Imagine how you feel after pulling an all-nighter or not getting much sleep for a night or two. Chances are you are completely fatigued, you struggle to find the right words, you ask people to repeat themselves because you have trouble concentrating, or you forget things. Overall, you feel like you are in a fog. But you know that with a constant flow of caffeine and a good night’s sleep you will back to normal. Now, imagine that even with all the coffee in the world and a great night’s sleep, you go for days, weeks, or months with that feeling.
For those with fructose malabsorption, celiac disease, gluten sensitivity, and other health related issues, that feeling is called brain fog. From personal experience, brain fog can be debilitating. Before I was diagnosed with the digestive disorder fructose malabsorption and before learning how to modify my diet by avoiding my trigger FODMAP foods, I had days, even weeks when I had no idea what was going on with me. I did not understand why concepts or ideas that were normally easy for me to grasp were a struggle, why participating in conversations would take so much effort, and why I felt like I was sleepwalking and my brain was in a fog. Additionally, I was constantly exhausted no matter how much I slept. I am not sure how I did it, but I was able to live my life fully through this brain fog and fatigue. I was productive at work, taught Cell Biology in the evenings during the fall semester, and spent time with my husband and friends. My survival techniques were coffee, will power, acupuncture, and sleeping every available opportunity I could. I became an expert in the long weekend nap. But no matter how much I slept, it was never enough.
What is brain fog?
Unfortunately, brain fog is not well understood by physicians. Many doctors are not even aware of it as a medical condition. Those with brain fog have described it as having trouble thinking clearly and not being on the top of their game. They may have difficulty with short and long term memory, multitasking, staying focused, paying attention, concentrating, and learning new material. Other symptoms are confusion, feeling disoriented, having thoughts come slower than usual, losing their train of thought, difficulty calling up words during conversations, needing to have things repeated, and feeling tired, even though they recently woke up.
Who is likely to have brain fog?
As mentioned above, people with digestive disorders including fructose malabsorption, celiac disease, and gluten sensitivity are likely to have brain fog as a symptom. Furthermore, patients with fibromyalgia, multiple sclerosis, rheumatoid arthritis, chronic fatigue syndrome, hypoglycemia, Lyme disease, and those undergoing chemotherapy have described brain fog. Women, during pregnancy, breastfeeding, or menopause are also susceptible to brain fog.
What causes brain fog?
There is currently no definitive cause for brain fog, but there are several possible reasons why it occurs. For this article, I am focusing on reasons for brain fog in relation to digestive issues.
- Nutritional Deficiency:
Iron, vitamin D, and folate are deficient in celiac disease and fructose malabsorption. Deficiencies in these vitamins and minerals have a role in mental impairment.
- Leaky Gut Syndrome:
Leaky gut caused by gluten and fructose, as well as other factors, is when bacteria and foreign substances leak through the intestinal wall. Nutritional deficiency is a result of leaky gut syndrome, which can compromise the necessary nutrients to the brain, possibly causing brain fog.
The inflammation caused by gluten can lead to an increase in cytokines, which are small proteins that have a role in our immune response. High amounts of cytokines have been shown to play a role in mental impairment.
Gluten and fructose malabsorption have been shown to decrease the essential amino acid, tryptophan. Tryptophan has a role in the production of the neurotransmitter serotonin, which is primarily located in the gastrointestinal tract, central nervous system (brain & spinal cord), and platelets (role in blood clotting). Serotonin plays a role in our mood, appetite, sleep, memory, and learning. Less tryptophan can lead to less serotonin, which can lead to a decrease in our cognitive abilities.
There are dairy allergies due to cow’s milk or dairy produced from cow’s milk that can affect the central nervous system and lead to brain fog.
Consuming large portions of sugar and artificial sweeteners can affect ones blood sugar level and subsequently brain activity, which can lead to brain fog.
How to treat brain fog?
There are always the short -term fixes to help get you through the day. I found that trying to get as much sleep as possible, staying hydrated, acupuncture, walks, and giving myself permission at times to just sit on the couch and veg helped me through those bad days and weeks of brain fog. Caffeine was also a must for me. Luckily, once there is a proper diagnosis, there are long-term treatments. Overall, the best way to treat brain fog caused by a digestive issue is to avoid the trigger foods.
- Gluten-free diet:
The results of a study conducted on a group of people with celiac disease equated their performance on cognitive tests with someone who was jet lagged or legally drunk. After a year of being on a gluten-free diet, the intestines and the attention, memory, motor function, and verbal fluency of these patients improved.
If you have fructose malabsorption, being on the low FODMAP diet can alleviate the brain fog as well as the other symptoms. Over time you can test out different FODMAP foods and learn which ones your body can handle and which ones it cannot. For me, brain fog is mostly a thing of the past. It can sneak up at times if I eat enough of something that I should not. But once I return to eating well, I feel better.
- Omega-3 Fatty Acids:
The brain requires Omega-3 fatty acids to work well and a deficiency can cause impairments in one’s mental capacity and function including brain fog. Since our bodies do not produce Omega-3 fatty acids, we need to make sure we eat enough of it. Some great sources are fatty fish including sardines, albacore tuna, and salmon, flax seeds, walnuts, dark leafy green vegetables, kidney and pinto beans, squash, broccoli, cauliflower, and papaya.
Brain fog is an unfortunate symptom of many diseases and the difficulty of being diagnosed with digestive disorders means people suffer longer than they need to. It does not help that there are physicians that are unaware of or do not take brain fog seriously. Hopefully, with more research and awareness, diagnosis and treatments can occur faster.
Have you experienced brain fog? How did you treat it?
- Lichtwark, IT, et al. (2014) Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity. Alimentary Pharmacology and Therapeutics, 40, 160-170
Photo taken by Paula Vermeulen on Unsplash