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Old 07-30-2012, 10:16 PM   #16
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Re: "Brain fog"

dan8819, Please find a way to keep me informed. I have the symptoms you describe. I will try to highlight similarities and differences. First, other issues have confounded any diagnosis. Several years ago, I had a disc herniation that changed my life. A couple years of NSAIDS messed up my stomach and caused esophageal erosion. I started taking Lortab (hydrocodone and acetaminophen). Took it for a year before having surgery for my esophpagus. After this laproscopic surgery, I feel that I have not completely waken up from surgery. My blood pressure got quite low during surgery due to getting close to related nerves in the area of the surgery. I immediately expected brain damage, but with that I would expect some improvement over time. Surgery can also sometimes cause depression, although my surgeons have no idea what I'm talking about in wither case - of course. After a couple years of chronic pain and brain fog, my doc says depression would be normal and the symptoms fit. Celexa has helped some with depression, but not at all with the brain fog - I want off it, just to take it as a source of my fatigue out of the equation. I saw him after questioning my upper level decision making. I went to a neurologist. He saw that I take Lortab and said, "I think your family doctor can figure this one out." I am very careful with how I use Lortab. I need it to keep pain level tolerable - abuse of it simply isn't sensible.

I was average in elementary school, well above average intellectually in high school, an overachiever in the Army and in college. I have had several challenging and stressful jobs. The brain fog has affected my personality (a little) and hurt my word recollection (a lot). I am 45 and have a family of four. I have to make sure this does not get worse. My employer recently asked me to improve my public speaking skills. I have never had a problem with that. Recently, I guess I have just never been called on that before. My delayed and perhaps less than flowing responses have people wondering if I'm the same person that wrote the report. This is new since the surgery. I know inside that I can double and triple check the report and that I don't have that luxury in a public meeting. I never really loved to read for enjoyment but go through technical manuals or text books as needed without a second thought. I don't enjoy it at all now.

Because I am still apparently high functioning and my coping mechanisms are alright, I don't think I will ever be "fixed". I am hoping that the light will get turned back on as quickly as it was turned off. That hope is perhaps the most illogical part of my thinking, but necessary to enjoy the small stuff and hold out hope for improvement. If I thought I could not improve, I would seek a lower paying job. I think about it everyday, but that would be a very big let down for my family and I would feel lazy. Maybe everybody goes through this as they age, I think to myself.

Just a bit ago I got on Healthboards to find anything related to this mess. What you describe sounds quite specific. I have not been on Healthboards since my disc herniation in 2006 (unless I forgot!). I did not go to work today due to back pain and fatigue. I have never done that before and obviously can not make that a habit. We moved furniture this weekend - I may have dealt with the back pain, but the combo punch of that and fog is a bit much. Generally speaking, I could go to sleep (or at least want to) most of the time.

Yes, my symptoms are like depression and I won't ignore that (it may run in the family) and they perhaps are like drug abuse. Only I know that this was a sudden onset that is at least somewhat independent of those. The liver function/processing you mention is intriguing, given my daily dose of Tylenol.

Drugs and environmental factors can not be discounted, but the combination is too complex to work through for just a few people. Many blame fungus or mold, for what that's worth. Even if, that doesn't explain the onset or link it with a specific trigger.

BTW, I think you are taking a healthy approach to tracking down the root of your problem. I will be glad to provide additional information as needed. If you do a book, you've sold one already! Keep your head up and keep a balanced life is the only advice I can offer so far.

 
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Old 07-31-2012, 04:46 AM   #17
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Re: "Brain fog"

A point of interest while I am thinking about it; I often find my greatest clarity late at night. I sometimes get a "second wind" after 11:00 if I stay up that long. I purchased melatonin to help regulate my circadian rhythm but only used it a couple of nights; not giving it a fair chance is suppose, but the last thing I want to do is start changing up hormones my body should be producing. Narrowing down the cause of my fog to one or a combination of things could be tough enough without adding variables.

One thing a hadn't considered is that there is very little chance of having to deal with people or use those parts of my brain so I just feel focused. Hmmm. I do not have social anxiety, at least not consciously.

The ebb and flow of concentration seem a little different for us, but none the less, good focus is rare. I will try to pay more attention to when things are good and if they trend downward in a random but repeatable time frame, kind of like you are describing.

