And I said, actually, it's unusual that people had any training and whatnot, but there is about at 5% or so that. He's like, I don't get why he thinks I'm neurodivergent. What does that have to do with anything? And I don't like labels and I wanna do things all natural. And that's big pharma and all of that. That is a minority, but it's still out there. And that's actually part of the reason why I hope the podcast and the YouTube channel that I'm trying to do more with help. Increase the insight and awareness and understanding, because it's really hard to explain these complex topics in a quick visit. And sometimes you're just like, well, here, read more, investigate. It's up to you if you want to look at this and explore it more. So I do wanna get to that question about the connection, but since you just mentioned your podcast and book, if you wanna put a plugin for that now so people can find you and we'll put it in at the end again. Yeah, so the YouTube channel conquering your fibromyalgia, the podcast, I think you'll get more out of the YouTube channel, especially if you're a neurodivergent listening to this podcast. you have a video b roll, other stuff to try to make it interesting. I'm trying to do my best to make this content interesting. Lots of videos on there and more to come and you get a chance to see the people on there. I have a book called Conquering Your Fibromyalgia, which is good evidence-based understanding that helps compliment both of those that are very useful tools and continue to have that information out there. I have lots more of information. You'll have monologues of me sharing information. I'll be interviewing experts. I have people who. Living with fibromyalgia might not be my patients, but are just living. So they may not be kicking butt, but at least I'm validating that there are other people struggling'cause I'm not their doctor. But just sharing part of that and also have people on there who have gotten better, who are living better with fibromyalgia or have reversed fibromyalgia. So it's a combination of all of those. And then I get again experts, like I mentioned Dr. Joel Young, who is out there doing the research to help bring this information. So, you know, it's interesting. I was talking to my mom just yesterday on the phone and she was talking about her fibromyalgia and how it was like in a knee and then it went to somewhere else, like the pain moved around and she said she had a conversation with her doctor and he said they don't prescribe stimulant medication to older adults because they're worried about addiction. that was the answer that she was given by her doctor. Yeah, so that would be a question that is wrong. That's an assumption that's wrong. I think you know that, Jami That's a misunderstanding. Whenever somebody is going to that. One of the things I always would preface this is when you're looking at, you may be listening to this and go, Hey, that makes sense and I guess I do have this and I have chronic pain, is before you even talk about it with your doctor. Or make an appointment, you can just ask the doctor or the nurse, Hey, how often do you diagnose and treat adults with ADHD? How often do you diagnose and treat adults? Over 65 with ADHD. And just like if you had an orthopedic problem and like my son gonna have a shoulder surgery, as you know, most orthopedic surgeons do not touch the shoulder. They're the hip and knee replacement guys working with the 65 plus crowd. They're not working with the 20 somethings. You want the one who works for the Lakers, who works with the Dodgers, you know, fixing the shoulders and likely that takes you, then takes them off the hook and if likely that doctor would say. Well, I don't really diagnose anybody with ADHD. I always send them off to psychology and I, I don't even treat them unless maybe they were continued on medication and now I'm continuing. It was by a trusted doctor. I just had a patient I saw today who the. Psychiatrist diagnosed it, he retired. The family practice took over, and the family practice doctor said, well, I'll continue the same dose, but I don't feel comfortable making any adjustments. And so obviously they don't have a lot of insight into that. And similar to the whole addiction, I just had a YouTube channel episode a couple weeks ago They took 15 to 35-year-old. People who had a substance use disorder and ADHD, a big database and they tracked them. It was a 1.2 million person database and they said, okay. Who is getting their ADHD medications filled and who is not filling them? So these are people with a substance use disorder, alcohol, tobacco, cannabis, cocaine, opioid use disorder. And it turned out there was a 30% lower mortality in those who were taking their ADHD meds. They were less likely to be on methadone. They were less likely to be intubated less likely to be dead, and the stimulants were more effective than the non-stimulant medications. They were 25% more likely to show up for doctor appointments, mental health appointments. So the overwhelming evidence is that it is not harmful or likely to cause an addiction. And more and more data is shown, its likely productive. It likely lowers the risk of mortality for multiple reasons. Obviously, a 15 to 25-year-old age group may be different. Than somebody over 65. So and then as far as heart issues in somebody in any age, but we're watching blood pressure sometimes it goes up, sometimes it stays the same, sometimes it goes down. I think a huge part of blood pressure is for many of my patients, and most people with ADHD at every age group are overweight or obese. So treating ADHD along with healthy lifestyle, implementing a more whole food, plant-based diet, regular exercise. And then the less impulsive eating, the less snacking on calorie dense food. Often their blood sugars come down, their blood pressure's actually come down. So that would be somebody who is not informed, is not up to date. Probably was told that by another doctor. And so I think I know. What are your thoughts on that, Jami? I'm just listening. I mean, that is my frustration is that