How to Reduce Brain Fog Without Restrictive Diets - Dr. Michael Ruscio, DNM, DC

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How to Reduce Brain Fog Without Restrictive Diets

How Increasing Carbs and Personalizing a Fitness Routine Improved Jeff’s Brain Fog, Energy, and Digestion

When Jeff came into the clinic, his primary symptom was chronic, non-responsive brain fog. The strategies we used to finally clear this fog included improving Jeff’s breathing, modifying his fitness program, and making his diet LESS restrictive by increasing his carb intake. 

This case study is a great example of a personalized diet making a huge difference. If you’ve been following a strict low FODMAP or low carb diet and you’re not noticing an improvement in symptoms, you may, like Jeff, be someone who actually feels better with more carbs in your diet. 

We also integrated a few key supplements which were NOT “brain supplements,” but which helped to regulate some of the imbalances that were likely leading to Jeff’s brain fog and digestive symptoms.

Watch Jeff’s story and learn exactly how we were able to improve his sleep, energy, digestion, and cognition without restrictive diets or brain boosting supplements.

In This Episode

Episode Intro … 00:00:45
Medical History & Symptoms … 00:03:22
Dietary Deviations … 00:05:36
Probiotics & Histamine Intolerance … 00:07:52
Taking a Supplement Holiday… 00:09:18
Breathing & Mouth Taping … 00:12:35
Positive Impacts of Low Level Cardio … 00:14:54
Seasonal Allergies & Histamine Issues … 00:19:20
Episode Wrap-Up … 00:22:44

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Hey everyone. This is Dr. Ruscio. Today I spoke with Jeff, who is a patient at our office. He came in with a predominant symptom of brain fog. His case study, as you’ll hear from him in a moment, was a good example of how much of brain fog actually emanates from the gut. And this is something I’ve personally learned. In addition to that, there were a few other lines of support that we had to integrate into his case to really allow him to resolve his brain fog. And these were not brain supplements like Lion’s Mane or gingko or what have you. They actually had to do with breathing and his fitness program as two fairly primary underlying factors that were needed to be addressed, in addition to actually making some dietary modifications in the opposite direction of low carb and keto. You will often hear the neurological merits of the keto diet, which do exist, but it doesn’t mean that everyone’s going to do best on a ketogenic diet when trying to optimize for their brain health.

So a couple of really good examples of how step-wise, personalized care can help resolve (in this case) chronic, non-responsive brain fog. There were a few different things that underlied that. By identifying those in a precision way and supporting those, we were able to see not only improvements in brain fog, but also in sleep energy, and digestive symptoms in general. We’ll go to the conversation now with Jeff.

➕ Full Podcast Transcript

Episode Intro:

Welcome to Dr. Ruscio Radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics, as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates, visit DrRuscio.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now, let’s head to the show.

Dr. Michael Ruscio:

Hey everyone. This is Dr. Ruscio. Today I spoke with Jeff, who is a patient at our office. He came in with a predominant symptom of brain fog. His case study, as you’ll hear from him in a moment, was a good example of how much of brain fog actually emanates from the gut. And this is something I’ve personally learned. In addition to that, there were a few other lines of support that we had to integrate into his case to really allow him to resolve his brain fog. And these were not brain supplements like Lion’s Mane or gingko or what have you. They actually had to do with breathing and his fitness program as two fairly primary underlying factors that were needed to be addressed, in addition to actually making some dietary modifications in the opposite direction of low carb and keto. You will often hear the neurological merits of the keto diet, which do exist, but it doesn’t mean that everyone’s going to do best on a ketogenic diet when trying to optimize for their brain health.

DrMR:

So a couple of really good examples of how step-wise, personalized care can help resolve (in this case) chronic, non-responsive brain fog. There were a few different things that underlied that. By identifying those in a precision way and supporting those, we were able to see not only improvements in brain fog, but also in sleep energy, and digestive symptoms in general. We’ll go to the conversation now with Jeff.

