- 11 Ways to Beat ‘Fibro Fog’
- How Fibro Fog Clouds Thinking and How to Break Through It
- What Is Brain Fog?
- Brain Fog Symptoms
- 5 Causes of Brain Fog (and How to Fix Them)
- Fixing Brain Fog: Where Do I Start?
- Getting Disability for Fibromyalgia Brain Fog, or Fibro Fog
- 23 People With Fibromyalgia Describe What ‘Fibro Fog’ Feels Like
- MORE ABOUT FIBROMYALGIA:
- Fibromyalgia: Managing Fibro Fog
- Topic Overview
- When waking up just doesn’t mean waking up.
- What is Fibromyalgia?
11 Ways to Beat ‘Fibro Fog’
Confused. Forgetful. Can’t concentrate. Mixing up your words. Experiencing short-term memory loss. Many of the 10 million people in the United States with fibromyalgia complain of these cognitive difficulties, commonly referred to as “fibro fog” or “brain fog.”
“I don’t have a percentage to give you,” says Elizabeth Lyster, MD, of the Holtorf Medical Group in Foster City, Calif., “but fibro fog is a very common complaint among patients with fibromyalgia.”
The cause of fibro fog isn’t fully understood. Many believe that it may have to do with fibromyalgia patients’ inability to sleep well. “Therefore they’re chronically fatigued,” says Corey Walker, MD, a rheumatologist at the Intermountain Health Care System in Logan, Utah. “Their minds aren’t rested.” Also, he says, fibromyalgia pain can be debilitating — it’s hard to concentrate when you’re in a lot of pain.
Another theory is that when people have fibromyalgia pain, parts of their brain do not receive enough oxygen, causing confusion or disorientation.
What You Can Do for Fibromyalgia Fog
There are some steps you can take to help alleviate your fibromyalgia symptoms, including feeling as though you’re in a fog:
- Avoid caffeine. “Most people think they’ll feel more alert or more awake with caffeine,” Dr. Lyster says. “However, caffeine can make things worse for people with fibromyalgia.” Even a small amount of caffeine can contribute to sleep disturbances. Also, caffeine is a stimulant, but you can crash when it wears off.
- Use a planner. Keep track of appointments and events in a calendar, either on paper or on your computer. Some computer programs allow you to set alarms to remind you when you need to make a phone call or attend a meeting. Set a kitchen timer to remind you to take the meatloaf out of the oven or pick your daughter up from hockey practice.
- Get in a rut. Establishing routines for simple tasks can help you deal with brain fog. For example, if every time you return home, you put your car keys on a hook by the door before you do anything else, you’re less likely to lose them and you won’t be frustrated trying to remember where they are the next time you have to go somewhere.
- Organize your space. It’s hard to concentrate when you’re surrounded by too much junk — that makes it too easy to get distracted. Throw out things that you no longer need, and store those you do use in their proper place. Removing clutter is a good way to control brain fog.
- Don’t multi-task. It’s very tempting to talk on the phone while making dinner or answer e-mails in between paying bills online. But it is harder to concentrate when you’re trying to do too much at once. Be upfront with your friends and family who may be asking for help when you’re busy doing something else: Tell them you need to do only one thing at a time and will help them as soon as you’re done.
- De-stress. Stress may cause fibro fog to worsen in some people, Lyster says. Susan Ingebretson of Los Angeles finds stress relievers such as yoga or meditation help her overcome fibro fog. “I’m constantly applying stress-relieving modalities to my life, which helps me balance the fibro fog as well as many other fibromyalgia symptoms,” she says.
- Breathe deeply. Ingebretson, 51, finds that if she takes deep breaths and relaxes it helps her considerably. “‘Fibrofolk’ are known to be shallow breathers,” she says. “We also hold our breath when under stress.” She has found that breathing deeply and consistently “does wonders for the brain.”
- Get better sleep. “One of the most important fibromyalgia treatments is getting quality sleep,” Lyster says. To improve sleep, go to bed and wake up the same time every day, even on weekends. Use your bed for sleeping, not reading, watching TV, or working on your laptop. Keep your bedroom dark, quiet, and cool so you’re comfortable when you sleep. Some herbal supplements also have shown to be effective in inducing quality sleep, Lyster says.
- Get regular exercise. “Low-impact exercise is helpful,” Dr. Walker says. Exercise not only improves blood flow, but also helps improve sleep, which can help alleviate some of the cognitive difficulties associated with fibromyalgia pain.
- Eat healthy. “I found that nutritional support (meaning actually eating real food) made a huge difference for me,” Ingebretson says. “So did drinking more water.” A healthy diet is one that is rich in fruits and vegetables and whole grains and includes lean meats and low-fat dairy. “Stay away from processed foods and sugars and fast foods,” Walker adds.
- Check on your meds. Your treatment for fibromyalgia pain may include medications. Talk to your doctor if you believe your meds are making you confused — a possible side effect. Also, you may want to discuss medications that can help with attention and concentration.
Cognitive difficulties are a common fibromyalgia symptom. But if you take care of yourself — eat healthy, exercise, relax, and try not to overdo — you can better cope with the mental issues associated with this chronic condition.
