The Heavy Toll of Brain Fog

I was recently sent an article on brain fog from The Atlantic. I tried to skim, but was sucked into the details. I felt like an obsessive-compulsive personality meticulously picking open an old wound–it was one of those situations where you’re staring at a horrific train wreck, but can’t bring yourself to look away.

For seven years I was plagued with what my neurologist labeled mild cognitive impairment. I forgot my parents’ and best friends’ birthdays. I couldn’t recall the instructions my boss had given me five minutes earlier. I constantly misplaced my things and leaving behind a purse, a phone, or a cart full of groceries. I frequently made up words when I couldn’t find the ones I was looking for. As a lifelong thinker and writer, it was excruciating to continually feel lost and confused.

Last year, an AI program quantified the size of various brain regions and spat out a new diagnosis: Alzheimer’s disease, type 3. Based on the objective measures, my 32-year-old brain was assigned a biological age of 73. And, suddenly, a lot of things made sense.

The Atlantic article dives into profiles of several individuals affected by COVID long haul syndrome. While I’ve been fortunate enough to avoid that particular infection, a cocktail of of fungal, bacterial, and viral infections in 2015 had led to similar results and, ultimately, a diagnosis of chronic fatigue syndrome (CFS). The profiles were painful to read because I understand what it feels like to lose friends and family, career progression, physical fitness, and personal aspirations due to an invisible illness and continual gaslighting by disbelieving medical professionals. Even with all of the visibility around long haul COVID, it seems that hundreds of thousands of people are suffering and unable to find help. My heart goes out to every one of them.

Earlier this year, British researchers analyzed MRI scans from the UK Biobank study, which compares brains scans pre- and post-COVID infection. The found the even mild infections can shrink the brain and reduce the thickness of the neuron-rich gray matter. At their worst, these changes were comparable to a decade of aging. These abnormalities were especially pronounced in areas such as the parahippocampal gyrus, which is important for encoding and retrieving memories, and the orbitofrontal cortex, which is important for executive function. They were still apparent in people who hadn’t been hospitalized. And they were accompanied by cognitive problems.

While my NeuroQuant results don’t match the those of the British study, I believe it does evidence that any level of inflammation or atrophy in the brain can manifest as cognitive difficulties.

Today, I have just enough focus and recall to bumble confidently through my life and I refuse to take off the rose-colored glasses. I have been largely able to recover. But it has cost us a fortune, literally and figuratively. On top of losing years of career progression and nearly all friendships, my body now requires I adhere to a very strict diet and sleep at least nine hours per night. One-third of my income goes to medical expenses, including multiple medications and supplements that are not covered by insurance. And this doesn’t include periodic financial help from my parents, grandparents, and in-laws. I’ve tested, trimmed, and refined my medical “stack” and this is my cost to achieve basic functionality.

I wish I could help those suffering from the crushing brain fog and debilitating cognitive impairment. What advice can I impart? Do your own research–learn to read medical abstracts on PubMed. You know yourself better than your doctor can–trust yourself. It’s not depression, it’s not anxiety, and you’re not a hypochondriac; your symptoms are real, even if not quantifiable. Request a NeuroQuant MRI. Look into mitochondrial dysfunction. Try an anti-inflammatory diet and see if that improves your symptoms. I’m sure there are nuanced differences from case to case, but there are surely also many similarities we can learn from. The body is resilient and inherently strives for a state of ease. However, we must provide it the tools and resources to achieve such a steady state–rest, micronutrients, and a environment devoid of neurotoxins.

Chronic fatigue and cognitive impairment are a nightmare but believe that, if you’re patient and persistent, it’s possible to eventually wake back up. I’m perhaps still in the lucid dream state, gradually easing out of the painful nightmare, but I can finally see the light at the end of the tunnel. There is hope. For me, and for all those suffering.