 
Old 07-31-2012, 04:47 AM   #18
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Re: "Brain fog"

A point of interest while I am thinking about it; I often find my greatest clarity late at night. I sometimes get a "second wind" after 11:00 if I stay up that long. I purchased melatonin to help regulate my circadian rhythm but only used it a couple of nights; not giving it a fair chance is suppose, but the last thing I want to do is start changing up hormones my body should be producing. Narrowing down the cause of my fog to one or a combination of things could be tough enough without adding variables.

One thing a hadn't considered is that there is very little chance of having to deal with people or use those parts of my brain at that time of night so I just feel focused. Hmmm. I do not have social anxiety, at least not consciously.

The ebb and flow of concentration seem a little different for us, but none the less, good focus is rare. I will try to pay more attention to when things are good and if they trend downward in a random but repeatable time frame, kind of like you are describing.

 
Old 07-31-2012, 04:56 AM   #19
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Re: "Brain fog"

Quote:
Originally Posted by Rileyroll View Post
I can be a bit like that but I suffer from depression and have mental illness.My advice to you would be to go to your local doctor and have a complete body check.If anything it will put your mind at rest,perhaps if you are allowed you could take an energy drink into your class,something that boosts the serotonin in your brain.Perhaps your brain is not producing enough serotonin,which is known as the happy drug.You need to get a supplement that will have serotonin booster in it.
Interesting you should say that. I probably have been self medicating with energy drinks for a while ( a couple of years ) now. I alternate sugar free and sugared so I don't get the sugar crash or take in too much of the substitutes. Like other medications, they can't be very good for the body as a whole and they have lost their effectiveness over time.

 
Old 07-31-2012, 04:58 AM   #20
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Re: "Brain fog"

I have no idea how energy drinks would affect serotonin levels though.

 
Old 08-01-2012, 06:35 PM   #21
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Re: "Brain fog"

My blood work shows normal thyroid numbers (although I have not seen them for myself), but I will be exploring adrenal gland issues as a cause of my issues. Because of the pressure put on myself over the course of my life and the surgery, loss of my dad, and change of career/moving the family all happening within a short time frame, perhaps I toasted my adrenal gland. Not even sure how that works but the symptoms fit with other posts and information I've read so I will look into it for myself.

Wondering if you had similar stresses around the time you first felt mental diminution.

 
Old 08-05-2012, 10:25 AM   #22
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Re: "Brain fog"

Absolutely Davesport. When my symptoms began, I was in high school. I was working really hard with school, band practice, and extracurricular clubs. I would only have about 15 minutes of free time each night, if that. I continued overworking like that for about 3 or 4 years in high school until I got to college, where I changed my habits to be much more balanced and healthy. However, my cognitive symptoms (the brain fog, or whatever we want to call it) had already set in by that point. I became aware of them most notably during my junior year in high school. At that point, I was feeling emotionally numb and mentally "checked-out" every day. I felt distant from everything around me. I couldn't feel any emotions. Intellectually, I was still able to handle school just fine (I eventually graduated valedictorian), but I didn't find anything interesting. I was just functioning on autopilot. Other things happened too that were stressful: my mom was diagnosed with breast cancer, my dad's job was in danger, and my girlfriend and I broke up after being together for 2 years (though in retrospect that was a good thing, haha).

When I eliminated the vast majority of that stress in college, things improved a lot for me. I was able to finally feel rested after sleeping and I didn't feel stressed out all the time. The stress-related symptoms were gone. The brain fog improved as well in the sense that I wasn't foggy all the time anymore. Instead, I entered into that pattern of feeling foggy most of the time, but with the occasional day or two (occurring maybe once every week or week and a half) when I'd feel fine. That pattern has continued to this day, six years later. So, I think the stress burned me out somehow, causing some neurochemical changes that I have yet to be able to treat.

I haven't had my thyroid levels checked well yet. They looked at the levels during a CBC (basic blood work), but that test isn't sufficient to check thyroid function. You really need a thyroid stimulating test performed, which isn't too difficult, but it's more than a CBC will accomplish.

Sorry I've been MIA lately! I'm still working on figuring all this stuff out, but unfortunately something new has popped up for me. I'm really a healthy guy--I don't have tons of medical problems or anything. However, about a month ago, some weird neurological symptoms started bothering me. Strange pressure headaches and sensations in my head and face. We're not sure what's causing them, but at the moment, figuring that out takes priority, unfortunately. Just one more obstacle in life, I suppose. Hopefully, these things improve sometime soon, because at the moment, they're severe enough that I have trouble doing things even as simple as reading a book. Crazy, haha. I'm trying my best to stay optimistic.