How Fibro Fog Clouds Thinking and How to Break Through It
One fibro patient found herself running a red light.(ISTOCKPHOTO)
Fibromyalgia patients often experience a loss of mental clarity and problems with memory. Dubbed “fibro fog,” this side effect of the syndrome can have a significant impact on patients’ lives.
Carolyn Nuth, 65, holds down a demanding job as manager of a patient information center for the Baltimore-based American Pain Foundation. She loves her job because as a fibromyalgia sufferer, she knows what chronic pain feels like and is able to relate to those who get in touch. But while she may share her experiences with people who have back pain, migraines, arthritis—you name it—only fibromyalgia sufferers share her experiences with fibro fog.
More about fibromyalgia
- How Patients Cope With Fibro
- I Faced and Fought Fibro
“Periodically the clarity is lost,” says Nuth. “I do feel like ‘Um, what?’ It’s almost a memory thing. ‘Did I do that?’ Or ‘Didn’t I do that?'”
A blight on the life of the fibro patient
Others describe it as having a ping-pong ball loose in your brain, trying to land on the right words to say. It could be as simple as constantly losing things or transposing phone numbers. But fibro fog can seriously affect people’s quality of life. For example: Lynne Matallana, co-founder and president of the National Fibromyalgia Association (NFA), found that her fibro fog made it dangerous for her to drive.
She had difficulty concentrating and felt less aware of her surroundings. Once she found herself running a red light. “It can be totally incapacitating,” says Matallana, 53, of Anaheim, Calif. “It’s not just being unable to come up with a word quickly, it’s a very, very serious part of this disease.”
In the past five years, physicians have been taking fibro fog more seriously, according to Daniel Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, in Ann Arbor.
Research has shown that sufferers annually lose more than three times as much “gray matter” brain tissue than healthy, age-matched controls. And some of that loss occurs in areas of the brain that are involved in memory and concentration, says Patrick Wood, MD, a senior medical adviser to the NFA and one of the coauthors of the 2007 study.
Matallana has discovered that being overstimulated makes things far worse. “I know I get it a lot when I’m in a situation where there are a lot of fluorescent lights or a lot of background noise. Or if I haven’t gotten a good night’s sleep or I’m feeling more pain. All of these things mean I can have a hard time focusing on the things that are important.”
She finds that by avoiding such conditions, she can manage her fog and make sure it doesn’t excessively impact her life. For tips on managing fibro fog, check out “4 Steps to Beating Fibro Fog.”
Does this situation sound familiar?
You’re in the middle of an assignment or a conversation when, suddenly, your brain seems to short-circuit. Maybe you forget a word or you totally space out. Instead of feeling sharp, you feel like you’re walking through jello. You lose concentration, and the world seems like it’s moving faster than you can keep up with.
If you’ve experienced an instance like this, you might be dealing with brain fog.
Put simply, brain fog is a term to describe mental fatigue. And, depending on how severe it is, it can impact your performance at work or school.
Brain fog is undeniably frustrating: you know you can do exceptional work, but having no mental clarity can feel like running in slow motion. On top of that, getting flustered can aggravate the symptoms, thus repeating the cycle.
The good news is that brain fog is not permanent. By taking the right steps, you can reverse the symptoms to find a clear mind and even prevent them from happening again.
That’s what this article is all about. In the following sections, we’ll explore the symptoms, causes, and solutions for brain fog.
What Is Brain Fog?
Before we dive into details, it’s important to note that “brain fog” isn’t an official medical term, nor is there a test or measurement for it. Rather, it’s a loose term used to describe chronic mental fatigue, difficulty concentrating, and cognitive dysfunction. It is not a disease, but rather a reaction to specific circumstances (which we’ll explore later).
“Suffering from brain fog is basically the opposite of feeling level-headed, calm, optimistic and motivated,” says Jillian Levy of Dr. Axe.com. “Brain fog can easily rob you of inspiration and happiness, while increasing the likelihood for symptoms of anxiety and depression.”
Think you might have brain fog? Let’s take a look at the symptoms so you can make an accurate self-diagnosis.
Brain Fog Symptoms
Brain fog affects people in different ways. You might experience one or all of the following symptoms which can vary in intensity depending on the day. Here are the four most common symptoms of brain fog:
1. Lack of Concentration
When you can’t concentrate, mental tasks can feel like a moving target. Rather than being able to hone in and focus, your mind constantly wanders off, making it difficult to get anything done.
Brain fog can affect your ability to remember all kinds of information, including academic material, daily tasks like forgetting your car keys, or personal memories like what you ate for dinner last night.
3. Chronic Fatigue
I fell asleep during my fair share of lectures in college, but chronic fatigue is much different. As a symptom of brain fog, chronic fatigue is characterized by extreme, never-ending tiredness that can’t be remedied by rest or caffeine.
Since chronic fatigue is also a symptom of other disorders, consider talking to your doctor if it’s happening to you.
4. Mental Flatlining
The remaining symptoms of brain fog can be classified under what I call “mental flatlining.” Instead of feeling sharp and active like you normally would, you feel “off”: dull, unmotivated, unproductive, and maybe depressed. In this state, all of your day’s tasks and activities blur together, making it seem like you’re living in slow motion.
