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Is Brain Fog Stealing Your Sharpness? Fix It Fast · Intellectual Medicine

• 0:00
  Well, the brain, it's one of my favorite organs.
• 0:03
  It's right up there with some of my other favorites, but maybe
• 0:06
  the best, really. If our brains not working right,
• 0:09
  everything becomes a hardship. There's a condition sometimes
• 0:13
  described as brain fog. It's not dementia, it's not a
• 0:17
  concussion. It's that state where the brain
• 0:21
  is a little sluggish. It's just not moving the way it
• 0:24
  normally does. Alacrity, speed of thought.
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  They're muddled. I hear this complaint
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  frequently, and oftentimes we look externally.
• 0:35
  Well, of course, my brain's a little fogged.
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  I'm stressed at work, my boyfriend's an idiot.
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  I don't like my job. I don't like where I live.
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  These variables are real. But remember, folks, the brain
• 0:50
  is an organ made-up of cells. Like your liver, like your
• 0:54
  kidney. So let's talk about what is
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  brain fog and what can be done in the presence of it.
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  Now this is different from dementia or mild cognitive
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  impairment. These are progressive decays and
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  memory function typically happening happening past the age
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  of 50 or later, and that's a critical topic to discuss.
• 1:20
  We'll take up at some other juncture, but brain fog.
• 1:24
  This can happen at any point in life and can complicate other
• 1:27
  entities. The clarity of thought and speed
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  of thought are impaired. Maybe word finding is a little
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  bit impaired. I used to be really sharp.
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  I could knock out numbers quickly.
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  It's not happening like that. I never hesitated to find a
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  word. I'm struggling to find the right
• 1:44
  noun to plug into a sentence. I'm having trouble with names.
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  So let's start with some of the very basics.
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  You got to take care of your brain.
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  It needs some basic things. It needs to be taken for a walk.
• 2:00
  Your brain needs physical activity, folks, and it needs to
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  be outside. I don't care what time of year
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  it is, it needs 5 or 10 minutes of just sunshine and air.
• 2:12
  Now sometimes I can go the whole day from my office to my car to
• 2:16
  my home and barely get outside. That's not good for the brain.
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  So take it out for a walk. It needs to be fed and watered.
• 2:25
  When you get dehydrated, when your fluid is behind, one of the
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  first places it shows up is in your brain.
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  I'll know sometimes if I get more irritable that I need to
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  have a little bit of water. Athletes know this.
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  When their brain is not properly hydrated, their function can
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  decline. So think about food, think about
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  water, and think about the connection from the brain to the
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  gut, the stomach. If your stomach is not right,
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  your brain won't be right. There's a nervous system and
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  there are hormones that connect these two organs very
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  critically. And in the space of gastric
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  inflammation, the brain can be impaired.
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  Now, that can happen even in the setting of chronic drug therapy,
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  things like proton pump inhibitors.
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  It's a drug that I love to hate. Look, sometimes you have to have
• 3:19
  omeprazole, pantoprazole, Prilosec.
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  There's a host of them. Without them, your life may be
• 3:27
  miserable. Constant heartburn.
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  But don't lean on the drugs, folks.
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  Too much dependence on the drug can weaken your body's own
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  gastrointestinal function. The stomach wants to have acid
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  in it. The acid is important for proper
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  gastric functioning. A heavy reliance on the proton
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  pump inhibitors can impair the bacterial balance of the
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  intestine in the in the rectum, thereby affecting the brain.
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  So what to do if you're on the drugs and you can't come off
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  them? You want to complement it with a
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  high dose, high quality, broad spectrum vitamin that has all of
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  the B vitamins in it and vitamin C.
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  Now, when you're shopping for a multivitamin, folks, look for
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  what's not there. It should have minimal, if any,
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  calcium. Calcium's a bad player.
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  Do not take it as a supplement. It serves no valuable purpose,
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  it does not protect your bone, and it correlates with an
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  increased risk of prostate cancer in men, maybe breast
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  cancer in women, and certainly possible coronary artery
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  disease. So no calcium, maybe a minimal
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  amount just to neutralize acidity.
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  Another thing I like to not have in a multivitamin, Copper.
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  I get it. Copper is essential.
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  But remember, there are different kinds of coppers.
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  There's a good one and a bad one.
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  The simplest way to think about it, the good one you get from
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  food, The bad one, those are in your copper pipes in your home.
