What is the root cause of your brain fog?
Case Study: Myra is a 45 year old female who has noticed that she is having trouble concentrating as well as making decisions. She is experiencing mental confusion. It takes her a lot of time and effort to focus on the tasks specially in the morning. She also has had trouble with remembering things to do including important appointments. This has been going for a year or so. All her basic blood work by her primary doctor was normal.
One word that summarizes all her symptoms is brain fog.
What is brain fog?
Brain fog is a term that is used to describe lack of mental clarity. It manifests itself in different ways in defferent people. Symptoms include
1. Difficulty concentrating or focusing,
2. Forgetfulness or dementia
3. Poor comprehension
4. Difficulty in making decisions
5. Mental confusion
6. Difficulty learning new skills
A lot of times, individuals with these symptoms are diagnosed as ADD (Attention Deficit Disorder) and/or Anxiety and started on medications for symptom relief.
One of the most important questions to ask yourself if you have these symptoms is 'what is the root cause of your brain fog?'
What are the root causes of brain fog?
The key issue in brain fog is malfunctioning of the brain cells. The brain cells consists of neurons and Glial cells. Neurons are a group of highly specialized cells that receive input from the body and transmit signals back to perform functions of the brain. About 90% of the brain consists of Glial cells which play a very important role in providing nutritional support as well as facilitating communication between the neuronal cells. Inflammation of the glial cells has been found in many conditions that effects brain function such as chronic pain, depression, fatigue and insomnia.
Any variable that affects the ability of the neuronal or glial cells to function will lead to brain fog. Following are some important and frequent causes of brain fog.
One of the key factors effecting the brain cells is the availability of nutrients such as B vitamins. In a randomized controlled study of elderly adults who were at risk of developing memory loss were given high dose of specific B vitamins over a course of 2 years. These individuals had a 7 fold decrease in atrophy of their gray matter compared to those who received placebo. It is not merely the quantity of vitamins that is important but also whether we can activate these vitamins as well as if we have the co-factors needed for the vitamins to carry out their function.
The structure of our brains is made of a special type of fat called phospholipids such as DHA (Docosahexaenoic Acid). DHA is an Omega 3 fatty acid. There has been a lot of research about the role of DHA in depression, anxiety, Attention Deficit Disorder (ADD) as well as dementia. It is important to assess the Omega 3 index to understand if we have adequate DHA.
A recent study highlighted that individuals with dementia had significantly low levels of total cholesterol as well as low non HDL (High density lipoprotein) and HDL. These results are not surprising because brain is a lipid rich organ that needs lipids for its proper functioning.
The gut plays a key role in effecting the function of the brain. There are many paths that connect the gut and the brain. The first is through the bacteria of the gut. Here is a blog on the gut bacteria and their role in human diseases. The second link is the connection between the brain and the gut nervous system. It is also called the 'Second brain' because it has the ability to directly impact how we feel as well as our eating behavior.
Inflammation in the gut leads to development of 'Leaky Gut Syndrome'. In this condition the barrier function of the gut is compromised. This allows undigested proteins as well as bacterial toxins to leak into the body and cause inflammation as well as direct toxicity to the brain.
Autobrewery Syndrome is the presence of yeast in the small intestine that ferments the food and produces alcohol. This internal production of alcohol can lead to many symptoms including brain fog.
Hormones play a key role in brain functioning. These include Cortisol, thyroid hormones, estrogen and progesterone. Women ofen experience brain fog around perimenopause because of hormonal imbalance. One of the key pillars to addressing brain fog is balancing the hormones.
Insomnia or lack of sleep
Sleep is one of the most powerful tools in sustaining both physical and mental health. Those who are unable to get adequate sleep are unable to heal their bodies. There are many causes of insomnia and it is important to address these in order to deal with brain fog.
Heavy Metal toxicity
Heavy metal toxicity such as copper and mercury can cause brain fog as well. A detailed history of exposure to heavy metals and an assessment to find out the levels of these in our blood is an important step to understand the root cause of brain fog.
Pre-diabetes and Diabetes
The new name of Alzheimer's disease is Diabetes type 3. Research has shown that even mild increase in blood sugar levels can damage the brain and cause cognitive dysfunction as well as brain shrinking of the brain. We know that sugar causes inflammation and is toxic to many organs. The damage occurs at blood sugar levels that are much lower than needed for the diagnosis of Diabetes.
Long term stress has the ability to change the structure of the brain. Research has shown that stress can alter the physical structure of the brain. The stress hormone Cortisol can cause changes in certain areas of the brain. It prevents the stem cells in the brain from developing into neurons and forces them to convert into Oligodendrocyte (a type of glial cell).
Stress can result due to external factors but can also arise from within due to inflammation or it can be a result of both.
Chronic infections such as Lyme disease can directly affect brain function either through inflammation or the toxic effect of the infective agent.
Systemic Diseases such as Chronic Fatigue and Fibromyalgia effect the entire body including the brain and hence lead to brain fog.
Side Effect of Medications
Certain medications can directly affect the ability of brain to function. There include pain medications, medications for mood disorders, cough medications as well medications for blood pressure.
1. Glia: the other brain cells
2. Preventing Alzheimer's disease-related gray matter atrophy by B-vitamin treatment. Douaud G1, Refsum H, de Jager CA, Jacoby R, Nichols TE, Smith SM, Smith AD. Proc Natl Acad Sci U S A. 2013 Jun 4;110(23):9523-8. doi: 10.1073/pnas.1301816110. Epub 2013 May 20.
3. Omega 3 fatty acids and the brain: review of studies in depression. Sinclair AJ, Begg D, Mathai M, Weisinger RS. Asia Pac J Clin Nutr. 2007;16 Suppl 1:391-7. Review.