A Root Cause Medicine Approach
|
May 3, 2022

9 Possible Causes Of Persistent Brain Fog

Medically Reviewed by
Updated On
September 17, 2024

Brain fog is a common complaint in our modern world. "Brain fog" isn't a medical condition but is a term used for specific symptoms that can affect your ability to think. A functional medicine approach to brain fog involves determining the patient's exact root cause and addressing it with an individualized approach based on an in-depth intake questionnaire and specialty lab results.

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Signs and Symptoms of Brain Fog

While there are no formal medical diagnostic criteria for brain fog, it is typically characterized by a constellation of several symptoms, including:

  • Difficulty concentrating
  • Difficulty multitasking
  • Forgetfulness
  • Short term and long term memory loss
  • Cognitive impairment
  • Feeling spacy or confused
  • Word-finding difficulties
  • Mental exhaustion or fatigue

It is important to recognize that these symptoms can be attributed to many health conditions or may separately be a signal of a more serious underlying health condition. Please discuss any concerns you have with your functional medicine or healthcare provider. Β 

Possible Underlying Causes of Brain Fog

There are numerous possible root causes of brain fog.Β Below are some of the more common reasons.

It shows central illustration of a brain. Arrows point to six factors: Prescriptive Medications, Stress, Poor Quality Sleep, Nutrient Deficiencies, Food Sensitivities, and Leaky Gut.

Prescription medications

Many prescription medications can cause decreased cognition. Sedatives, sleep medications, pain medications, antihistamines, bladder control medications, and others often come with the side effect of dizziness or sleepiness. Polypharmacy, which is becoming increasingly common in the current healthcare system, increases the risk of harmful side effects, including decreased mentation, and this tends to worsen as you age. Β 

Lifestyle Factors

Stress and sleep quality have a significant impact on overall health.

Chronic stress can cause hormonal imbalances that affect the body in various ways.

The body and brain complete a self-cleaning cycle of removing toxins during sleep. When this is unable to occur due to lack of quality sleep, it can result in brain fog. Β 

Leaky Gut

The Gut-Brain axis plays an important role in the body's overall health. If you have GI symptoms such as excess gas, bloating, fullness after eating, constipation or diarrhea, and food intolerances, these may be symptoms of a leaky gut.

Food Sensitivities

Brain fog is a common symptom for people with celiac disease and non-celiac gluten sensitivity. While the link between gluten and brain fog is not fully understood, it is a well-documented symptom of people with gluten sensitivity.

Nutrient Deficiencies

A poor diet can also be a factor in the development of brain fog. Poor quality food, high in simple carbohydrates, trans fats are loaded with artificial food additives, causes inflammation in the body. This inflammation can cause brain fog symptoms. Additionally, nutrient deficiencies, particularly vitamin D and B vitamins, are associated with brain fog.

Sleep Disordered Breathing

Sleep-disordered breathing is a more common occurrence than previously thought and, as of 2018, affects upwards of 100 million people worldwide. Obstructive sleep apnea remains the leading type of sleep-disordered breathing and affects up to 50% of men and 31% of women worldwide. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may not be getting adequate oxygen to your brain and other vital organs during this time nor restful, restorative sleep. This leads to grogginess and fatigue the next day.

Mold and Heavy Metal Toxicity Β 

External toxicants such as mold or heavy metals can cause brain fog. Some molds produce chemicals that can lead to brain fog. Heavy metal toxicity, such as too much mercury and aluminum, has long been linked to brain fog symptoms.

Post-Viral Syndrome

Viruses, such as the COVID-19 virus, can cause systemic inflammation. The COVID-19 pandemic has brought brain fog to the forefront as a symptom of COVID long-haulers syndrome. While it is not possible to test for every virus we're exposed to or prove that the brain fog you're experiencing is related to COVID-19, the good news is that the treatment is the same, and with time, symptoms should improve.

Menopause & Perimenopause

Brain fog is a common complaint for women going through perimenopause and menopause. Fluctuating hormone levels, particularly estrogen shifts, during this time not only affect energy levels but can cause symptoms such as forgetfulness, difficulty concentrating, and brain fog.

Functional Medicine Labs to Find the Root Cause of Brain Fog

Many functional medicine lab tests are beneficial in determining if an underlying condition is causing brain fog symptoms.

