Clearing Brain Fog: Comprehensive Insights To Conquer Conditions Such As Meniere's Disease

Embarking on a journey through the foggy realms of cognitive health, “Clearing Brain Fog: Comprehensive Insights To Conquer Conditions Such As Meniere’s Disease” unveils a holistic exploration guided by the expertise of Dr. Jessica Povall. In an era where mental clarity can often be impacted negatively by the pressures of modern life, this blog post delves deep into the enigmatic condition known as brain fog – unravelling its symptoms, uncovering its myriad causes, and presenting groundbreaking strategies for management and relief. 

From the impact of lifestyle factors like stress, sleep, and diet to the medical complexities introduced by COVID-19 and neurological conditions, Dr. Povall offers the latest research as well as clear, practical advice. Whether you’re grappling with the disorienting haze of Meniere’s Disease or seeking ways to reclaim your cognitive alertness, this comprehensive guide illustrates the path to clearer thinking and improved well-being. Join us as we part the fog together, equipped with Dr. Povall’s insights and the latest in therapeutic innovations, tailored to bring clarity to those affected locally and beyond.

From Confusion to Clarity: Understanding the Symptoms of Brain Fog (01:30-03:20)

An explanation of brain fog, common symptoms, and how the term gained mainstream attention post-COVID.

  • Brain fog is in fact a cognitive dysfunction.
  • The common symptoms are memory problems, lack of mental clarity, poor concentration, and the feeling of being “spaced out.”
  • Brain fog has recently gained more attention, possibly relating to its increased prevalence and recognition in the medical community.
  • COVID-19 brought brain fog into mainstream discussions, indicating a surge in cases as well as awareness post-pandemic.

 

What is brain fog?

Oftentimes when people are experiencing brain fog, this might present as a clouded mental state in which they struggle to make decisions, or concentrate on tasks.

They may also experience things like mental fatigue, and they might feel mentally exhausted even after doing a small amount of work or small cognitive load. Some people also describe it as sluggish thinking, or a feeling that they’re operating at a slower pace than they would normally like to. 

After COVID, the term brain fog became a little bit more mainstream. A recent article from 2023 in the Journal of Neurology looked at what are the actual reported symptoms of brain fog, and this dives into it a little bit more. This article highlights that forgetfulness and poor concentration are some of the most reported symptoms, but headache and general fatigue are also quite common.

It is important to know that brain fog differs for different people, and it’s not as simplistic as just that slow sluggish thinking. Brain fog can certainly impact people in different ways, work performance being the most common thing we think of when people are struggling with brain fog.

This requires cognitive load for most of us. And if you’re having a bit of brain fog, just not being able to process information or perform at the rate that you normally would at your job, could certainly be an issue. 

Other social interactions can also suffer as a result of brain fog, such as carrying on a conversation, being in busy environments, not being able to enjoy the activities that you’d normally like to do. 

Mental wellbeing can suffer as a result of brain fog too, and people sometimes feel anxious, they’ll feel frustrated, and not sure what the root cause of these symptoms are.

Why You’re Feeling Foggy: The Connection Between Brain Fog, Stress, Sleep, and Diet (03:20-05:40)

Discussion on common causes of brain fog, focusing on stress, sleep disturbances, and dietary factors.

  • Stress: How chronic stress can impair cognitive functions and lead to symptoms of brain fog.
  • Sleep: The critical role of sleep in brain health, explaining how sleep disturbances can cause or exacerbate brain fog.
  • Diet: The impact of diet on brain function, suggesting that certain dietary choices may contribute to the development of brain fog


This chapter underscores the importance of managing stress, ensuring good sleep quality, and maintaining a healthy diet to prevent or mitigate brain fog.

There are several common causes of brain fog. Stress, sleep disturbances, and dietary factors can all play a major role.

Stress

Let’s start with stress. We know that stress plays a major role in the nervous system. When the nervous system is under stress, we have increased levels of cortisol, or an elevated fight or flight response.

