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Mental fogginess/altered state of consciousness?

Hi.  I hope someone (especially a doctor) will have some insight to share.  I was diagnosed with Hashimoto's 2 years ago at age 29 (although it most likely began much earlier), and have had my levels managed with levothyroxine and synthroid since then.  My dosage has only ever been .25mg and .5 mg, so as my endo' says, I'm not really all that bad, and my levels stay normal when I'm on the meds.

But, my question is about a symptom that has not gotten better after 2 years of carefully managed thyroid treatment.  My problem is difficult to express clearly, but I'll try.  Basically, it's a heavy feeling of being only half-awake; of living in a dream; like I'm sleepwalking; heavy mental fogginess; serious difficulty concentrating due to this feeling; difficulty focusing on what's happening around me.  Really, it is the feeling you get right before you lose consciousness- like I'm on the edge of passing out and losing consciousness, and the world around me is seeming really distant and starting to fade away and get dark.  This feeling has been permanent since I was 16 years old, although it started as brief, random episodes when I was 12.

My endo' says that it can't be my thyroid, because my TSH, T3 and T4 levels are all normal when I'm on my meds.  He sent me to a neurologist who did an MRI, but there was nothing abnormal on the MRI, and the neurologist doesn't seem to have anything else to offer.  The only thing the neurologist seemed to suggest is that this might all be an endocrine problem.  I have no idea, but I am going to see my endo' again soon, and I am going to press him for more tests and more ideas of what could be causing this.  

It is so extremely difficult to live like this.  Every part of my life feels like a burden, because I am struggling so hard to focus and "be here", when my brain seems to be trying to shut down on me.  I've had to learn to cope, learning all kinds of ways to deal with this and try to live a normal life, and trying to get by with my mind almost shut down on me.  (This post will take me a very long time to compile, because I will reread it and fix it).  I just don't know how much longer I can go on like this, and I'm desperate for answers and help.

Thanks for any suggestions or ideas.
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Avatar universal
This is an old thread and it is very doubtful you will hear from carrie.  If you will post your test results and reference ranges shown on the lab report, we will be happy to give you an assessment.  Do you have any other symptoms?
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Hello Carrie,

I'm 20 years old, male, and a few days ago I have been having the same mental fog you explained in earlier posts. My mind seems to remember past experiences through the day as if it was a dream. My senses seemed to be altered and I can't quite figure out what is wrong. I went to the doctor and they did a blood test but everything was normal. Can you please update us on how you are currently feeling?? Thank you!
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Avatar universal
Thanks for taking time to tell us about your experience.   I agree with you about treating hypothyroidism clinically.  In fact you might find the following interesting.  I post it a lot so that hypo members will notice it and understand what tests and treatment they should be getting.  



A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf


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I found that my brain fog and mental fatigue, which I had over 6 years, did not go away until I got my TSH below 1!  It all had to do with my thyroid! I had been taking levothyroxine (T4) (brand name Synthroid) since 2003 because I was diagnosed with Hashimoto's hypothyroidism (an autoimmune condition where your immune system attacks your thyroid, causing too little thyroid hormone to be produced).  However my TSH (Thyroid Stimulating Hormone produced by the pituitary gland in the brain) blood test was always in the "normal" range (anything under 5, or now 3 is the recommended high normal), and so I never suspected it could have anything to do with my worsening brain fog and mental fatigue.  BUT I came across an article that stated it is difficult for women to get pregnant if their TSH is above 2! So it got me thinking I should try reducing my TSH and see what happens.  And that was the answer!  I told my doctor my goal to get it below 2 and so we gradually increased the levothyroxine.  It took time to get it right because as took more levothyroxine, my TSH would go down, but then it would go up again because my thyroid was being stimulated less by the lower TSH, so it would produce less thyroid hormone, and then my TSH would go back up a bit.  So you have to keep getting tested at least every 4 weeks.  If TSH goes up again, take more levothyroxine.  I went from 75mcg gradually to now 150mcg.  Now my TSH seems to be staying around 1 or less, and I'm free of brain fog!!!!  I'm able to work at a computer job again after 6 years of suffering.  I feel like a new man again!  So remember, it's more important how you feel, not what the TSH level is or the doctor says.  A good doctor will go based on how you feel.  Everyone is different.  I found I only feel normal if my TSH is below 1.  I hope this helps people out there who are suffering like I did!
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Avatar universal
Did you ever find anything out??
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Have you had your Vitamin D and B12 check ?
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Thanks CarrieMae for the update.  Hope things improve for you soon.  