Toxin & Toxicity Testing

Inflammation and Chronic disease Testing

  • Inflammatory markers:
  • hs-CRP is a good marker of inflammation and cardiovascular risk. Goal level <0.9 mg/dL
  • homocysteine (goal <7) Β 
  • ‍Insulin resistance and/or diabetes panel (Test for Hgb A1C, Insulin, and fasting glucose levels) Β 
  • Goals: Fasting insulin <5.5 micro IU/m
  • Hgb A1c 4.0-5.3%
  • Fasting blood glucose 70-90 mg/dl

Leaky Gut and Gut Microbiome Testing

Food Sensitivity Testing

Nutrient Testing

  • Optimal Vitamin D 50-80 ng/mL

Sleep Apnea

  • Sleep apnea is very common and is characterized by daytime sleepiness and mental fatigue. It is very easy to do an at-home sleep study test to determine if you have sleep apnea. Treatment is very effective, and you may be surprised at how good you feel after getting a restful and restorative night's sleep!

Liver Function

  • It is also good to check liver function, as the liver is the body's main detoxification organ. If it is not functioning properly, even small amounts of toxins can build up over time. (AST and ALT goal levels < 25)

Functional Medicine Treatment for Brain Fog

Treatment for brain fog aims to treat any underlying health conditions that are contributing to the symptoms. For example, if you are deficient in Vitamin D, restoring the body to a functional level can help reduce brain fog symptoms. Β 

Food as Medicine

Whole foods and anti-inflammatory diets, such as the MIND Diet or Keto-Flex, have been shown in many research studies to help reduce total body inflammation and improve cognitive function.

Supplements

While a food-first approach is generally recommended in functional medicine, anti-inflammatory and antioxidant supplements can help reduce inflammation in the body that may be contributing to brain fog.

Turmeric, Omega 3 fatty acids, CoQ enzyme 10, Glutathione, and NAD can be helpful in the short term. Prebiotics, probiotics, and glutamate can be essential for gut healing and support.

Lifestyle Changes

Positive lifestyle changes support reducing brain fog and promote healing. Adequate sleep is vital in brain healing and reduces the overall stress burden. Daily physical activity and movement help with hormonal balance, detoxification, and gut health and decreases systemic inflammation. Stress management is also a key factor. There are many ways to incorporate stress reduction into your daily routine. Β 

Reducing or limiting pharmaceuticals can also help decrease polypharmacy and side effects from medications. Be sure to talk with your health care provider before making any changes to your prescription medications.

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Summary

There are many potential causes of brain fog, and uncovering what may be happening with your body is the key to reversing the symptoms. Utilizing a functional medicine approach, reducing exposure to toxins, managing stress, prioritizing sleep, eating a healthy diet of a variety of whole colorful foods, limiting pharmaceutical medications, and incorporating movement into your daily routine can help improve brain fog symptoms. Β 

Brain fog is a common experience in our modern world. While "brain fog" isn't a medical condition, it is a term used to describe specific symptoms that can affect your ability to think clearly. A functional medicine approach to brain fog involves identifying potential contributing factors and addressing them with a personalized plan based on a detailed intake questionnaire and specialized lab results.

[signup]

Signs and Symptoms of Brain Fog

Although there are no formal medical diagnostic criteria for brain fog, it is typically characterized by a combination of several symptoms, including:

  • Difficulty concentrating
  • Difficulty multitasking
  • Forgetfulness
  • Short-term and long-term memory challenges
  • Cognitive difficulties
  • Feeling spacy or confused
  • Word-finding difficulties
  • Mental exhaustion or fatigue

It's important to recognize that these symptoms can be associated with many health conditions or may indicate a more serious underlying health issue. Please discuss any concerns you have with your functional medicine or healthcare provider. Β 

Possible Underlying Causes of Brain Fog

There are numerous potential factors that may contribute to brain fog. Below are some of the more common reasons.

It shows central illustration of a brain. Arrows point to six factors: Prescriptive Medications, Stress, Poor Quality Sleep, Nutrient Deficiencies, Food Sensitivities, and Leaky Gut.

Prescription Medications

Many prescription medications can affect cognition. Sedatives, sleep medications, pain medications, antihistamines, bladder control medications, and others often come with side effects like dizziness or sleepiness. Polypharmacy, which is becoming increasingly common, can increase the risk of side effects, including cognitive challenges, and this risk tends to increase with age. Β 

Lifestyle Factors

Stress and sleep quality have a significant impact on overall health.