there's so many people who don't know and there's so much misinformation. So it was, I was actually just thinking while you talked and we still haven't answered the question, which I definitely am still gonna get to, but, if somebody's listening to this podcast, especially 'cause we're gonna use that word fibromyalgia in the title if they suspect that they have ADHD, that they're in that 70% with the overlap. Where do they go? Especially older adults, where do they go from here? Yeah. Well, it is trying to find somebody. And for many people, I think half of people treating and evaluating people for ADHD end up being nurse practitioners. So if you're in a somewhat. Urban area, odds are there's some group there. You might have to find that. And then it's kind of hit and miss with primary care doctors. You might find a doctor like me who has a special interest in this and it's part of what they do. In some regions, it's much harder to find. I think California, Nevada, west Coast, not as many doctors have had training. The northeastern part of the country and east coast are much more where I'm at. I realized that I went to Virginia, Richmond, Virginia for my residency. I think part of why I got training, I think it was more part of what was more understood there, more part of the regular evaluation. If I stayed here, I think the doctors that trained in the Milwaukee area where I'm at in Wisconsin didn't have as much training. Unfortunately, that leads to those doctors now who are training the next generation So you end up having this delay. And that's why for somebody like me, a huge part of my practice ends up being patients who are needing somebody who gets care. So part of it is trying to find. You can start with your primary. More than likely your primary doctor is going to say, I don't do that. They refer to a psychologist. Sometimes they don't even, they don't know much about it. And often they're doing neuropsych testing, so you end up having to find somebody who does ADHD. And there are people out there and there are clinics that do that. So we didn't really give a good answer, which I understand because I, it varies on where you're at and there isn't right now. It's not always, and where people are listening all over the country, it might be hard. In some places it might be very easy and they're. Regular Dr. May be perfectly fine with that. No, and I meant to go somewhere with that, which is just to maybe reach out to your local area. Find an ADHD coach.'cause they're likely going to have connections with professionals in the areas that you are. And I know that you can go to ADDCA, A-D-D-C-A to find a coach. There are other coaching. We'll have those links in our page. So, okay. And then I wanted to go finally back to the question, which is what do you think the overlap is caused by, can you explain the connection of, you know, fibromyalgia and ADHD? Well, fibromyalgia has a difference in how the brain processes information. We know that overlap with being autistic, same kind of thing. Differences in praying and pain. And so we understand in the world of fibromyalgia is that, think about it like a guitar plugged into an amplifier. The amount of pain, somebody feels the distress. That people have and just general sensitivities.' cause it isn't just pain. It might be the flickering light, the sounds, the smells, all of them are turned up. and what we know is through these functional MRI's studies done in academic settings, there are differences in how the brain processes this information. And what happens is that the ADHD brain has a lot more sensory overload. There's a lot more stuff. That the brain is trying to process and has a hard time filtering out the information, and a lot of times, and part of fibromyalgia is there are things that are not causing any pain, but the brain and the nervous system are so hypervigilant. The sympathetic nervous system is so wound up and it's threat detection is turned up so high that it'll interpret things that are not injuring you as being painful. Treating ADHD. Is like putting blinders on. It helps filter out that unnecessary information, right? Mm-hmm. And allow people to one, filter that part out so there's less pain that people associated. When we look at fibromyalgia, it's not just pain, but for many, it's fatigue That's worse. Or chronic fatigue syndrome emphasizes the fatigue. That's a huge part of ADHD and emotional regulation. People with ADHD and fibromyalgia overreact to things. Many autistic people have an overreactive over-responsive nervous system. I don't know if you've heard of the book Highly Sensitive Persons by Elaine Aaron, but she talks about this whole group, which really are likely ADHD or autistic, high functioning autistic adults with this. Hypersensitivity And so we know treating ADHD helps turn down that emotional overreaction, and we know emotions affect pain, right? We know that have an important factor on it, and there's many different parts of the factors with it. Then there also can be the connections with lifestyle things. If somebody, for example, one of my patients here is living in Wisconsin, we wish she could be in San Diego. This would probably make her fibromyalgia drop 30% if she could go for a walk in the warm weather. At night, but it's cold. I'm like, well, you have to go inside and walk on a treadmill. And she's like, I hate walking inside. It's boring. And for a lot of ADHD people walking on a treadmill is so boring, but when their ADHD gets treated, they can now watch this show on Netflix for an hour while they're walking on the treadmill. Would they love to be walking along the beach in San Diego or along the beautiful park right next to that golf course? what's the name of that? In Torry Pines. Torry Pines, yes. Beautiful hiking area. Like who would rather be hiking outside along the ocean than on a treadmill? I do that regularly. I am very fortunate to live in San Diego. So I was actually looking at the questions that you had provided me.' cause we're getting close. And I wanted to make sure they hadn't missed anything. So when you asked