Improve Mental Clarity by Reducing Inflammation and Healing the Gut
Brain fog is one of the most frustrating symptoms to deal with, in part because it’s not always recognized by healthcare providers. Although it’s a common symptom, there’s not much direct research about brain fog, and there are no standard tests, treatments, or criteria to aid diagnosis.
However, for practitioners and patients who are willing to dig a bit deeper, there’s lots that can be done to relieve symptoms of brain fog.
Learning how to get rid of brain fog can help you to get back to your life, and get through your days without such a struggle. Based on the research that is available so far, reducing systemic inflammation and supporting the gut seem to be the most promising strategies when it comes to reducing mental fatigue and fogginess [1, 2, 3, 4, 5, 6, 7].
Here, we will explore the research behind the root causes of brain fog and how to get rid of the symptom.
What is Brain Fog?
Brain fog is a term that is used to describe symptoms including slow or cloudy thinking, difficulty focusing, reduced memory or forgetfulness, and difficulty completing cognitive tasks [8, 9].
Brain fog has been described or reported in relation to several different chronic health conditions, including:
- Chronic fatigue syndrome 
- Crohn’s disease 
- Fibromyalgia  (sometimes referred to as “fibro-fog”)
- Small Intestinal Bacterial Overgrowth (SIBO) 
- Celiac disease and non-celiac gluten sensitivity [13, 14, 15]
- Non-celiac gluten sensitivity [14, 15]
- Hypothyroidism [16, 17]
- Postural tachycardia syndrome (POTS) 
- Mast cell disorders 
- Menopause 
How to Get Rid of Brain Fog: A Snapshot
Let’s take a quick look at some of the simple steps that can be taken in order to get rid of brain fog:
- Start with the basics
- Prioritize sleep
- Get regular exercise
- Practice stress management
- Reduce inflammation
- Follow an anti-inflammatory diet
- Determine individual trigger foods (ex. gluten)
- Consider the role of histamine and mast cells
- Support your gut
- Consider probiotics
- Identify and treat any underlying imbalances such as SIBO
We’ll explore each of these steps in more detail later, but first, let’s take a look at some of the common root causes of brain fog.
Underlying Causes of Brain Fog
There is no single cause of brain fog, but a few key factors, including inflammation and gut imbalances, appear to contribute.
Chronic inflammation throughout the body has been associated with cognitive dysfunction, and it is a common thread across many of the conditions that are associated with brain fog [21, 22, 23].
Brain fog has been observed in various disorders, including fibromyalgia, multiple sclerosis, and among patients undergoing chemotherapy. As noted in one review on brain fog and cognitive impairments among patients with celiac disease:
“All of these disorders have one thing in common with [celiac disease] — they are associated with systemic inflammation” .
Mast Cells and Histamine Intolerance
Brain fog is a common symptom of mast cell disorders and histamine intolerance, which both involve excess or chronic inflammation [24, 25].
Mast cells are specific kinds of white blood cells that release inflammatory molecules, including histamine, in response to various triggers. This is a normal function of a healthy immune system. But in some cases, mast cells are triggered too often or without appropriate cause, which can lead to excess inflammation and histamine levels throughout the body (including in the brain).
The gut and the brain are connected in a multitude of ways, and brain fog may be caused by imbalances in the gut [26, 27]. For example, intestinal inflammation and leaky gut can lead to inflammation in the brain [28, 29, 30, 31]. Imbalances in the gut microbiome can also directly contribute to brain function [26, 32, 33].
Brain fog is one of the most common symptoms I see among my patients, and it often comes alongside fatigue and digestive symptoms. In the clinic, when we target and treat gut health, mental clarity and brain function also tend to improve.
SIBO and Liver Dysfunction
The gut-liver-brain connection might not seem obvious, but it may have a role to play in brain fog. Think of the connection this way: all toxins in your gut are processed by your liver. If your liver is overburdened for any reason, these toxins may build up and get into your brain.
A type of cognitive impairment that sometimes occurs in liver disease, hepatic encephalopathy (HE), has been linked to small intestinal bacterial overgrowth (SIBO).
In fact, the presence of SIBO is often what sets cirrhosis patients with mild cognitive impairments apart from cirrhosis patients without brain issues .
Research has also shown that Rifaximin, an antibiotic that is often used to treat SIBO, can prevent and improve HE [35, 36]. In a 2020 study, treatment of SIBO significantly improved minimal HE, while treatment of the stomach infection Helicobacter Pylori (H pylori), did not . This further highlights the significance of a gut-liver-brain connection.
These findings may be relevant for brain fog and cognitive function in general, as they suggest that treating bacterial overgrowth in the gut can help to reduce mental fogginess and cognitive dysfunction.
How to Treat Brain Fog
Now that we have a better idea of what’s behind brain fog, it’s time to dive into treatments that address these underlying causes.
Start With the Basics
A few fundamental lifestyle changes can help reduce inflammation and improve brain fog.
- One of the most important things you can do to support brain health is to eat an anti-inflammatory diet that focuses on whole foods.
- Avoiding sugar, processed foods, and other inflammatory foods can make a huge difference when it comes to cognitive function [1, 2]. We’ll provide more detailed information about this essential piece in the next section.
- A 2020 systematic review of 29 studies concluded that exercise or physical activity may help to treat brain fog associated with cancer and chemotherapy (“chemo fog”) .
- Exercise has been shown to reduce inflammation and improve leaky gut, which may help to explain the cognitive benefits [39, 40].
