If you’ve ever walked into a room and forgotten why you went in, or met someone new only to mentally misplace their name a moment later, you’ve experienced brain fog. Finding the right words in everyday conversation might be difficult, and sometimes your mind seems to go blank. Along with feeling forgetful or spacey, brain fog can lead to trouble focusing, mental fatigue, and distractedness.1Ross AJ, Medow MS, Rowe PC, Stewart JM. What is brain fog? An evaluation of the symptom in postural tachycardia syndrome. Clin Auton Res. 2013;23(6):305-311. doi:10.1007/s10286-013-0212-z
The brain may be small—only about three pounds—but it is the most complex and critically essential part of the body. That’s why it’s important not to ignore symptoms like memory loss, cloudiness, and confusion.
Brain fog is not a medical term but a description of various issues that affect cognitive clarity.2Van der Feltz-Cornelis C, Turk F, Sweetman J, et al. Prevalence of mental health conditions and brain fog in people with long-COVID: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2024;88:10-22. doi:10.1016/j.genhosppsych.2024.02.009 Mental performance and function change with age, as specific facts or memories may take longer to recall. However, age is one of many factors that contribute to brain fog symptoms.
“Permanent loss of what should be ‘rote memory,’ like not remembering how to get somewhere in your hometown or forgetting the names of people you see frequently, can be more foreboding,” says Naturopathic Oncologist Tina Kaczor, ND, FABNO. “I think of brain fog as functional or pathological, with the latter being conditions [ranging] from brain tumors to neurodegenerative disease. In my clinical practice, many patients experience brain fog [after chemotherapy], often referred to as ‘chemo brain.’”
What Causes Brain Fog?
The first step in treating brain fog is identifying the possible causes and any underlying medical conditions. Health issues that negatively influence cognitive function include the following:
- Long COVID2Van der Feltz-Cornelis C, Turk F, Sweetman J, et al. Prevalence of mental health conditions and brain fog in people with long-COVID: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2024;88:10-22. doi:10.1016/j.genhosppsych.2024.02.009
- Chronic pain and pain medications3Dass R, Kalia M, Harris J, Packham T. Understanding the experience and impacts of brain fog in chronic pain: a scoping review. Can J Pain. 2023;7(1). doi:10.1080/24740527.2023.2217865
- Chronic fatigue syndrome4Ocon AJ. Caught in the thickness of brain fog: exploring the cognitive symptoms of chronic fatigue syndrome. Front Physiol. 2013;4:63. doi:10.3389/fphys.2013.00063 and fibromyalgia5Kravitz HM, Katz RS. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatol Int. 2015;35(7):1115-25. doi:10.1007/s00296-014-3208-7
- Cancer treatment6Eide S, Feng Z. Doxorubicin chemotherapy-induced ‘chemo-brain’: meta-analysis. Eur J Pharmacol. 2020;881. doi:10.1016/j.ejphar.2020.173078
- Multiple sclerosis and other neurological diseases7Morrow SA, Kruger P, Langdon D, Alexandri N. What is the true impact of cognitive impairment for people living with multiple sclerosis? A commentary of symposium discussions at the 2020 European Charcot Foundation. Neurol Ther. 2023;12(5):1419-1429. doi:10.1007/s40120-023-00519-z
- B12,8Markun S, Gravestock I, Jager L, et al. Effects of vitamin B12 supplementation on cognitive function, depressive symptoms, and fatigue: a systematic review, meta-analysis, and meta-regression. Nutrients. 2021;13(3):923. doi:10.3390/nu13030923 iron,9Ferreira A, Neves P, Gozzelino F. Multilevel impacts of iron in the brain: the cross talk between neurophysiological mechanisms, cognition, and social behavior. Pharmaceuticals. 2019;12(3):126. doi:10.3390/ph12030126 or vitamin D deficiency10Anjum I, Jaffery SS, Fayya M, et al. The role of vitamin D in brain health: a mini literature review. Cureus. 2018;10(7). doi:10.7759/cureus.2960
- Chronic inflammation11Kverno K. Brain fog: a bit of clarity regarding etiology, prognosis, and treatment. J Psychosoc Nurs Ment Health Serv. 2021;59(11):9-13. doi:10.3928/02793695-20211013-01
- Hormonal changes12Ali S, Begum T, Reza F. Hormonal influences on cognitive function. Malays J Med Sci. 2018;25(4):31-41. doi:10.21315/mjms2018.25.4.3
- A poor diet high in processed foods13Bhave VM, Oladele CR, Ament Z, et al. Associations between ultra-processed food consumption and adverse brain health outcomes. Neurology. 2024;102(11). https://doi.org/10.1212/WNL.0000000000209432
- Not enough sleep or poor sleep14Csipo T, Lipecz A, Owens C, et al. Sleep deprivation impairs cognitive performance, alters task-associated cerebral blood flow and decreases cortical neurovascular coupling-related hemodynamic responses. Sci Rep. 2021;11. https://www.nature.com/articles/s41598-021-00188-8
- Overworking or burnout15Khammissa R, Nemutandani S, Feller G, et al. Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. J Int Med Res. 2022;50(9). doi:10.1177/03000605221106428
An integrative approach to improving cognitive health includes a thorough review of diet, lifestyle, and nutritional supplements. As a naturopathic practitioner, Dr. Kaczor starts by checking gastrointestinal health and overall energy levels. “Leaky gut and a leaky blood–brain barrier go hand in hand and can lead to neuroinflammation,” she explains. “To assess if a patient has impaired energy production, I consider all the pathways to adenosine triphosphate (ATP) production, including effective glucose [use] by brain cells.”
