Does your gut need a reset?

Yes, I'm Ready

Do you want to start feeling better?

Yes, Where Do I Start?

Do you want to start feeling better?

Yes, Where Do I Start?

How to Target Neuroinflammation and Beat Brain Fog

The Role of Inflammation in Anxiety, Depression, and Brain Fog

Key Takeaways:
  • Brain inflammation (neuroinflammation) is linked with brain fog, depression, and anxiety.
  • Chronic neuroinflammation may start with gut inflammation and gut dysbiosis.
  • Gut bacterial imbalances can create a leaky gut that allows toxins to cross into the brain.
  • The Mediterranean, Paleo, keto, and low FODMAP diets all have some anti-inflammatory qualities. (The exact diet you choose is personal to your own symptoms and gut sensitivities).
  • Quality sleep and exercise also help in dealing with neuroinflammation.
  • Limbic system retraining is something to consider for trickier cases of neuroinflammation or anxiety symptoms.

Brain inflammation (neuroinflammation) is often equated with something catastrophic like traumatic brain injury or spinal cord injury. However, If you’ve ever experienced brain fog or stress-related difficulties in clear thinking, chances are that inflammation has played a part. 

Neuroinflammation (inflammation that occurs in the cells and structures of the brain and CNS or central nervous system) is actually common and not always a bad thing. But when it’s chronic or severe, your cognitive function and mental well-being start to suffer. 

What we know from research and from clinical experience is that brain inflammation isn’t usually a standalone condition. It will usually be part of a more generalized inflammation of the body and often stems from issues with unhealthy gut bacteria.

For example, patients like Adrian describe debilitating brain fog and other signs of inflammation (e.g. joint pain) that got better through following a gut health protocol. 

Of course, neuroinflammation will present in many different ways and the causes and cures will be very individual. But in this article, I’ll go through some of the strategies that help most people.

Signs and Symptoms of Neuroinflammation

One of the most common symptoms of neuroinflammation is “brain fog” — that fuzzy-headed feeling that comes along with difficulty in concentrating, remembering, and focusing on specific tasks [1, 2, 3].

Researchers measure brain inflammation by checking levels of inflammatory mediators (markers), such as IL-1β, C-reactive protein, and interleukin-6. Having higher levels of these inflammatory chemicals has also been associated with:

  • Greater mental effort being required during cognitive tests [4]
  • Having regular migraines [5]
  • Experiencing chronic fatigue [6]

Longer term neuroinflammation also seems to be a factor in several more serious neurological diseases and conditions such as anxiety, depression, and even neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease and multiple sclerosis [7, 8].

We don’t know if inflammation causes these symptoms and illnesses, or whether the disease states create the inflammation (a bit of both is quite likely).

Either way, there’s a strong association between many cognitive impairment/ neurological conditions and neuroinflammation, meaning that interventions that help to lower excess inflammation are a great tool for improving brain health.

Not All Bad

Neuroinflammation isn’t always a problem, and in the complex world of neuroscience and brain morphology, controlled levels of inflammation are actually part of the brain’s protective mechanisms. Positive aspects of mild neuroinflammation include protection from infections, assistance with memory and learning, and tissue healing. 

As a normal part of being sick, controlled neuroinflammation also induces fever, low appetite, decreased activity, and reduced social interaction allowing the body to reallocate immune system resources to healing [9].

But neuroinflammation can become destructive when it is chronic and/or severe [9]. 

Drivers of Unhealthy Inflammation

How to Target Neuroinflammation and Beat Brain Fog - Drivers%20of%20Neuroinflammation 01 L

Gut imbalances, infections, pathogens, and other injuries to tissues are common drivers of harmful neuroinflammation. It’s thought that these trigger an immune response from the innate immune system (the immune system we were born with). 

More specifically, neuroinflammation involves the activation of brain immune cells known as microglia or microglial cells, which are a subgroup of the brain’s glia or glial cells.

