Brain Fog

[Yumm]

My brain fog:  difficulty concentrating, moody, lethargic -- it feels like I don't fully awaken

Symptoms:
- Difficulty getting out of bed due to a tired, lazy feeling (but, I do awaken without an alarm)
- The problem is mostly related to mental energy and not physical energy
- The lazy feeling continues through the day, but slowly diminishes as the day progresses
- By afternoon I am functional, sometimes feel pretty good
- In the evening I feel good
- Symptoms are very consistent and the worst in the winter (November to February)
- I can barely function when the symptoms are severe - I feel like sitting in a chair or laying in bed, but not doing much else
- Symptoms are less severe and less consistent in the other months
- Symptoms are least in May and June
- Except for the winter months I may be symptom-free on any given day, sometimes for several days (it seems arbitrary, but I'm sure it's not)

General health - I have a positive attitude, I eat very well, I am not overweight, I exercise, I have no other chronic conditions, I sleep well (fall asleep at around 10:00, awaken at around 5:30), standard blood tests show no problems

Medical diagnosis: My doctor thought it was depression related

Treatments for depression as prescribed by psychiatrist:
- Seasonal affective disorder light - no positive effect
- St. John's Wort (for 6 weeks) - no positive effect
- Wellbutrin (for 6 weeks) - no positive effect
- Pristiq (for 6 weeks) - no positive effect
- Amphetamine salts - 20 mgs has improved my alertness and apparent energy level, but it is not enough when symptoms are severe

Tests and treatments for allergies:
- Scratch test indicated dust and mold allergies
- Various antihistamines - no positive effect
- Various nasal sprays - no positive effect
- The allergy doctor does not think that allergies are causing my problem

The only treatment that has a positive effect is amphetamine salts, but that doesn't help me to know what the problem is.

My opinion:
- It is not a depression related disorder because the symptoms are not continuous from one day to the next (meaning, I feel better in the afternoon and evening)

- I keep thinking that the problem is allergy related.  I feel good when I go to bed.  It seems like I am exposed to something (dust from the forced air heating system?) when I am sleeping.

Is it a metabolism/hormone problem?  

Any ideas?

[Yumm]

Your comments about winter lethargy seem reasonable.

My symptoms are so inconsistent that I really can't conclude that my condition is worse in the winter.  For example, I had a lot of brain fog in January 2013, but felt great during the whole month of February.

Currently, I am taking vitamin D.  My vitamin D level was slightly low as indicated in a blood test (the blood test was done in May).

[Yumm]

I only took the adderall a few times.  I also tried Nuvigil a few times.  On really bad brain fog days both were very effective for a few hours, but the effectiveness didn't last beyond 4 hours.

[hiyer1]

also I really hope you stopped taking the amphetamines as based on the problems you described they are not good solution. They are often over-prescribed for misdiagnosed cases and addiction/dependency are all too common. Many teen and adult lives have been destroyed by careless diagnoses of ADHD and reckless prescription of ritalin/adderall and the like

[hiyer1]

I have the same issue and I have every single symptom exactly as you describe them. I am a male in my mid/early twenties. I dread winter every year because I know how its going to impact my mood, productivity, and fitness (I'm a competitive triathlete and my performance really suffers from Nov-March).

I realized last year it might be vitamin D deficiency since I'm vegan and also have skin pigment, in winter without supplementation I get 0 vitamin D. I got a blood test and they found that vitamin D, thyroid, and testosterone were all low. I started supplementing vegan D3 and it helped a little - retested after about a month and my levels were normal, but I still couldn't shake the fogginess/low motivation of winter.

I'm fairly certain it's an evolutionary response to cold temperatures. Are your ancestors from a tropical climate? I suspect that even for humans winter is a time when we're supposed to reduce our activity levels across the board, shut ourselves in, try to stay warm, and just make it to spring just like most other mammals do. Probably that's all Seasonal Affective Disorder is - a natural response to cold temps. If you think how humans were for the thousands of years before technology and farming, it would make little to no sense for them to keep the same level of activity in the winter when food is scarce and energy requirements are high vs the spring and summer. We probably developed some adaptations to our endocrine, muscular, and nervous systems over the millenia to help us reduce our activity and make it through the winter still alive. Unfortunately or fortunately we still have those adaptations today. If you monitor your diet carefully, you may notice you go for lipid (fat) based foods like nuts and cream more in colder seasons, and more sugary, starchy foods in warmer seasons. Other mammals do the same thing, as fats have more energy per unit of mass than carbohydrates.