me, I was like, oh, I'm reading the question. So I'm very into our conversation, but I was like, Ooh, It was the widespread pain index. so I wanted to make sure that there was nothing that I missed that I felt like our listeners should know about before we end our conversation. So it was kind of scrolling through where we were. Yeah. Yeah, so, so go ahead. One, the question would be how do we diagnose fibrologists by careful history? And we use the widespread pain index, WPI and symptom severity score. You can look those up online. And another tool that I help use to assess on your severity of functioning is called the. FIQR stands for Fibromyalgia Impact Questionnaire Revived. It's a tool to assess functioning and actually one of the, many of those factors overlap with ADHD, like one of them is how often do you feel overwhelmed From zero, never to 10. Always. Well, my fibromyalgia patients often when they get their ADHD dialed in who have coexisting A-D-H-D I diagnose ADHD. Treat their ADHD if they have fibromyalgia. I don't just give them stimulants if they don't have co-occurring ADHD. But when those who do have those co-occurring and well, maybe they're 10 out of 10 for feeling overwhelmed all of the time, and then we come back and dial in and their Vyvanse and they're on 60 milligrams and we check back, and then I ask these questions and I have the before and after and they'll be like overwhelmed, like I, I don't know, maybe a one. Wow. and I'm like, oh yeah, did you know you were a 10 before? How sensory sensitive are you? How stiff you are, what is your level of pain? And that's the neat part. And when you talk about the emotion and these other aspects. Is that they see that improvement. So it's another tool to assess over time, and that's really gratifying to see somebody get better. Can I share a cute story, another happy success story? So please. So I just saw a patient yesterday. He came in new to me and he was. Working in kind of a factory setting as a blue collar kind of person, and every hour he was having to run to the bathroom and it'd take him like 20, 30 minutes to just try to get through. Getting the business done, so to speak. Mm-hmm. Mm-hmm. And you know, it's a small enough company that they weren't giving him a hard time, but he went with trying to get help. The short of it was he did have co-occurring restless leg syndrome, which is very common in people with ADHD and fibromyalgia. We treated him with Pregabalin, adjusted the dose. I assessed him for ADHD, he had diagnosed with ADHD. We adjusted medication over about two to three month period. He went From having a lot of anxiety about work. Obviously they're nice, but like, Hey, you can't be in the toilet. For every hour for the first four or five hours of the day. I mean, what are you, you know, are you malingering? Are you faking it? I don't know. Now he's like, I maybe go once or twice. Bowel movement, the whole eight hour shift. He's like, I'm in there within five minutes and I'm done 10 tops. He's like, I have so much more energy. I'm sleeping better. And he said that. I'm doing well, and he said the head of the company, the president of the company, came over and said, you are. And he told him, he said, you are doing such an awesome job. And part of what he can do now is he has not the typical assembly line, but it's a small enough company that you have to do a lot of different things and you gotta anticipate, which is plan, organize, and not just do what's easy and fun. And he's, as the boss, said, kick an ass. He said, love it. And so you have somebody that you can take within a couple months and go from struggling to a whole different dynamic. And at the end of the conversation he like many 30 somethings. Never finished college, never wanted to go to college, doesn't have a tech degree. And I've had patients who are in similar stories maybe started and dropped out and I said, Hey. I want to just plant a seed, but consider going to the technical college and just considering maybe a night school or something and see what things you can maybe dip your toes in because you really are capable of a lot of things and right now you have an entry level job, but what if the company goes bankrupt and or who knows? Right? You want to have some education that you can put on your resume. Mm-hmm. That is a great story. I really genuinely so appreciate you and the work that you're doing because as we shared, you actually don't have ADHD. A lot of people who work in this space are impacted and that sort of was what made them want to be in that. But I know you have a family connection to it as I recall. Yeah, and it's kind of similar to Dr. Daniel Claw, if you ever looked him up. University of Michigan, he got a couple lectures on YouTube. He says, you know, he's like, he never gets chronic pain. He hardly ever has any pain, hardly gets a headache unless he's. Traveling to Africa for a mission trip and he's, you know, jet lagged and not sleeping in a airplane for 24 hours straight. He's like, then I get sore and stiff. But it's also, as I told that patient yesterday, it's so gratifying to, help somebody and help this group of people who has not been getting good care for, and you know, I didn't know I'd be doing this as most people don't know what your career is. But the cool part and why I did not specialize per se, but I'm kind of a subspecialist now because of this group of patients that there is no specialty to take care of is when you. Get to be specialist of the whole body, all of the organ systems. You get to have a true holistic understanding of what's going on. And it's much more than simply maybe a psychiatrist who isn't recognize the fibromyalgia, the IBS and the restless leg, and the GI doctor who might recognize IBS, but they're not screening for neurodivergency and all of this. So. I hope that more and more primary care doctors can not become urologists, which is I refer anything that I don't get, I don't understand. And they just had you know, get these emails for special things and one of them said the UK just made an announcement that they're