Although it is not a clinically recognized term, brain fog is a commonly used definition to describe periods of mental confusion or lack of focus, leading to a decrease in cognitive performance and inability to think clearly. Individuals who experience brain fog do not exhibit complete cognitive disability or dementia, but they appear to have deficits in working memory, information processing, and attention, which then may translate into decreased productivity. A variety of factors can contribute to brain fog: it can be lifestyle related, caused by an underlying medical condition, or come up as a side effect of medications.

What Can Cause Brain Fog and What Is Its Impact on Daily Life?

Causes of brain fog and mild cognitive impairment have been investigated and it is believed that, as a whole, the symptoms experienced may be viewed as the interaction of physiological, cognitive, and perceptual factors.

Since to date, there are no standard methods to evaluate the subjective complaint of brain fog and dependence on self-reporting is necessary. The variety of symptoms experienced by patients suggests central nervous system impairment, ranging from prolonged fatigue and lightheadedness to temporary neurocognitive deficits, which can be exacerbated by stressful stimuli such as difficult mental tasks, exercise, and orthostatic stress.

Brain fog periods are characterized by deficits in speed and efficiency of information processing, attention, concentration, and working memory. Some of the most reported symptoms include the inability to concentrate, difficulty in thinking and focusing, forgetfulness, disorganized thinking, communication difficulties and difficulty to properly verbalize or write what the person wants to say. Some individuals also complain of drowsiness and low levels of energy.

What triggers brain fog?

Some of the most frequently reported brain fog triggers are fatigue, lack of sleep, prolonged standing, and dehydration. Chronic dehydration causes shrinkage of brain tissue and has negative effects on cognitive performance. Studies show that following dehydration, an increased perceived mental effort may be required.

Brain fog is also aggravated by upright posture and experienced frequently in individuals with postural hypotension. Postural hypotension is characterized by a drop-in blood pressure due to a change in posture, by moving to a more vertical position. This causes a temporary reduction in blood flow and a shortage of oxygen to the brain, leading to short periods of loss of consciousness.

Brain fog could be triggered by the excessive reductions in cerebral blood flow that often occurs when upright, and cognitive impairments may be associated with impaired cardiovascular hemodynamics, decreased total cerebral blood flow, and altered activation of cerebral blood flow during mental tasks. Alternatively, brain fog is also reported to persist after assuming a recumbent posture, suggesting that it may have a multifactorial etiology, with factors not restricted solely to prolonged upright posture. Future research looks to further explore these interactions, how they produce cognitive impairments, and explain the perception of brain fog from a mechanistic standpoint.

What Can Be Done to Minimize or Prevent Brain Fog?

There are innumerable causes of brain fog that might be difficult to determine. Firstly, it is important to evaluate if cognitive impairment is being triggered by medication or by a medical condition. The list below contains some of the most common drugs that can cause confusion and cognitive symptoms as side effects. If you suspect that a medication is affecting your thinking, talk to your doctor about reducing the dose or substituting the drug.

If the fog is being caused by a medical condition, making lifestyle changes will only help to a certain extent and you should discuss with your doctor the possibility of taking medication to keep it under control. On the other hand, if you think it might be a consequence of an unhealthy lifestyle, you can implement some healthy habits in order to fix it.

There are some important factors to keep in mind in order to achieve optimal brain function. Some habits may take some time until you start to feel mentally clearer and it is important to stick to a treatment routine for at least 4 weeks, before dismissing it as being ineffective.

Water intake

A common trigger from brain fog is dehydration. Water comprises from 75% body weight in infants to 55% in the elderly, and it is essential for cellular homeostasis and life. Drinking water and brain function are integrally linked and prolonged states of reduced water intake adversely impact cognitive function. Drinking 6 to 8 glasses of water daily is highly recommended to guarantee proper hydration and optimal brain function.

Nutritional deficiencies

The human brain is nearly 60% fat, and fatty acids are among the most crucial molecules that determine the brain’s integrity and ability to perform. Essential fatty acids are required for maintenance f optimal brain function, but they cannot be synthetized by the body and must be obtained from dietary sources. These essential fatty acids are based on linoleic acid (omega-6 group) and alpha-linoleic acid (omega-3 group).

Beyond their important role in building the brain structure, fatty acids act as messengers and are involved in the synthesis and functions of brain neurotransmitters that determine optimal brain performance. While using dietary supplements may seem the easiest way to get your daily dose of essential fatty acids, consuming food sources such as nuts, seeds, vegetable oils and oily fish from cold water, such as herring or salmon, is necessary as well. Incorporating essential fatty acids in a balanced diet is necessary to pursuit optimal wellness. In addition, consider taking a multivitamin supplement in order to fill any nutritional gap.

B-complex vitamins also have a great impact on neurological health. They are essential for proper brain function and transmission of nerve signals, and vitamin B deficiency can lead to neurological complications. B vitamins can be found in whole unprocessed foods, like whole grains, legumes and fruit, and foods from animal origin, such as meat, eggs, and dairy products. However, the B12 vitamin can’t be found in plant products, so individuals who don’t include animal or animal derived products in their diet are at risk of vitamin B12 deficiency and should evaluate if supplementation is needed.

Stimulant withdrawal

Most people rely on caffeine rich products (coffee or energy drinks) due to their stimulant effect to increase energy and focus. However, caffeine only acts as a short term solution, and tolerance will develop over time. If you suddenly stop using caffeine, you may experience a more severe kind of brain fog than before you started using it.

Exercise

Exercise is considered to be both a trigger and a treatment for brain fog. Acute exercise was reported to make brain fog worse, yet regular aerobic exercise was reported to improve it. Exercise often worsens orthostatic intolerance symptoms, especially fatigue, which in turn could trigger brain fog. However, it is known that exercise increases blood circulation to the brain and enhances neural activity and a regular cardiovascular exercise program has been proved to have profound physiological and clinical benefits in orthostatic intolerant patients. Epidemiological studies have found positive correlations between cognitive performance and physical activity in healthy adolescents, however, the effect of exercise on cognitive performance is yet unknown. Nevertheless, regular aerobic exercise may improve cognition and general health and staying active leads to more long-term improvements in cognitive function than sedentarism.

Sleep

Poor quality or quantity of sleep for an extended period clearly impairs your ability to learn, respond quickly, and perform complex tasks in the face of distractions or changing information. Always make an effort to take proactive measures to reduce stress and practice good sleep hygiene, by going to bed and waking at the same time each day and maintaining a balanced and regular sleep pattern.

If you need support, you should consider joining a support group or chronic disease support groups.

Brain fog is a problem that can severely affect daily performance and well-being and, to date, a single cause for this symptoms remains unknown. While some people may respond well to making healthy lifestyle changes, such as implementing a diet plan or improving sleep quality, in other cases, brain fog can be a symptom of a health condition that needs proper evaluation by a professional. If you feel brain fog affects your life and ability to function, talk to your doctor and perform a self-evaluation in order to identify triggers and come up with a solution.

Join an health care forum and support group to learn more about how to cope with brain fog and other chronic diseases.

References

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  7. LARRY, J. N. (2017). Overview of vitamins – nutritional disorders – Merck manuals professional edition. Retrieved February 23, 2017, from http://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency,-dependency,-and-toxicity/overview-of-vitamins
Ana is a Doctor of Pharmacy currently working in Medical Writing and Healthcare Communications.