In any case, in light of the fact that this is probably a biological/evolutionary adaptation I can't get rid of, I can't think of what to do short of relocating to California to solve this problem. In the meantime I'm just hoping I don't lose too much fitness (or my job and friends) this winter.

[hiyer1]

I have the same issue and I have every single symptom exactly as you describe them. I am a male in my mid/early twenties. I dread winter every year because I know how its going to impact my mood, productivity, and fitness (I'm a competitive triathlete and my performance really suffers from Nov-March).

I realized last year it might be vitamin D deficiency since I'm vegan and also have skin pigment, in winter without supplementation I get 0 vitamin D. I got a blood test and they found that vitamin D, thyroid, and testosterone were all low. I started supplementing vegan D3 and it helped a little - retested after about a month and my levels were normal, but I still couldn't shake the fogginess/low motivation of winter.

I'm fairly certain it's an evolutionary response to cold temperatures. Are your ancestors from a tropical climate? I suspect that even for humans winter is a time when we're supposed to reduce our activity levels across the board, shut ourselves in, try to stay warm, and just make it to spring just like most other mammals do. Probably that's all Seasonal Affective Disorder is - a natural response to cold temps. If you think how humans were for the thousands of years before technology and farming, it would make little to no sense for them to keep the same level of activity in the winter when food is scarce and energy requirements are high vs the spring and summer. We probably developed some adaptations to our endocrine, muscular, and nervous systems over the millenia to help us reduce our activity and make it through the winter still alive. Unfortunately or fortunately we still have those adaptations today. If you monitor your diet carefully, you may notice you go for lipid (fat) based foods like nuts and cream more in colder seasons, and more sugary, starchy foods in warmer seasons. Other mammals do the same thing, as fats have more energy per unit of mass than carbohydrates.

In any case, in light of the fact that this is probably a biological/evolutionary adaptation I can't get rid of, I can't think of what to do short of relocating to California to solve this problem. In the meantime I'm just hoping I don't lose too much fitness (or my job and friends) this winter.

[Yumm]

I have considered food allergies or intolerances.  I have been keeping track of foods that I eat for many years, trying to detect a pattern with certain food types.  I have eliminated certain foods at times.  Strict elimination is sometimes difficult for certain foods.  The thing is, I can have brain fog for a week and then feel good for 3 weeks in a row with no noticeable change in diet.

[balee]

Have you considered food intolerances, not an allergy, intolerances are more subtle and often have a delayed reaction. A strict elimination diet followed by introduction of different food groups and additives will show if that is what's causing your brain fog and other symptoms.

[Yumm]

Unfortunately, I have not found out what causes my brain fog.  My best guess at this time is that it is sleep-related.

[Rasto123]

Did you find out what was the matter? I have the same symptoms... but without changes in months. I suffer from brain fog daily. It starts in 30 minutes after waking up, in the afternoon it calms down a bit and dissapear after a short sleep (15-20min).

I was going thru this the last 2 years, doctors dont know what to do, whats the matter...

[Yumm]

Thank you for your additional thoughts.

[PlateletGal]

"How do I get definitive diagnosis for CFS/FMS?"

Hi ! Here is the CDC's criteria for a CFS diagnosis. Of course many other conditions should be ruled out including cardiac issues, lyme disease, autoimmune diseases and thyroid problems (which can also accompany CFS or fibro).

I hope that you will consider joining me in the fibro / CFS forum. I am one of the Community Leader's in the forum. Here's the link:

http://www.medhelp.org/forums/show/44?personal_page_id=216197

And here are diagnostic tests that can help your physician make a CFS diagnosis:

http://www.medhelp.org/health_pages/Fibromyalgia/Diagnostic--Blood-Tests-to-Help-Diagnose-CFS/show/376?cid=39



A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

cognitive dysfunction, including impaired memory or concentration
postexertional malaise lasting more than 24 hours (exhaustion and increased symptoms) following physical or mental exercise
unrefreshing sleep
joint pain (without redness or swelling)
persistent muscle pain
headaches of a new type or severity
tender cervical or axillary lymph nodes
sore throat
Other Common Symptoms

In addition to the eight primary defining symptoms of CFS, a number of other symptoms have been reported by some CFS patients. The frequency of occurrence of these symptoms varies among patients. These symptoms include:

irritable bowel, abdominal pain, nausea, diarrhea or bloating
chills and night sweats
brain fog
chest pain
shortness of breath
chronic cough
visual disturbances (blurring, sensitivity to light, eye pain or dry eyes)
allergies or sensitivities to foods, alcohol, odors, chemicals, medications or noise
difficulty maintaining upright position (orthostatic instability, irregular heartbeat, dizziness, balance problems or fainting)
psychological problems (depression, irritability, mood swings, anxiety, panic attacks)
jaw pain
weight loss or gain

http://www.cdc.gov/CFS/cfssymptomsHCP.htm

[PlateletGal]

I agree. With Chronic Fatigue Syndrome (or fibromyalgia)... you would have muscle aches, frequent infections, headaches, swollen lymph nodes and other symptoms.