If you’ve experienced any or all of the above symptoms, you know they take a toll on your academics, work, and social life. But what causes these brain fog symptoms? And what can you do about it? Read on to find out.
5 Causes of Brain Fog (and How to Fix Them)
When you have the flu, it’s usually just a matter of bad luck that you have to wait out until you feel better. Brain fog, on the other hand, is different: it’s not something you can catch, nor something you can ride out until the symptoms disappear.
Brain fog is your body’s way of telling you that you probably need to make some changes in your daily life. However, when you can’t think straight and you have assignments and obligations piling up, figuring out and fixing what’s causing brain fog probably isn’t at the top of your to-do list.
To help you regain mental clarity ASAP, here are five common causes of brain fog (and what to do about them):
1. Lack of Sleep
College students typically aren’t known for having great sleep habits: maybe you’re even pulling an all-nighter as you’re reading this.
You might be tempted to sacrifice sleep to get more done, but that comes with a price.
Lack of sleep, and the inevitable fatigue that follows, can be one of the main causes of your brain fog. Optimal rest (which is 7-8 hours per night for most college-aged students) plays a key role in cognitive function. Without it, we’re left feeling groggy and stressed.
Solution: Get Enough Sleep
Max Hirshkowitz, chair of the National Sleep Foundation Scientific Advisory Council, suggests that college-aged people should get between 7 and 9 hours of sleep each night.
This will allow your body to rest and recover after long days of rigorous mental and physical activity. If you have trouble getting to bed on time and getting enough sleep, check out our guide to best practices for sleeping.
2. Lack of Exercise
Did you know that aerobic exercise (the kind that gets your heart pumping) actually increases the size of the parts of your brain that are associated with thinking and memory? Exercise increases blood flow to the brain and has been demonstrated to improve sleep, boost memory, and reduce stress in addition to its physical health benefits.
As you can see, when we let our bodies become inactive for too long, we put our brains at risk for becoming inactive, too. This can lead to the symptoms of brain fog: difficulty sleeping, impaired memory, and increased stress.
Solution: Exercise Regularly
The internet is flooded with information that can cause us to feel overwhelmed about what a “good workout” really is.
Truthfully, you don’t need all the frills to counteract brain fog. Your goal is to sweat—it doesn’t matter how you get there.
For starters, you can try this free app called 7 Minute Workout that gives you (you guessed it) a seven-minute workout every day. And if you’re having trouble motivating yourself to exercise, we’ve got a guide for that.
When the human body is faced with stressful situations, it releases cortisol, the “fight or flight” hormone. Normally, cortisol levels subside when stress passes. But if you’re stressed 24/7, those hormones continually flow throughout your body, making it difficult for you to calm down and think clearly.
It’s no surprise that some of the symptoms of high cortisol levels mirror the symptoms of brain fog, such as:
- Having a hard time falling asleep
- Inability to focus
- Constantly craving junk food
Solution: Manage Your Stress
Some people are better at handling stress than others, but the biological effects of stress can still contribute to brain fog. Here are some practical tips for stress management that can be applied in college and beyond:
- Recognize that you are stressed and don’t deny it. That tends to make it worse.
- Be okay with saying no to obligations that aren’t absolutely necessary or that you don’t have time for.
- Talk to somebody. There’s no shame in asking someone for help or just expressing your struggles to someone you trust. You’d be surprised how many of your peers experience the same issues.
4. Poor Diet
If you thought binging on potato chips and candy only had physical consequences, think again. Your brain is the hardest-working organ in your body, and if you want it to function at the highest level, you need to give it the fuel it needs.
A poor diet consisting of processed sugar (such as candy or ice cream), refined carbohydrates (such as chips, white bread, and cookies), and a lack of protein and vitamins can have a severe impact your mood, energy, and focus. And all of this leads to brain fog.
Solution: Fuel Up With (Healthy) Brain Food
The main macronutrients that feed our brains are proteins, which are the building blocks of our neurotransmitters. Additionally, foods such as salmon, walnuts and pecans, avocado, extra virgin olive oil, and coconut oil contain brain-boosting omega-3 fatty acids that our brains rely on to build brain cells and process information.
If you’re looking for a simple, effective diet solution, focus on adding more leafy greens, dark berries, omega-3s, and a high-protein lunch.
Have you ever noticed how runners are often dazed and confused after finishing a marathon? Chances are, they’re dehydrated — and you can experience the same side effects if you’re not hydrated throughout your classes, work, and extracurriculars.
Your brain clocks in at 73% water. And according to a study at the University of Connecticut, even a 1% dehydration level can impair cognitive function. Here are just a few side effects of dehydration:
- Increased fatigue
- Inability to focus
- Impaired short-term and long-term memory
- Impaired problem-solving capabilities
Sounds a lot like brain fog, right?
Solution: Drink More Water
You may have heard that you need to drink 8 glasses of water a day to stay hydrated. However, it turns out that this is a myth.