And by the way, even hypochondriacs get sick occasionally.  LOL

Best to you.
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Avatar universal
A ~very~ long time since I posted or responded.  Have re-read through everyone's posts, to catch up properly.

Long story short:  Now living in Melbourne, Australia.  Over here, thyroid problems are managed differently, and ~no~ natural thyroid replacement medication (such as Armour Thyroid) is available.  So, I am again on Levothyroxine.  It was a very hard transition back to the synthetic hormone.

Something that has been determined in the last 2.5 years is that I technically have PCOS (poly-cystic ovarian syndrome).  Although all hormone levels come back 'normal' I do have one ovary with many follicles.  Read up about it, but this in essence means that my body is exposed to more of the androgens than a 'normal' woman would be.  I have been on Spiractone/Aldactone for over a year.  It hasn't helped or changed the brain fog, ~but~ it did completely fix the problems with irritability, aggressive feelings and is lessening the unwanted hair growth.  And, within months I could sing all the high soprano notes again, which for years had been just squawks because they had become to high.  

The brain fog has not gotten any better.  But, here's something:  Recently, it got worse.  I was quite unwell, but really couldn't put a finger on what was wrong.  I was having ~drenching~ night sweats every night, fevers during the days, headaches, and for a few days I was in agony with nerve pain, especially in my neck.  As it happened, I was due for blood work during that time.  Kidney function & TSH came back normal. ~But~, all 4 liver enzymes were significantly elevated; my lymphocytes were extremely high, and my platelets were extremely high.  I had episodes of palpitations (heart rate suddenly at 110+ bpm) and skipped beats.  This has meant a series of more blood work, ultrasounds of my liver & glands, Holter heart monitor, etc...  The doctor was very confused to have any of these types of results come back abnormal, because the initial blood work was just routine stuff that's always "normal".

Well, point being:  The doctors can tell that I've had a fairly serious viral infection, most likely viral meningitis.  So far, after testing for every type of virus they can think of (from those initial blood samples) they cannot determine what virus it was.  Not hepatitis, not TB, not cytomegalo virus, not Epstein-Barr, not mono nucleosis, not mumps...  Whatever it was, it really affected my liver and I had a very strong immune reaction to the infection.  The time period (all of March) that I was "coming down" with the infection and then was sick with it is a real blur.  My memories are scattered and fuzzy- there were events in that time period like Easter, my birthday, 2 weddings, etc... that I can just barely piece together.  I am still not feeling 100% better.  More blood work to monitor 'deranged liver function' in 2 weeks' time.

So...  Someone else had mentioned they'd experienced meningitis, (bacterial or viral?  That wasn't mentioned).  There seem to be so many possible causes, even multiple causes, of brain fog and an infection around the lining of the brain seems like a ~very~ valid possibility!  Especially considering my recent illness.  I wonder whether as a young adult or child this could also have happened, because there were multiple times in childhood (not having medical insurance) where I got very ill and never saw a doctor (like with Strep throat; ear infections and who knows what else that we were just told to stay in bed & sleep off).  

Another suggestion, which is closer to the suggestion of dissociation (triggered by traumatic events), was 'borderline personality disorder'.  Again, I'll let others read about that elsewhere, but there are elements of that which do speak to many of the 'brain fog' symptoms.  And, yes, actually it's possible for myself that borderline personality disorder is a cause.

Other possibilities (though not in my case) are very low Vitamin D levels, problems with adrenal glands (as someone has already mentioned) and sleep apnea.  Depression, stress, insomnia and food allergies are real possibilities for others, too.  

(Yes, I do have food sensitivities, and in my case the foods that cause the symptoms of fatigue, headaches, body aches and general exhaustion are: black pepper, peanut butter, oranges, pineapple, red wine (not intoxication!) and silicates- used as a preservative in dried fruits, wine, cured meats, etc...)

Although it can make a person sound like a hypochondriac, I have met other people with Hashimoto's Thyroiditis who ~also~ have polycystic ovarian syndrome and food sensitivities/allergies.  So, it really does seem that some of these things are related and come as a 'package deal'.  There are so many symptoms within each of these diagnoses that it can take a person ~years~ to sort through things and get the right treatment or understanding of their body & have adequate symptom management.

