Brain fog. It's an increasing problem affecting women not just in their 60s and 70s and beyond, but women of all ages. A 22-year-old patient came to see me because she was having trouble focusing during her final year of college and was told by her local medical doctor that her brain fog was just a normal fact of aging! He then offered her Ritalin as the solution. She's just one of many women of all ages who are telling me they are concerned about their cognitive function.
What is Brain Fog?
What is brain fog? It’s a term that’s commonly used to describe cloudy mental thinking, difficulty with focus or concentration or sometimes difficulty with memory, or the ability to memorize new information. If you’re experiencing brain fog, you may find that you’re not able to cut through to that clear incisive thinking you know you used to have.
I want to make something explicitly clear – while brain fog may be a natural reaction to specific circumstances, as we’ll discuss below, it’s never normal to have brain fog – certainly not in our 20s – but also not even in our 60s, 70s, and beyond. It’s a sign that something is affecting your brain. In optimal health, we should be able to age with our cognitive function intact. We should all become wise and sharp old ladies some day and we don't need to buy into aging myths that tell us otherwise. While our brains do age, if we keep our brains nourished and supple, as I’ll talk about in this article, we should not experience brain fog or cognitive decline.
So let’s take a look at the circumstances that lead to brain fog. By understanding these, you’ll have the roadmap to identify not only your root causes, but you’ll be able to start to turn them around. In fact, because I’ve heard from thousands of women who have shared their own concerns with me about their brain fog, I’ve also written a book that specifically addresses the root causes you’re about to discover that can affect brain health. It’s called The Adrenal Thyroid Revolution, and it’s available here. I highly encourage you to read it because the root causes of brain fog are also the same root causes that can lead to a host of other chronic long-term health problems, including digestive problems, hormone problems, immunity system imbalances and even autoimmune disease, diabetes, heart disease, and dementia. And hey, your mind is a terrible thing to waste!
The good news is that all of our symptoms are our body’s way of telling us something needs to shift – whether in our diet, lifestyle, self-care, or environment. Making the changes I point to in this article, to turn around your personal root causes, can halt and reverse your current symptoms, and prevent and often reverse the early onset of chronic disease.
The Top 10 Root Causes of Brain Fog
Stress, Overwhelm, Worry, & Distraction
The first thing to take a look at is your stress level and check in on what’s going on in your life. If you’re stressed out, frequently worried, overwhelmed, or distracted, this in itself might the source of your brain fog. Stress, worry, and overwhelm lead to activation of the Stress Response System (the “fight, flight, or freeze” reaction – or “survival mode”), which has several impacts on the brain that can lead to brain fog. Adrenaline, a neurotransmitter released by the adrenal glands when you are in survival mode causes your brain to become preoccupied by being on the lookout for danger. When your brain is stuck in this response it becomes almost impossible to concentrate, learn new information, or draw on your memory banks for higher levels of information. At the same time, the hormone cortisol is released from the adrenals, and over time cortisol actually rewires your brain to make it harder to exercise your higher thinking mode. While we all have occasional stress or overwhelm, we don’t want to allow this to be our usual mode. Increasing your time spent in relaxation practices – meditation, time in nature, deep breathing, yoga, relaxing self-care, and gentle exercise can all shift your brain out of survival mode. In my book The Adrenal Thyroid Revolution I teach you to find your healthiest internal ‘zone’ so that you can learn how to achieve inner peace more easily and stay in it more often, which supports brain health.
Distraction is a super interesting phenomenon – most of us have become accustomed to an unhealthy level of distraction – often way more often than we realize – through our exposure to social media. Evidence is now showing that this is having an impact on our ability to focus – so if you’re on social media even daily, and have noticed a decrease in concentration and an increase in brain fog, this could explain it. I am now using a practice called Deep Work in which, while I don’t stay off of social media 100% because my work is so centered in it, I have cut back drastically by staying off of the internet, including email, until after I’ve had a large block of several hours of uninterrupted focused time for my writing. Also, when I do go to Facebook, I go for my work and then get off rather than the habit I’d unconsciously gotten into of following one thread after another. The amazing thing is that not only does my own brain feel happier, but my anxiety level because of the practically inevitable “compare and despair” phenomenon I was increasingly experiencing is no longer able to happen. I invite you to join me in making a commitment to ‘intermittent social media fasting’ a regular part of your life!