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  It's in the copper that they typically use in almost all
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  supplements. Why?
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  Because it's cheap. Why?
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  Because you don't know the difference.
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  Just as copper, you don't know what you're taking.
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  Let's be honest. So where do I get my copper?
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  I I get it from cashews. Cashews are high source, as is
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  dark chocolate. So multivitamin feed your brain.
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  How about probiotic? I think probiotics are generally
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  a little bit over utilized. Look, if you're eating a good
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  diet high in fiber, your gut's fine, you're pooping regularly,
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  you don't overdo the alcohol. You're not putting anything in
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  there that would muck it up. A probiotic is not an intrinsic
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  essential need. But let's say that's not you.
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  You're bloaty, your gut doesn't feel right.
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  Maybe you're on a proton pump inhibitor, maybe you just got
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  over an infection you're putting on, placed on antibiotics.
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  Antibiotics can disrupt the bacteria in your colon for up to
• 6:03
  three months. In that case, restoring it,
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  restoring the bacterial balance with a high quality probiotic.
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  High quality. Do not expect this off the shelf
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  from a big box store, or for that matter most pharmacies.
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  That's because these bacteria are alive and when they get
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  shipped they start to die off. You want to get this from your
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  healthcare provider ideally, or a high quality source where you
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  can trust what's in it. These are hard to find.
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  Most of your naturopathic doctors, chiropractors, and a
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  lot of osteopathic and functional medicine doctors are
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  plugged in. What are you looking for?
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  If you're in a recovery phase after antibiotics, you want to
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  have upwards of 100 billion units bacteria in there.
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  It's one of the few things that have shown to actually improve
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  cognition in people with dementia.
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  So you got to make sure the gut's healthy.
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  We got to feed it, water it, take the brain out.
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  What else can cause this post infectious neuro inflammation?
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  I'd say this is one of the more common triggers.
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  It's sometimes ascribed to COVID or long COVID, Right?
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  And COVID is clearly a risk factor for brain fog.
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  Post COVID is a risk factor but any infection can do this.
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  Lyme disease, left flu, RSV, fill in the blank, pneumonia, a
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  chest sinus infection. What happens?
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  You end up with a post infectious inflammatory
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  environment, a cytokine overload creating neuro inflammation.
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  The way to neutralize that? I like a good cycle of
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  nicotinamide, adenine dinucleotide, NAD.
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  Do not take NAD orally. It doesn't absorb.
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  There are quality precursors. Nicotinamide riboside is one of
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  them. You can get any idea as an
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  injectable. You need to get that from your
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  doctor. It's not something you can get
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  off the shelf and in many cases may not be necessary.
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  The nicotinamide riboside can work quite well.
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  I recommend a two to three month cycle of nicotinamide riboside
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  at 300 to 500 milligrams per day or in our practice we do
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  subcutaneous injections twice a week for our patients as a
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  recovery tool for the young and the healthy.
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  You do not need NAD every day for its anti aging merit.
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  You don't need it for its health preserving value until you're at
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  least past 40, maybe 50, because your body's making plenty of it.
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  So we want to restore the brain post infectious, reduce
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  neuroinflammation. What other things can do that?
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  Good antioxidants like vitamin C, like omega-3.
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  A pure Omega is another difficult thing to buy, high
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  quality. There are some good sources you
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  can get online, Nordic Naturals, Carlson's, or two name brands
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  that come to mind. Many functional doctors stock
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  this in their office. It's reliable.
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  Another thing you do not want to get from the big box stores
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  Because it's fish oil, right? Means you can go rancid and they
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  put aromatics in it so you can't smell that it's a fish oil.
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  We keep ours refrigerated until it's dispensed.
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  I recommend you keep it refrigerated at home as well.
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  You're looking for EPA and DHA on the label.
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  Those are the two components of the fish oil that are most
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  valuable for brain health. And you're aspiring to get about
• 9:54
  900 milligrams into you if possible.
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  Of course, if you're taking salmon twice a week, you're
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  probably good to go. So we've got the micronutrients,
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  we've got the need to feed water, nurture brain cells.
