Neurodivergent and Sick: 5 Chronic Health Issues Associated with Autism and ADHD

DISCLAIMER: This page is for educational purposes only and does not constitute medical advice. 

If you’re ADHD and/or Autistic, it can feel like the way you process information and move throughout the world is so complex. In the same vein, navigating all of the co-occuring chronic illnesses that you are likely to experience as a neurodivergent person can add to that complexity. Understanding your body’s needs can help you to understand yourself better (like why you feel so tired all the time) and can help you map out the accommodations you need to live a pain-free life, get more energy, and thrive as a neurodivergent person. 

This article will review 5 common comorbid medical conditions that are likely to co-occur with neurodivergence so that you as a neurodivergent person can understand and prioritize your wellbeing. 

A Note on Language 

In this article, I use identity first language i.e. “Autistic person” or “ADHD/AuDHD person” versus “person with Autism” and use other language preferred by actually Autistic individuals. However, the scientific articles referenced in this article often use terms like Autism Spectrum Disorder and discuss “curing” neurodivergence. 

Correlation Not Causation: What is Comorbidity? 

The term “comorbidity” refers to the concept that 2 or more medical conditions or disorders are more likely to occur together. When saying that a particular condition is comorbid with another, it means that the two conditions often coexist in the same person. 

For example, POTS (Postural Orthostatic Tachycardia Syndrome) can be comorbid with Autism and ADHD (see more below on this connection) meaning that if you're Autistic and/or ADHD, you may also have POTS, or vice versa, more frequently than would be expected by chance. These conditions and identities are related - but they are not caused by one another. It simply means that these conditions are more commonly found together in the same individual incredibly frequently. 

Why is neurodivergence associated with so many health issues? 

The chronic health issues listed in this article are only the tip of the iceberg when it comes to conditions associated with ADHD, Autism, and other types of neurodivergence. But you might be asking “why?” Why are you as a neurodivergent person far more likely to experience such a wide amount of medical issues than neurotypical people?

There are a few theories in the medical and scientific community that explore the connection between neurodivergence and a cluster of health issues. For instance, some researchers believe that Central sensitivity syndromes (CSS) (Grant et al., 2022), a group of comorbid medical conditions affecting the central nervous system, are related to underlying hyper-sensitivty of the central nervous system. You might notice your hyperactive nervous system show up as sensory issues such as sensitivity to light, sounds, or textures such as with your food or your clothing. 

Some researchers also point to a potential genetic link. The methylenetetrahydrofolate reductase (MTHFR) gene is in charge of helping you process folate that your body needs to modify protein and make DNA. When there’s a variant in this gene, it can cause issues with a variety of systems in your body such as cardiovascular and reproductive systems (Liew & Gupta, 2015). There is also evidence that this genetic variant could also be associated with ADHD (Williams, 2019) and Autism (Sener et al., 2014) which could help explain why these health issues often occur with neurodivergence. It is important to note that this research is still emerging. 

Keep reading to explore chronic health issues that you might experience if you’re Autistic, ADHD, or AuDHD. 

 5 Chronic Health Issues Associated with Autism and ADHD 

1. Dysautonomia / POTS 

Dysautonomia is a disorder of the autonomic nervous system. This part of your nervous system controls “automatic” functioning (i.e. things that your body does automatically without you have to think about these things). This can include blood pressure, heart rate, temperature control, and kidney function. There are several types of dysautonomia including Postural Orthostatic Tachycardia Syndrome (POTS), Neurocardiogenic Syncope (NCS) - the most common form, and Multiple System Atrophy (MSA), the most serious form that is a fatal neurodegenerative disorder (Dysautonomia International, 2019). There is significant research that supports the relationship between neurodivergence and dysautonomia including POTS which falls under the umbrella of dysautonomia (Csecs, 2022). Underlying causes of dysautonomia can include Amyloidosis, Antiphospholipid Syndrome, Celiac Disease, Charcot-Marie-Tooth Disease, Chiari Malformation, Chronic Inflammatory Demyelinating Polyneuropathy (CIPD), Crohn's Disease and Ulcerative Colitis, Delta Storage Pool Deficiency, Diabetes, Ehlers-Danlos Syndrome (EDS), Fabry Disease, Mast Cell Activation Disorder (MCAD), and even pregnancy and major surgeries or traumas. 

POTS can affect a variety of bodily systems, meaning symptoms can be varied. Symptoms for POTS can include issues with balance or experiencing vertigo (dizziness/lightheadedness especially when standing up), fainting or feeling faint, nausea and vomiting, brain fog or trouble focusing on tasks, fast heart rate (tachycardia) or slow heart rate (bradycardia), overly dry or overly watery eyes or blurred vision issues, digestion issues, chronic fatigue, chest pain or discomfort, frequent urge to pee or urinary incontinence or even difficulty assessing cues to urinate, shortness of breath, clammy or pale skin, heart palpitations, sleep hygiene issues, frequent migraines, trouble swallowing or frequent drooling, sensory issues with sound or light, exercise intolerance, and issues regulating temperature (Dysautonomia International, 2019). 

