Daily Headaches and Brain Fog

Hello-

I’m a 41 year old male, 6ft-2in tall and 180 lbs in overall good health, other than almost daily headaches and brain fog, with migraine headaches every 2 to 4 weeks that last between 12 hours and 4 days.  The last 6 months the brain fog seems to be getting worse, making it hard to focus and concentrate at work.  I work as an engineer in an office environment and spend a lot of time staring at a computer screen.  I have far more days where I don’t feel great due to my head than days where I feel fine.

My feeling is that my headaches are caused by something in my sinuses or somehow related to my neck or posture.  Every time I have a migraine, one or both sides of my sinuses are completely stuffed up.  The stuffy nose always goes away when the migraine is over, although I never really breathe well from my nose, probably due to my deviated septum.  I also don’t seem to have a very good sense of smell if that helps.  It’s definitely not as good as it was when I was younger.

The pain always seems to start in either my nose area or the back of my neck.  Excedrin Migraine stops the headaches about 75% of the time, and seems to work better when the pain starts in my neck instead of my nose.  Since Excedrin only works if I catch the headache early, I use it 4 or 5 times a week since I have headaches pretty much every day of the week.  Below is some additional information:

- I had a CT scan approximately 14 years ago.  Everything looked normal.  Doctor told me to quit drinking caffeine.
- I’ve quit caffeine for 6 months straight on two different occasions, only to have daily dull headaches plus migraines every 2 weeks or so.
- If I sleep more than 6 or 7 hours, I’m almost guaranteed to wake up with a headache.  Sleeping in results in throbbing pain in my lower neck as well as behind my eyes.  
- I’ve been to 2 different ENT doctors who both said I have a deviated septum, but there were no bone spurs or anything like that and no need for any kind of surgery.  One doctor gave me a prescription for migraines and the other a prescription for a steroid spray for my stuffy nose.
- I usually wake up with somewhat of a stiff neck, and always hear ‘crunching’ sounds when I stretch my neck by tilting my head left/right etc.
- When I stand up when getting out of bed, I feel a fluid-type sensation from behind my nose, almost like fluid is draining out, but it does not come out my nose.
- I’ve tried increasing caffeine, such as drinking a cola in the morning and before bed, which seems to make my head feel better when I wake up, but does this contribute to brain fog?

Is the brain fog related to not getting enough sleep?  How am I supposed to get more sleep if it triggers headaches as described above?  Are my symptoms related to any of the following:

- Thyroid issue?
- MS?
- Leaky gut?
- CSF leak?
- Nutritional deficiency?
- Overactive immune system?  I’ve literally only taken 2 sick days in  6 years, and those were due to migraines.
- Spinal alignment / posture issue?

Sorry for the long post!  Any help our thoughts would be greatly appreciated!

Troy

[Dr Santos]

Hi,
How are you? Cognitive dysfunction or brain fog may present with loss of intellectual functions such as thinking, remembering, and reasoning that may  interfere with daily functioning. There are a number of medical or psychiatric conditions associated with this condition such as chronic fatigue syndrome, fibromyalgia, and sleep disorders, including disrupted sleep. You may benefit from further evaluation by a sleep specialist and recent imaging studies like CT scan or MRI of your head and neck. Check with your your doctor for proper evaluation. Take care and do keep us posted.

[troy555713]

Dr. Santos - Thank you for the information and prompt response.  I appreciate it.  Is it possible or like that there is a connection between my sinuses and headaches/migraines?

Troy

[Dr Santos]

Hi Troy,
There are sinus headaches which present with pain over nasal area, often increasing in severity throughout day. Migraine and cluster headaches are often misdiagnosed as sinus in origin. Precipitating factors include infection, nasal polyps, anatomical deformities, such as a deviated septum (as in your case) that block the sinus ducts. This can be treated with antibiotics, decongestants, and even surgical drainage if indicated. Discuss this with your doctor for proper evaluation. Take care.

[troy555713]

Dr. Santos-

Thanks again for the information.  

Troy

[Caryopteris]

Hi Troy

I'm finding out that a lot of sinus problems and headaches are from food allergies.  I know it sounds awful to stop eating favorite foods, but what if stopping dairy or wheat made the headaches (and a lot of other aches and pains too) go away?  My sinuses cleared up when I quit milk years ago, and when I discovered I am allergic to wheat, I stopped that and could breathe even better.  I had migraines as a kid, and one of the things that seemed to trigger them were peanuts.  Turns out I'm allergic to peanuts and nuts too!  

I feel so much better now that I've eliminated problem foods.  If I accidentally eat gluten or nuts, it's a migraine that lets me know (just the light show, not the pain).  

[troy555713]

Thank you for the information. How long does it typically take to trigger a migraine when you eat gluten or nuts?  Is it typically a few hours or longer than that?  Did an allergist make the diagnosis regarding food sensitivities / allergies?

Thanks again.

Troy