This elevated fight or flight comes from the autonomic nervous system. Those who are less familiar with what our nervous system is, we have two sides to the system. What we call our “fight or flight”, and our “rest and digest”.

As the name implies, that “fight or flight” shunts blood or stimulates the nervous system. For example, if you think of crossing the street and you nearly get hit by a bus, your body will quickly release cortisol, which will put you into this fight or flight. This will shunt blood to your extremities, rather than for example your gut to digest your lunch, in order to get you out of harm’s way as quickly as possible. 

We know that people who are in this fight or flight, or this stress state, often experience a development of brain fog as a result. 

Sleep

Sleep is certainly another major cause of brain fog.As a clinician, I feel sleep is one of the easiest things a patient can prioritise to support their nervous system. As we’ve all probably experienced at some point in our life, when we are sleep deprived, the brain certainly doesn’t function as we would like it to. 

Poor sleep, especially if this is a habitual thing (and extremely common among people with young children, or people who work shift work), this poor sleep can certainly impact brain function day after day. 

Diet

Dietary factors have a huge impact on how our brains function. This can often be related to poor food choices such as hyperpalatable processed foods, foods with preservatives, artificial colours. These are some examples that can trigger brain fog in many people. It’s also worth noting that some are even more sensitive than others to this.

Our hydration levels and electrolyte consumption also impact brain function in a significant way.

Post-COVID Syndrome and Brain Fog: Unravelling the Neurological Links (05:41-07:23)

Analysis of how medical conditions, especially post-COVID and neurological disorders, contribute to brain fog.

  • COVID-19’s Role: Addresses how COVID-19 has been a significant factor in the rise of brain fog cases, possibly due to the virus’s effects on the brain.
  • Neurological Conditions: Explores how various neurological disorders, such as multiple sclerosis or chronic fatigue syndrome, can contribute to the onset of brain fog.

We also know that there are other medical contributors to brain fog. First and foremost, COVID. COVID is an inflammatory illness that creates as well as increases pre-existing neuroinflammation in the brain, and throughout the body. We also know that other neurological conditions such as concussion and vestibular conditions, including Ménière’s of course, can increase brain fog presence.

Metabolic disruptions such as hormone imbalances, nutrient deficiencies and the use of certain medications also disrupt mental clarity.

Physiologically, if we dive deeper into some of these causes and how they impact brain fog, COVID is certainly one factor that can lead to brain fog. Inflammation caused by COVID has a direct impact on the brain.

In the brain, we have what we call microglial cells, which are the immune protectors of the brain. These cells signal to work with the gut, as well as our whole systemic immune system. 

When the body is under attack by inflammation from an illness such as COVID, this is the direct link to how the brain is affected. 

Other neurological causes, such as Ménière’s and different vestibular issues, can contribute to brain fog by interfering with sensory processing.

This communication between the inner ear and the brain can contribute to further sensory strain and cognitive overload. If you are affected, you can be left with an element of brain fog as the brain is struggling to juggle all of these numerous mismatches and information from different systems. 

Other metabolic factors also can include alcohol as well as medicine. In this day and age, many people are on quite a few medications, and just the actual chemical reactions of this within the body can also lead to a slowness in thinking, and become a contributor to brain fog.

Meniere’s Disease and Brain Fog: Understanding and Managing Cognitive Symptoms (07:36-09:19)

Focused discussion on Ménière’s disease and its association with brain fog, including physiological explanations.

  • Association with Ménière’s Disease: Discusses the connection between brain fog and Ménière’s Disease, a disorder of the inner ear.
  • Physiological Factors: Explains the physiological aspects of Ménière’s Disease that may lead to brain fog, such as inner ear dysfunction affecting balance and hearing.
  • Management Strategies: Provides insights into managing brain fog specifically for patients with Ménière’s Disease, likely involving a combination of medical and lifestyle approaches.

 

If we look specifically at how brain fog impacts Ménière’s, there are a few different theories in how a Ménière’s attack can contribute to brain fog. One of the possible causes of Ménière’s disease for brain fog is the abnormal buildup of fluid or endolymphs in that inner ear, which interferes with the normal balance and the hearing signals between the inner ear and the brain.