At the moment, I'm just chipping away at my book and research as I can. With the brain fog treatment, my psychiatrist and I are trying our first new approach. I'm going back on Pristiq, but we're going to try a higher dosage this time (probably 100 mg) and see if that helps. If it doesn't, I might eventually try St. John's Wort (as it seems to affect serotonin in some way, though nobody knows how) or tryptophan supplementation.

Something I've been wondering lately about brain fog like ours is that it seems to arise after prolonged psychological stress. If we accept that psychological stress induces a physical response (which is well-established in science), and if we know that that physical response becomes a negative one over time, perhaps there is some link to inflammatory/immune system changes in the brain after a period of chronic stress. There is some interesting research being done now about the link between depression and inflammation. I haven't done a ton of reading about it, but there's talk about using injections of ketamine to treat depression (by targeting inflammation, I think). Apparently, there's been some fascinating cases where patients with major depression were given ketamine, and their symptoms were completely alleviated within a few hours. You might find it interesting to Google some of the papers about it. I don't know if you have any science background, but if you have any trouble understanding the technical terms or anything, feel free to post the name of the article you're reading and I can take a look at it. I've published science research myself (in a completely unrelated field, nanomedicine) and was a medical student before having to drop out. I can sludge through the jargon

 
Old 09-10-2012, 09:26 AM   #23
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Re: "Brain fog"

Hey davesport, got something that you might find particularly interesting. A friend of mine (who I met a few months back through a different forum) has a very similar story to yours. He underwent surgery for...something GI, I think. Maybe gallbladder or appendix, I don't know. But, when he came out of the surgery last year, he found that his brain wasn't working the same as it used to. His symptoms are nearly identical to mine (and yours)--brain fog, for lack of a better term.

He's seen a bunch of different doctors about it, like I have. After the initial surgeon said the surgery couldn't cause such symptoms, he was sent to a psychiatrist to be examined for depression. He was diagnosed with depression and started on an anti-depressant, which didn't help. He continued seeking help, and eventually saw a surgeon, then GI guy, was hospitalized and given lots of blood tests (more than the normal CBC most primary docs mean when they say "blood work").

To his surprise, they found very low levels of ACTH, cortisol, and one other hormone he couldn't remember. I can't say for sure about the last hormone, but the first two are intimately related in what's called the HPA axis. It's an endocrinology system in the body that consists of the hypothalamus, the pituitary gland, and the adrenal glands. ACTH stands for the adrenocorticotropic hormone, a chemical released from the pituitary that does a couple of different things. Notably, it goes into the adrenal glands (right on top of the kidneys) and kicks up the production of cortisol, the "stress hormone". Cortisol then floats around and does a bunch of different things related to the stress response. Interestingly, it does a bunch of things in the brain, and cortisol is implicated in a variety of psychiatric disorders.

My friend's treatment now is going to veer away from psychiatry toward endocrinology. It's been about a week or so since I've last heard from him, but I'm really hoping the treatment turns out to be helpful for his brain fog. I've already had to drop out of medical school because of the fog--I hope he doesn't have to drop out of his professional school as well.

For me, it's been 8 years or so of trying to find help for my brain fog. This past year I took off from school and moved back home so that I could devote all of my attention to it. I've seen many doctors and taken many tests, but nothing has been revealed. The only avenue left for me to look into is endocrinology, which is what I'm actually in the process of getting started this week.

An important note about endocrinologists (and doctors in general): not every physician is created equally, ESPECIALLY when you have a mystery illness like brain fog. The average physician lacks the knowledge, caring, or commitment to appropriately help someone whose complaints are little vague and hard to understand. Most of them end up pointing their patients to psychiatrists, psychologists, and counselors. Now, there's certainly a place for those fields, and there are well-established cases of psychosomatic disorders or psychologically-induced physical/neurological/cognitive symptoms. Furthermore, the chemistry of the brain is complicated. Even if the root cause of a problem is something like ACTH "in a different organ system (endocrinology)", it doesn't mean that psychiatric medicines can't still help. Standard anti-depressants tend to affect serotonin. If you look at a diagram of cortisol's effects on chemicals in the body, somewhere you'll see serotonin appear (along with the other common "brain chemicals"). Hence the good and bad effects of psych meds on things like cognition and energy level.