trying to get primary care doctors up to speed on ADHD because it's a two year wait list. To get in, in the National Health system if you're listed in UK to get any evaluated unless you go to a private evaluation, which is crazy. Well, I, that's amazing that they are stepping up and, recognizing ADHD and its population. And we could go on down a whole rabbit hole on the percentage of people who probably have it and don't know it. I've read crazy numbers anywhere from five to 25%. I don't think the 25% is right, but, you know, anyway, I don't wanna. Sidetrack squirrel too much. Is there anything that I didn't ask you or any of the, information you wanna make sure we share before we end this podcast? I try to make it as quick as possible 'cause I've got that attention, ADHD situation going on. Well, as I say in the subtitle of my book this is real answers and real Solutions for real Pain. There's real hope that's evidence-based. And if you're struggling out there hopefully they'll be validated. I just saw a patient this morning who found me because she heard me on the other autism podcast talking about Neurodivergency ADHD and the connections with chronic pain, and she said she cried when she listened to the podcast. She said she felt more validated listening to that our episode. Then the last 10 years of all the medical visits she's had. So, you know, hopefully, and I guess what you can do is sharing this with your provider, with your clinician with others out there, that this becomes more normal. This is more common that more people have training on and understanding. Of these important topics. That's great. I wanna say one more thing too, and I don't remember where I heard it. You know, because ADHD is my super interest, I'm constantly absorbing information, but I heard that there was a way that they would be able to basically get rid of ADHD. but the punchline was really good. And they said if they were to do that, then there would be so much innovation that would be gone if they did get rid of ADHD, our society would just suffer. So I just, wanna say that I think it's really important because we have spent so much time beating ourselves up. With ADHD about, you know, why can't we get it together? Why can't we pay our bills on time? You know, why this, why that? And I truly believe that we have these exceptional brains that have their good parts and their bad parts. I would definitely say that having chronic pain and fibromyalgia would not be a good part of having this amazing brain. But I just wanna really acknowledge you and the work that you're doing, and thank you again so much. Again, you can. Find Dr. Michael Lenz on his own podcast, conquering your fibromyalgia and his book as well. any final closing thoughts? Yeah, and probably I would say as best you can check out the YouTube channel. That's probably where the best new stuff and old stuff. There's a bunch of archives and it's great information on there. And like you said, as I learned more about this in Neurodivergency, especially the. Discussion on ADHD and autism being autistic, is it, it's like you said, it's a double-edged sword. You know, it's, we need that innovation and thank goodness there's a autistic neurodivergent, ADHD brains yet, often in the modern world, it's really can be challenging and it's a little bit, sometimes like wearing the glasses or the hearing aids, it helps somewhat normalize the playing field, but allow people to not be burdened by some of those barriers and. Be able to, to live a full life. And I guess the other thing that I will just say that we didn't talk about, but I talk about you can dive deep on and talk about a lot on my YouTube channel and podcast is the whole hormone connection with perimenopause and post menopause is that we are learning, there's a strong connection to that. And most of the research is supporting the using hormone therapy in that perimenopause, post menopause neurodivergent. ADHD people are more strongly affected by that. About 25% of women have their. Fibromyalgia start during menopause. There might be other things happening, but often that's part of it too. So that's a huge part. And the whole hormone connection with girls who are younger, women younger who are having the PMDD and the PMS is all part of that, which are very important to be aware of as well. Rest assured that we are definitely covering the perimenopause post menopause conversation in this podcast. I am officially almost menopausal myself. in a couple weeks I will have hit that one year mark and I am a huge proponent of hormone replacement. It has been life changing for me. It has been life changing and my pain level in the way that I function. And yes, so. Yeah, so we're taking care of all of that, so thank you for bringing that up. Thank you all so much for tuning in. Again, thank you for giving me not one interview, but two interviews, Dr. Michael Lenz. I mean, you are definitely a physician whose heart is really in the right place. I really appreciate it. So as all of you know, when I end this podcast, I always say, you know, I'm committed to making the rest of your life, the best of your life. And definitely if you are struggling with fibromyalgia or chronic pain and you've listened to this podcast, I definitely think I couldn't say it any better. So thanks so much for listening. The opinions expressed on Grandma has ADHD podcast are those of our guests and hosts and are intended for informational and entertainment purposes only. This podcast does not provide medical advice, diagnosis, or treatment. The content discussed in this episode is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental health, professional, or other qualified health provider with any questions you may have regarding a medical condition or mental health concern. Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast. If you think you may have a medical emergencies. Call your doctor or emergency services immediately. The host, guests and producers of Grandma has ADHD. Do not assume any liability for the content of this podcast. Listen at your own discretion.