Microglial activation, in turn, creates the production of pro-inflammatory cytokine and chemokine chemicals, which can damage neurons (nerve cells) and cause cell death [7].The presence of activated microglia and pro-inflammatory cytokines can also activate other cells called astrocytes, leading to a secondary inflammatory response that further exacerbates neuroinflammation and potentially cognitive disease progression [10].

In more advanced neuropathology, at least in animal models, type 1 interferons ( IFN-I) are released and believed to contribute to a worsening of brain health [11].

An Anti-Inflammatory Diet Helps

I always suggest that people with brain fog and other nerve inflammation symptoms like mild anxiety and depression look to their diets first before trying any more radical steps. One reason is the strong gut-brain connection that I talk about often and go into in more detail below. Improving your diet also underpins general health, with none of the potential downsides that could occur with anti-inflammatory medication. Research shows that [12]:

  • Highly refined carbohydrate, calorie-dense meals are associated with higher biomarkers of inflammation (C-reactive protein and interleukin-6) in the body.
  • Foods most likely to lead to inflammation are refined starches, refined artificial trans-fats, and saturated fats eaten with lots of carbs. 

An anti-inflammatory diet is the obvious choice for quelling body and brain inflammation, and a healthy Mediterranean diet is the first choice for many. The Mediterranean model of eating includes plenty of fresh fruits and vegetables, salads, nuts, and oily fish, so will dampen down inflammation and offer neuroprotection in most people who try it [13]. 

Bear in mind, however, that if you have been struggling with brain and gut inflammation for a while, you may have food sensitivities that require individualized food choices. For instance, a Paleo version of the Mediterranean diet (with fewer grains and minimal dairy) has been a game-changer for a number of my patients with gut and brain health symptoms.

Still, others have required a period on either a keto or a low FODMAP elimination diet to really get to grips with neuroinflammation, brain fog, and mood/emotional dysfunction.

It’s not possible to be prescriptive about which anti-inflammatory diet to go for, and it will take some trial and error to discover what makes your own symptoms better.

However, any move away from neuroinflammatory hyper-processed foods is a move in the right direction.

One solid clinical recommendation I can give you is to start with minimal food restrictions. You should then only cut out extra foods as necessary based on your symptoms and the foods that trigger issues for you.

Probiotics for Neuroinflammation and Brain Fog

Probiotics have been shown to be useful at reducing systemic inflammation (throughout the whole body) [14, 15], and this likely extends to neuroinflammation more specifically. 

For example, one study showed that participants taking probiotics experienced reduced stress and anxiety, as well as a drop in pro-inflammatory cytokines after 12 weeks. Those taking probiotics also experienced improvements in memory, social-emotional cognition, and verbal learning, [16, 17, 18].

Though there is no solid information on the exact types of probiotics that might be best for people with neuroinflammation, review studies have shown a multi-strain approach seems to work best when it comes to gut issues like IBS and constipation [17, 19]. 

At the clinic, we have seen the best results across a range of gut, inflammation, and brain fog issues when our patients follow a triple therapy probiotic protocol (taking one probiotic from each of these three categories):

Category 1: Lactobacillus and Bifidobacterium blends (including different strains of probiotics such as L. acidophilus, L. plantarum, B. infantis, and B. lactis).

Category 2: Saccharomyces boulardii (a beneficial yeast)

Category 3: Soil-based probiotics (usually Bacillus species)

For many patients who have tried probiotics in the past without success, this multi-pronged approach makes all the difference.

The Gut-Brain Axis

How to Target Neuroinflammation and Beat Brain Fog - The%20Gut Brain%20Connection Landscape L

The way a healthy diet and probiotics help in damping down inflammation is via the “gut-brain axis”. This two-way communication happens largely via the vagus nerve, which passes from the brain to the stomach and small intestine. 

The gut-brain axis means the brain can communicate with the gut (e.g. instructing it to digest food) while allowing mood-managing neurotransmitters made in the gut (e.g. dopamine and serotonin) to pass to the brain [20]. 