DrMR:

Hey everyone. This is Dr. Ruscio. I am here today and joined by Jeff, who has had some struggles similar to my own – mainly with brain fog. Jeff – man, I feel your pain there. I know how much of a challenge and annoyance brain fog can be. I wouldn’t say we’re fully out of the woods yet, but you’re clearly much better now than when we started working together. And I wanted to take this opportunity to share with people how much of brain fog can be resolved by somewhat simple things. One of the philosophical points your case illustrates is everyone can say, “Hey, this diet or this thing is good for brain fog…” but it may not be the case for you. And so I want to especially share that dietary piece that we were just talking about before we started the recording. Before we start going into some of the nitty-gritty of what we did to help improve your situation, give us the short snapshot of the symptoms you were struggling with before we started working together.

Medical History & Symptoms

Jeff:

Sure. So, I started struggling with a little bit of back pain initially and then I went to my doctor. She prescribed some prednisone and I felt great for a few days. And then all of a sudden, the floodgates opened and I had really bad brain fog… I had tons of nausea… really bad sinus problems… and that just continued on and on and on. I started taking antibiotics and it started making things a lot worse. From a brain standpoint, the sinus and brain fog just got worse and worse and worse over the coming weeks.

DrMR:

Sure. One of the things is that when you hear sinus issues, congestion running nose, and what have you combined with brain fog, you’re thinking of some sort of histamine overload. And there are definitely elements of this in your case. The things that seem to have moved the needle the most (And Jeff – modify this at all because I think since you are living through this, you’re going to have the most precise understanding of this), but getting off of a more strict low FODMAP diet and upping your carbs was one. Mouth taping was another, and this doesn’t hit for everyone, but for those whom it does, it’s clearly noticeable. Cardiovascular training – I think you were just going too hard on the weights. I have to credit Dr. Mike T. Nelson for bringing this to my attention on the podcast — some people just need to balance out their exercise stimulus. And probiotics. And maybe some antihistamine support. Those are maybe the main levers.

DrMR:

Let’s start with the dietary one first. I think this is where people will think, “Okay, maybe it’s histamine… maybe it’s SIBO…” That can affect your brain. There’s certainly evidence showing this connection, and so people can shoehorn themselves into, “Well, I have to do this diet because of X, Y, Z.” Before we started the recording, you were saying one of the initial things you really noticed as you upped your carb intake was that it led to one jump in improvement (roughly speaking, about 20%) Tell us a little bit more about that realization and what was going on in terms of reading all this stuff saying you have to do this to feel better, but yet you’re doing that and you’re not feeling better. How did you jump tracks to deviate from that?

Dietary Deviations

Jeff:

Yeah. I was a month in or so, and I realized I just wasn’t getting better, so I went deep into “What can I do with diet?” So, I did Paleo Autoimmune Protocol. That was really difficult, but it did help a little bit. Then I eventually got on a low FODMAP diet and that helped a little bit, as well, but I was on it for probably two or three months. And I really just wasn’t finding the benefits that I thought I was going to get with it. And I think we spoke about this the last time we met, but you had one of these testimonials with somebody and you told them to start eating gluten in small doses. And I was like, “You can’t do that. You can’t say that.”

DrMR:

Heresy! <laugh>

Jeff:

I thought, “Okay, that’s really interesting.” I used to eat all that stuff and more carbs. Maybe I should just try going back to bit more of a broader paleo diet. And so I introduced rice and potatoes back into my diet, and almost within a week felt (like you said) 20%, 30% better. I just had more energy and a little bit more clarity from the brain fog standpoint. I immediately realized that whether it was the under utilization of carbohydrates or calories, or a blend of those, it really started to help me. The biggest thing was – and this is why I really wanted to come to you and I like your work – when I was on those diets, I was also in the diet mindset. It was so stressful if I had any sort of thing that might be tempting the diet. I know that stress was added to it. So, to free up and say, “Look, if you had gluten once or if you just increase your carbohydrates…” it gave me that bit of buffer that I think mindset also helped a lot, too.

DrMR:

It’s a great point. People tend to build these dietary prisons around themselves that they oftentimes don’t need to build. That ability to go outside the box and discover is crucially important. It’s not that easy. I get it. 10 years or so ago, I was very apprehensive about anyone eating outside of the paleo template. But then you have one case where you say, “Well, let’s just try this higher carb thing.” And it goes well, and then you do it again. You do it enough times and you start seeing some of the early indicators that someone may be on too low carb of a diet; you see the benefit, like you said.