For More Clarity, Prioritize Cognitive Health
Optimizing brain health to fight atrophy requires regular physical activity, proper hydration, and sufficient sleep quality and quantity.
Sleep activates the glymphatic system, which clears the brain of toxins associated with neurodegenerative diseases like Alzheimer’s. “The glymphatic system’s job is to remove waste or protein aggregates that form in the brain,” notes Dr. Kaczor. “Removal of these aggregates is optimized with proper hydration and sleep. Exercise is one of the most proven means of reducing the risk of brain atrophy.”
Clearing Brain Fog the Natural Way
Alongside proper sleep, exercise, and hydration, mindful activities like meditation and deep breathing can reduce anxiety and help the body manage chronic stress.
Whole-food, pescovegetarian, and semi-vegetarian diets rich in omega–3 fatty acids, leafy greens,16Agarwal P, Leurgans SE, Agrawal S, et al. Association of Mediterranean-DASH intervention for neurodegenerative delay and Mediterranean diets with Alzheimer disease pathology. Neurology. 2023;100(22). doi:10.1212/WNL.0000000000207176 olive oil, and antioxidant-rich fruits and vegetables protect and enhance cognitive and metabolic health. The Mediterranean diet is best known for promoting healthy fats (such as olive oil and nuts), fresh fruits and vegetables, minimal meat, and low levels of processed food. This way of eating can help reduce brain and whole-body inflammation.17Zupo, R., Griseta, C., Battista, et al. Role of plant-based diet in late-life cognitive decline: results from the Salus in Apulia Study. Nutr. Neurosci. 2021;25(6):1300–1309. https://doi.org/10.1080/1028415X.2020.1853416
Natural Remedies to Alleviate Brain Fog
Occasionally, vitamin and mineral deficiencies cause or contribute to cognitive impairment. “I want to ensure the brain is not deficient in anything needed for proper functioning,” she says, “so I will often start by recommending a high-quality multivitamin–mineral supplement as a helpful baseline.” Taking a multivitamin may help improve general cognitive function and memory.18Vyas CM, Manson JE, Sesso HD, et al. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the Cocoa supplement and multivitamin outcomes study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr. 2024;119(3):692-701. https://doi.org/10.1016/j.ajcnut.2023.12.011
Some of Dr. Kaczor’s “go-to” brain health nutrients include flavanols (found in cocoa),19Nehlig A. The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. Br J Clin Pharmacol. 2013;75(3):716-727. doi:10.1111/j.1365-2125.2012.04378.x proanthocyanidins from plants, and herbs such as bacopa,20Walker EA, Pellegrini MV. Bacopa monnieri. [Updated 2023 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK589635 Gotu kola, and Lion’s mane mushroom.21Docherty S, Doughty FL, Smith EF. The Acute and Chronic Effects of Lion’s Mane Mushroom Supplementation on Cognitive Function, Stress and Mood in Young Adults: A Double-Blind, Parallel Groups, Pilot Study. Nutrients. 2023;15(22):4842. Published 2023 Nov 20. https://doi.org/10.3390/nu15224842 Dr. Kaczor also avoids dietary supplements with stimulants.
“When it comes to positively influencing neurotransmitters for focus and improved processing, I want to improve innate function, which requires a slow and steady strategy that will lead to more permanent changes in neuroplasticity and have a healing effect on the brain,” she says.
Keeping Track of Brain Haze
Dr. Kaczor offers some final advice for anyone experiencing recurrent bouts of fuzzy thinking. “If you are having good days and bad days, consider keeping a diary to track your sleep, activities, and food intake, to see if there are any trends you can address. Even though the brain is complex, don’t overlook the basics—sleep, gut health, and correcting any nutrient deficiencies.”