Things can go wrong when gut dysbiosis (an imbalance of the healthy mix of bacteria and microbes in the gut) impairs these communication pathways [20].

More specifically, dysbiosis causes degeneration of the gut lining, allowing infiltration of antigens (allergy-inducing chemicals) and other toxins into the body, stimulating systemic inflammation. These neurotoxic particles can also cross the blood-brain barrier contributing to inflammation in the brain. 

Thankfully, an anti-inflammatory diet and probiotics, as detailed above, can improve microbiota composition and gut barrier function (reduced leakiness), which in turn may reduce the chance of harmful inflammation and neuroinflammation [21].

Get Good Sleep

How to Target Neuroinflammation and Beat Brain Fog - How%20to%20Improve%20Sleep Landscape L

Alongside making improvements to your diet and taking probiotics, you can do a lot to fight neuroinflammation by improving the quality of your sleep and dealing with stress.

Sleeping too few hours has been linked with inflammation in the body. For example [22]:

  • Regularly getting less than 7 hours of sleep was associated with high markers of inflammation such as CRP.
  • Losing 4-8 hours of sleep in one night increased the inflammatory cytokines IL-6 and TNF-α.

Disturbed sleep was shown to stimulate higher levels of inflammation too [22]. 

If at all possible, it’s a good idea to sleep in a room that is properly dark and quiet. Combining this with a regular bedtime schedule that allows you 7 hours of unbroken sleep will do much to fight the symptoms of neuroinflammation.

If thoughts flooding through your brain keep you awake, practicing mindfulness meditation techniques (which also treat gut issues very well) may help you get to sleep faster.

Exercise Reduces Inflammation

If you have neuroinflammation symptoms like brain fog and fatigue, exercise may feel like the last thing you want to do, but research shows it’s a really valuable way to dampen down inflammation (exercise also has mood-boosting benefits). 

The good news, if you’re feeling rather fragile and exhausted, is that just 20 minutes of moderate exercise is enough to reduce inflammation. A study found that people who worked out on a treadmill at just two-thirds of their VO2 max (maximum exertion level), achieved a 5% drop in the production of monocyte-produced tumor necrosis factor-α (TNF-α), which is a chief marker of anti-inflammatory cellular response.

What counts as “moderate” exercise will be different from one person to another, but can include the range of fast walking to slow running. 

The bottom line to combat neuroinflammation is that you should be performing exercise at a level of perceived exertion that feels like at least around 6 out of 10.

Try Limbic System Retraining

If changing your diet, taking probiotics, and nurturing yourself with better sleep and quality physical activity still leaves you with mood-based or cognitive symptoms, you might want to consider if you are a candidate for limbic system retraining.

The limbic system is the part of the brain buried under the cerebral cortex involved in processing emotion and memory. It includes the hippocampus, amygdala, and hypothalamus.

For some patients who have experienced long-term gut and health issues, including health anxiety, limbic system retraining has proved very helpful.

I consider neuroinflammation and its symptoms, such as brain fog, depression, and anxiety, good candidates for limbic system retraining (also known as neuroplasticity healing). But it does totally depend on you as an individual.

You can think of limbic system retraining as essentially a rewiring of the brain, which can help you feel calmer when you have become stuck in a frenetic pattern of being worried about your physical symptoms, causing you to spiral down into an anxious state. 

I recommend Ashok Gupta’s limbic system retraining program, though it requires some dedication as you need to practice meditation-type exercises daily. This program was recently backed by a pilot scientific study [23] that found it reduced chronic pain, depression, and anxiety by more than 40% after eight weeks in women with fibromyalgia.

You can find more information about the Ashok Gupta program here and listen to the experience of my patient Danielle, who found limbic retraining very helpful, here

While limbic system retraining isn’t for everyone, it’s definitely a thing to consider if other neuroinflammation-reducing strategies have not worked.

You Can Successfully Fight Neuroinflammation 

When you’re troubled by brain fog and other mental issues related to brain inflammation, it can be hard to feel positive. However, by targeting your gut health, sleep and exercise, improvements should start to slowly but surely happen.

