What causes brain fog?

There are many causes, including stress. How to cope better through diet

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One of the most common complaints I hear in my nutrition clinic is fatigue, especially mental fatigue, the fog that descends like autumn mist but stays all year.

My approach with every client struggling with brain fog is to understand the root cause. From a nutrition perspective, there are several possibilities: nutrient deficiency, food intolerance, gut disorders, blood sugar dysregulation. And then there’s stress.

Stress is not a nutrition issue, I hear you say. But it is, I reply. You may not think that diet is part of the body’s coping mechanisms, but think again. Your body is hardwired to deal with stressful situations, given the right nutritional terrain.

Stress is the bell ringing in your brain and heard by every cell in your body. It vibrates through your blood vessels, making your arteries stiffen and your blood pressure rise. Stress triggers the release of sugar into your blood, sugar that unless you’re about to run a marathon won’t be burned as fuel. Instead, it will be stored as fat around your middle. It will even change the activity of the bacteria in your gut, and not in a good way.

Yet it is unavoidable. Every day we face the stress of going out, getting from A to B, confronting others, doing difficult or tedious jobs, shopping, making our way home, settling domestic disputes, cooking, and then attempting to get some sleep.

It’s a tough old world, and that’s exactly how it’s going to stay for the foreseeable.

It may be unwelcome, but stress is the norm, and feeds human creativity. Would you really want to live a life devoid of challenges? The problem is that many people are just not coping with life’s slings and arrows.

The body’s response to stress is activated by the hypothalamic-pituitary-adrenal (HPA) axis. The hypothalamus is a gland in the brain which tells the pituitary gland to produce the hormone ACTH, which in turn tells the adrenal glands to produce hormones in response to stressful situations, or just mere thoughts.

When the HPA axis is dysregulated, all sorts of health issues may ensue, including brain fog.

Anatomy of stress

It was the world authority on the subject, and author of ‘The Stress of Life’ (1956), Hans Selye, who first identified a common response to stress, which he called the “General Adaptation Syndrome”. According to Selye, humans respond in three stages when under extreme pressure. These are:

Stage one — the alarm reaction, when your body goes on full alert. Stress is detected and the body reacts by producing adrenaline (aka epinephrine) and noradrenaline (aka norepinephrine). This is a sort of knee-jerk reaction to a given situation. It prepares you for “fight-or-flight”, and is short-term only.

Blood sugar rises, to give you more energy to fight or flee, and the heart pumps faster to get more oxygen and nutrients to muscles. Energy is routed away from non-essential functions, such as digestion. Breathing increases, and the respiratory passageways widen to accommodate more air, and therefore more oxygen. Blood clotting agents are mobilised, in case of wounding. Pupils dilate, to improve vision.

The alarm reaction is nothing less than a spectacular feat of biochemical engineering, and it is a pity that you are too busy panicking to appreciate its elegant sublimity while it’s going at full throttle.

Stage two — adaptation, or resistance. You adapt to, and learn to cope with, the stressor, which is now a full-time feature in your life. During this stage, the hormone cortisol is produced continuously. Normally, cortisol is produced cyclically in what is termed the circadian rhythm: levels start to rise between 3am and 6am and gradually decrease throughout the day so that by night-time they are at their lowest.

Like most essential things, cortisol is required in just the right amounts: too little, or too much, can disturb the homoeostasis of the body. With a continuous output of cortisol, you are vulnerable to infection and disease, because virtually all components of the immune response are suppressed by this hormone.

If you are at stage two, your symptoms are likely to include:

• Frequent headaches

• Insomnia

• Weight gain, especially around the abdominal area

• Frequent colds and infections

• Signs of premature aging

Yes, it’s true - too much cortisol makes you fat, sick and old before your time. The aging effect occurs because too much cortisol suppresses another important adrenal steroid hormone, dehydroepiandrosterone, or DHEA. DHEA is the hormone that keeps you young and slim, and although it decreases naturally with age, cortisol speeds up the process. As if things weren’t bad enough already.

Stage three — exhaustion. You are no longer able to deal with the stress and your resistance is gone. The fog has descended, and settled into the crevices of your neural pathways.

Although the resistance stage can last for several years, the body’s capacity for adaptation has its limits, and if there is no let-up in the burden of mental trauma, the exhaustion stage is inevitable. It is at this point that disproportionate cortisol output, which the adrenals can no longer sustain, starts to decline, falling to below normal levels.

Mental and physical exhaustion ensue. You are running on empty, and every day have a new mountain to climb. It can feel overwhelming, as well as exhausting.

Chronic fatigue syndrome is associated with an under-functioning HPA axis. So too is fibromyalgia, a condition characterised by musculoskeletal pain and fatigue. People suffering from post traumatic stress disorder have been found to under-secrete cortisol, as have otherwise healthy individuals living under conditions of chronic stress.