You/your kid on ADD meds. NOT hungry. Best way to replace electrolytes?

May 19, 2018 1:32 PM

Up front: the parents are going to talk to the prescribing physician. I just want to hear first-hand experiences. I have a student who just started ADHD (inattentive subtype) meds, and it is like night and day. Everyone's psyched that it's working so well, but his hands are shaking because he isn't eating because of the appetite suppressant end of stimulants. If this is you, what do you use to replace electrolytes when you just can't eat full meals?

Vyvanse is working gangbusters for his ADHD inattentive subtype (I have never seen such a dramatic change--it's magic), but not so much for his appetite. His hands are shaking. We need to replace electrolytes -- but with what?

He's already skinny, and the meds basically take all of his appetite away. His hands are shaking so badly that he can't write, which kind of defeats the purpose of the med (help him do well in school). I've had students on ADHD inattentive subtype meds before, and all they needed was a banana and they were good to go. That is not this kid. I've been reading up on all of the different options for electrolyte replacement, and I'm a bit overwhelmed.

Is GatorAde still considered the best way to rehydrate and replace electrolytes, or is that really more for someone who is engaged in physical activity, and are there other/better options for a kid who just isn't hungry? The other options I've seen over and over are in my internet search are:

A glass of chocolate milk

Enhanced coconut water

PediaLyte (better than GatorAde because it's higher in potassium and lower in sugar)

A smoothie made of probiotic yogurt, a banana, cubed pineapple, cubed watermelon, and spinach.

Would any of these be just fine? Has anyone got any better suggestions?

posted by tzikeh to Health & Fitness (8 answers total)

Ensure and other similar things are really great for the times in my life when I'm not eating for whatever reason but require replenishment in my body. Get the high protein version. Basically anything I can drink, kefir works, and also dairy like yogurt or cottage cheese. These have kept me alive for as much as a couple of months at a time when food was all turning to sawdust in my mouth.
posted by hippybear at 1:37 PM on May 19, 2018 [3 favorites]

I mean, I'd try the Gatorade or Pedialyte first just to actually make sure this is what this actually is, before going to any greater lengths. It might not be electrolyte-based at all, is why I say this. He should definitely be eating, in general, whether he wants to or not--it can help to try to load up on food first thing in the morning and push dinner as late as possible? But I'm not sure I'd assume that the tremor is an electrolyte problem if Gatorade doesn't improve it substantially. If something like that works, then try to work out healthier/cheaper alternatives at that point.

But he might just need a lower dose than what he's currently getting, for example, because high doses of stimulants just don't necessarily sit well for everybody.
posted by Sequence at 1:46 PM on May 19, 2018 [8 favorites]

I am an adult who has been taking Vyvanse 70mg and Adderall IR 20mg for several years now. I am constantly thinking about hydration and electrolytes.

So, here’s the only thing I would really warn against. Vitamin C can reduce the effectiveness of stimulant medication (ask me how I know). If you are giving him anything Vitamin C-rich for electrolytes either before or when he takes the medication, you will likely reduce the effectiveness of the medication. I am not telling you to never given him anything with Vitamin C, just to be mindful of this if it’s around the time he’s also taking his medication. This goes for anything else that is acidic. So, I would not recommend he take orange juice (which is great for electrolyte replenishment) before or with his medication. Once it’s kicked in, he should be fine.

My two preferred methods of electrolyte replenishment are 1) coconut water and 2) chocolate milk. However, coconut water tends to be pretty cost prohibitive. I recognize that chocolate milk may not be every parent’s preference for a daily electrolyte source, given the sugar content. Chocolate milk tends to be recommended as a post-workout (if the workout was strenuous) drink for athletes/runners, because it has both electrolytes and protein. If you are worried about him losing too much weight, this may make it a preferable option.

Neither Pedialyte nor Gatorade contain Vitamin C, as far as I know from reviewing the nutritional facts online. So both are great and shouldn’t be too expensive.

There are also electrolyte powders you can purchase and mix with water, which may help curb costs.

I would not overthink this too much. Everything you listed is great for electrolyte replenishment; your best bet may be to focus on what is also the most nutritionally sound and, if money is a factor, low cost. It is not the end of the world to give him something Vitamin C rich with his medication, but there are enough alternatives available that you can make sure he gets his electrolytes without putting his medication’s effectiveness at risk.

Bananas are indeed a great cheap source of potassium; throw them in a smoothie for him.
posted by nightrecordings at 2:26 PM on May 19, 2018 [1 favorite]

I'd go for the smoothie or the chocolate milk over the other options if he can handle them, or ideally ensure or similar. Electrolytes are necessary, but not sufficient, and his hands could well be shaking because of a lack of glucose. I've seen someone go from skinny to dangerously underweight fairly quickly on ADD meds; it's really worth taking action now to try to prevent that.
posted by Acheman at 3:17 PM on May 19, 2018 [1 favorite]

I don't think you get hand-shaking from lack of electrolytes? Cramping, yes. Hand-shaking sounds more like low blood sugar + amphetamines, to me. I get shaky hands when my blood sugar is low, and when I was on adderall/vyvanse it was for sure worse.

I would work on making sure this kid is getting enough calories. I definitely had my appetite surpressed a lot, especially for the first month or so. I lost weight (which was fine for me) even though I was still making myself eat regularly. Maybe what he needs are some meal-replacement drinks or other calorie supplements.
posted by Anticipation Of A New Lover's Arrival, The at 4:18 PM on May 19, 2018 [3 favorites]

Bottom line will be a lot of late evening meals.
posted by bq at 8:24 PM on May 19, 2018 [1 favorite]

When I was on Adderall and dehydrated and it was summer in Texas, I drank a ton of plain Goya coconut water and found it very helpful on the hydration/electrolyte front.

But... it's not a substitute for real food, and I agree with folks upthread that shaky hands sounds like needing calories too.
posted by nebulawindphone at 4:01 PM on May 20, 2018

When I'm electrolyte and hydration deficient due to gastro-issues, I start with Pedialyte. If it tastes sweet, I know I'm lacking and slowly drink it until it doesn't taste good. If it starts out tasting bad, something else is the culprit.

How long has he been on the meds? The shaking could be a side effect of the meds that has not yet stabilize, brain meds can take a couple months to fully stabilize in a system (ask me how I know). Obviously he needs proper nutrition as well, but the visible symptoms may not be related int he way you are thinking.
posted by RhysPenbras at 12:44 PM on May 21, 2018