Probiotics & Histamine Intolerance

DrMR:

Let’s talk about probiotics for a second. That’s something where I wish there was a more responsible narrative online about this. You’ll have people making the claim that because probiotics contain histamine, they’re always going to be bad for anyone with histamine intolerance unless you use a super special histamine-free probiotic. I think it’s really discounting the fact that probiotics tend to be net antihistamine. Even if they contain histamine, the net effect tends to be anti-histamine. Now, it’s not to say that someone may have some reactivity to probiotics. It’s fairly rare, but it can happen. And there was a little bit of that in your case, but as you started to improve, your tolerance for probiotics really opened up, and then you saw this progressive benefit from the probiotics. Anything on the probiotic piece that you want to make people aware of?

Jeff:

Yeah. I know there are the three stools for the probiotics and I had a really hard time starting on any of them. When we first started meeting, I tried one — I think it was the lacto first — and I really struggled with it. And then over time, with the more stuff we added on, I eventually was able to take all three. There have been periods though where I was feeling bad taking them and then I stopped taking them and I felt better. It does seem to be a hit or miss thing for me. Overall, after my net benefit, I can definitely say it has added more relief to my symptoms than anything else.

Taking a Supplement Holiday

DrMR:

Right. Along those lines, you had noted on a supplement holiday. I think you had come across one of our podcasts (or something similar) where we discussed the concept that sometimes it’s helpful to just clear the deck and come off everything; that there might be one or two things in this array of stuff that you’re taking that’s actually aggravating your problem. And the only way to figure that out is to throw all stuff off the table, take some time off, and let the system gestate. In your charts, I have this great note that the supplement holiday was hugely helpful for you, and I think that’s worth underscoring for people.

Jeff:

Yeah. I tried so many restrictive diets, but every time I did a restrictive diet, I felt like I added supplements <laugh>. It just occurred to me that I’ve never restricted supplements. And so I thought, “What if I just stopped taking supplements for a week? What would happen?” Out of 15 pills, you wonder which one of these is working. I had no idea. To really try to separate that out and then come back on them and say, “Well, which ones are actually contributing here?” and being a bit more scientific about it has been really helpful.

DrMR:

Yeah. And that’s why we go through this slower and step-wise process. For some patients, this can be challenging because they’re saying, “Why aren’t we supporting this? Why aren’t we supporting that? Why aren’t we supporting the other thing?” It’s the same thing that clinicians go through – especially younger clinicians – as they don’t want to potentially withhold any one thing of the 15,000 things that could help someone, so they end up just giving a bunch of supplementation. However, it doesn’t allow you to pinpoint reactions and it doesn’t allow you to know what’s helping and what’s not helping. Knowing what’s helping or what’s causing a reaction, that’s all diagnostic information that the clinician is losing out on if you’re shotgunning it and just throwing a bunch of stuff at someone. So yeah, it’s a great point, and I’m glad we have your case to give people watching and listening to this another evidence point for why aggressive supplementation isn’t the best approach. It oftentimes leads to wheel spinning and suboptimal response.

Breathing & Mouth Taping

DrMR:

Another thing to bring into this would be the breathing piece and the mouth taping. This is such a great intervention for some people because it’s cheap. Tape may cost you $7 for a roll that will last you an entire month. If someone is breathing through their mouth at night, it’s counterproductive for a number of reasons. It puts you into more of a sympathetic state and it thwarts the production of nitric oxide. The book entitled ‘Breath: The New Science of a Lost Art’ by James Nestor really did a phenomenal job of outlining how important it is to breathe through your nose and not through your mouth. They went through this experiment where he had his nose clogged with some sort of medical tape so he could only breathe through his mouth for a week. His blood pressure spiked, his fatigue went way up, and his sleep regressed.

DrMR:

Presumably, what was happening your case, is there was a degree of nocturnal mouth breathing and the tape over the mouth re-encouraged you to nasal breathe. On the user side of that, that was another one of those 20-ish% point gain pieces. Anything there that you think people should know about or consider?