I hope any of that update helps.  I guess the best answer is to keep a really good symptom diary, listing how much sleep you've had, what you've eaten & drunk, the weather, what physical activity you've had, what you did that day (work/school/life activities & stresses), for women where you are in your "cycle", and then throughout the day keep a detailed list of the symptoms you were experiencing.  ~That~ is how they diagnosed my food sensitivities.  With this specific and detailed information, you'll be much more able to state clearly and firmly to the doctor what your exact symptoms are, and give the doctor something to "go on", because they can review weeks or months of the symptom diary to see whether there are patterns & trends of things like certain foods, stresses, activities, etc... that are influencing or causing your symptoms.  

God bless, and try to stay positive everyone.  It is ~hard~ sometimes, but there's always hope for a better tomorrow.
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Avatar universal
CarrieMae has not posted on this Forum in years, so I seriously doubt she will see your post and respond.  If you would care to share with us your thyroid related test results and reference ranges, along with symptoms you have other than brain fog, perhaps a member can provide some useful info for you.
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Avatar universal
Please update us on your brain fog!! I desperately need hope that this will get better. Please let us know if yours is gone!
Thanks!!
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Avatar universal
I suffer from the same thing every day, It has gotten so bad that I forget where im driving while behind the wheel, I forget what year it is, I forget peoples names I have known for years and so on. I also understand the dream state thing I experienced that when my thyroid levels switched to hyper I kept saying I feel like this is all a dream, is this all really happening? am I really here? it was like watching the movie of my life detached from it. I have an endo appointment, a neuro appointment and a internal medicine appointment and thousands of dollars in bills from all of the other tests done in the last 6 months an no answers. im sorry I have no advise for you but I wanted you to know you are not alone and yes it is very scary!
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If you look at this list of 26 typical hypothyroid symptoms, do you seem to have any of them?  Have you ever been tested for the possibility of being hypothyroid?

http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
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Avatar universal
It sounds like you might have high anxiety/depression. I have all the same symptoms you have described: fogginess, darkness, alienation, disconnected, tiredness, etc. I've been to several doctors and in and out of the hosiptal, had an MRI and several tests and nothing is physically wrong with me. A couple of doctors determined that I may have anxiety so I went to see a psychiartrist and I described all my symptoms and she diagnosed me with high anxiety/depression.  I've done a lot of research of my symptoms and it all points towards anxiety. The meds I was prescribed helped a little but were either not strong enough or were benzo's which are not to be taken regularly because they are highly addicitive (althought the benzos worked the best) I tried ignoring it which helped some but I've found anxiety is a viscious cycle that feeds itself and ignoring it only prolongs the feelings. Also, fighting anxiety or your feelings will only intensify them. I decided to just deal with it and have found that confronting the way you feel and embracing it and doing the opposite of what anxiety or fear tells you to do helps more. It may take awhile but I believe it will get better. I also believe that God is the ulitmate healer and trust and devotion to Him will cure any anxiety or bad feelings or perceptions I may have but that's just what I believe. High anxiety is an irrational fear and cannot hurt you and if the doctors have told you that are physcially ok then this could be what you're experiencing. I understand how difficult it is, trust me I'm struggling, but I'm am confident you can get better.
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Avatar universal
What you have described sounds more like Dissociation. It comes from early trauma and EMDR and EFT will be far more effective than this typical response of desperately running around to different doctors, trying to figure out what is medically wrong...There is a movie called "Numb" that describes this so well.  So sorry to hear you are going through all this.
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How about explaining what you mean by depersonalization and what it involves and some verification that it is worth even pursuing.
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It sounds to me like a brain fog is a name for another condition. Everyone on here should look in to depersonalization. This can be treated with meds.
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Avatar universal
There can be multiple possible causes for some of the symptoms you mention.  Why did you choose the Thyroid Forum to post your message?  Have you had thyroid tests that indicated a problem?  If so, please post your thyroid related test results and their reference ranges shown on the lab report.  