Adrenal fatigue is a secondary condition... due to stress or medical conditions. Of course this excludes Addison's disease.

I'm not sure... but my guess would be allergies (environmental or food), chemical sensitivities or a sleep disorder. (although I can't explain why you would be more tired during winter months).

There is a lab, "ELISA/ACT" that does allergy testing and tests for foods & chemicals. I had chemical testing through that laboratory and I was very satisfied with my results. I knew that the fumes from vehicles were making me sicker... and I was right.  You may want to consider googling the lab name and perhaps calling them for more information. Your insurance may or may not cover testing. My insurance did pay for the testing.

Also, MedHelp has an expert that posts in the Sleep Breathing Disorders forum. I really enjoy some of his blogs on sleep disorders and insomnia. Here's his info:


http://www.medhelp.org/doctor_profiles/show/645869 --- Dr. Park's profile

http://www.medhelp.org/user_journals/index/645869 --- Dr. Park's blogs

http://www.medhelp.org/forums/show/305?personal_page_id=9647 --- Sleep Breathing Disorders (Expert Forum)

[Yumm]

Thank you for your suggestions and comments.

My symptoms are: low energy level and difficulty focusing and concentrating.  I don't have any other discomfort such as headache or nausea or muscle/joint ache.  My symptoms seem to be significantly cyclical, both daily (worst in the morning) and seasonally (worst in the winter).

If I had a sleep disorder I would think that there wouldn't be any seasonal variation, and why would I feel "normal" (alert) in the evening?  I would think that I would have low energy consistently throughout the day.

Anemia:  If I was anemic why would I be much better (almost "normal") in May and June and much worse in the winter?

FMS/CFS:  Aren't there more symptoms, typically?  I have no muscle/joint pain.

MCS:  Maybe.  My symptoms that follow daily and seasonal cycles could be based on what I am exposed to at certain times of the day and in certain seasons.

Hypothyroidism, hypothalamus disorder:  Is weight gain and difficulty losing weight always a symptom?  I am very thin.  Could daily and seaonal cycles be explained?

Depression:  Maybe, but I have a positive attitude and I did not improve when I used 3 different anti-depression medications.

Adrenal insufficiency:  I don't have many of the typical symptoms: nausea, loss of appetite, dizziness, anxiety

Any more thoughts?

[FurballsMom]

This sounds like me, too.  How do I get definitive diagnosis for CFS/FMS?  It's necessary for the right treatment.  It's not far-fetched, since I already clearly have MCS myself.  I have already gotten rid of everything toxic in the house and only use those homemade recipes for non-toxic cleaning.  And, I've changed over to non-toxic cosmetics and personal care products.

[Bhupinder Kaur, MD]

Hello,

You have described your symptoms pretty well.From you symptoms it sounds like chronic fatigue syndrome. It also manifests with widespread myalgia and arthralgia, cognitive difficulties, chronic mental and physical exhaustion,headaches and concentration difficulty and memory problems.A diagnostic evaluation is required to rule it out.

Other possibilities are anemia, hypothyroidism, disorders of the hypothalamus,
psychiatric disorders like depression and sleep-related breathing disorders.I feel that a thorough clinical examination and investigations are needed to rule them out one by one and reach a confirmatory diagnosis.

Hope it helps.Take care and pls do keep me posted if you have any additional doubts.Kind regards.

[margypops]

Addrenal Insufficiency ', maybe check out the forum about this, I think I have it, my symptoms were similar to yours I am taking supplements in the form of Adrenal capsules from my health food store and withing a few days I felt better than I have in a long time, it works for me . I hope you find something to help you also ,Good Luck

[PlateletGal]

You may want to consider getting tested for chemical sensitivities. Actually... I think the easier route is just getting rid of all of your household cleaners and using white distilled vinegar and baking soda. There is also a non-toxic brand that I use and highly recommend... Seventh Generation products.

In addition to that, you might want to consider having a sleep study done to rule out a sleep disorder.

Do you have any other symptoms such as headaches, muscle aches, frequent infections, etc ?