This physiological stressor can lead to episodes of vertigo, hearing loss, and tinnitus, which can trigger the activation of the brain’s stress response, and thus release an inflammatory molecule that can in turn affect the brain tissue. 

This is what can result in that cognitive impairment, or that brain fog development. It’s also worth noting that when the brain’s immune gatekeepers, the microglia, are activated by infection or stress, they release pro-inflammatory molecules that can cause damage to brain tissue in the short term, and disrupt the communication between the neurons communicating with each other mid- and long-term.

Another possible cause of brain fog in Ménière’s disease is the lack of oxygen. If you’re having a very high oxygen level, you’re likely to have a high level of oxygen and blood flow to the brain during and after an attack of vertigo.

We know that when vertigo happens, this can cause nausea, vomiting, sweating, and hyperventilation, which can lower the blood pressure as well as reduce oxygen level in the brain. This can also contribute to the development of brain fog as one of the many different physiological pathways in which a Ménière’s attack could impact the brain.

From Foggy to Focused: Lifestyle Adjustments for Clearer Thinking (09:21-11:34)

Overview of various lifestyle changes like sleep, diet, meditation, and exercise to manage brain fog.

  • Sleep Quality Improvement: Emphasises the importance of good sleep hygiene and routines to enhance brain function.
  • Dietary Adjustments: Recommends dietary changes that may alleviate symptoms of brain fog, focusing on nutrient-rich foods and hydration.
  • Stress Reduction: Suggests methods for reducing stress, such as mindfulness and relaxation techniques.
  • Physical Activity: Highlights the role of regular exercise in improving cognitive health and reducing brain fog symptoms.

 

Many of the self-management tips for brain fog are not totally unique to Ménière’s. They’re quite broad self-management strategies that can be used for a lot of different root causes of brain fog. Some of the lifestyle management techniques are sleep (mainly getting an adequate amount of sleep each night), diet, meditation, and exercise.

All of these things have been known to help lessen the impact of brain fog. These lifestyle changes can certainly serve as a foundation to build on, because without this foundation, other treatment strategies will often be less successful. 

If we start with sleep first, it’s important to establish a consistent sleep routine and aim for seven to nine hours of quality sleep each night.

It’s been shown that people often struggle to get past six hours of sleep, depending on how much they sleep. If you’re having a very high oxygen level for example, you’re going to want to start with six hours of sleep a night (depending on your lifestyle). But it is really critically important for the function of your brain to be aiming for consistency by getting an adequate amount each night.

Other things such as engaging in activities like meditation, exercises, or hobbies that you enjoy to help reduce stress levels can also support mental clarity. 

Hydration and quality food

We all must be getting enough water each day to support our optimal brain function and prevent dehydration. Understanding the role of processed foods, particularly sugar and alcohol on the body, and how this impacts you as an individual can also provide some insight in terms of how you’re coping with brain fog. 

Nutrition

Nutrition is a very complex and fundamentally important topic in regards to brain fog. What we eat impacts us. What we eat becomes us.

As a clinician, I feel this is a critical point to stress. The basics around reducing processed food is key, but individuals who have been struggling with brain fog for a while may also need to dig deeper into our brain, deeper into other causes such as food sensitivities.

Exercise

Exercise is one of the most underrated tools for managing brain fog. The following article dives deeper into the topic as it explains the mechanism by which exercise impacts brain fog positively in your body.

The Brain-Exercise Connection: Strategies to Clear Brain Fog (11:37-13:17)

Detailed insights into how physical exercise benefits brain health and aids in managing brain fog.

  • Cognitive Benefits of Exercise: Explains how regular exercise can enhance cognitive functions and clarity, thereby reducing symptoms of brain fog.
  • Recommended Exercise Types: Discusses specific types of exercises that are particularly beneficial for brain health.
  • Mechanism of Action: Provides insights into how physical activity positively impacts brain function and alleviates brain fog.