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  We've got methylene blue. A methylene blue is used in this
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  setting as a transient therapy. That is for about two or three
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  months. In my practice, we prescribe it
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  from compounding pharmacies. Why it's reliable, why it's
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  safe, Why? Because we can trust what's in
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  it. You buy it online, it's a roll
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  of the dice. The nutraceutical and supplement
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  manufacturers not as highly scrutinized, regulated and
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  reliable as a good compounding pharmacist.
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  I recommend 20 milligrams once a day for a 90 day cycle to
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  restore brain, restore its acuity, sharpness and function.
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  What else makes the brain foggy? It's hormones folks.
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  It's hormones, or I should say it's a decline in the ideal
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  hormone levels. I see this quite frequently.
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  Young women in particular are very hormonally sensitive with
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  regard to the brain function. Same thing for men, although it
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  happens later. Women, when they're still
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  menstruating and they're premenopausal, technically start
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  to in some cases experience cognitive impairment, dullness
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  of mental function, increase in irritability and short
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  temperedness, sometimes mood disturbance.
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  Often this gets labeled as depression or anxiety and they
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  get put on drugs. That's horrible idea.
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  Unless you absolutely need an antidepressant drug because you
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  cannot function, find a better remedy.
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  The drugs can sometimes be life changing and critical for your
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  function. However, they can also amplify
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  the brain fog, make you dull and tired, interfere with sexual
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  function. So what do we do?
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  We implement hormone therapy in the form of testosterone,
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  especially testosterone. Yes, for women, the proper dose
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  does not 'cause andronization, does not 'cause facial hair or
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  acne or deepening voice. It does not do that.
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  Women, you need testosterone. You have it already, just not
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  enough of it. As you get older, it's the first
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  hormone to leave the building as you're entering in the
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  perimenopausal window. Do not rely on a blood test.
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  You cannot tell from a blood test where you are in that
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  menopausal arc. If a woman goes to the
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  gynecologist and says I want you to test me for menopause, it's a
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  waste of time. Your symptoms and your age
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  dictated. So where does that fall?
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  By process of elimination, Folks, you've got to address
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  brain health and brain fog, right?
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  Do the basics first. Make sure the gut is right.
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  Feed and water the brain. Avoid drugs that can impair it.
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  Beta blockers sometimes utilize for blood pressure.
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  They can be brain fogging. Antidepressants can be brain
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  fogging. Proton pump inhibitors can
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  impair cognitive acuity. So you've got to be thoughtful
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  about the drugs you're on. Scrutinize them.
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  Micronutrient insufficiency. Not enough B vitamin, Not enough
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  vitamin C, those things can impair the brain and put a drag
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  on it. Inflammation, we talked about
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  that. That can put a drag on it.
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  So as I'm processing this for my patients and we're addressing
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  brain health, we get to the hormone piece.
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  How do we know if your brain fog is coming from inadequate
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  testosterone? The best way, after things have
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  been analyzed and we've made sure there's no medical
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  contributor and we've made sure there is no reversible basic
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  function need food, water, etcetera.
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  In our practice, we do intravenous high dose vitamins.
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  Fabulous. If you can get to a high quality
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  infusion center. High quality.
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  How do you know if it's a high quality?
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  A little sidebar #1 the doctor or the nurse practitioner is on
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  site. You go to the drip bar and say
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  I'd like to talk to the doctor. Well, there's not a doctor here.
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  Find another drip bar. Nurse practitioners equally
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  skilled in this, by the way, because you want to talk to them
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  at least for a minute. In fact, that's a requirement in
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  most states, certainly in Rhode Island where I am.
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  Then a high dose infusion is fantastic.
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  It bypasses the gut, eliminates the absorptive issues, and can
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  have an immediate charge effect on the brain.
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  In fact, you put in NAD in there as well, and that can help.
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  So the brain is still not hitting on all cylinders.
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  A cycle of testosterone therapy is completely rational, safe to
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  do, self administered in most cases, either injectable or as
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  an implantable pellet or as a topical cream.
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  How it gets in you is less important than the proper dose
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  and monitoring. You'll know right away, within a
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  matter of a few months, maybe weeks even, The brain clarifies
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  why. Testosterone is a
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  neurotransmitter. It stimulates the speed of
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  electrical impulse from one nerve to the next.
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  Your brain does not work its best without it.
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  Confidence gets weak, speed of thought gets impaired.