In reality, staying hydrated isn’t about drinking the “perfect” amount of water (or other fluids that contain it). This is because the quantity of fluids you need changes based on all kinds of factors such as your weight, activity level, and even the temperature.
To keep yourself hydrated, just follow these simple rules:
- Drink fluids when you feel thirsty. This will be easy if you always keep a reusable water bottle with you.
- Eat a balanced diet of vegetables, fruits, and high-quality protein sources (which contain both water and electrolytes).
- Limit your consumption of drinks that contain caffeine or alcohol.
Fixing Brain Fog: Where Do I Start?
Okay, that was a lot of information (which I hope you found valuable.) Now you might be thinking: Where do I start?
Whenever I’m faced with a chronic problem, I always try to understand the whole situation before obsessing over particulars.
In the case of brain fog, you’ll want to identify its root cause before making specific changes. For instance, it won’t matter how many leafy greens you eat if you’re only sleeping four hours each night or taking on more work than you can handle.
There might not be a magic pill to beat brain fog, but with moderate adjustments and a little patience, you can put the odds of a fog-free life in your favor.
Image Credits: featured
Getting Disability for Fibromyalgia Brain Fog, or Fibro Fog
Brain fog due to fibromyalgia (FMS), a.k.a. fibro fog, is a commonly reported symptom of fibromyalgia. Fibromyalgia patients often describe multiple sensations of fatigue and listlessness combined with transitory states of confusion, poor attention and concentration, and short-term memory loss. This fibro fog tends to exacerbate the deficits in daily functioning that a fibromyalgia sufferer must deal with.
What causes fibro fog? There’s no conclusive origin for this symptom of FMS, nor an explanation as to why it exists in varying degrees for different fibromyalgia patients. Sleep deprivation and significant difficulty in achieving and/or maintaining deep level sleep, however, may very well point to the answer. It is at the deeper levels of sleep (delta wave sleep) that a person’s mind conducts its internal “housekeeping.” During this phase of sleep, newly acquired information is assimilated and integrated. The inability to get enough restorative deep-level sleep may have an impairing effect on an individual’s ability to recall information or operate at a normal level of mental efficiency.
If the SSA agrees with your diagnosis of fibromyalgia and believes it is a severe impairment, the SSA will assess your physical and mental abilities and come up with an RFC. (This is discussed in our general article on fibromyalgia disability.)
If you have fibro fog that affects your ability to concentrate or remember instructions because of mental confusion and short-term memory loss, the SSA will give you a mental RFC. Your mental RFC will rate your ability to do skilled work, semi-skilled work, or unskilled work. If your RFC says you can do unskilled work, the SSA will likely say that you can get a job. But if you have a mental RFC for unskilled work (because of poor concentration and inability to follow instructions), and a physical RFC that allows you to do only desk jobs, the number of jobs you can do will be greatly lowered. For more information, see our section on getting disability with an RFC.
While fibromyalgia is a disease that is most known for the widespread pain it causes, some say that it can also cause memory issues.
For example, a November 2018 study by Marina Pidal-Miranda, of Universidad de Santiago de Compostela, in Spain, and colleagues sought to explore the connection between the disease and this cognitive issue.
“Although it has been suggested that FM patients display problems in working memory, the data are inconsistent, and the overall working memory status of the patients is unclear. It is also not clear whether the working memory problems are related to cognitive complaints or how the dyscognition is affected by the characteristic clinical symptoms of FM,” the team wrote.
The study included approximately 60 women — half with and half without fibromyalgia — and while both groups showed similar results in working memory, the fibromyalgia patients struggled cognitively as a result of their other symptoms.
“Only the performance of a task related to visuospatial WM was significantly poorer in the FM patients than in controls, and the differences were mediated by the presence of depressive symptoms, fatigue, and pain. Analysis of the individual performances revealed deficient execution of this visuospatial task in almost half of the FM patients,” the authors wrote.
Susan Knowles, MD, of Carson Tahoe Medical Group in Carson City, Nevada, told the Reading Room that she has seen many fibromyalgia patients with cognitive dysfunction: “The extent of their symptoms seems to vary from patient to patient, and also seems to correlate with their pain severity as well as any associated mood disturbances such as depression,” she stated. “For many patients, it is a feeling of ‘brain fog,’ including difficulty concentrating, some difficulty with word finding, forgetfulness — i.e., losing their keys, or going into a room and forgetting what they came in to do.”
For her patients suffering from cognitive dysfunction, Knowles recommends exercise and restorative sleep.
“If they have underlying depression that is not adequately treated, then we discuss therapies for mood issues, which also can contribute to cognitive dysfunction,” she wrote. “In some patients, we pursue formal neurocognitive testing and seeing psychologist/psychiatrist.”
A 2018 review by Tiago Teodoro, MD, of the Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute of the University of London in the U.K., and colleagues aimed to find the connection between fibromyalgia, chronic fatigue syndrome, and functional memory disorder. Approximately 50 studies on fibromyalgia were used as part of the research.
