Consider Additional Supplements

You may have heard the term “nootropics,” which refers to a broad range of drugs, supplements and other substances that are taken to improve cognitive performance. Sometimes referred to as “smart drugs” or “cognitive enhancers,” these substances can range from caffeine and adaptogens, to amphetamines. While the list of nootropics is long, there are few that I like that are science-backed for improving brain fog, and safe for those of us with chronic disease.
These include:

• L-carnitine: This critical amino acid is concentrated in the body’s most metabolically active organs — the brain, heart, and muscles — and transports fatty acids into the mitochondria where they’re burned for energy. It also helps in the production of acetylcholine, which is the neurotransmitter most associated with memory function. Studies have shown that acetyl l-carnitine is helpful in slowing brain-related aging and decline. Additionally, an overpopulation of opportunistic (bad) bacteria in the gut can lead to the production of ammonia, which can be another cause of brain fog. Studies have shown that taking L-carnitine can clear ammonia from the body. In a 2016 study, 60 hypothyroid patients who were experiencing fatigue, were given L-carnitine for 12 weeks. After 12 weeks, the researchers noted that the group receiving L-carnitine showed improvements in fatigue, with the most significant improvements seen in brain fatigue. The most significant results were in those younger than 50, those over the age of 50 with high levels of free T3, and those who had hypothyroidism due to a thyroidectomy (who were taking relatively high doses of thyroid hormone). Researchers concluded that these populations were more active metabolically (and therefore had relative carnitine deficiency). I recommend taking one capsule per day Carnitine Synergy, which contains the L-carnitine and Acetyl-L-carnitine forms, for its unique properties in supporting brain function and reducing mental fatigue.

• S. boulardii: Another supplement that can help clear excess ammonia (often the result of poorly digested protein) from the body is the yeast S. boulardii. It has the additional benefits of strengthening the intestinal barrier and counterbalancing pathogenic bacteria in the gut, which can be root causes of leaky gut and brain fog. S. boulardii is also good for antibiotic induced diarrhea or to take as a preventative anytime you are on antibiotics. I recommend taking S. boulardii as Floramyces by Designs for Health. Therapeutic doses of up to 8 capsules a day may be helpful, though I recommend slowly working up to that dose with 1-2 capsules per day.

• Fish Oil: Essential fatty acids (EFAs) are naturally occurring fats that the body cannot produce and are therefore essential. They must be derived from either whole foods (like fish), or supplements. EFAs help manage inflammation and autoimmunity, promote blood vessel health, support healthy skin growth, provide the precursors to balance hormones, and support healthy brain and nervous system function. They are considered essential because they are crucial to our health in so many ways. Omega-3 fatty acids, found in fish oil, provide powerful anti-inflammatory support for the brain. Supplementing regularly can improve cognitive performance, including memory, concentration, and learning abilities. Look for a professional quality fish oil supplement that has been molecularly distilled and filtered, such as OmegAvail Hi-Po or OmegAvail™ Synergy by Designs for Health. This process ensures purity and helps eliminate contaminants including heavy metals, pesticides, solvents, and PCBs. I recommend 1-4 grams of fish oil per day, taken with a meal that contains quality fats.

• Trimethylglycine: Also known as TMG, trimethylglycine is a compound found in beetroot (and other plants and animal foods). It was originally known as betaine because it was first discovered in sugar beets. However, TMG is just one of many betaines that have since been identified. One of the main functions of TMG is to protect cells from stress, and it has many health benefits – it protects the liver, heart, and kidneys, and can enhance physical performance. Studies have shown that participants who were given cobalamin supplementation (which increases TMG levels), experienced better reaction time, memory, and brain function. A dose of 2.5 grams of trimethylglycine per day is recommended to reduce brain fog.

• L-Tyrosine: The amino acid l-tyrosine is a precursor of the thyroid hormone thyroxine and neurotransmitters, enhancing mood and cognitive function, especially under situations involving stress or when dopamine, epinephrine or norepinephrine levels require additional support. I recommend taking 1-4 capsules per day, in divided doses.

