Popular Rationalism Takes on Brain Fog
Brain fog was known prior to COVID-19 and the COVID-19 vaccine. It would be a mistake to lose focus on what was already known about brain fog prior to 2021.
Having recently come through a nasty, prolonged non-COVID respiratory illness that came with days and days of severe cognitive decline, I did today what I always do: I checked out what research was available on the issue: Non-COVID-19-related brain fog.
Here’s an article I wrote when I “came back” from barely being able to hold a conversation.
In short, share this article with your doctors, and ask them if they know whether he flavenoid luteolin, the antioxidant N-acetylcysteine (NAC), magnesium L-threonate, and the central alpha agonist guanfacine can all act to help reduce brain fog so when it sets in, they feel comfortable helping you out. This is not medical advice. Talk with your physician, please!
Dr. Peter McCullough of course has published an empiric long-COVID protocol (3-12 months or more guided by clinical parameters (Nattokinase 2000 FU (100) mg orally twice a day without food, Bromelain 500 mg orally once a day without food, Curcumin 500 mg orally twice a day (nano, liposomal, or with piperine additive suggested - see their publication.) They did not specifically address brain fog.
Clearing the Fog Around Brain Fog
Many of us never heard of brain fog until the COVID-19 pandemic. Now, estimates of rates of brain fog are as high as 30% among adults. Brain fog is a term used to describe a constellation of symptoms that include reduced cognition, inability to concentrate, and loss of short and long-term memory. It's not just a condition that affects those recovering from viral infections; it's a widespread issue that can be triggered by various environmental factors such as air pollution, pesticides, and even certain foods.
Recent studies have shown that brain fog may be due to inflammatory molecules, including adipocytokines and histamine released from mast cells, which further stimulate microglia activation, causing focal brain inflammation(2). The good news is that there are many things people can do to reduce brain fog via choices they make in their daily lives.
What is Brain Fog?
A recent study (2) of first-person online descriptions of brain fog included forgetfulness (26%), difficulty concentrating (22%), dissociative phenomena (17%), cognitive ‘slowness’ and excessive effort (13%), communication difficulties (11%), ‘fuzziness’ or pressure (5%) and fatigue (4%).
Understanding the Environmental Causes
The Role of Inflammation
Inflammation is a natural response of the body to injury or infection. However, chronic inflammation can lead to various health issues, including brain fog. Inflammatory molecules like adipocytokines and histamine are released from mast cells and can stimulate microglia activation, causing localized brain inflammation (1).
Air Pollution
Air pollution is a significant environmental factor contributing to brain fog. Fine particulate matter (PM2.5) and volatile organic compounds (VOCs) can cross the blood-brain barrier, leading to oxidative stress and inflammation in the brain.
Pesticides
Exposure to certain pesticides like organophosphates has been linked to cognitive impairments. These chemicals can disrupt neurotransmitter activity, leading to symptoms of brain fog.
Food Additives
Artificial sweeteners, MSG, and other food additives can also contribute to brain fog. These substances can cause an imbalance in gut flora, leading to inflammation and, consequently, brain fog.
COVID-19 Infection, Vaccination
Studying three variants >12 days after infection, Diexer et al., found that fatigue and cognitive impairment were the most frequent symptoms.
Notably, in that study, the unvaccinated infected with the Omicron variant had the lowest risk of post-Covid-19 lingering symptoms.
Navigating Through the Fog: Treatment and Prevention
Understanding the environmental causes of brain fog is the first step in finding effective treatments. Lifestyle changes, such as avoiding exposure to pollutants and harmful chemicals, can make a significant difference.
Lifestyle Changes
One of the most effective ways to combat brain fog is through lifestyle changes. Simple adjustments like improving sleep quality, staying hydrated, and incorporating exercise into your daily routine can go a long way in enhancing cognitive function.