 

Brain-Derived Neurotrophic Factors

I wanted to make you aware of a recent publication that talked about brain health and exercise. This article noted that both cardiovascular exercise, as well as resistance training, had a significant impact on the neurotransmitters of the brain. As a physio, I use exercise as one of many tools in helping to treat and manage brain fog with my patients.

The article showed that the pathways from exercise mediated the effects of brain function, and resistance exercise, even with different kinds of exercises like cycling, swimming, weights. All of these allow for synthesis and release of brain-derived neurotrophic factors, BDNF as they’re often sometimes called. These BDNF are released into circulation and these molecules can cross the blood brain barrier, the barrier between the brain and the rest of the body. 

This is critical. At this level, the brain capillaries are really small and can be impacted by the things we do and the functional abilities that we have. This is what can help impact that level of inflammation, that sluggishness. This is how what we do physically can actually get through, and impact our brain directly. 

We also know that exercise has a positive effect on the immune system. In conjunction with the physiology we have just explored, further support of the immune system definitely is a great thing in helping to clear that brain fog

Innovative Therapies for Clearing Brain Fog: A Comprehensive Guide & What You Need To Know (13:20-14:15)

Exploration of clinical and medical strategies, including autonomic nervous system testing and cognitive behavioural therapy.

  • Clinical Strategies: Discusses advanced clinical methods for diagnosing and treating brain fog, possibly including neurological assessments.
  • Autonomic Nervous System Testing: Highlights the importance of testing the autonomic nervous system in the context of brain fog.
  • Cognitive Behavioral Therapy (CBT): Mentions the use of CBT as a tool to manage symptoms associated with brain fog.

Other medical treatments for brain fog:

Being able to identify these dietary sources of brain fog

Working with a local functional medicine doctor as required to really get to the root of what might be contributing in terms of nutrition, or nutritional deficits.

Autonomic nervous system testing

At Brain Hub, we’ve got the tools to be able to test heart rate variability and assess the autonomic nervous system in different positions, as well as through different breathing strategies to see if the autonomic nervous system is under an element of stress, or if it is responding as we would hope it would.

Cognitive behavioural therapy

Working with a psychologist can really be helpful with managing brain fog. A lot of people wouldn’t consider this as their first point of call, but the research is quite clear that cognitive behavioural therapy certainly has a place in the treatment of brain fog, given how debilitating we know it can be for some.

The Cutting Edge of Brain Fog Relief: Which Therapeutic Approaches And Tools Are Working Now (14:20-16:34)

Unique clinical tools and therapies used in treating brain fog, such as vagal nerve stimulation.

  • Innovative Therapies: Discusses cutting-edge therapeutic techniques that are being explored or used to treat brain fog.
  • Use of Clinical Tools: Describes specific tools or technologies that aid in the management or treatment of brain fog.
  • Vagal Nerve Stimulation: Highlights vagal nerve stimulation as an example of a unique approach to managing brain fog symptoms.

At Brain Hub, we use a variety of sophisticated assessment and treatment tools. We’ve talked about exercise, we’ve talked about diet, we’ve talked about some of the other strategies that you can utilise if you are suffering from brain fog.

In the same vein as doing autonomic nervous system testing, if we uncover that there is indeed a deficit, we can take this opportunity to unravel the fight or flight response, discover if your vagal nerve isn’t functioning and therefore responsible as the main contributor to that. 

In addition to modifying lifestyle strategies and giving you some homeplay to do, we can use a variety of tools in the clinic to help stimulate this vagus nerve. Our vagus nerve directly impacts our heart, lungs and organs, and it plays a foundational role in our autonomic nervous system.

This is one tool that we use to clip on the ear. It is pain free, but creates a buzzing sensation through a galvanic stimulator. This can help engage that vagus nerve which is very close to that point on the skin. 

The vagus nerve actually runs through our neck, but it has been shown we can access it also externally, particularly on the left ear. We will often use this with patients in clinic.