Jeff:

Yeah. It’s not as scary as it sounds. My wife thought I was insane when I told her I was going to start doing it. A little hack for everybody — So, they sell those little strips you can put on and they’re specifically made for it. I struggled to keep those on at night, mostly because I have a beard most days and they may have been a little too small for my mouth. So, I actually got some surgical tape that you can buy for about $4 on Amazon. You put that right over your mouth, it stays on no problem, and it’s really easy to take off in the morning. I would say the biggest thing I noticed is just waking up refreshed. I also read that book around the same time we were thinking about this, and I just noticed there are so many nights I’d wake up on my back with my mouth open. And I was curious as to how many hours I had been mouth breathing and getting that really difficult sleep. Without the good sleep to get the brain refreshed and all the symptoms I was having, it just made sense — Why not try this?

Positive Impacts of Low Level Cardio

DrMR:

The other thing that was a bit surprising to me in your case — in terms of the magnitude of positive impact it had — was balancing out your exercise plan to include some low level cardio. Low level cardio is sometimes unjustifiably maligned. There are some who have the belief that the best thing for body composition is weight training, and that actually may be true, but I think what’s left out of that is it’s not all about optimizing solely for body composition and someone can drift into this imbalance. This is something I remember Paul Chek speaking about years and years ago — this left ventricular hypertrophy, which can happen in some strength athletes if they’re just doing lots of heavy lifting, and it leads to this imbalanced hypertrophy of the chamber of the hearts. And I thought maybe this was more speculative conjecture until Nelson came on the podcast and we had a conversation. This was the first patient case study where making that change really led to a pretty notable improvement. You were quite jazzed about the level of improvement. Tell us a little bit more about that.

Jeff:

In retrospect, I don’t know why I wouldn’t have thought this would contribute to some of the problems I was having. I spent the better part of five to seven years just doing weight training. That’s all I did. I thought cardio was a sin and you shouldn’t do it, so I avoided it. I listened to this podcast and started thinking about when I did walk or go for a run — what was my heart rate? I noticed it was so high. It was into zone three within a minute of doing any of those activities. I thought – 1. This can’t overall be healthy and 2. From a stress standpoint and an ability to adapt to stresses, I wonder if my body has just gotten weak in that area.

Jeff:

I didn’t really do any specific protocol, but just started off with more zone two training each week and then kept upping the number of minutes. I saw a significant benefit from the standpoint of a symptom, but also from the ability to just do more work – whether it was mental work or actual physical work (for example, sports or working out).

DrMR:

That’s also one of the things that Nelson mentioned — if your baseline heart rate is elevated, it’s going to make it much more difficult for you to do anything. It’s like you’re driving around one gear too low, so the engine is always revved up a little bit too high. I think that’s a great analogy to connect. When we build on top of that with the breathing at night and the carbs, all these things are just going to be chronically stressing you out metabolically. Resolving those is probably one of the great underpinnings as to why the mental clarity got better. Even though it wasn’t like, “Here’s the hot nootropic supplement. Take this! It helps with BDNF and all these other things.” That’s interesting, but these really are the pillars; this is why we harp so much on getting these pillars in place. Those are what really give you the movement of the needle to a significant degree. And the cherry on top could be maybe experimenting with things like Lions Mane or what have you, but for most people that’s not going to be the root underlying cause of their brain fog.

Jeff:

They also feel most more robust. With supplements, if they can help that’s great, but if you stop taking them and all of a sudden symptoms come back, it’s not enough. Life is too dynamic. You travel, you do things, work gets stressful, whatever the case may be, and sometimes supplements feel a little too fragile.

DrMR:

Sure. It’s a partial dependency, which we don’t want. We want you to be, like you said, as robust and resilient as you can be. Now, there is one wrinkle here I want to close out on because this articulates to people that healing is oftentimes not this super short journey. Now that being said, I strongly disagree with the… this is going to be a three year process… there are all these layers… That’s not holding yourself, as a clinician, to a high enough standard if you think something is going to take three years to resolve. Now, on the other end, three weeks is probably too unrealistic of an expectation. In your case, over a few months, we’ve seen fairly remarkable improvements, but there’s still something going on with the histamine.