Chronic stress may contribute to hormonal imbalances that affect the body in various ways.

The body and brain undergo a self-cleaning cycle of removing waste during sleep. When this process is disrupted due to lack of quality sleep, it may contribute to brain fog. Β 

Leaky Gut

The Gut-Brain axis plays an important role in the body's overall health. If you experience GI symptoms such as excess gas, bloating, fullness after eating, constipation or diarrhea, and food intolerances, these may be related to gut health.

Food Sensitivities

Brain fog is a common experience for people with celiac disease and non-celiac gluten sensitivity. While the link between gluten and brain fog is not fully understood, it is a well-documented experience for people with gluten sensitivity.

Nutrient Deficiencies

A poor diet can also be a factor in the development of brain fog. Diets high in simple carbohydrates and trans fats, and those with artificial food additives, may contribute to inflammation in the body. This inflammation can be associated with brain fog symptoms. Additionally, nutrient deficiencies, particularly vitamin D and B vitamins, are linked to brain fog.

Sleep Disordered Breathing

Sleep-disordered breathing is more common than previously thought and, as of 2018, affects upwards of 100 million people worldwide. Obstructive sleep apnea remains the leading type of sleep-disordered breathing and affects up to 50% of men and 31% of women worldwide. Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. This may result in inadequate oxygen supply to the brain and other vital organs, as well as non-restorative sleep, leading to grogginess and fatigue the next day.

Mold and Heavy Metal Exposure Β 

External factors such as mold or heavy metals can be associated with brain fog. Some molds produce chemicals that may contribute to brain fog. Exposure to heavy metals, such as too much mercury and aluminum, has been linked to brain fog symptoms.

Post-Viral Syndrome

Viruses, such as the COVID-19 virus, can cause systemic inflammation. The COVID-19 pandemic has highlighted brain fog as a symptom of COVID long-haulers syndrome. While it is not possible to test for every virus we're exposed to or prove that the brain fog you're experiencing is related to COVID-19, the good news is that with time, symptoms may improve.

Menopause & Perimenopause

Brain fog is a common experience for women going through perimenopause and menopause. Fluctuating hormone levels, particularly estrogen shifts, during this time may affect energy levels and contribute to symptoms such as forgetfulness, difficulty concentrating, and brain fog.

Functional Medicine Labs to Explore Potential Causes of Brain Fog

Many functional medicine lab tests can be helpful in exploring whether an underlying condition is contributing to brain fog symptoms.

Toxin & Toxicity Testing

Inflammation and Chronic Disease Testing

  • Inflammatory markers:
  • hs-CRP is a marker of inflammation and cardiovascular risk. Goal level <0.9 mg/dL
  • homocysteine (goal <7) Β 
  • ‍Insulin resistance and/or diabetes panel (Test for Hgb A1C, Insulin, and fasting glucose levels) Β 
  • Goals: Fasting insulin <5.5 micro IU/m
  • Hgb A1c 4.0-5.3%
  • Fasting blood glucose 70-90 mg/dl

Leaky Gut and Gut Microbiome Testing

Food Sensitivity Testing

Nutrient Testing

  • Optimal Vitamin D 50-80 ng/mL

Sleep Apnea

  • Sleep apnea is very common and is characterized by daytime sleepiness and mental fatigue. It is possible to do an at-home sleep study test to explore whether you have sleep apnea. Treatment can be effective, and you may notice improvements in how you feel after getting restful and restorative sleep!

Liver Function

  • It is also beneficial to check liver function, as the liver is the body's main detoxification organ. If it is not functioning optimally, even small amounts of toxins can accumulate over time. (AST and ALT goal levels < 25)

Functional Medicine Approaches to Support Brain Health

Approaches to support brain health aim to address any underlying factors that may be contributing to symptoms. For example, if you have low Vitamin D levels, supporting the body to reach optimal levels may help with brain health. Β 

Food as a Supportive Tool

Whole foods and anti-inflammatory diets, such as the MIND Diet or Keto-Flex, have been shown in many research studies to support reduced inflammation and promote cognitive function.

Supplements

While a food-first approach is generally recommended in functional medicine, anti-inflammatory and antioxidant supplements may support the body in managing inflammation that could be contributing to brain fog.