Fatigue is one of the biggest detractors from optimal brain function. Whether it’s adrenal stress, life stress, work shifts, or not making sleep a priority in your life, not getting enough sleep or good quality sleep can be a singular cause of brain fog. We need at least 7 hours of sleep each night for optimal brain function. Even just one night of sleeping for only 5 hours can have a negative impact on your cortisol level. If you’re not getting good sleep you can pretty much count on weighing at least 5 extra pounds, having sugar cravings, and brain fog. If people are saying they can hack their sleep down to just 5 hours a night – or less – with certain coffee products, for example, don’t believe it. It’s not sustainable – or healthy – for your brain or your health in general. You can go here to read more about improving your sleep.
Blood Sugar Imbalances
Your brain relies on a steady source of glucose in your blood for proper functioning, including focus, memory, and clarity. To your brain, low blood sugar is like a 4-alarm fire and when this is occurring chronically, you end up in SOS – Survival Overdrive Syndrome – a phenomenon I talk about extensively in The Adrenal Thyroid Revolution, and which is a major contributor to not only brain fog in the short run, but possibly dementia in the long-run. Skipping meals, especially breakfast or lunch, is a super common cause of low blood sugar for women. Further, low blood sugar then makes us crave quick fixes in the form of sugary foods and quick carbs (muffins, cookies, pastries, for example), which cause toxic inflammation that can also impact your brain health. A sharp brain all day starts with a healthy breakfast that includes foods with high quality protein and fat, for example, an egg cooked in coconut or olive oil, and ½ of an avocado on the side. It’s also important to be aware of the symptoms of low blood sugar so you can learn to avoid it. There is a tremendous emphasis on maintaining healthy blood sugar balance in my book, and you can learn a quick way to keep your blood sugar steady in my article The 24-Hour Adrenal Reset.
Depression and Anxiety
Depression flattens out your brain signaling. Your neurons (nerve cells) just don’t fire with the same frequency as when you're in a more vibrant mood. Further, the lower levels of neurotransmitters including adrenaline (adrenal depletion can lead to decreased adrenaline production over time), serotonin, and dopamine that accompany depression can impact your ability to focus, remember, and feel mentally sharp. Worry and anxiety are on a spectrum, anxiety a more debilitating form of worry, which like worry, creates mental distraction – you’re focusing on the problem and this keeps your brain from processing new information easily, having easy recall, and paying attention to what’s immediately in front of you. Your brain is diverting its attention onto the worry. There are many causes of depression and anxiety, including current life circumstances, history of trauma, “brainflammation” (chronic inflammation affecting your brain), alterations in your gut microbiome, nutritional insufficiency, gluten or dairy intolerance, and more, all of which I discuss in The Adrenal Thyroid Revolution where I teach you how to shift your brain back to health by addressing all of these root causes.
Brain fog is not an inevitable fact of life or aging. We should all eventually become wise, sharp minded old ladies! @avivaromm
Trouble in Your Microbiome
Disruptions in the gut microbiome, particularly when there’s overgrowth of a variety of Candida, a naturally occurring type of yeast, can cause fatigue, anxiety, and depression, and can lead to a state of low-level intoxication much like alcohol intake, all of which can affect focus, memory, and concentration. The microbiome can become disrupted due to stress, diet, history of antibiotic use, leaky gut, as well as other imbalances in the gut. Therefore, restoring microbiome health is an essential step I take with all my patients who have brain fog and either also have gut symptoms or who don’t have the reasons for brain fog above even if they don’t have obvious gut symptoms. This starts with a diet Reboot (Elimination Diet) during which I recommend adding in fermented foods (sauerkraut, kimchi, lactofermented vegetables, and if tolerated, organic sheep, goat, or cow yogurt or kefir) and in most cases, a probiotic as well. For more information on how to do an elimination diet see this article here, and get my complete 4R Gut Healing Plan in The Adrenal Thyroid Revolution. Also, check out my 28-Day Gut Reset Challenge, a complementary program to my book.
Yes, this is a real term – and it’s a phenomenon that occurs when chemicals and immune system components causing inflammation in the general circulation of the body cross the blood brain barrier (BBB) and cause inflammation in the brain. Brainflammation has been associated with anxiety, depression, brain fog, and dementia, and can occur as a result of anything that causes general inflammation. In my medical practice, the first thing I do when I am trying to find the root of inflammation is to remove the most common food triggers of brainflammation including gluten, grains/flour products, and dairy and do the 4R Gut Reset or Reboot + 4R Gut Healing Plan. I’m not against these foods, but if you have brain fog they could be a problem for you.
I also do a complete medical exam and lab workup to assess for other common medical causes of brainflammation including autoimmune disease, diabetes, chronic fatigue syndrome, hypothyroidism, nutritional deficiencies, and stealth infections including Epstein-Barr Virus (EBV) – any of which can cause brain fog and brainflammation, and which may occur singly or together (for example, EBV and Hashimoto’s commonly co-occur).