Seasonal Allergies & Histamine Issues

DrMR:

And when your seasonal allergies recently kicked up, you were brought down a level. Understandably so, that made you concerned and I totally feel that concern. What’s reassuring about that is if the only thing that changed was that seasonal allergies hit, that tells us this is an environmental thing. We know that is going to be temporary. We know what the cause is. And with some supplementation and/or further healing as your system becomes more robust over time, your histamine load is likely going to be greatly diminished. Even if we did nothing else, over time the brain fog impact of seasonal allergies will likely attenuate. We’re just getting you going now and I don’t think it’s early enough for you to be able to report back.

DrMR:

I think you just received everything, but with a higher dose of some of the natural antihistamines. Just to illustrate for people, that’s the next thing that we’re working on. Oftentimes, there are iterations we had to go through — diet… lifestyle… supplemental — and we’re making progress all the way. And even though we’re in a good spot right now, there’s still a couple final things that we’re trying to sort out. Again, to articulate to people, a three week turnaround would be unrealistic, but three years is also ridiculous. We don’t need to wait that long. Anything there you want to share with people?

Jeff:

To your point, the more diagnostics as a clinician you can get from me, the better you can help me. I think there were a lot of times early on where I would find a level of 80% (and not 100%) and I would stay there. So, I wouldn’t test the foods. I wouldn’t test new things. I just wanted to stay at this level. Each time, especially with you, when I’ve gone backwards in something, we’ve gone at least four steps forward. For anybody nervous about going backwards a few steps, the ability to then use that as diagnostic input to then go farther/go faster with this healing process is always going to be a beneficial thing. I’ve definitely gone from freaking out to knowing there are only a few handful of things left. Through time, it becomes a lot easier.

DrMR:

Great. Well said.

Dr. Ruscio Resources:

Hi everyone. If you are in need of help, we have a number of resources for you. Healthy Gut, Healthy You – my book and your complete self-help guide to healing your gut. If you’re not a do-it-yourselfer, there is the clinic – The Ruscio Institute for Functional Medicine – and our growing clinical and supporting research team will be happy to help you. We do offer monthly support calls for our patients where I answer questions and help them along their path. We also have health coaching support calls every other week. We also offer health coaching independent of the clinic, for those perhaps reading the book and/or looking for guidance with diet, supplementation, et cetera. There’s also the store that has our elemental diet line, our probiotics, and other gut health and health supportive supplements. And for clinicians, there is our FFMR – The Future of Functional Medicine Review database – which contains case studies from our clinic, research reviews, and practice guidelines. Visit drruscio.com/resources to learn more.

DrMR:

Jeff – this has been great. Anytime I can help someone not have brain fog like I did <laugh>, that’s a huge win. Anything you want to leave people with, in close?

Jeff:

The number one thing is you will get better. I can say I sat in many online forums that were full of sick people <laugh> and didn’t make you feel good. Dr. Ruscio – using the simplified path that you give people from your book, the supplements, and obviously this podcast as well, makes it easier and shows it doesn’t have to be so rigid and scary. It gets better.

DrMR:

I’m all over these sage points, Jeff. Thank you for being diligent and being okay with the more methodical road; not falling to the ploy of the lab companies or the gurus who promise your brain fog is because of this really cool, exotic new mechanism… and if we can just pinpoint that with $4,000 worth of labs, then we can resolve the treatment. Part of what allows doctors to stay in business is patients who are supporting different care models. The more patients who are going to be savvy and not get pulled into some of these specious arguments and promises – that’s actually better for the field. It’s like people supporting big processed food companies or shopping locally.

DrMR:

Where your dollars go, you’ll foster a marketplace or you’ll cause one to dwindle. So a thanks back to you for having the clarity to (I’m going to pat myself on the back a little bit here…) make a good decision in terms of who you worked with. Also, thank you so much for the willingness to share your story. I’m so glad that you’re at this 90%. We’ve got a few more things to tweak and we’ll keep at it. We’re just on the doorstep or we’re going to get over the threshold if we just give your body a little more time. Again, I think that’s really important to reiterate for people. Jeff – it’s been a pleasure working with you. You’ve been awesome. And thank you again so much for sharing your story.

Jeff:

Thank you.

Outro:

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