Addressing the Underlying Cause of Brain Fog
To get to the root cause of brain fog in chronic disease, we must start with the basics. Optimizing thyroid hormones should be the first item to check off in addressing brain fog for most people. Next, since so many of the causes of brain fog are based in poor gut health, we must eliminate food intolerance that may lead to intestinal permeability (leaky gut), support proper digestion of the food we eat, and address nutrient deficiencies that may be contributing to symptoms of brain fog.
Checklist of What Needs to be Looked at
1. Optimize TSH Levels
TSH (Thyroid Stimulating Hormone) is a pituitary hormone that responds to low/high amounts of circulating thyroid hormone. While the standard reference range for TSH is 0.2-8.0 μIU/mL, a new normal reference range was defined by the American College of Clinical Endocrinologists to be between 0.3-3.0 μIU/mL. Functional medicine practitioners have defined that normal reference ranges should be between 1 and 2 μIU/mL, for a healthy person not taking thyroid medications. Anecdotally, most patients feel best with a TSH between 0.5-2.0 μIU/mL. Get your TSH checked with UltaLab Tests or your primary care provider.
If your TSH test shows a TSH level above 2.0 μIU/mL, even when all other thyroid tests fall within normal ranges, this is considered subclinical hypothyroidism. This means your thyroid is losing its ability to make enough thyroid hormone. At this point, you may benefit from starting on a thyroid medication (or increasing your current dose). For many, getting your TSH levels within optimal ranges will relieve many of the common hypothyroid symptoms, including brain fog.
2. Optimize T3
Some people may not properly convert T4 to T3 (the active thyroid hormone). (There are many factors that may contribute to a person not being able to properly convert thyroid hormone, including liver congestion, stress, low zinc levels, and other nutrient deficiencies… which are all common in those with chronic disease!) This is why many people continue to struggle with thyroid symptoms such as hair loss, brain fog, weight gain, depression and fatigue, even after they’ve started taking thyroid medication.
Studies have suggested that T4-only therapy might not be enough to address the symptoms of hypothyroid patients, especially those related to mental well-being, such as brain fog and depression; and people who continue to have thyroid symptoms despite having normal TSH levels may benefit from a trial of T3, in addition to T4 medication. Get your T3 checked with UltaLab Tests or your primary care provider.
If this sounds like something you may benefit from, you do have a few options when it comes to T3-containing medications:
3. Eliminate Food Intolerances
I have found that most people with chronic disease will need to give up gluten, dairy, and soy, as they are the primary food sensitivities affecting people with chronic disorders. However, undergoing an elimination diet and food sensitivity testing will help you to pinpoint the foods that are problematic for you and lead to intestinal permeability, leaky gut.
4. Address Adrenals
Healthy adrenal hormones tame inflammation (including inflammation in the brain), and the most important strategy for combating adrenal hormone dysfunction is stress reduction. In the early stages of adrenal fatigue, the adrenals secrete excessive levels of cortisol; in the later stages, they secrete less and less, leading to inadequate levels of the anti-inflammatory hormone in the body. This can be a major contributing factor to brain fog.
Stress reduction, adequate sleep, taking the ABC’s (adaptogenic herbs, B vitamins and vitamin C) are great starting points for addressing adrenal hormone imbalances. Adrenotone is a formulation of adaptogenic herbs and vitamins that is designed to support stress levels and brain health, by promoting healthy cortisol levels and hypothalamic and pituitary function (HPA axis), as well as dopamine, norepinephrine, and epinephrine production. Taking three capsules per day can help with brain fog due to adrenal issues.
For additional ideas on how to reduce stress and support your adrenals, please take a look at my article on adrenal health.
5. Support Digestion
A lack of digestive enzymes and stomach acid are common in chronic disease, and can allow undigested food particles to enter the bloodstream through a leaky gut. This can often be the cause of food sensitivities and nutrient depletions, which can lead to brain fog (among other symptoms). I recommend using betaine with pepsin (Betaine HCL) and digestive enzymes, to help your body break down the foods you consume, so that they can be readily utilized by your body and reduce damage to your gut. Additionally, taking a quality probiotic can help restore the balance of bacteria in the intestines, and help prevent leaky gut.
My theory is that the body is focused on the backlog of undigested foods, instead of on creating luxuries like, brain power and energy.
6. Address Nutrient Deficiencies
Nutrient deficiencies can occur as a result of eating nutrient-poor foods, having inflammation from infections or food sensitivities, taking certain medications, or having an imbalance of gut bacteria. A lack of sufficient thyroid hormones can also lead to nutrient deficiencies, as it makes nutrient extraction from food more difficult and less efficient.
The nutrient deficiencies that we see with Hashimoto’s that can lead to brain fog include:
If you find that you are still experiencing symptoms, I recommend a few additional supplements that have been shown to support brain function. I will address these additional supplements tomorrow!! So Stay Tuned!!