You might notice that a number of these symptoms can present as symptoms of anxiety (racing heart, clammy hands, blurred vision), meaning many of these symptoms might be originally dismissed as anxiety versus dysautonomia. Your anxiety about these symptoms (i.e. feeling fearful when you feel your heart rate spike suddenly) might even mask a dysautonomia diagnosis with many patients reporting memory issues or brain fog - which might actually be more associated with problems focusing during a flare up of POTS symptoms) (Garland et al., 2015). To diagnose dysautonomia, your doctor may order a variety of tests, blood work, and even nerve or muscle biopsies. To diagnose POTS, your provider may use a standing test or a tilt table test or diagnose based on reported symptoms alone (Dysautonomia International, 2019). 

Certain factors might trigger your dysautonomia such as hot temperatures or sudden temperature changes, eating a large meal, prolonged standing, deconditioning (meaning a decrease in physical activity), and dehydration (Garland et al., 2015). Management of dysautonomia might include taking medications or making certain lifestyle changes such as drinking more water, ingesting more sodium, sitting down or lying down when feeling a flare up, avoiding certain triggers, and wearing compression socks or binders.

2. Hypermobility / Ehlers Danlos Syndromes (EDS) 

Hypermobility refers to disorders related to hyperconnectivity of connective tissue, including Hypermobile Ehlers Danlos Syndromes (hEDS) the most common type of hypermobility spectrum disorder. It is a complex condition with 13 classified types of EDS. As a genetic condition, it includes features such as being extremely flexible or double jointed, frequent joint pain or chronic pain, frequent dislocations, recurrent hernias or rectal prolapse, clumsiness and easy bruising, motor or speech delay in childhood, chronic fatigue (feeling tired frequently), unusually soft or velvety skin, and “loose” or foldable skin. Other symptoms/disorders associated with EDS include anxiety, chronic pain, frequent fatigue, gastrointestinal issues, bladder dysfunction (such as incontinence), migraines/headaches (often more disabling than headaches experienced by the general population and associated with neck pain), sleep issues, high arched or narrow palette leading to teeth crowding and myofascial pain, and recurrent cramps (Yew et al., 2021). Up to 90% of EDS patients experience some form of chronic pain, with many reports of pain being associated with external factors such as sports injuries, accidents, and surgery (Chopra et al., 2017). In addition to the physical symptoms associated with hypermobility, there are also psychological symptoms associated with hypermobility including anxiety, depression, OCD, panic attacks (Bulbena‐Cabré et al., 2021). As with other health issues listed in this article, there is a high comorbidity between EDS and ADHD and Autism (Kindgren et al., 2021). Hypermobility has also been linked to gynecological and reproductive issues, especially menorrhagia (76 % - prolonged and/or heavy menstrual bleeding), dysmenorrhea (72 % - excessive pain during menstrual cycle) and dyspareunia (43% - lasting or recurrent genital pain that occurs just before, during or after sex) (Hugon-Rodin et al., 2014).

Hypermobility/EDS is typically diagnosed by meeting symptom criteria and through the use of the Beighton hypermobility assessment (although the Beighton hypermobility scale was originally developed for epidemiologic research and not a diagnostic tool (Atwell et al., 2021). 

While there is no treatment for hypermobility, symptoms associated with hypermobility such as chronic pain or dental issues can be identified and managed and often requires a multidisciplinary approach. For example, physiotherapy focused on stabilizing the correct muscles and creating joint awareness can assist with chronic pain as can cognitive behavioral therapy or similar therapies to aid in pain management (Chopra et al., 2017). There are also medications that can assist with pain management for hEDS, including medications to address MCAS, dysautonomia, and other comorbid issues that can worsen pain. It is also important for any surgical team you work with to be aware of an EDS diagnosis as fragile blood vessels associated with EDS can complicate surgery (Joseph et al., 2018).

3. Mast Cell Activation Syndromes (MCAS)

Mast Cell Activation Syndromes (MCAS) refers to a group of disorders where someone experiences allergy or anaphylaxis-like symptoms due to the activation of abnormal mast cells. Mast cells, which release mediators as an allergic or inflammatory response to stimuli such as medications, infections, or insect bites, assist your body with responding to a threat. However, those with MCAS have mast cells that create too many mediators meaning that you may experience too strong of a response to a perceived external threat to the body (Akin, 2017). These responses can be a minor annoyance or cause sensory issues for you or can even be life-threatening in the most severe of cases. The severity of your defective mast cells’ responses depends on a variety of factors including genetic differences, availability of mast cells, type of allergen/trigger, and how MCAS interacts with additional comorbidities (such as dysautonomia) (Valent, 2013). 