Nutritional Interventions
Diet plays a crucial role in cognitive health. Foods rich in antioxidants, Omega-3 fatty acids, and vitamins like B12 can help alleviate symptoms of brain fog. Moreover, avoiding foods that trigger inflammation, such as processed foods and sugary beverages, can be beneficial.
Natural Remedies
Natural remedies like herbal teas and supplements can also be effective. For instance, luteolin, a flavonoid found in herbs like thyme and parsley, has anti-inflammatory properties that can help treat brain fog(1).
Pharmacological Treatments
While lifestyle changes are the cornerstone of treating brain fog, some may require pharmacological interventions. Medications like nootropics and certain antidepressants have shown promise in improving cognitive function. However, it's essential to consult a healthcare provider for a personalized treatment plan.
Environmental Adjustments
Reducing exposure to environmental triggers like air pollution and pesticides is crucial. Using air purifiers, avoiding the use of harmful chemicals in gardening and cleaning, and opting for organic produce can help mitigate the effects of these environmental factors.
Cognitive Behavioral Therapy (CBT)
For some, brain fog may have a psychological component. Cognitive Behavioral Therapy can help individuals understand the triggers and thought patterns that contribute to their symptoms.
The Flavone Luteolin
Interestingly, natural flavonoids like luteolin have shown promise in treating brain fog. Luteolin has antioxidant, anti-inflammatory, and neuroprotective properties(3).
Treatment and prevention of brain fog are multi-faceted. A combination of lifestyle changes, nutritional interventions, and, in some cases, pharmacological treatments can be effective in improving cognitive function.
The Science Behind Brain Fog: What Research Tells Us
The Neurological Basis
Brain fog is not merely a psychological phenomenon; it has a neurological basis. Studies have shown that the prefrontal cortex, responsible for executive functions, is particularly vulnerable to inflammation and stress(2).
Pharmacological Interventions
Researchers at Yale have been exploring the use of N-acetylcysteine (NAC) and guanfacine for treating brain fog. These medications have shown promise in improving memory, multitasking abilities, and organizational skills(2).
The Role of Antioxidants
NAC, an antioxidant, has been tested for its potential in treating traumatic brain injury (TBI) and has shown some improvement in patients' energy and memory(2).
The Prefrontal Cortex and Inflammation
Inflammation can interfere with the molecular needs of the prefrontal cortex, inhibiting its ability to function properly. Guanfacine is designed to strengthen prefrontal cortex connections and protect against inflammation and stress(2).
Magnesium L-Threonate
This form of magnesium is formulated especially for brain health and has been shown to make individuals calmer and more focused. See the review by Botturi et al. (4).
A Multimodal Approach
A combination of NAC and guanfacine has been successful in relieving brain fog symptoms. This multimodal approach takes advantage of the synergistic relationship between NAC and guanfacine (brand names Tenex* and Intuniv*; 2). Making sure your brain has sufficient magnesium is smart, too.
Sleep is When You Do the Most Work on Your Brain
Not getting enough high-quality sleep is a surefire way to induce brain fog. Making sure you schedule and arrange your life so you have regular 6-8 hours of uninterrupted sleep is a better way to avoid and defeat brain fog. Functional medical doctors sometimes advise the use of melatonin to help people set better sleep patterns. However, long-term use of melatonin has been associated with unpleasant side effects, including melatonin dependency, dizziness, stomach cramps, headaches, nausea, confusion or disorientation, depression, and irritability.
Empowering Choices: How You Can Take Control
Be Informed
Knowledge is power. Being aware of the environmental triggers and potential treatments for brain fog can help you make informed decisions. Consult reliable sources and stay updated on the latest research.
Diet and Nutrition
Opt for a balanced diet rich in fruits, vegetables, and lean proteins. Organic foods like berries, fish, and leafy greens are rich in antioxidants and can help combat inflammation.
Physical Activity
Regular exercise not only boosts your physical health but also improves mental clarity. Even a 30-minute walk can make a difference.
