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.
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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.
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.
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.
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.
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
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)
- Insulin resistance and/or diabetes panel (Test for Hgb A1C, Insulin, and fasting glucose levels)
- 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
- Micronutrient testing - include vitamin D and B vitamins
- 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.
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.
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.
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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.
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