Having him tested doesn't necessarily mean you HAVE to use meds. My 7-year old son was recently diagnosed with ADD (he's not hyperactive), and we were given many options along the way. We weren't forced to do anything we weren't prepared to do. We chose meds, and do not regret it for one instant. I won't say that any one approach is better; all I'm offering is my own experience.
Testing involves a lot of observation both by you and by the school. There are many forms to fill out. Your primary care doctor should do several other tests, such as the Celiac test mentioned already, to rule out purely physical causes. All this could take six months to a year. If done properly, it will be quite thorough.
My son was very difficult to manage and was wearing our family out. He would go-go-go all day until he would literally drop from exhaustion. He talked incessantly. He was beginning to bully other kids. He was behind on everything in school, despite having extra help and intervention. I agonized over having him tested, but when I mentioned the possibility to his teachers last year, the lights went on behind their eyes. They changed the teaching techniques they used with him and we saw a slight improvement. Just before school this year, our doctor put him on a low dose of Concerta, and the change was immediate. He isn't doped, his personality hasn't changed, except that he isn't as angry and frustrated. He's rapidly catching up in school, and actually looks forward to it. I make sure his teachers know so they can take it into account in teaching him. I expect him to be disciplined the same as any other kid (and he knows it).
I would suggest checking out the book "Right-Brained Kids in a Left-Brained World" by Jeffrey Freed and Laurie Parsons. It might give you insight into how his brain might be working. ADHD kids aren't dumb by any means. Most are gifted, in fact. But many are visual learners and most teachers use an auditory style.
The thing that has helped a lot with my son is that I've never told him that he's "broken" or that there's something wrong with him. I've tried to be positive, but honest. His brain works differently than others kids', and his meds help him quiet the chaos in his head and lets him learn.