All that being said, make sure that you have at least one doctor who believes your symptoms are real and who is willing to pursue treatment for you. My family doctor is that person for me. He is fantastic, and unlike nearly every other doctor I've seen, he didn't give up on my case after a three months of not responding to treatment. Furthermore, make sure your endocrinologist is well-practiced in all of endocrinology. I'm not sure how big Austin, CO is, but in my city (which is pretty big), we don't have many endocrinologists to choose from. Of those endos who are here, most of them spend their time dealing with the common problems like diabetes and perhaps thyroid issues. My family doc and counselor both have advised me to make sure I see someone whose experience is not limited to just diabetes or something. (It's like seeing a cardiologist for a rare heart defect. It's understandable if the cardio spends all of his time with heart attacks since they're so common, but I wouldn't trust him to handle something well that he's not familiar with). Fortunately, there's one endo in town that should fit the bill, and I'll be seeing him soon.

Finally--make sure that if your doctor (whoever he or she is) orders "blood work" that you know what kind of blood work it is. As I mentioned before, a simple CBC can easily miss even thyroid conditions; they may not even check HPA axis chemicals at all. Unfortunately, not all doctors understand or care enough to be thorough; an uninformed patient could easily think he or she is fine because "the blood work came back negative" when in fact that blood work was insufficient.

Best of luck to you. Hope to hear from you soon!

 
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Old 09-30-2012, 06:01 PM   #24
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Re: "Brain fog"

Hi everyone. I found this while searching for brain fog on Google. I have had brain fog for three or four years now, and it has been awful for the past few weeks, so I'm really thinking about it (which, as you all know, requires a lot of energy when you have brain fog!). I was on Lexapro once for about two months about two years ago, but I didn't feel like it was helping or that my depression/anxiety was bad enough to warrant meds, so I stopped taking it. I thought for a long time that my brain fog was linked to hypoglycemia. That came up when I first started searching for causes, and when I was tested, I was borderline hypoglycemic. When I eliminate sugar and white flour for my diet for a few weeks, I do start feeling better, although never great. And it's basically impossible for me to stick with that diet, so it rarely happens.

I also have indoor/outdoor allergies, which I just found out and read that that is linked to brain fog as well. And, as I discovered tonight, a whole list of other things are linked with brain fog. However, I haven't found a doctor yet (and I have been to MANY!!!) who really cares about finding the cause of this, so it seems like I'm stuck with it! Sometimes I wonder how I am going to live my entire life like this- I am a teacher, and it's very, very difficult to teach when I can barely think straight. Kids will ask me a question, and I struggle to answer them. The OP said they feel stupid- same here! I graduated with a 3.9 GPA, but people look at me like I'm an idiot quite often because I often have trouble talking. I can't blame them, though, because I feel the same way!

I also saw someone mention that they feel better after 11pm. I usually feel better in the evenings, usually around 7 or 8, which I read is a symptom of hypoglycemia, but maybe it's related to brain fog. Lately, however, I have been falling asleep between 8 and 8:30 because I'm so tired that I can barely move. Tonight I'm up, but brain fog is still there, so maybe things are changing.

Anyway, I apologize for writing a book, but it's relieving to find people who have the same symptom as I do and know that it's not in my head as some doctors insinuate!

 
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Old 10-01-2012, 09:49 AM   #25
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Re: "Brain fog"

Hey hb1125, good to hear from you. I'm sorry that you've been dealing with this for so long, but I'm glad you found this post. As I'm sure you've discovered, there are many, many suggestions on the web about "brain fog", what causes it, and what cures it. To fully exhaust all of the possibilities and cures (or "cures") could take years. I know, because I've been treating this for 8 years now, haha. Your experience with healthcare professionals is, unfortunately, par for the course. As a medical student, it's been incredibly disappointing, even infuriating, to witness how poorly the average doctor handles an illness that isn't easily categorized or treated. I spent the past few years seeing four different psychiatrists. Some were better than others, but none of them knew what was going on, as they admitted directly to me.

Now, it's nice to know that others are suffering in the same way as us, but what you, I, and everyone else on here really need is some medical relief. Perhaps the most important thing to do is find a primary care physician who will respect your condition and seek to treat it. Most doctors (sadly) will quickly grow frustrated if your symptoms don't match anything in the current medical literature and don't respond to "simple" fixes like diet, exercise, social support, stress reduction, and the like. Since the symptoms are cognitive/behavioral, you'll most likely get sent to a psychiatrist.