Footnotes
- 1Ross AJ, Medow MS, Rowe PC, Stewart JM. What is brain fog? An evaluation of the symptom in postural tachycardia syndrome. Clin Auton Res. 2013;23(6):305-311. doi:10.1007/s10286-013-0212-z
- 2Van der Feltz-Cornelis C, Turk F, Sweetman J, et al. Prevalence of mental health conditions and brain fog in people with long-COVID: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2024;88:10-22. doi:10.1016/j.genhosppsych.2024.02.009
- 3Dass R, Kalia M, Harris J, Packham T. Understanding the experience and impacts of brain fog in chronic pain: a scoping review. Can J Pain. 2023;7(1). doi:10.1080/24740527.2023.2217865
- 4Ocon AJ. Caught in the thickness of brain fog: exploring the cognitive symptoms of chronic fatigue syndrome. Front Physiol. 2013;4:63. doi:10.3389/fphys.2013.00063
- 5Kravitz HM, Katz RS. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatol Int. 2015;35(7):1115-25. doi:10.1007/s00296-014-3208-7
- 6Eide S, Feng Z. Doxorubicin chemotherapy-induced ‘chemo-brain’: meta-analysis. Eur J Pharmacol. 2020;881. doi:10.1016/j.ejphar.2020.173078
- 7Morrow SA, Kruger P, Langdon D, Alexandri N. What is the true impact of cognitive impairment for people living with multiple sclerosis? A commentary of symposium discussions at the 2020 European Charcot Foundation. Neurol Ther. 2023;12(5):1419-1429. doi:10.1007/s40120-023-00519-z
- 8Markun S, Gravestock I, Jager L, et al. Effects of vitamin B12 supplementation on cognitive function, depressive symptoms, and fatigue: a systematic review, meta-analysis, and meta-regression. Nutrients. 2021;13(3):923. doi:10.3390/nu13030923
- 9Ferreira A, Neves P, Gozzelino F. Multilevel impacts of iron in the brain: the cross talk between neurophysiological mechanisms, cognition, and social behavior. Pharmaceuticals. 2019;12(3):126. doi:10.3390/ph12030126
- 10Anjum I, Jaffery SS, Fayya M, et al. The role of vitamin D in brain health: a mini literature review. Cureus. 2018;10(7). doi:10.7759/cureus.2960
- 11Kverno K. Brain fog: a bit of clarity regarding etiology, prognosis, and treatment. J Psychosoc Nurs Ment Health Serv. 2021;59(11):9-13. doi:10.3928/02793695-20211013-01
- 12Ali S, Begum T, Reza F. Hormonal influences on cognitive function. Malays J Med Sci. 2018;25(4):31-41. doi:10.21315/mjms2018.25.4.3
- 13Bhave VM, Oladele CR, Ament Z, et al. Associations between ultra-processed food consumption and adverse brain health outcomes. Neurology. 2024;102(11). https://doi.org/10.1212/WNL.0000000000209432
- 14Csipo T, Lipecz A, Owens C, et al. Sleep deprivation impairs cognitive performance, alters task-associated cerebral blood flow and decreases cortical neurovascular coupling-related hemodynamic responses. Sci Rep. 2021;11. https://www.nature.com/articles/s41598-021-00188-8
- 15Khammissa R, Nemutandani S, Feller G, et al. Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. J Int Med Res. 2022;50(9). doi:10.1177/03000605221106428
- 16Agarwal P, Leurgans SE, Agrawal S, et al. Association of Mediterranean-DASH intervention for neurodegenerative delay and Mediterranean diets with Alzheimer disease pathology. Neurology. 2023;100(22). doi:10.1212/WNL.0000000000207176
- 17Zupo, R., Griseta, C., Battista, et al. Role of plant-based diet in late-life cognitive decline: results from the Salus in Apulia Study. Nutr. Neurosci. 2021;25(6):1300–1309. https://doi.org/10.1080/1028415X.2020.1853416
- 18Vyas CM, Manson JE, Sesso HD, et al. Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the Cocoa supplement and multivitamin outcomes study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr. 2024;119(3):692-701. https://doi.org/10.1016/j.ajcnut.2023.12.011
- 19Nehlig A. The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. Br J Clin Pharmacol. 2013;75(3):716-727. doi:10.1111/j.1365-2125.2012.04378.x
- 20Walker EA, Pellegrini MV. Bacopa monnieri. [Updated 2023 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK589635
- 21Docherty S, Doughty FL, Smith EF. The Acute and Chronic Effects of Lion’s Mane Mushroom Supplementation on Cognitive Function, Stress and Mood in Young Adults: A Double-Blind, Parallel Groups, Pilot Study. Nutrients. 2023;15(22):4842. Published 2023 Nov 20. https://doi.org/10.3390/nu15224842