“Patients with FM reported cognitive difficulties including forgetfulness, distractibility, speech/language difficulties, and disorganized thinking,” the team wrote. “The proportion of patients reporting cognitive symptoms ranged from approximately 50% to 90%,” the authors wrote. “This prevalence was higher than in healthy controls or controls with rheumatic disorders. Contributing factors included pain, fatigue, depressed mood, and poor sleep.”
Teodoro and colleagues concluded that the pain and fatigue of fibromyalgia are what could cause memory issues.
“We hypothesize that pain, fatigue, and excessive interoceptive monitoring produce a decrease in externally directed attention,” the researchers said. “This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular, multitasking. Routine cognitive processes are experienced as unduly effortful.”
A December 2018 study assessed memory struggles in 66 female fibromyalgia patients. “In fibromyalgia patients, cognitive impairment in the field of direct memory was confirmed. There could be a specific type of personality in people who develop fibromyalgia; these people are more conscientious and agreeable than people in the reference group and the population,” wrote Weronika Bartkowska of Poznan University of Medical Sciences in Poland, and colleagues.
“The presence and intensity of depressive symptoms correlate significantly with the symptoms of fibromyalgia. Anxiety is a relatively constant feature of the personality of people with fibromyalgia,” the team said, stressing the importance of involving psychotherapy in the treatment of fibromyalgia patients.
Knowles said that treating fibromyalgia is best with a team approach: “Fibromyalgia is very difficult to treat in general, especially the cognitive impairments,” she said. “It often requires a team of providers including psychologists, psychiatrists. It also is important to adequately educate the patients regarding their symptoms and disease.”
An October 2018 study evaluated 64 fibromyalgia patients who had a variety of treatments including sessions with an occupational therapist, a physiotherapist, and a psychologist.
“A 12-week multicomponent therapy for fibromyalgia, well described and gradually applied, showed improvement in functioning: women were less affected by fibromyalgia in daily life, had a lower indication for depression, used fewer coping strategies, had less pain at the tender points, gained strength of upper extremities, and improved physical condition compared to their baseline measurement,” the authors wrote.
However, there was a high dropout rate in the study at 28%, which the researchers attributed to patients who already had moderate to severe depression before starting therapy.
Still, with cognitive issues in fibromyalgia patients tied so closely with their other symptoms, the use of multi-component therapy and its impact on memory loss may warrant further research, the investigators said.
Source Reference: Pidal-Miranda M, et al “Broad cognitive complaints but subtle objective working memory impairment in fibromyalgia patients” PeerJ 2018; 10.7717/peerj.5907.
Journal of Neurology, Neurosurgery and Psychiatry
Source Reference: Teodoro T, et al “A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review” J Neurol Neurosurg Psychiatry 2018; 89: 1308-1319.
Journal of Biological and Clinical Anthropology
Source Reference: Bartkowska W, et al “Cognitive functions, emotions and personality in women with fibromyalgia” J Biol Clin Anthropol 2018; DOI: 10.1127/anthranz/2018/0900.
Reprinted with the kind permission of Cort Johnson and Health Rising
What a dread disease dementia is. At its worst, dementia can result in the total loss of one’s personality: loved ones don’t register, reasoning is gone, even simple matters such as dressing and bathing require assistance. Even in its more moderate forms, dementia can be all-encompassing, causing memory loss, problems doing ordinary tasks, mood swings and more.
Dementia is a broad term used to refer to several conditions that cause a severe enough reduction in the ability to think so as to impact one’s daily living. If you live long enough, you have a very good chance of developing dementia. While just 1-2% of people aged 65 have dementia, the risk of developing it after that doubles roughly every five years. If you make it to 85, your risk of developing dementia is somewhere between 30-50%. For those of us with aging parents, the costs that dementia imposes can become painfully clear.
Fibromyalgia, of course poses its own unique costs. Those costs were made clear in the 2017 study on FM and dementia.
“Fibromyalgia is a widespread musculoskeletal pain disorder associated with chronic fatigue, emotional distresses, and sleep disturbance. Previous studies revealed that fibromyalgia is associated with the increased risk of irritable bowel syndrome, dry eye syndromes, depression, suicide rates, stroke, and coronary artery diseases.”
They left out migraine (55% of FM patients met the criteria in one study) and chronic fatigue syndrome, but never mind; fibromyalgia is “widespread” and is associated with a boatload of other conditions.
The pain, fatigue and sleep issues, of course, can be terrible, but the problems don’t stop there. There’s also the “fibro-fog,” the short-term concentration and word-finding problems, the problems with multi-tasking, and the general fogginess where clarity used to reign. FM, then, is a kind of all-inclusive disease; it causes pain, fatigue, sleep issues, throws people off emotionally, and causes problems with cognition.
Diseases don’t ordinarily cause cognitive issues. Look up diseases that cause cognitive problems, and you’ll find mostly brain disorders like autism, stroke, Parkinson’s disease, Huntington’s disease, brain injuries, multiple sclerosis (brain-fog), cancer (chemo-brain), chronic fatigue syndrome (brain-fog) and, of course, Alzheimer’s. The cognitive issues in FM are pretty mild compared with the issues found in some of these diseases, but they obviously raise a concern: could fibro-fog be a prelude to something worse? Do people with FM have to be concerned with early-onset dementia as well?
