Brain fog

Has anyone heard of brain fog with Hep C?  I found three websites that listed it as a symptom.  And here I thought I was just naturally loopy.  Maybe not.

[James10500]

Fact

[tjrusert]

Fact that Im naturally loopy or fact that Hep C can cause brain fog?  Or Both?

[uncledudeness]

yep, brain fog is a side effect of HCV. it seems that i ask the same question everyday; did i take my riba?

i guess the technical term is encephalopathy...

What is Encephalopathy?

Encephalopathy is a term for any diffuse disease of the brain that alters brain function or structure. Encephalopathy may be caused by infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased pressure in the skull, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain. The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of encephalopathy, common neurological symptoms are progressive loss of memory and cognitive ability, subtle personality changes, inability to concentrate, lethargy, and progressive loss of consciousness. Other neurological symptoms may include myoclonus (involuntary twitching of a muscle or group of muscles), nystagmus (rapid, involuntary eye movement), tremor, muscle atrophy and weakness, dementia, seizures, and loss of ability to swallow or speak. Blood tests, spinal fluid examination, imaging studies, electroencephalograms, and similar diagnostic studies may be used to differentiate the various causes of encephalopathy.

sheeeez, that sounds like one of those drug ads on tv; may cause blah blah blah...

i noticed a bit of twitching in my left hand, which is not too bad and infrequent.

what were we talking about?

[RobertBeWell]

We're just kidding with you. It would have been better to ask "Has anyone NOT heard of brain fog with Hep C?"

It's about the most common side effect I've heard expressed.

[willbb]

  What was the question again??

[spectda]

I know Ill catch a lot of flack for this but personally I believe that brain fog is an overplayed hand with hcv unless one is cirrhotic or treating. It's easy to attribute every problem we have to this disease. Not that I don't every feel tired and spacey occasionally when not on tx, but its difficult to say that this isn't typical of getting older.

For the most part after 30 years of hcv and being 53 I feel plenty of energy and clarity of mind. Brain fog is such a subjective symptom, very different then measurable blood levels and other physically evident and scientific symptoms.
- Dave

[Bill1954]

I agree with Dave. Treatment can make us feel a bit muddled, but ‘brain fog’ is probably best reserved for hepatic encephalopathy, a condition associated with cirrhosis only. This won’t occur outside of cirrhosis; the liver will otherwise filter toxins from the blood before they affect the brain.

--Bill

[nygirl7]

I agree with Dave and Bill and am glad Spec had the courage to bring it up.

Brain fog on treatment is one thing but just for having HCV.........well that would explain why I've always been muddled too ;)

[uncledudeness]

let me also jump on the Fog train....my foggy ride started when i began treatment. i have to say that my memory was sharp as a slightly used tack prior to tx. but now it's a different story. i just assumed the question was related to brain fog while on tx.

thanks for clearing that up Dave.

[tjrusert]

Thanks for the answers everyone.  It was fun reading the answers.  You guys are great.  So since Im not currently on tx, (hoping that changes this year), Im probably just a blond with brunette hair.  Just a joke blond ppl.  But you know what I mean.  No real excuse for goofiness except my own little mind.  :)  I'm getting a little excited that we may get to have a new tx soon.  I stopped tx because I didnt respond.  Thanks again.

[jr_jupiterfl]

Reading the comments... I had to post. I doubt I have hepatic encephalopathy but 28-29 weeks into the treatment " brain fog" is very real. Lack of concentration, memory lapses, lack of focus have increased & made work very difficult to keep pace with.
The good news is most of the side effects are now manageable .
I'm considering discontinuing Tx @ 36 weeks based on low initial viral loads & an early response. Someone pointed me to a study that showed negligible change between outcomes from 24 weeks - 48 weeks , when the initial viral load was low and the patient is an early responder to Tx. I met all the conditions of the study & my gastro said he'd agree if I'd stick it out 36 weeks.  I'd like to start repairing some of the collateral damage from Tx sooner than later.

[RobertBeWell]

My personal experience has been that brain fog, and a "disconnected" feeling, as if I were outside observing myself, has been a recurring and worsening theme as time has gone on in my adult life.

While I can't *prove* it was the Hep C, what I can say without a doubt is that since I began treating, and my viral load dropped like a rock, is ALL THOSE SYMPTOMS have disappeared. My mind is clear and sharper than it's ever been, even with my being on treatment. Additionally, unexplained joint pain and muscle ache are no more for me. My digestion and gastro function as better than they have been in years.

It seems self-evident to me that with your immune system running at 200% for 30+ years, lethargy, and associated symptoms such as slowed mental processes would be very common. The liver doesn't have to be working very, very poorly in order not to be working optimally. It's functionality only has to degrade a bit.