If you feel your health or neurological issues are more complex, feel free to contact our experienced practitioners at the Ruscio Institute for Functional Health

Another resource that might be useful is the step-by-step guide to better gut and general health detailed in my book Healthy Gut, Healthy You.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References
  1. Theoharides TC, Stewart JM, Hatziagelaki E, Kolaitis G. Brain “fog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. Front Neurosci. 2015 Jul 3;9:225. DOI: 10.3389/fnins.2015.00225. PMID: 26190965. PMCID: PMC4490655.
  2. Conti P, D’Ovidio C, Conti C, Gallenga CE, Lauritano D, Caraffa A, et al. Progression in migraine: Role of mast cells and pro-inflammatory and anti-inflammatory cytokines. Eur J Pharmacol. 2019 Feb 5;844:87–94. DOI: 10.1016/j.ejphar.2018.12.004. PMID: 30529470.
  3. Jones KA, Thomsen C. The role of the innate immune system in psychiatric disorders. Mol Cell Neurosci. 2013 Mar;53:52–62. DOI: 10.1016/j.mcn.2012.10.002. PMID: 23064447.
  4. Balter LJ, Bosch JA, Aldred S, Drayson MT, Veldhuijzen van Zanten JJ, Higgs S, et al. Selective effects of acute low-grade inflammation on human visual attention. Neuroimage. 2019 Nov 15;202:116098. DOI: 10.1016/j.neuroimage.2019.116098. PMID: 31415883.
  5. Kursun O, Yemisci M, van den Maagdenberg AMJM, Karatas H. Migraine and neuroinflammation: the inflammasome perspective. J Headache Pain. 2021 Jun 10;22(1):55. DOI: 10.1186/s10194-021-01271-1. PMID: 34112082. PMCID: PMC8192049.
  6. Nakatomi Y, Mizuno K, Ishii A, Wada Y, Tanaka M, Tazawa S, et al. Neuroinflammation in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: An 11C-(R)-PK11195 PET Study. J Nucl Med. 2014 Jun;55(6):945–50. DOI: 10.2967/jnumed.113.131045. PMID: 24665088.
  7. Kaur N, Chugh H, Sakharkar MK, Dhawan U, Chidambaram SB, Chandra R. Neuroinflammation mechanisms and phytotherapeutic intervention: A systematic review. ACS Chem Neurosci. 2020 Nov 18;11(22):3707–31. DOI: 10.1021/acschemneuro.0c00427. PMID: 33146995.
  8. Bradburn S, Murgatroyd C, Ray N. Neuroinflammation in mild cognitive impairment and Alzheimer’s disease: A meta-analysis. Ageing Res Rev. 2019 Mar;50:1–8. DOI: 10.1016/j.arr.2019.01.002. PMID: 30610927.
  9. DiSabato DJ, Quan N, Godbout JP. Neuroinflammation: the devil is in the details. J Neurochem. 2016 Oct;139 Suppl 2(Suppl 2):136–53. DOI: 10.1111/jnc.13607. PMID: 26990767. PMCID: PMC5025335.
  10. Kwon HS, Koh S-H. Neuroinflammation in neurodegenerative disorders: the roles of microglia and astrocytes. Transl Neurodegener. 2020 Nov 26;9(1):1–12. DOI: 10.1186/s40035-020-00221-2. PMID: 33239064. PMCID: PMC7689983.
  11. Nazmi A, Field RH, Griffin EW, Haugh O, Hennessy E, Cox D, et al. Chronic neurodegeneration induces type I interferon synthesis via STING, shaping microglial phenotype and accelerating disease progression. Glia. 2019 Jul;67(7):1254–76. DOI: 10.1002/glia.23592. PMID: 30680794. PMCID: PMC6520218.
  12. Schelke MW, Attia P, Palenchar DJ, Kaplan B, Mureb M, Ganzer CA, et al. Mechanisms of risk reduction in the clinical practice of alzheimer’s disease prevention. Front Aging Neurosci. 2018 Apr 10;10:96. DOI: 10.3389/fnagi.2018.00096. PMID: 29706884. PMCID: PMC5907312.