Distraction or Dementia?
A 94-person 2016 study suggested not. The study suggested that the cognitive issues in FM are different in kind from those found in Alzheimer’s. It found that the “encoding mechanisms” needed to transfer personal events into memory that are broken in Alzheimer’s were, for the most part, functioning in fibromyalgia. FM patients may have cognitive problems, but they didn’t experience the “episodic memory losses” or progressive cognitive decline seen in Alzheimer’s.
The major cognitive problem in FM, the authors said, comes from their brains’ inability to correctly filter out irrelevant data. Several studies suggest that fibromyalgia patients brains keep focusing on innocuous stimuli that healthy controls are able to quickly assess and then stop paying attention to. A correlation between reduced pain inhibition and cognitive issues also suggests that being in pain causes cognitive issues. The cognitive findings suggest that even ordinary tasks such as dressing and personal hygiene take longer, are more difficult, and require more mental thought for people with fibromyalgia.
But what about dementia? The 2016 study suggested that when faced with distractions, FM patients actually do have the problems “encoding” personal memories. When placed in quiet, distraction-free environments, however, they do just fine. The authors concluded that the cognitive problems in FM relate to problems with cognitive distraction, rather than an Alzheimer’s-like process. They hoped that their findings “allay the worries of many with fibromyalgia who fear that fibro-fog is the start of a dementing process.”
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Distraction and Possibly Dementia
Not so fast, though. This year, an 165,000 person Taiwanese study, the Fibromyalgia and Risk of Dementia – A Nationwide, Population-based, Cohort study, concluded differently. The study followed 41,000 FM patients and 124,000 healthy controls over 50 years old for ten years.
After adjusting for confounding factors (gender, age, monthly income, urbanization level, geographic region, comorbidities), the study concluded that FM is indeed associated with a significantly increased risk (hazard ratio- 2.7 x’s) of dementia, and not just one type of dementia either. All types of dementia were increased in FM patients as they aged with Alzheimer’s (3.35-fold increase) and non-vascular dementia (3.14-fold increase) showing the highest increases. FM patients suffering with depression, epilepsy, Parkinson’s disease, stroke, TBI, or liver issues had a further increased risk of dementia. Interestingly, the rate of depression in the FM patients in this study was quite low.
(Hazard ratio is associated with an increased hazard of an event occurring. The 2.77 HR of FM means that FM patients over 50 were 2.77 times more likely to be diagnosed with dementia than the healthy controls.)
It should be noted that this study does not suggest that dementia is imminent or even common in people over 60 who have fibromyalgia; the rate of dementia is simply increased. Just over 4% of the FM patients developed dementia in the study – as opposed to the 1.2% of the healthy controls.
It’s not clear why dementia is increased in FM, but citing the role that inflammation may play in other dementia-prone diseases, the authors suggested that systemic and/or brain inflammation might be the culprit.
Neuro-inflammation is certainly present in dementia but whether it’s causing it is unclear. A 2013 review study, which reported that anti-inflammatory drug trials have not been effective in Alzheimer’s, discounted the idea that inflammation is a key player in the disease.
A more recent review, however, suggested that the very idea of what constitutes inflammation in Alzheimer’s needs to be re-assessed and that targeting different parts of the immune system may be helpful. (A similar re-assessment regarding inflammation may be occurring in FM and chronic fatigue syndrome (ME/CFS).)
That more recent review suggests that if you’re worried about developing dementia, finding ways to reduce inflammation could help. A UCLA study employing a multidimensional approach called metabolic enhancement for neurodegeneration (MEND) which involved reducing inflammation was able to reverse Alzheimer’s symptoms in all of the participants.
The idea was to “target multiple pathways simultaneously in order to effect an improvement in symptoms and pathophysiology.” The protocol involved low glycemic/carbohydrate/grain diets, short fasts, stress reduction (yoga), exercise, brain stimulation, and supplements to reduce inflammation, enhance cognition, improve mitochondrial functioning, improve sleep, etc.
The study was very small (n=10) and bigger studies will be needed to validate the results, but they were astonishing for such a treatment-resistant disease. One man’s cognitive test score increased from 3rd percentile to 84th percentile (3 standard deviations). Other participants’ scores increased from the 1st to the 50th percentile, from the 13th percentile to the 79th percentile, and from the 24th to the 74th percentile. One person went from considerably below average to considerably above average in many of his cognitive tests. An expanded study is reportedly underway.
About the Author: ProHealth is pleased to share information from Cort Johnson. Cort has had myalgic encephalomyelitis /chronic fatigue syndrome for over 30 years. The founder of Phoenix Rising and Health Rising, he has contributed hundreds of blogs on chronic fatigue syndrome, fibromyalgia and their allied disorders over the past 10 years. Find more of Cort’s and other bloggers’ work at Health Rising.
23 People With Fibromyalgia Describe What ‘Fibro Fog’ Feels Like
If you have fibromyalgia, you’re likely familiar with the term “fibro fog.” But those outside of the community might not truly get what that means. Most people know what it’s like to have a word on the tip of your tongue but not be able to say it, or how it feels to walk into a room with a purpose but quickly forget what you meant to do in the first place. Fibro fog, depending on the person experiencing it, can go beyond this.
