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Some ADHD medications can be affected by things like diet. For example, according to Dr. Dodson, citric acid can break down ADHD medication faster and reduce its efficacy. There may be other factors too like the dose, hydration, or other medical issues that could be impacting what’s going on.
If your office is doing immediate response drug tests (typically ones that are available over the counter) those are not very specific. Lab tests and blood tests are more effective, but also more costly. I think you’re right to keep asking them to check your blood levels and to discuss dosing based on that. You can also ask if there are any other things they would like you to do in order to “prove” that you’re taking your medications.
It can be really frustrating when providers look for reasons not to prescribe and start withholding medication that is so helpful. It sounds like you’re doing a good job of hanging in there. Good luck!