  13. Tsigalou C, Konstantinidis T, Paraschaki A, Stavropoulou E, Voidarou C, Bezirtzoglou E. Mediterranean diet as a tool to combat inflammation and chronic diseases. an overview. Biomedicines. 2020 Jul 8;8(7). DOI: 10.3390/biomedicines8070201. PMID: 32650619. PMCID: PMC7400632.
  14. Morshedi M, Hashemi R, Moazzen S, Sahebkar A, Hosseinifard E-S. Immunomodulatory and anti-inflammatory effects of probiotics in multiple sclerosis: a systematic review. J Neuroinflammation. 2019 Nov 21;16(1):231. DOI: 10.1186/s12974-019-1611-4. PMID: 31752913. PMCID: PMC6868771.
  15. Alexandrov P, Zhai Y, Li W, Lukiw W. Lipopolysaccharide-stimulated, NF-kB-, miRNA-146a- and miRNA-155-mediated molecular-genetic communication between the human gastrointestinal tract microbiome and the brain. Folia Neuropathol. 2019;57(3):211–9. DOI: 10.5114/fn.2019.88449. PMID: 31588707.
  16. Morris G, Fernandes BS, Puri BK, Walker AJ, Carvalho AF, Berk M. Leaky brain in neurological and psychiatric disorders: Drivers and consequences. Aust N Z J Psychiatry. 2018 Oct;52(10):924–48. DOI: 10.1177/0004867418796955. PMID: 30231628.
  17. Lew L-C, Hor Y-Y, Yusoff NAA, Choi S-B, Yusoff MSB, Roslan NS, et al. Probiotic Lactobacillus plantarum P8 alleviated stress and anxiety while enhancing memory and cognition in stressed adults: A randomised, double-blind, placebo-controlled study. Clin Nutr. 2019 Oct;38(5):2053–64. DOI: 10.1016/j.clnu.2018.09.010. PMID: 30266270.
  18. Chong HX, Yusoff NAA, Hor YY, Lew LC, Jaafar MH, Choi SB, et al. Lactobacillus plantarum DR7 alleviates stress and anxiety in adults: a randomised, double-blind, placebo-controlled study. Benef Microbes. 2019 Apr 19;10(4):355–73. DOI: 10.3920/BM2018.0135. PMID: 30882244.
  19. Ford AC, Quigley EMM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547–61; quiz 1546, 1562. DOI: 10.1038/ajg.2014.202. PMID: 25070051.
  20. Tran N, Zhebrak M, Yacoub C, Pelletier J, Hawley D. The gut-brain relationship: Investigating the effect of multispecies probiotics on anxiety in a randomized placebo-controlled trial of healthy young adults. J Affect Disord. 2019 Jun 1;252:271–7. DOI: 10.1016/j.jad.2019.04.043. PMID: 30991255.
  21. Anderson RC. Can probiotics mitigate age-related neuroinflammation leading to improved cognitive outcomes? Front Nutr. 2022 Nov 24;9:1012076. DOI: 10.3389/fnut.2022.1012076. PMID: 36505245. PMCID: PMC9729724.
  22. Swanson GR, Burgess HJ. Sleep and circadian hygiene and inflammatory bowel disease. Gastroenterol Clin North Am. 2017 Dec;46(4):881–93. DOI: 10.1016/j.gtc.2017.08.014. PMID: 29173529.
  23. Sanabria-Mazo JP, Montero-Marin J, Feliu-Soler A, Gasión V, Navarro-Gil M, Morillo-Sarto H, et al. Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial. J Clin Med. 2020 Oct 11;9(10). DOI: 10.3390/jcm9103246. PMID: 33050630. PMCID: PMC7599726.

Need help or would like to learn more?
View Dr. Ruscio’s, DC additional resources

Get Help


I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!