We asked members of the National Fibromyalgia Association‘s Facebook community how they would describe fibro fog to someone who doesn’t understand. After receiving more than 1,000 responses, it’s clear the experience can differ for everyone — but the frustration and fear is often shared.
Here are just some of the community’s answers:
1. “Everyone forgets words sometimes. But usually when you do you are able to give a definition or a synonym. With the fibro fog, the word is gone — completely and utterly gone. You sit and stutter, ‘The thing, you know, the thing. The thing.’ And you have no way to explain what you are saying. That’s when you can remember that you had a point at all. There are times when you are talking, and mid-sentence you forget what you were talking about. Nothing makes sense. It can creep up on you or hit you full steam out of nowhere. It’s one of the most frustrating parts of FMS for me.” — Sarah Smith Edelmaier
2. “It’s called ‘fog’ for a reason. Fog can move in slowly or quickly, and without warning. Fog is very disorientating. It messes with sound perception, what and how much you see, it confuses your senses. You can lose direction and your way in fog. You may not be able to function properly, navigate well or at all until it clears. Imagine that. That feeling, and now place it in your head. In your brain.” — Angelique Figueroa
3. “Fibro fog is thinking in a manner that would equal trying to see clearly through waxed paper.” — Kayla Moen
4. “You know what you need to do, but you never get to it, not because you’re procrastinating, but because you can’t remember. You stand up and walk towards your goal, then the pain in your body overrules your thoughts, and you just can’t accomplish what you set out to do. It’s beyond the occasional forgetfulness because you can’t laugh it off. It’s not funny, it’s frustrating and demoralizing.” — Tina Blakeman
5. “Fibro fog is as if you’re getting startled awake in the middle of the night to find you’re on stage with a live audience and have to recite a song/poem/grocery list with duct tape on your mouth, and if no one can tell what you’re saying, you lose. And repeat all day.” — Cee Ruda
6. “Fibro fog is like being temporarily disoriented. You cannot connect your thoughts. They come in and are not processed properly. It’s like having a brain full of cotton.” — Jennifer Parrett Piel
7. “Fibro fog is really, honestly forgetting to brush my teeth in the morning. Fibro fog is not being able to remember words that I use every day. Fibro fog is making a list of things I need at the store, driving to the store and forgetting I have a list. Fibro fog is not remembering how to turn on the car. Fibro fog is having to set alarms on my phone for every… single… thing.” — Ashley Garza
8. “For me fibro fog is being right in the middle of a conversation, and all of a sudden I stop talking, look at my husband and say, ‘What was we talking about?’ Because I can’t remember to save my life!” — Angel Moore
9. “Fibro fog is like your body is awake, but your mind is in a deep sleep. It takes forever to get something done because your concentration is not working.” — Geraldine Molloy
10. “As you can see from the many comments here, ‘fibro fog’ can vary considerably from person to person, just as the other symptoms we suffer through vary from each individual with fibromyalgia.” — Beth Stokes
11. “I know what an apple is, but to tell you that I see an apple in front of me is quite scary when the words won’t come. It is real. It isn’t fake or faked.” — Beth Wilcoxen
12. “Fibro fog is like a jigsaw puzzle floating around in your head. You know where the pieces go, but when you try putting it together, the pieces disappear.” — Violet Ali
13. “Fibro fog is a blanket of mist on the mind. Your brain is no longer your own. You’re more of a visitor to a place you’ve been before, but it was a very long time ago. Thoughts, names, dates and plans are all things you should remember, but you just vaguely have this feeling you’ve forgotten to remember something.” — Stephen Miskell
14. “If I can carry on a conversation, that is a great day. If I say a sentence that doesn’t have all the right words, this is why. It’s like a fumbling football. If I say, ‘thingy,’ it’s because the words and ability to think of it is totally gone. So when disciplining or trying to tell kids what to do, I may just make noises to get their attention.” — Tara Parmenter
15. “Fibro fog is when someone asks you a question, but you have to solve complicated math in your head before you can think of the answer.” — Anje Ravenda-Sauer
16. “Fibro fog for me comes in different ways. It can be where my mind goes blank completely, and I can’t even remember what I was doing/saying and it doesn’t come back. It can be where I can see the word in my head, but it’s covered in fog and I cant quite make it out. It can be where I can’t think of words and have to describe them. It can be where I can see the word but can’t get my mouth and brain to connect and make sense of it and say it out loud.” — Jodie Sparks
17. “Fibro fog feels like being lost (lost in words or thought or action), and you can’t remember where you are, where you came from or where you’re going. It’s disorienting, confusing, lonely and scary. It’s that cloudy-head feeling like when you have a cold, but worse. You feel like a drone.” — Melissa Michaud
18. “Fibro fog is like living life underwater while trying to do your daily tasks. Everything is slower and harder to complete.” — Janna Haynes
19. “Fibro fog is frightening. You have lived a lifetime being organized, remembering names, dates, appointments. You have college degrees. Yet you are reduced to being forgetful, not being able to articulate your ideas and not being able to follow a conversation. Your life is in chaos. And you feel very, very lost.” — Monica Hawkins Pflugh
20. “Finding thoughts during fibro fog is like wading through quicksand. You get sucked under and feel helpless when you can’t grasp what you were looking for.” — Whitney Flewwellin
21. “Fibro fog is like having a door between your thoughts. Sometimes the wind slams that door shut, other times it closes slowly, while most times the door remains open, allowing full thought flow process to happen. But when the door closes, it keeps you from living and being the person you are. And it hurts.” — Christine Bloomfield-Reinke
22. “The worst part of fibro fog for me is not having any creative ideas. I was a practicing artist and art teacher, and I used to come up with so many creative concepts for artwork, but now it’s always a blank canvas. My multicolored world has turned sadly grey.” — Meg Kenny
23. “Fibro fog is like a turtle trying to run in peanut butter.” — Tamela Walker
Editor’s note: Some of these responses have been edited for brevity and clarity. These responses are also based on personal experiences. Please consult a medical professional for any health questions you have.