This disease is very unique to each individual, and everyone experiences it differently. One thing that millions of patients have reported is "brain fog".

Hard to dismiss that.

RBW

[DoubleDose]

I think that symptoms like "brain fog", and others such as gastrointestinal irritation, salivary gland and eye inflammation (pseudo-sjogrens), muscle pain and joint aches can ALL be characteristic of HCV infection.  How many symptoms one has, and how severe, probably has to do with how each person's immune system uniquely deals with the virus.  The literature is chocked full of examples of people with HCV who have literally no symptoms whatsoever, and those at the other extreme who have all of the above and more.  Some are in the middle and have only a few regular and chronic issues...most common of which are brain fog, memory problems, and maybe muscle and joint pain a close second.

  Personally I began to experience the brain fog and lethargy in my late 20's (so it was NOT due to old age), and on later biopsy in my early 40's found that I was at most a stage 1, so it was not at all related to liver degradation.  I also had decades of gastro related problems that cleared after my SVR.  Same with many of the severe joint pains that I had in my earlier decades!

Chronic viral infections often cause a myriad of immune system related problems, and can in many cases cause very debilitating symptoms.  This is all very normal because there is a daily war going on between the person's immune system and the virus.  Some people have a less 'reactive' immune system, for lack of a better term, and show very few if any symptoms.  Others have a highly reactive immune system, and frequently feel miserable.  

There have been PLENTY of research studies over past decades on HCV, documenting HCV-induced symptoms like the pseudo-Sjogrens noted above, and the "brain fog" effect, and also studies on the various forms of "arthralgia" caused by HCV, and also potentially Fibromyalgia, and diabetes, etc.  Stroke and cardiovascular problems are more common (significantly) in HCV carriers.  

So let's all realize that just because someone does not have any symptoms with HCV, that that does NOT mean that everyone else who DOES have extra-hepatic HCV symptoms is either just showing signs of aging...or exaggerating their problems, or even worse, imagining them.  Many of us went from doctor to doctor for years looking for the cause of our many symptoms, only to find years later, when testing was available, that it had been HCV all along.  Some of us were, on the other hand, blind-sided by testing, because for years THEY had no symptoms at all.  Its just different for each person.  Both ends of the spectrum are common, and everywhere in between.

Lots of older articles on HCV symptoms, and medical studies of extrahepatic problems have merely been forgotten by many of us, or are in the old literature 'dust bin'.  Most of the focus today is on treatment and new drugs.  But, the literature is still there, and the HCV array of symptoms have been well documented, studied, and categorized.  Brain Scans even have shown alterations in the brain from HCV, which are thought to cause the brain fog, depressive feelings, memory problems, and other functioning difficulties common to many with HCV.

Hopefully this explanation will provide a better understanding of the real basis for HCV symptoms.

DoubleDose

[tjrusert]

Thanks for the reply.  As I recall, the reason that I first went to see the doctor was because I fell and was dizzy.  I didnt know if I was dizzy because I fell or fell because I was dizzy. I had felt like I was in a bit of a brain fog.  But I didnt know what to call it.  I went through all kinds of testing.  My BP had suddenly spiked.  Thats when the doctor tested my cholesterol and found that it was good except my triglycerides were twice as high as they should be.  The doctor said either I was a heavy drinker or I was eating a tremendous amount of sugar or I had a liver disease.  Since I hardly ever drank and if I ate that much sugar I would be obese (and Im not) then he needed to test my liver functions.  The rest of it you can guess.  So my brain didnt seem right before I knew I had Hep C.  They even did an MRI on my brain to try and figure things out.  Thats why I wondered if the Hep C and brain fog were related or just coincidental. Its been 15 months since I stopped tx and my hands still shake.  The only way I know how to deal with this kind of thing is to joke around about it.  I have suffered with a lot of pain.  I had back surgery one year prior to the Hep C diagnosis.  I have a lot of scarring where they did the surgery so I am in pain a lot. I think pain can also effect your brain.  All of this causes depression and anxiety.  These can also effect your thinking.  So pretty much Im a mess but I try to laugh so I dont cry.  I know things could be worse.  I read a lot of posts and see ppl that are way worse off than me.  But it does get to you sometime.  I feel like my body is a battlefield a lot of the time.  I may be one of those ppl who has a more "highly reactive immune system"  I also feel like sometimes ppl think that some of us are just whiners. Thanks again for the answer. I will try not the whine too much.

[Aussielee]

Not sure if my brain fog is due to hcv, insomnia, menopause or all three lol.
Underneath the loopeyness  I'm probably a genius. hahahaha
Anyway I found a bit of light reading on the subject.

http://onlinelibrary.wiley.com/doi/10.1053/jhep.2002.30688/abstract

Cheers
Lee