As I've written in earlier posts in this thread, some brain foggers have had success with certain anti-depressants. The sample size is very small (I've found maybe three seemingly reliable success stories), but they found relief with a drug that targets serotonin. In one woman's case, that relief was consistent across two different serotonin reuptake inhibitors as well as St. John's Wort (which seems to have an effect comparable to a serotonin reuptake inhibitor).

However, it's clear to me that targeting serotonin hasn't had much, if any, beneficial effect (as seems the case for you as well). There are literally dozens of other psychiatric medications that you can try (and I have tried probably about a dozen myself). Perhaps you'll find relief down that path, but it's a long one, and it can be very draining to deal with side-effects. It might be a good idea to investigate other causes first, or at the same time. Seeing an endocrinologist and a neurologist would probably be the best avenues to investigate.

But, first thing's first: find a primary care doctor who listens to and trusts you. Without somebody who believes in your symptoms and is serious and critically-minded enough to try to figure it out, you're going to have a rough time getting the care you need.

Second, get detailed, very detailed. I'm friends with a number of teachers, and I know how detailed you guys have to be, so I imagine this will come easy to you . Try to organize everything you know about your symptoms into a document. Every thing you've noticed about your brain fog and how it works can be a clue (to a critically-thinking physician). For instance, does anything make your symptoms better or worse? Personally, if I have a cold or other light illness, I'll often feel almost completely better; at least until the infection is taken out, then I feel foggy again, haha.

Third, right now, I'm investigating endocrine causes. I'll find out the results of some blood tests this week; I'll try to remember to share that here. Hopefully something comes up. Whether the tests show something or not for me, it still might be a good idea for you to see an endocrinologist, just to rule out other potential causes. Another brain fogger I know had some tests done that revealed very low levels of ACTH and cortisol. He's still waiting to see an endo about the results, but it was this discovery that prompted me to investigate adrenal issues myself.

Fourth, get copies of all test results, so you know exactly what was tested. You may not understand the numbers, but it's good to have everything on hand.

Fifth, keep your head up! You are not alone in this! It's my hope that I one day find a cause for my symptoms. It may not be THE cause for every case of brain fog out there, but it will be the cause for some. I hope to get some sort of study published about it so that patients can finally point their physicians to something they will respect as "real".

I wish you the best! Stay in touch.

dan8819

 
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Old 10-01-2012, 12:38 PM   #26
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Re: "Brain fog"

Thank you for your reply! I made an appointment with the endocrinologist this morning after reading these posts- I am very interested in seeing what happens there! If that doesn't work out, I'll schedule an appointment with the neurologist, too. I really appreciate all of your help, and I will definitely be following your advice. It sounds like you will be an amazing doctor, and I hope you can do that study! I hope your test results are helpful!

 
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Old 10-04-2012, 08:33 AM   #27
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Re: "Brain fog"

Hey everyone, just wanted to update you on the endo test results. Unfortunately, nothing really showed up. Slightly elevated folic acid and bilirubin, but that's it. My doctor says my thyroid levels (i.e., free T3) were a bit on the low end of "normal", so he wants to supplement with some thyroid medication he's ordering from some company that'll ship them to me. Plus Vitamin D3 supplements...I'm not sure why. I can't help but raise an eyebrow at this treatment regimen, but I'm willing to try. Endocrinology has long been a tricky area to study because we know too little about how everything works to determine what "normal" is. So, though the established reference range for free T3 is from 1.80-4.20 pg/mL, my doctor says I might feel better at a higher level than what it was when we tested (4.16). It'll be another week before I get the supplements, and then probably at least a week before I start noticing their effect. I'll make sure to let you guys know what happens.

My endo only talked to me about five minutes, and that whole time he was talking to me out of the side of his mouth as he filled out my chart (stuff you should do after seeing the patient, but what does medical school know about patient care?). I quite literally had to put my hand on his shoulder to get his attention when I wanted to ask a question like "Have you ever heard of my symptoms before? Given what I've told you, what do you think might be going on?". His answers were No and I'm not sure, maybe your body temperature is too low?

So, the search goes on, I guess. Trying to keep my head up though!

Eternally frustrated by the medical establishment,
dan

 
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