Thursday, May 23, 2013

Functioning with Brain Fog -- Part I.

Journey to the Eternity by Baban Shyam Flickr
The goal, of course, is to feel well enough that we never experience brain fog.  For a lot of us, however, brain fog is at least a temporary, if not permanent, symptom that we have to battle.   It seems to be common to all autoimmune diseases and especially in conditions that make you hypothyroid.  Others who experience brain fog are people with CFS or fibromyalgia, women in menopause or other times of hormonal shifts, and patients who are going through cancer treatments. For most of us, brain fog comes and goes, just as real fog drifts in when conditions are right and evaporates in the sunshine.

The technical term for this problem is cognitive dysfunction.  I personally describe it as episodic cognitive dysfunciton, for it is not the same as a more permanently settled cognitive issue.

What does this clouding of the consciousness feel like?  For me, it can be something just short of a headache, where my brain seems swollen.  Or, it can be a fatigue so deep that it hinders quick decision making.  It can hamper with short term memory or make concentrating difficult.  Sometimes, it can feel as if my brain is stuffed with cotton.  For me, a change in weather or air pressure may worsen an episode.        

Because cloudy thinking is a subjective experience, it is difficult to measure and to treat.  At any given time, a sufferer might be experiencing one or multiple causes.  Some of these causes can be pinpointed through laboratory tests.  Others are more nebulous and might need some sleuthing on your part and on the part of your physician to detect.  Still others may be unknown to current medical science.

As hard as it is to define and treat, brain fog strikes a chord with anyone who's suffered from it.  He or she may not be able to describe it accurately but will know exactly what you mean when you say you have cotton brain today.     

There are a number of theories about why brain fog occurs. Here's one that makes sense to me:  a failing thyroid leads to a slowing of both your metabolism and blood flow, as well as underproduction of certain brain chemicals. Thus, the cognitive centers in your brain do not receive the nourishment or energy that they require to function at their peak.

I suspect this is so.  I know that for me, I have experienced the most brain fog either before my Hashimoto's was properly diagnosed or at times right before tests have shown that I have needed an increase in my thyroid medicine.  With every increase, my symptoms improved -- at least for a good while. :)  This is just a guess, but I imagine that fluctuations in thyroid performance might account for the episodic nature of brain fog.

A similar theory is that in anyone with an autoimmune disease, the body is so focused on your illness that it goes into survival mode. It redirects energy and blood away from parts of the brain and body that are not essential to immediate survival toward body and brain processes that will aid in fighting the disease.  This is somewhat like the lethargy you might feel when your body's in attack mode against acute infections, such as the flu.  At such times, your body's focus is not on delivering some pep or making sure you've balanced your bank account.  It's main goal is to defeat an invader -- real or not -- and to keep you alive.  

Other theories are that an autoimmune condition can interrupt the restorative sleep that you need to function both mentally and physically, that Hashimoto's hypothyroidism might co-exist with iron and other energy sapping deficiencies, Hashimoto's might affect blood sugar levels, Hashmioto's might result in mental distraction due to anxiety or depression, undertreatment or wrong treatment of Hashimoto's affects metabolism, having a second autoimmune disease or fibromyalgia along with Hashimoto's multiplies cognitive difficulties, cardiovascular disease slows blood flow to the brain, or medicaiton used to treat symptoms might contribute to a sense of mental cloudiness. 

I have even read a theory that any of us, even the healthiest, can have brain fog when we refuse to "see" something in our life clearly; in other words, we don't want to admit a painful conflict, so we subconsciously subvert our own mental clarity.  I think this last one takes the cloudy metaphor too far, but who knows?   I suppose any emotional or physical stress can sap our acuity.       

Regarding iron, I was considered borderline anemic for many years.  I do think that this was because I was in my childbearing years.  However, research suggests that Hashimoto's disease may be associated with either iron levels that are too low or iron levels that are dangerously high, the latter of which can contribute to clogging of your arteries.  Anemia can cause some of the same symptoms as low thyroid, including brain fog.  If you are suffering from cloudy thinking, it might be wise to ask your doctor to check your iron levels. If low iron is the problem, you will see almost instant relief with treatment.

Whatever the cause of brain fog, there are ways to cope with it.  I'll be talking about that in future posts. 

To your health!



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