This tool is what we call a RezziMax. It is vibration therapy, with that blue prong being applied on either side of the neck, stimulating both vagus nerves on the right and the left. 

Another tool that we use clinically is low-level laser therapy. We can use this by stimulating different pathways where we know that the vagus nerve is more superficial, and we also will use things such as a trigeminal nerve stimulator.

The thing that I’m holding up to my forehead there is stimulating one of three branches in the face of the trigeminal nerve. We will use these in conjunction with other therapies such as looking at the jaw, and looking at the neck. This is all part of a comprehensive Ménière’s assessment to see if there’s anything that we could stimulate to reduce your symptoms, help mitigate some of their impact, and help people on their way with clearing brain fog.

Cervical Spine and TMJ: Uncovering Their Roles in Brain Fog Symptoms (16:36-19:02)

Discussion on the importance of assessing the cervical spine and TMJ in relation to brain fog.

  • Assessing the Cervical Spine: Emphasises evaluating the cervical spine as part of diagnosing and understanding brain fog.
  • TMJ Considerations: Highlights the temporomandibular joint (TMJ) and its potential impact on brain fog symptoms.
  • Holistic Approach: Suggests a comprehensive assessment approach, looking at various physical factors that could influence brain function.

On the topic of the cervical spine and TMJ, a thorough neck and cervical spine assessment is recommended to those with brain fog (the neck is referred to as our cervical spine in the clinic). 

The red portion is your cervical spine, so it is close to your ear.

Anything that comes close to the ear or the skull, and as a result, the brainstem, plays a vital role in managing Ménière’s, managing brain fog. 

The TMJ, or the temporal mandibular joint, which is our jawbone, also is really close to the ear, and really close to the neck.

With Ménière’s symptoms, it’s been shown that if we work on the TMJ, for example by trying to improve the movement of your jaw, or trying to balance the muscles around that TMJ. In some cases we are also making referrals for things like a night splint or a night guard, or a jaw brace, which all can help that position of the TMJ, and in turn affect the symptoms of the ear. 

It’s also worth noting, while we’re talking about these bones and muscles, that we need to also consider what we call the cervical trigeminal nucleus as part of the brain stem. This collection of nerves receives sensory information from both the trigeminal nerve, as well as the upper cervical spine nerves.

The trigeminal nerve is a nerve, it’s one of our cranial nerves, and it wraps around the top of the eye, the cheek, and down the jaw. We will often look at how the trigeminal nerve is relaying information to and from the head back to the brain stem. The cervical trigeminal nucleus is the point where the neck information and the jaw information come together. It integrates and processes these sensory signals, and sends them to other parts of the brain, such as the brain stem, the thalamus, the somatosensory cortex, and the cerebellum.

Conclusion and Contact Information (19:02-20:06)

In order to do a really comprehensive assessment on someone with brain fog, we must look at all of the aforementioned components. In conclusion, brain fog is certainly a common but misunderstood condition that can significantly impact people’s daily lives.

By implementing some of these lifestyle changes mentioned here, as well as seeking medical guidance: with a multitude of tools to tackle this condition, we’ve got the best chance of being able to effectively manage and overcome brain fog for individuals.

If any of this resonated with you and you feel that you would like to discuss this with me further, I do offer a free 15 minute phone call to find out what we might be able to do for you before you even come in. Our clinic is located in Gladesville, which is in the Lower North Shore of Sydney.

Next Steps

To assure that you receive the right advice for your unique situation, it would however be beneficial to have a consultation with a trained professional to discuss your treatment options with you. To know more about concussion and related topics, read our blogs: https://brainhub.com.au/blog/

At Brain Hub, we strive to provide effective treatment for brain fog and Meniere’s disease in Sydney, tailoring our approach to each individual’s unique recovery needs. Contact the clinic on 1300 770 197, or click here to pick a time for your initial appointment:

DR JESSICA POVALL

Doctor of Physiotherapy
DPT, BSc (Hons), PGCertPhty