Dear Community,
This past year, after DS13 had a challenging year in 8th grade, we looked at what had been going on with him for the last couple of years academically and for a few years socially. We realized that ADHD had been staring at us in the face. I suppose his 144 FSIQ/151 GAI got him through to a point where he finished MS with 3Bs and the rest As but the classes, for the most part were not difficult, even Honors Core. He really started tanking in Algebra this year even with scaffolding at home and a grading system that was set up for success for most students. Basically, he was learning nothing in class because he could not focus. Really it's a miracle he cranked out a B.
We took him to a pediatric psychiatrist because that we could not get into a neuropsych quickly and we wanted to get a plan in place. since he starts high school with an all Honors course load in mid-Aug. Psychiatrist was equivocal but said based on what DS told him, it seemed like a good idea to start meds. So, he started about 14 days ago on the lowest dose of Concerta (generic). )(NSERT PART WHERE I STEW, CRY, AND PULL MY HAIR OUT TRYING TO DECIDE WHETHER TO GIVE HIM MEDS-WE DECIDED YES) We figured he was mostly inattentive type but seeing him on meds made us realize he was combined. He's had a number of summer enrichment classes as well as an online high school class he takes ahead of time. He has shown a marked improvement in his ability to self-direct, focus, and self-regulate with his work and socially.

He decided on a small private high school rather than the hugemongous highly rated pressure-cooker public school that all his friends are going to that boasts 35 kids+ in most AP classes. The small high school he chose has class sizes of about 21. So I feel good about his ability to have a good classroom experience given the better ratio.

So, he is starting this high school in a month. How will I know if he is floundering and needs a higher dose as opposed to just more help? Or is the point for him to improve his EF on his own with the meds? Will he know he needs a higher dose?
Should I resign myself to keeping him on the lowest dose and just scaffolding him with tutors and other help if needed? Are there signs I can look for?

We really want to keep him on the lowest dose because he is a 6 ft tall 112 lb 13 year old. He has lost what was a voracious appetite. I've read all the advice and feed him well in the morning and evening when his appetite returns. He needs to keep his weight on if at all possible.
Insight? BTDT?
Thank you in advance. I truly appreciate it.