• Choline: Choline is an essential nutrient that can be found in beef liver and egg yolks but is deficient in many diets. Citicoline is a bioavailable version of choline that has been well studied to be less toxic and more effective than other versions. Numerous clinical studies have shown that citicoline boosts mental energy by improving cerebral blood flow and protecting brain cells from free radical damage. In fact, its effects on the brain are so powerful that it’s used to enhance cognitive function in patients damaged by neurological disorders or brain trauma. Choline boosts acetylcholine levels, a neurotransmitter closely involved in learning and memory. It also contains CDP choline, an active component of phosphatidylcholine, which comprises 30 percent of brain tissue and preserves brain cell membranes, protects memory, and facilitates neural communication. One study investigated the effects of choline on memory disturbances and working memory and found that citicoline can mitigate the effects of mental fatigue by increasing frontal lobe activity and brain energy reserves. Additional studies have shown choline to improve cognitive speed and attention in young adults, stroke patients, and elderly individuals with dementia. I recommend the product Brain Vitale which contains Citicoline. The usual daily therapeutic dosage of citicoline is 500-2,000 mg, taken daily.

• Glycine: If you find that your sleep is not restful, you might want to try taking a glycine supplement at bedtime for more refreshing, deeper rest. A recent study found that glycine (a non-essential amino acid) subjectively and objectively improved sleep quality in people who suffered from insomnia. The effects of glycine on daytime sleepiness, fatigue, and performances in sleep-restricted healthy subjects were evaluated during this study. Sleep was restricted to 25 percent less than the usual sleep time for three consecutive nights. Before bedtime, 3 grams of glycine powder were ingested, and sleepiness and fatigue were evaluated using the visual analog scale (VAS) and a questionnaire. In subjects given glycine, the VAS data showed a significant reduction in fatigue and a tendency toward reduced sleepiness. These observations were confirmed with the questionnaire, indicating that glycine improves daytime sleepiness and fatigue induced by acute sleep restriction.
• CogniAid™ is an herbal formula designed to help support healthy cognition, mood and memory.** This product supplies herbs and extracts that have been shown to work through a variety of mechanisms, including helping to maintain proper levels of the neurotransmitter acetylcholine, as well as supporting healthy neurons and nerve impulse transmission.** CogniAid™ contains a wildcrafted blueberry complex, which in addition to blueberries, uses extracts of huckleberries and bilberries. This product also features vinpocetine, huperzine-A (a naturally occurring alkaloid compound), the green tea polyphenol EGCg, and the Ayurvedic herb Bacopa monnieri.

Additional Steps to Relieve Brain Fog

If you are still experiencing brain fog after tackling the fundamental strategies I’ve outlined above, you may want to dig a little bit further and incorporate one or more additional steps to uncover your root causes.

• Try a ketogenic diet: Some people find that eating a high-fat, low-carb ketogenic diet — where the body breaks down fats for fuel instead of relying on carbohydrates — can help stabilize blood sugar and keep insulin levels low, while providing your brain an alternate fuel source that also lowers inflammation. A well-designed ketogenic diet would include healthy high-fat foods, including wild-caught seafood, avocado, flax and chia seeds, and raw organic nuts. You also want to include plenty of gut-supporting foods, including fiber-rich leafy and cruciferous vegetables, as well as probiotic-rich foods like sauerkraut and kimchi.

• Eliminate mold toxicity: If your symptoms started around the time that you moved into your home, there’s a high potential that mold or toxic exposure may be the root cause of your condition. Potential symptoms can include brain fog, despite thyroid medications. You can read more about mold toxicity and how to protect yourself in my mold article that will be posted tomorrow.

• Look into EMF sensitivity: Another type of sensitivity that some people with chronic disease can have is to electromagnetic fields (EMFs), such as those emitted by fluorescent lights, mobile phones, Wi-Fi, cordless phones, and power lines. Symptoms of EMF sensitivity include sleep disturbances, stress, fatigue, headaches, and brain fog, any and all of which may be exacerbated with increased exposure to EMFs. You can take a look at the World Health Organization’s guidelines for safe levels of EMF exposure, but this is a topic that I’d like to explore more in an upcoming article!

• Eliminate mercury exposure: Mercury from dietary sources, including high-mercury fish, can disrupt thyroid function. This leads to numerous symptoms including brain fog.