In the long time period you mention, you must have seen different doctors.  What have your doctors said about possible causes for your symptoms?
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I can't believe I found this forum. I have had very similar symptoms to what some of you are describing. My first experience with this was at 17, playing soccer in high school. This overwhelming sensation hit me, like I wasnt really there on the field and that I might pass out at any second. It lasted about 3 hours. For the next 20 years ( Im 37 now) I have gradually been getting worse and experiencing this "out-of-body" sensation more often. The last 3 months have been the worst. I now cant go into a store without feeling like Im going to pass out. It hits me all of a sudden, this sensation like Im outside of my body and on the edge of consciousness. I often have to hold on to my girlfriends purse or sleeve, or a shopping cart for fear I might topple over. Its just the weirdest dream-like state, almost like Im a ghost, like my actions arent really being performed by me, I find myself reciting my phone # over and over in my head to try and stay alert.

It sometimes happens at home, like I can stand up and look at my couch, but it feels to me like the couch might not really be there. I struggle with attentiveness lately, and have zero sexual drive towards my live-in girlfriend( which presents its own issues..).

Have pretty much lived with depression and anxiety my whole life. Physicals, MRIs, blood pressure, etc. have all shown Im pretty healthy physically.

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If you haven't already done so get checked for allergies and chronic sinusitus.......it can come on very gradually.......things to watch for are sensitvity to smells and fatigue........I had it for years as did my son and we just never knew what it was........we had the same......diffiuculty concentrating, fatigue, weakness, spaciness etc.
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how's the brain fog?  In the mist of one myself....had off and on as long as I can remember but this one hit about 6-8 weeks ago and still going strong!
Had one about 5 years ago, Dr and Neuro coudd find nothing, went away on it's own....any new news on what to do for this?
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IANAD but I have been suffering from brain fog myself and have been researching the potential causes. One potential cause of brain fog is low ferritin/low iron levels. Please take note that ferritin can be "in range" and still be too low. The range is something like 25-300. That's huge and that's a red flag right there. Another potential brain fog cause is low levels of serotonin. I myself have recently found I have low levels of this which I think might be the culprit. There are also various other vitamin and chemical deficiencies that can cause this. Also having your sex hormones out of whack can cause this as well. If you are suffering from any of this please seek out a reputable alternative or integrative doctor and ask them to test you in all the areas I mentioned above. If nothing else, it will at least allow you to rule out more potential causes. God bless you guys, take care.
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Update From Lisa
After I wrote my statement, I fell ill. I had Shingles and whooping cough within a week of each other. After losing all faith in my doctor, I started seeing a Naturopath Doctor. Long story short, my adrenal glands and immune system were shot. After intense supplement therapy and an elimination diet (for about 6 months~ no wheat, red meat, milk, sugar or soy because many new food allergies were present) I am full functional again! After years of brain fog, I feel human again!  Please ask you doctors to check your adrenal functions and please consider food allergies.
My thoughts are with all of you. That dark inhuman place is an awful experience. I hope you find your cause.
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About to post a comment and got distracted - now 2 hours later! Ah, one of the fun aspects of my Brain Fog, which started about 3 months ago. Find myself having to write everything down at work to make sure I keep myself on track. I'm so used to being motivated and mentally alert that this has really thrown me for an emotional loop - probably part of the whole deal. Going back to my naturopathic/thyroid doctor tomorrow and a neurologist next week. I hope that we can get this train back on the track, because this is only living half a life at best . . . . and I have too many great things in my life to be so disengaged!

Fog started when my TSH shot up, although I don't think my T3 and T4 were too off. I'll need to look again at my levels. But also just found out that my mom has a parathyroid problem, so should look int that, as well.

I began to get migraines when my Hashimoto's started after the birth of my first child. Have others experienced the same? My doctors say the two aren't linked, but I disagree and have found information on the Intranet that headache/migraines frequently co-exist with hypothyroidism. Interestingly enough, I've had my most clear-headed, mental fog free moments after taking Imitrex for my migraines. It's like my brain has been short-circuiting and the Imitrex has reconnected my synapses. Weird.

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Thanks!!!!!!!!!!  47 next month and fogged in! Hyperthyriod in late 20s.  I  crashed  @ 29-30 been on thyriod meds..every since 5 miscarriages 2 kids high blood pressure 16 yrs.  and anti-phospolipid (thick Blood/blood clots, so far only in the miscarriages.)  Never had anyone else discribe fog  like I do till I came across this forum.  My Mom had radioactive meds. to kill her thyriod in her early 30s , she is only 19 yrs older than me.  Menal illness runs on her side of the family and diabeties and addison disease on my Dads side. So I know all 'bout endo system and its problems.  Now perimenopause too!!  Foggy......
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