So often when we think about out diets we focus on what to take out, but it’s also critically important to feed your brain by adding in the nutrients your brain requires for health, and also that keep you out of overall inflammation. The top macronutrients that feed our brains are proteins, which make up the building blocks of our neurotransmitters, the chemicals involved in brain and nervous system signaling, and fats (salmon, walnuts and pecans, avocado, extra virgin olive oil, coconut oil, for example) which are the basis for healthy cells, including nerve cells. Additionally, foods like dark leafy greens – and an abundance of vegetables in the diet to the tune of 8-10 servings per day, and dark berries, for example, blueberries and blackberries – are great brain food and are anti-inflammatory. Our brains also require B-vitamins for optimal functioning, and in fact, low B12 contributes to cognitive problems. Low iron can also cause brain fog and in one small study, simply adding a high protein lunch with iron rich sources improved brain function in just 4 months. And hey, here’s another treat for your brain: dark chocolate!
During certain times in our hormonal lives we might notice changes in our brain function – for example, few of us want to (though we can!) do higher mathematics or take finals or board exams on the first day of our periods (moontimes), and many women report changes in concentration and memory during pregnancy, breastfeeding (some of which is due to loss of sleep!) and perimenopause. This is largely due to natural fluctuations in estrogen levels and changes in our psyches, desires, and focus that occur cyclically as a result. The problems arise when either 1) we are experiencing hormonal imbalances that exaggerate or cause extreme hormonal fluctuations that might increase challenges with attention and mental clarity, or that impact our life in a way that amplifies brain fog, for example a newborn that keeps you awake at night, or hot flashes that do the same – leading to fatigue and brain fog as a result, or 2) incongruence between our natural hormonal cycles and the external demands of life – for example, you really want to stay at home and read a book or do art on the first day of your period, but instead your job as a school teacher means you have to take your class of 7th graders on a field trip or you’re a grad student and you’re scheduled to defend your PhD dissertation!
If you are experiencing other symptoms/conditions that suggest you have hormonal imbalances, it’s important to repair your hormonal health – none of us should be living with monthly menstrual cramps or chronic endometrial pain, for example, that causes physical or emotional distraction for days at a time and requires us to take pain medications that themselves can impact focus. Because cyclic hormone fluctuations are natural and to be expected, learning to pay attention and starting to track your own can give you insight into whether your brain fog is following a pattern, and you can learn to use these to your advantage and do your best to try to schedule activities accordingly. Start paying attention to your moods, mental focus, and emotions, and desires during various points in your cycle. The FloTracker app, created by my colleague Alisa Vitti, was designed to help you do exactly this. You can learn more about it here.
Thyroid and Adrenal Imbalances
One of the functions the thyroid plays is to maintain brain health. Hypothyroidism – when the thyroid is under-functioning – has a known impact on cognitive function, to the extent that even at subclinical levels, hypothyroidism can cause focus and memory problems, and over time, can cause dementia. The impact of cortisol and adrenaline on the brain, both prolonged overexposure or excessively low levels, also brings the adrenals and Stress Response System as a whole into play in brain fog. Seeing the prevalence of adrenal and thyroid problems in my patients and in readers who wrote to me, and the vast numbers of women also experiencing brain fog, was a big impetus for me to write The Adrenal Thyroid Revolution, which addresses what conventional medicine seems to perpetually overlook – the interconnectedness of all body systems, and how shifts in any one can affect the whole.
Medication Side Effects
Numerous medications, most notably antihistamines, blood pressure lowering medications, anti-anxiety medications, medications for urinary incontinence, some sleep and pain medications, and even some antibiotics, can cause a feeling of brain fog and affect memory. If you have started on a new medication, or have been on a medication for awhile, and notice that your mental clarity has changed, speak with your doctor. In The Adrenal Thyroid Revolution you’ll find natural alternatives to a number of prescription medications but of course, speak with your medical provider before discontinuing a medication you may need.
When to Get Medical Attention for Brain Fog
It is important to see a medical doctor if you have experienced recent and sudden onset of cognitive function changes, have other concurrent neurologic symptoms, have or have recently had an infection or fever, a tick bite, or are experiencing a significant level of cognitive changes. A proper neurologic workup can put your concerns to rest, or help you get appropriate care if needed.
Brain fog is something to take seriously because it’s your body’s way of telling you something is up that needs attention, and dementia is a real and escalating health problem, particularly as more baby boomers reach their 60s and beyond. But as I said earlier, cognitive decline is not inevitable, and dementia is preventable, so we need to make sure that we’re not chalking brain fog up to age and moving on. In most cases, addressing the root causes I’ve described above that apply to you personally is all that’s needed to restore focus, clarity, and memory.