Takeaway

Brain fog is an incredibly common symptom in Chronic Disease and can leave a person feeling unable to function in their day-to-day life. Confusion, lack of focus, memory loss… these can all sap a person’s self-confidence and greatly impact their quality of life. I know this to be true, as it was my own experience!
The good news is that, by making sure our thyroid hormones are optimized, and by addressing gut health, we can eliminate most of the underlying causes of brain fog and regain mental clarity. It might take some work; after all, healing from chronic disease involves some detective work to get the bottom of everyone’s underlying causes. But I have no doubt that you can get there. When brain fog is eliminated, there is no limit to what you can accomplish!

Look for my article on Mold and Mold Exposure tomorrow!!

References

1. Simopoulos AP. An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity. Nutrients. 2016 Mar; 8(3): 128.
2. Banks WA. The Blood-Brain Barrier: Connecting the Gut and the Brain. Regulatory Peptides. 2008 Aug 7; 149(1-3): 11–14.
3. Dissing-Olesen L, Ladeby R, Nielsen HH, Toft-Hansen H, Dalmau I, Finsen B. Axonal lesion-induced microglial proliferation and microglial cluster formation in the mouse. Neuroscience. 2007 Oct 12;149(1):112-22.
4. Gierach M, Gierach J, Skowrońska A, Rutkowska E, Spychalska M, Pujanek M, Junik R. Hashimoto’s Thyroiditis and Carbohydrate Metabolism Disorders in Patients Hospitalised in the Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2001 and 2010. Endokrynologia Polska. 2012;63(1):14-7.
5. Vojdani A, O’Bryan T, Green JA, Mccandless J, Woeller KN, Vojdani E, Nourian AA, Cooper EL. Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism. Nutritional Neuroscience. 2004 Jun;7(3):151-61.
6. Remaud S, Gothié JD, Morvan-Dubois G, Demeneix BA. Thyroid Hormone Signaling and Adult Neurogenesis in Mammals. Frontiers in Endocrinology (Lausanne). 2014 Apr 28;5:62.
7. Theoharides TC, Stewart JM, Hatziagelaki E, Kolaitis G. Brain “fog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. Frontiers in Neuroscience. 2015 Jul 3;9:225.
8. Ransing RS, Mishra KK, Sarkar D. Neuropsychiatric Manifestation of Hashimoto’s Encephalopathy in an Adolescent and Treatment. Indian Journal of Psychological Medicine. 2016 Jul-Aug;38(4):357-60.
9. Canelo-Ayba C, David Loja-Oropeza D, Cuadra-Urteaga J, Romani-Romani F. Hashimoto’s Encephalopathy Presenting with Neurocognitive Symptoms: A Case Report. Journal of Medical Case Reports. 2010;4:337.
10. Kobayashi S, Iwamoto M, Kon K, Waki H, Ando S, Tanaka Y. Acetyl-L-carnitine improves aged brain function. Geriatr Gerontol Int. 2010 Jul;10 Suppl 1:S99-106. doi: 10.1111/j.1447-0594.2010.00595.x.
11. Malaguarnera M, Vacante M, Motta M, Giordano M, Malaguarnera G, Bella R, et al. Acetyl-L-carnitine improves cognitive functions in severe hepatic encephalopathy: a randomized and controlled clinical trial. Metab Brain Dis. 2011 Dec;26(4):281-9. doi: 10.1007/s11011-011-9260-z. Epub 2011 Aug 26.
12. Eussen SJ, Ueland PM, Clarke R, Blom HJ, Hoefnagels WH, van Staveren WA, et al. The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people. Br J Nutr. 2007 Nov;98(5):960-8. Epub 2007 May 31.
13. Silveri MM, et al. Citicoline enhances frontal lobe bioenergetics as measured by phosphorus magnetic resonance spectroscopy. NMR in Biomedicine. 24 Sep 2008. https://doi.org/10.1002/nbm.1281
14. An JH, Kim YJ, Kim KJ, et al. L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: a randomized, double-blind, placebo-controlled trial. Endocr J. 2016 Oct 29;63(10):885-895. Epub 2016 Jul 16.
15. Bannai M, Kawai N, Ono K, Nakahara K, Murakami N. The Effects of Glycine on Subjective Daytime Performance in Partially Sleep-Restricted Healthy Volunteers. Front Neurol. 2012; 3: 61. doi: 10.3389/fneur.2012.00061