Symptoms of MCAS range in intensity and can include typical allergy responses you might be aware of such as hives, swelling, low blood pressure, diarrhea and/abdominal cramping, and nausea. Managing mast cell activation syndromes can include a combination of approaches such as avoiding food or conditions that trigger your MCAS, taking medication that affects your mast cell mediators, and treating comorbid conditions such as hypermobility or dysautonomia (Akin, 2017). 

4. Gastrointestinal (GI) / Digestive issues 

Neurodivergent people are more likely than the average population to experience gastrointestinal (GI) issues, with 46-84% of Autistic children experiencing GI issues. These issues can include frequent constipation, chronic diarrhea, acid reflux, frequent nausea and/or vomiting, ulcers, and food intolerances. Autism is also highly correlated with (meaning it occurs frequently with) disorders such as colitis and inflammatory bowel disease (IBS). (Al-Beltagi, 2021). Your GI issues as an Autistic person might be related to immunity issues, gut inflammation, or even underlying issues with dysautonomia, another comorbid disorder (Bresnahan et al., 2015). 

Restrictive eating patterns, common for Autistic individuals, can also complicate digestive issues. Avoidant restrictive food intake disorder (ARFID) is a common eating disorder among Autistic people where you might restrict your diet to a limited number of safe foods resulting in difficulty getting enough nutrition. It might look like restriction due to sensory issues with food (such as not liking different food textures) or fear of causing discomfort when eating certain foods. However, it can also be difficult to differentiate between restrictive eating due to ARFID or restrictive eating due to necessary dietary changes with certain digestive diseases (Fink et al., 2022). For example, if you have celiac disease, you might avoid certain foods to avoid a flare up. However, this avoidance can also cause severe stress related to eating and lead to severe restriction. It is important to seek out a provider that can offer updated assessments for ARFID if you have complex digestive issues. 

Additionally, ADHD is also associated with a variety of digestive issues (Pan & Bölte, 2020), with scientists suggesting the comorbidity might be due to the unique relationship between the gut microbiome (GM) and the central nervous system (CNS) for ADHD individuals (Sukmajaya et al., 2021). Additionally, characteristics of ADHD itself, such as hyperfocus, executive functioning issues, etc., might make it difficult for you to break away from a task and eat regularly to address underlying digestive issues. 

5. Chronic pain / Migraines

ADHD and Autistic individuals are likely to experience chronic pain more than the average population through the phenomenon of joint hypermobility (Csecs et al., 2022), with neurodivergent people reporting higher rates of musculoskeletal skeletal pain and orthostatic intolerance (where symptoms worsen when you stand up and improve when you lie down). This chronic pain and co-occurring conditions are related to dysfunction of the autonomic nervous system. The autonomic nervous system helps your body complete “automated” tasks that you don’t have to consciously think about such as breathing, digestion, or blood pressure. Individuals with fibromyalgia, widespread musculoskeletal pain, were more likely to score high for Autistic traits with rates up to 89.1% (women) and 90.5% (men) (Ryan et al., 2023). 

ADHD and Autistic individuals are also more likely to experience chronic migraines, a multi-system headache condition that affects up to 1 in 6 individuals in the United States (Peters, 2019) and is one of the most common brain diseases in the world (Vetri, 2020). Migraine is 1 of 4 headache types (cluster, migraine, sinus, and tension) and can either be with aura (sensory disturbances) or without aura (Peters, 2019). 

Symptoms can include, but are not limited to, gastrointestinal issues such as nausea, vomiting, abdominal cramps, or diarrhea. You might also experience heightened sensitivity to light, sound, and strong smells. Additionally, you may experience blurred vision, stuffy nose, incorrectly feeling like you have to use the restroom (tenesmus), producing large amounts of urine (polyuria), pale skin, and sweating. Many people who experience migraines also under report symptoms of nausea and vomiting even when it occurs in more than 90%  of all migraine sufferers (Silberstein, 1995). ADHD has been linked to high rates of migraines (Salem, 2018) as has Autism (Vetri, 2020). 

Pain manageemnt for migraines can vary based on the individual and depending on symptoms. Medication options might include acute or abortive medications, where you take medication at the onset of a migraine, or preventive medications where you might take a regular medication that prevents migraines (Peters, 2019). 

Are any of these symptoms feeling familiar to you as a neurodivergent person? 

If so, it may be helpful to talk to a medical provider about your symptoms. Use the article “The Neurodivergent Guide to Advocating at Your Next Medical Appointment” to help you map out your advocacy plan before you go to your appointment. Interested in using therapy to help you make sense of your medical and mental health needs as a chronically ill and neurodivergent person? Check out the article “Making the Most Out of Online Therapy If You’re Chronically Ill” to see if online therapy can be the accommodation you need to make therapy work for your brain and body. 

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