By Dr. Shawna Darou, ND
Technically brain fog is not a diagnosis or a clearly definable condition, but is a way of expressing a change in thinking or cognition that can have a profound effect on quality of life.
Some to the symptoms can include:
- difficulty with focus and concentration
- attention problems
- slow thinking
- reduced short-term or long-term memory
- less mental clarity
When you first read this list, you may think of ADHD or dementia as possible diagnoses instead of brain fog. What distinguishes them is the timing of onset, other health conditions occurring at the same time, and identifiable causes. For example attention problems and difficulty with focus could absolutely be ADHD, but in this case you should be able to trace similar issues all the way back through your childhood. If this is something that has developed or worsened in the past couple of years, it probably isn’t ADHD. Dementia and Alzheimer’s also present with all of these symptoms, and what makes these diagnoses distinct is worsening over time, and usually age of onset over 65 years.
The brain is impacted by so many things – lack of sleep, nutrient deficiencies, infections, stress, hormones, toxins, and many medications to name a few. All of these can cause physiological symptoms that may include changes in cognition, memory or concentration. As always, the key is to identify the cause or causes of brain fog so we can allow the body to fully heal, including repairing the cognitive changes. Interesting, this is not much different from the Bredesen protocol for Alzheimer’s disease where we are investigating all of the factors that can affect the brain. The difference here however is that we expect to identify less causal factors, and a much quicker and thorough improvement.
Most common causes of brain fog:
Let’s go through the most common causes of brain fog here, which probably account for about 80% of the cases I see, although there are many, many other possibilities.
(1) Lack of sleep or poor sleep quality
- The most common cause of change in short-term memory, brain fogged trouble concentrating is issues with sleep. In some cases it is really obvious because you have known insomnia, or are not getting a consistent 7 hours of sleep nightly. Other times, it may be because night-time cortisol levels are too high (very common post-partum), you’re not getting enough REM or deep sleep, or you may have undiagnosed sleep apnea. A thorough look at sleep is the first step.
(2) Nutrient deficiencies
- The most common nutrient deficiencies associated with a change in cognition, memory changes or brain fog are iron deficiency, vitamin B12 deficiency and vitamin D deficiency. If you are also experiencing fatigue, numbness and tingling in your hands and feet, feeling cold and especially if you have heavy menstrual cycles, then iron deficiency or vitamin B12 deficiency might be the cause. Symptoms of vitamin D deficiency can vary tremendously, but when levels get very low cognitive symptoms are common, as well as depression, muscle twitches, bone or joint aches (especially post-menopause) and fatigue.
- There are several hormones that can impact memory, cognition and mental clarity, including estrogen, cortisol, DHEA, insulin and thyroid hormones. If your symptoms also suggest a hormone imbalance, or are happening during or after a period of high stress, the next step would be a through look at your hormone levels. Hypothyroidism, insulin resistance, high or low cortisol, low DHEA and a sudden drop in estrogen are all associated with mental and cognitive changes.
- Most of you have probably heard of post-COVID brain fog, which is one or the more common lingering effects from infection with the SARS-COoV-2 virus. There are also other infections that are associated with brain fog and cognitive changes, such as Lyme disease, and other less serious imbalances like SIBO (small intestine bacteria overgrowth) and intestinal dysbiosis (microbial imbalance in the gut). Each of these would have a different treatment plan, whether it is to actually treat the infection, or reduce inflammation and support neurological repair after the infection has been resolved.
- The last more common cause of brain fog brings us back to environmental medicine again, with exposure to heavy metals, and to mold toxins especially. A main symptom associated with both is change in memory and cognition, and in more acute cases there will also be confusion. Again some good detective work would be needed to determine whether you have had exposure to a toxins – through living or working water-damaged building, or lead pipes going into your home, poorly filtered well-water, or multiple metal amalgams in your teeth. If suspected, there are good test available to help confirm, before beginning to treat.
As you can see, there are many things that can affect the brain as well as the body. If you’re not sure where to start, look at what else is going on in your body at the same time. Are you also experiencing digestive issues? Low energy? Body aches and pains? Sleepiness? Changes in your menstrual cycle? The constellation of symptoms will help to guide you to know where to test and assess, and how to resolve cognitive changes.
If you have been experiencing a change in your memory, attention, concentration or focus, we can take a good look at this list, and other possibilities to get to the root of the issue. There are tests available for each of the issues mentioned above to assess and guide your treatment plan.