Turmeric, Omega 3 fatty acids, CoQ enzyme 10, Glutathione, and NAD may be helpful in the short term. Prebiotics, probiotics, and glutamate can be essential for gut health support.

Lifestyle Changes

Positive lifestyle changes can support reducing brain fog and promote overall well-being. Adequate sleep is vital for brain health and can help reduce stress. Daily physical activity and movement support hormonal balance, detoxification, and gut health, and may help manage inflammation. Stress management is also a key factor. There are many ways to incorporate stress reduction into your daily routine. Β 

Reducing or limiting pharmaceuticals may also help decrease polypharmacy and side effects from medications. Be sure to talk with your healthcare provider before making any changes to your prescription medications.

[signup]

Summary

There are many potential factors that may contribute to brain fog, and exploring what may be happening with your body is key to addressing the symptoms. Utilizing a functional medicine approach, reducing exposure to potential toxins, managing stress, prioritizing sleep, eating a healthy diet of a variety of whole colorful foods, limiting pharmaceutical medications, and incorporating movement into your daily routine may help support brain health and improve brain fog symptoms. Β 

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Annweiler C. Ann N Y Acad Sci. 2016;1367:57. Vitamin D in dementia prevention. Β https://nyaspubs.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/nyas.13058

Bredesen, D. The End of Alzheimer’s Program. 2020.

Budson, Andrew. (2021, Mar 8). Harvard Health Blog: What is COVID-19 Brain Fog and how can you clear it? https://www.health.harvard.edu/blog/what-is-covid-19-brain-fog-and-how-can-you-clear-it-2021030822076

Calderon-Ospina, C, and Nava-Mesa M. (2019 Sep 6) CNS Neuroscience & Therapeutics. B Vitamins in the Nervous System: Current Knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin.

https://doi.org/10.1111/cns.13207

Drake, V. Nov 2017. Micronutrient inadequacies in the US population: An Overview. Oregon State University. Β https://lpi.oregonstate.edu/mic/micronutrient-inadequacies/overview

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Gwak, M and Chang, S. (2021 Jun 16). Immune Netw. Gut-Brain Connection: Microbiome, Gut Barrier, and Environmental Sensors. doi: 10.4110/in.2021.21.e20

Khezrain, M, et al. (2020, Jun 12). Therapeutic Advances in Drug Safety. An Overview of prevalence, determinants, and health outcomes of polypharmacy. https://doi.org/10.1177/2042098620933741

Krishnan, K. et al. (2022 Feb 2). Journal of Health Service Psychology. Multidisciplinary Approach to Brain Fog and Related Persisting Symptoms post COVID 19. https://doi.org/10.1007/s42843-022-00056-7

Lee MH, et al. (2020 Dec 30) Β  N Engl J Med. Microvascular Injury in the Brains of Patients with Covid-19. DOI: 10.1056/NEJMc2033369

McEwen, B. (2012 Oct 16). Proceedings of the National Academy of Sciences. Β Brain on stress: how the social environment gets under the skin.

https://www.pnas.org/doi/epdf/10.1073/pnas.1121254109

Meerlo, P. et al (2009 Jun). Sleep Medicine Reviews. New neurons in the adult brain: the role of sleep and consequences of sleep loss. https://doi.org/10.1016/j.smrv.2008.07.004

Ratnaseelan, A, et. al. (2018, Jun). Clinical Therapeutics. Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes. https://doi.org/10.1016/j.clinthera.2018.05.004

Santoro, N. et al. (2011 Sep). The SWAN Song: Study of Women’s Health Across the Nation’s Recurring Themes. Obstet Gynecology Clinic North America. doi: 10.1016/j.ogc.2011.05.001

Schofield, P. (2005). Dementia associated with toxic causes and autoimmune disease. International Psychogeriatrics, 17(S1), S129-S147. doi:10.1017/S1041610205001997

Theoharides, T, et al. (2015, Jul 3). Frontiers in Neuroscience. Brain β€œfog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. https://doi.org/10.3389/fnins.2015.00225

Theoharides, T, et al (2021, Apr 12). Long-COVID Syndrome associated brain fog and chemofog: Luteolin to the rescue. https://doi.org/10.1002/biof.1726

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Yelland, G. (2017, Feb 28). Journal of Gastroenterology and Hepatology. Gluten-induced cognitive impairment (β€œbrain fog”) in celiac disease. https://doi.org/10.1111/jgh.13706

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