In my practice i see an unusual amount of comorbidity with adhd and asthma. anyone else experienced this? what is the possible pathophysiology here?

Medication: Do you see high incidence of ashma on untreated adhd? Asthma could be induced by adhd medications.

Norwegian/US studies: New studies, including several large ones in the usa, seem to confirm a significant connection between adhd and asthma. A norwegian study published in august 2011 concludes that adults with adhd are more than twice as likely to suffer from asthma. They are also more associated with allergies, and early anti-histamine use. Biomed central psychiatry journal.

Food intolerances: There is signficiant information available regarding the link between food sensitivities (especially gluten) and increased incidence of immune system overactivity. Minimal considerations in your patients may include the usage of probiotics AND digestive enzymes immediately before meals. A 6 week trial of a grain-free, dairy-free diet would also provide insight.

Not uncommon: Since many asthmatics do also have upper airway involvement with chronic inflammation, congestion and possible allergies, Eustachian tube dysfunction (ETD) is also a common pathology resulting in some hearing impairment leading to hyperactivity like symptoms, so is asthma, with air trapping and chest tightness causing this fidgety behavior, ruling out ETD/hearing surprisingly helps a lot in management