Mindfulness and Stress Management
Practices like meditation and mindfulness can help you become aware of your thoughts and feelings, which is the first step in managing stress effectively.
Environmental Choices
Choose organic produce to reduce pesticide exposure. Use air purifiers to minimize the effects of air pollution. Opt for natural cleaning products over chemical-laden ones.
Consult a Healthcare Provider
If you're experiencing persistent symptoms of brain fog, it's crucial to consult a healthcare provider for a personalized treatment plan, which may include medications like NAC and guanfacine[^2^].
You have the power to make choices that can significantly impact your cognitive health. From dietary changes to environmental adjustments, small steps can lead to big improvements.
Clearing the Path Forward
Brain fog is a complex and multifaceted issue that can affect anyone, regardless of age or health status. While it has gained more attention due to its association with COVID-19, post-COVID-19 vaccination, and long-haul COVID-19 symptoms, it's crucial to understand that this cognitive impairment has various causes, including environmental factors like air pollution and pesticides.
The good news is that there are actionable steps you can take to mitigate the effects of brain fog. From lifestyle changes like diet and exercise to pharmacological interventions, the options are numerous. Research is still in its early stages, but the findings are promising, offering hope for more effective treatments in the future (2).
As we continue to learn more about the causes and treatments for brain fog, it's essential to stay informed and make choices that promote cognitive health. Remember, the power to clear the fog lies in your hands.
Research is still in its nascent stages, but early findings are promising. A combination of medications, lifestyle changes, and environmental adjustments can go a long way in treating brain fog.
*IPAK-EDU, Dr. Lyons-Weiler, and Popular Rationalism have no financial relationship with the makers of these medications.
The author would like to thank Dr. David Brownstein for reminding him of the importance of hydration during respiratory infection. And for Dr. McCullough for a pre-publication read of this article.
References
See first: McCullough PA, Wynn C, Procter BC—clinical Rationale for SARS-CoV-2 Base Spike Protein Detoxification in Post COVID-19 and Vaccine Injury Syndromes. Journal of American Physicians and Surgeons Volume 28 Number 3 Fall 2023, 90-93.
Theoharides TC, Stewart JM, Hatziagelaki E, Kolaitis G. Brain "fog," inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. Front Neurosci. 2015 Jul 3;9:225. doi: 10.3389/fnins.2015.00225. PMID: 26190965; PMCID: PMC4490655.
McWhirter L, Smyth H, Hoeritzauer I, et al What is brain fog? Journal of Neurology, Neurosurgery & Psychiatry 2023;94:321-325.
Diexer S, Klee B, Gottschick C, Xu C, Broda A, Purschke O, Binder M, Frese T, Girndt M, Hoell JI, Moor I, Gekle M, Mikolajczyk R. Association between virus variants, vaccination, previous infections, and post-COVID-19 risk. Int J Infect Dis. 2023 Nov;136:14-21. doi: 10.1016/j.ijid.2023.08.019. Epub 2023 Aug 25. PMID: 37634619.
Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020 Jun 3;12(6):1661. doi: 10.3390/nu12061661. PMID: 32503201; PMCID: PMC7352515.
"Yale Researchers Discover Possible 'Brain Fog' Treatment for Long COVID" - [Yale Medicine](https://www.yalemedicine.org/news/long-covid-brain-fog-treatment)
Excellent overview, applicable to fibromyalgia/CFS, seronegative Lyme Disease, etc. My only criticism of these recommendations is that the psychological symptoms of Long Covid have more in common with trauma-related mental disorders such as CPTSD than with depression, and thus therapies such as dialectical behavioral therapy (DBT), eye movement desensitization reprocessing (EMDR), and emotional freedom technique (EFT) aka tapping, are more appropriate.
It will be interesting to see future research on the effects of a ketogenic diet, fasting, and autophagy. I know that there has been research in these topics as they relate to seizure disorders and Alzheimer's, and it seems logical to want to expand that research to brain fog.