- Getting enough sleep might be one of the most important things you can do for your gut and your brain.
- Lack of sleep can lead to leaky gut and inflammation .
- A study on cognitive impairment in Crohn’s disease also found a strong association between poor sleep quality and cognitive dysfunction .
- Chronic stress is a common cause of inflammation and leaky gut, which can have a negative impact on cognitive function [42, 43].
- Practicing mindfulness meditation and reducing stress levels in other ways may help to calm inflammation and reduce brain fog.
What’s the Best Diet for Brain Fog?
The most important thing to remember when choosing your ideal diet for brain fog is that you want to reduce inflammation.
A healthy, anti-inflammatory diet eliminates processed and refined foods, added sugar, and other inflammatory foods. The emphasis is on a balance and variety of fresh, whole foods.
- A 2019 review suggested that an anti-inflammatory diet may prevent or reduce leaky gut and brain inflammation, thereby reducing cognitive symptoms like brain fog .
- A 2016 review suggested that a diet high in omega-3 fatty acids and low in added sugar may help reduce inflammation and brain fog in cancer patients undergoing chemotherapy .
There are a few different templates for an anti-inflammatory diet. However, I often recommend the Paleo diet. The Paleo diet eliminates processed foods, grains, dairy products, and additives, and it focuses on fresh fruits and vegetables, fish, eggs, grass-fed meats, and healthy fats.
I would recommend trying a Paleo diet for brain fog if:
- Your current diet is higher in inflammatory or processed foods, and;
- You don’t have any other known conditions or intolerances that may benefit from a more specialized diet.
Gluten and Other Food Sensitivities
Some specific foods might trigger an immune system response and inflammation.
Gluten is one example of a food sensitivity or intolerance that has been linked to brain fog:
- Brain fog has been reported as a common symptom among patients with both celiac disease and non-celiac gluten sensitivity .
- One small study on patients with celiac disease found that brain fog was resolved after following a gluten-free diet for 12 months .
Does this mean that everyone who has brain fog should avoid gluten? No. Gluten is highly inflammatory to those who are sensitive to it, but not everyone needs to go gluten-free. A 2-3 week gluten-free trial is a great way to determine if you are gluten-sensitive. If your brain fog improves on a gluten-free trial, continue with the gluten-free diet. If not, there is no need to go gluten-free.
Low FODMAP Diet
The low FODMAP diet may help some people with brain fog, especially those with IBS or SIBO . Studies have found that a low FODMAP diet can reduce leaky gut, inflammation, and digestive symptoms [44, 45].
One study showed that a low FODMAP diet led to improvements in brain fog for patients with IBS . These improvements were related to changes in the gut microbiome and a significant reduction in the inflammatory molecule histamine.
A low FODMAP diet eliminates certain kinds of carbohydrates that are fermented by (and feed) gut bacteria. High FODMAP foods include various types of legumes, grains, and certain fruits and vegetables.
I would recommend trying a low FODMAP diet if:
- Symptoms do not improve on an anti-inflammatory or Paleo diet, and;
- You have suspected or diagnosed SIBO or IBS.
Low Histamine Diet
A low histamine diet may help some people to reduce brain fog. This diet reduces the intake of dietary histamine, which is important if your body is producing excess histamine.
A low histamine diet eliminates aged and fermented foods, alcohol, and certain kinds of fruits and vegetables.
I would recommend trying a low histamine diet if:
- Symptoms do not improve on an anti-inflammatory or Paleo diet, and;
- You have suspected or diagnosed histamine intolerance or a mast cell disorder.
Recent studies have shown that probiotics can help to improve cognitive function [5, 6, 7, 26, 46].
- A 2020 meta-analysis of 7 human and 11 animal studies concluded that probiotics enhanced cognitive function. Effects of probiotics on cognitively impaired individuals were greater than those on healthy ones .
- A 2020 clinical trial on healthy older adults showed that probiotics changed the makeup of the gut microbiome and improved cognitive function and mood .
- Two clinical trials have demonstrated that supplementing with probiotics for 12 weeks can improve cognition in patients with Alzheimer’s [6, 7].
- A study found that probiotics can help to improve cognitive function in fibromyalgia .
Probiotics work by restoring balance to the gut ecology. This stops the cycle that leads to leaky gut and systemic inflammation. Research confirms that probiotics reduce inflammation [47, 31].
There are a few other treatments that have been shown to provide some benefits for patients with brain fog:
- One review found that luteolin, a flavonoid (a type of chemical found in plants) with anti-inflammatory and antioxidant properties, can improve brain fog in patients with the mast cell disorder mastocytosis .
- Another review found that fasting can help to improve cognition and brain health for those with neurological diseases and slow down age-related cognitive decline .
Other anti-inflammatory supplements, such as curcumin, fish oil, and resveratrol may also help to reduce brain fog, but research is lacking.
Reduce Gut Inflammation to Get Rid of Brain Fog
Brain fog is a signal that your body and brain are inflamed and may be an indication of imbalances in the gut. By following a few key strategies, you can reduce inflammation, heal your gut, and clear up brain fog.
Eating to reduce inflammation is essential to getting rid of brain fog. Supporting a healthy gut with high-quality probiotics is another important step.
It’s also important to get 7-9 hours of sleep per night, practice stress management techniques, and get regular exercise.
For a more detailed and personalized plan to heal your gut and reduce inflammation, check out my book, Healthy Gut, Healthy You.
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