What would you add to this list? Share with us in the comments section below.
MORE ABOUT FIBROMYALGIA:
Fibromyalgia, a chronic illness with three main symptoms — widespread pain, chronic fatigue and cognitive trouble. Fibromyalgia is a complicated illness that’s not well understood. In the past, it was mischaracterized as a mental health disorder. Even today, some doctors wave off fibro symptoms as being “all in your head.” This isn’t the case. Read The Mighty’s comprehensive guide to fibromyalgia here. and connect with people who get it.
Fibromyalgia: Managing Fibro Fog
“Fibro fog” is the name commonly given to the cognitive problems that can go along with fibromyalgia syndrome. These problems with concentration and memory can lead to confusion, losing your train of thought, or forgetting or mixing up words or details.
You can take steps to manage fibro fog. Try some of the following tips:
- Write it down. Making a note helps you get a thought more firmly in your mind. You might want to keep a calendar or notebook with you so you can write things down while you’re thinking of them.
- Get treated. Other symptoms that commonly go along with fibromyalgia—including depression, pain, and lack of sleep—can also make it harder to concentrate and remember. Medical treatment for these other problems may also help your memory.
- Stay active—mind and body. Keep your mind working by doing puzzles, reading, or seeing a play to get yourself thinking. Moderate physical activity can increase your energy and help clear the fibro fog. Talk with your doctor or physical therapist about an exercise program that is right for you.
- Find ways to help you focus. Try breaking tasks up into small steps. Don’t take on more than you can comfortably manage, so you’re not trying to do too much at once. When you do start a task, avoid distractions that can keep you from concentrating. A loud radio or TV, or trying to work where other people are talking, can make it hard for you to focus on what you’re doing. Try working in a quiet place when you are trying to concentrate or remember, so you can give the task your full attention.
When waking up just doesn’t mean waking up.
Everyone knows what it is like to be tired—to feel so worn out that you barely feel like yourself. There are long days, short nights and long to-do lists that will push your energy level to the limits, and the result of this is days that are filled with fatigue. But for some people this experience of mind-numbing fatigue isn’t a once-in-a-while thing, it is an everyday thing. This is the case for those who struggle with fibromyalgia, but the problem is that many people don’t realize that there is actually a medical reason that is causing the excessive tiredness.
What is Fibromyalgia?
Fibromyalgia is a chronic disorder that causes muscle and skeletal pain across the body. The symptoms of fibromyalgia are often widespread and will often start off mild but will grow more intense over time. The pain, fatigue and tenderness associated with fibromyalgia unfortunately becomes a way of life for those who struggle with this disease, but one of the most frustrating symptoms of the condition is definitely the extreme fatigue that is associated with the disorder.
Chronic fatigue is one of the most common and often the most severe symptom of fibromyalgia, coming in only behind the deep muscle pain and body aches that only compliment and often further the feeling of tiredness and fatigue.
The fatigue with fibromyalgia doesn’t go away after a good night’s sleep or a strong cup of coffee. On good days a nap might help, but those with FMS know all too well the way that the insomnia and muscle aches weigh on the mind and body day after day. Turning to caffeine or sugary items to try to wake up can actually backfire, making it more difficult to get restful sleep later on.
There are ways to combat the fatigue of fibromyalgia, however. While every person responds differently, these strategies include:
- Taking vitamin supplements, including vitamin D
- Reducing caffeine intake
- Alternative treatments like chiropractic care and acupuncture
- Stress management
- Medical weight loss
Many people who struggle with fibromyalgia report that the mental fatigue and tiredness is actually more difficult to deal with than the muscle pain itself. Making regular improvements in your health by increasing vitamin intake and making healthy dietary changes can help you overcome the feeling of intense fatigue that holds so many with FMS back.
Not all cases of chronic fatigue are associated with fibromyalgia, but if you are experiencing daily fatigue that doesn’t seem to go away despite your best efforts to sleep, then you may want to talk to your functional medicine doctor about potential treatment options. Working closely with your functional medicine doctor you can find healthy solutions that could help you finally get a peaceful night’s rest and wake feeling refreshed.