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  I've had men and women come to me starting to struggle in their
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  job, which relied on a lot of good high quality brain
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  function, Have it all come back to them when they started some
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  of their testosterone therapy. You should never accept a foggy
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  brain. You should never accept it
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  because of your age or your circumstance or the stress.
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  Sleep is important as well. Sleep is important to restore
• 16:08
  the brain, but you can't do it with drugs.
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  That'll fog it up even more. So sleep comes down to the
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  basics. Controlling ambient light, get
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  away from electronics, do all the good sleep hygiene stuff.
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  And if all that's not working quite well enough, the cycle of
• 16:28
  peptide can be of some value. There is a peptide that I'll
• 16:32
  occasionally use called samarellin, which is a growth
• 16:37
  hormone releasing peptide. Growth hormone correlates with
• 16:41
  restoration and often times supportive of sleep.
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  So that's a factor, another factor for women more than men.
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  We're back to hormones. If you're not sleeping well,
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  oftentimes it's indicative of a low progesterone level relative
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  to what your body needs. You can't tell the the results
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  of this based on the blood test. Your blood test can say, well,
• 17:07
  your progesterone's in the normal range.
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  You know, we can't measure receptors, we can't measure
• 17:14
  testosterone receptors or progesterone receptors.
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  You only can perceive their effect based on how you feel.
• 17:21
  Once again, a therapeutic trial is in order.
• 17:25
  This is called one way to assess whether or not that substance is
• 17:30
  going to help you. Sometimes the only way to know
• 17:33
  is to execute the trial and put it to work.
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  Fresh brain, clear brain, fast brain, confident brain, stress
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  resilient brain are all your birthright, right?
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  Of course you avoid stuff that hurts it.
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  What hurts a brain? Alcohol.
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  How much? It's interesting.
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  It may be that a small amount of alcohol is good for the brain.
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  We don't know. I know it's a heresy for a
• 18:02
  doctor to talk that way, but it's true.
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  We know that small doses have never been shown to cause
• 18:09
  neurologic harm. And what's a small dose?
• 18:12
  My dad was a family doctor. Used to joke the cut off for
• 18:15
  drinking alcohol is anything less than your doctor drinks.
• 18:18
  In reality 1 oz is pretty safe for the majority of people.
• 18:23
  That's one ounce per day. No, you don't get to save them
• 18:27
  up and have 5 oz on Friday night.
• 18:29
  Does not work that way. How about cannabis?
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  It's damaging to the brain. Can we get over the fact or the
• 18:36
  perception that somehow this is a health enhancement?
• 18:41
  Cannabis, it's got its niche. You know what?
• 18:44
  I understand it can help some people.
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  Pain, nausea can have some value, but as an intrinsic
• 18:51
  health support, I don't think so.
• 18:53
  As a possible neurocognitive Fogger, yeah, it's totally
• 18:56
  possible. So cleaning up, making sure that
• 19:00
  you're eating well by eating well, you guys know, I'm not an
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  advocate of fasting unless it's for religious purposes or
• 19:09
  philosophical pursuit. I prefer frequent small meals.
• 19:15
  Everybody's got to listen to their own body.
• 19:16
  I do have people who swear by it.
• 19:19
  They'll say dock, I eat once a day and I feel great.
• 19:23
  OK, I'm not going to dispute your sense of internal Wellness.
• 19:27
  But for the rest of us, that type of a fasting approach
• 19:30
  typically does not correlate with the best brain function.
• 19:34
  Brain likes to be fed. No, not simple carbohydrates,
• 19:39
  not junk food, real food. So brain fog looking at the
• 19:43
  basic elements of it and then more advanced looking at hormone
• 19:49
  therapy, micronutrients support. Think about your vitamins, think
• 19:53
  about vitamin D. Now, vitamin D is critical for
• 19:56
  brain function in our world. We love to see people with blood
• 20:00
  levels above 50 but below 100, which is quite a bit higher than
• 20:05
  most conventional doctors would endorse.
• 20:07
  But it can be tested, of course. Methylene blue, testosterone,
• 20:13
  these are all attributes of pure Omega on an omega-3 fatty acid.
• 20:17
  DHA and EPA all go to the brain and physical activity.
• 20:23
  Notice I didn't say exercise. Exercise is quite optional.
• 20:27
  But physical activity, literally walking, moving, all good for
• 20:32
  the brain. So take care of your brain.
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  Look, I'm advocating for you to live to be 100 in my world.
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  I want to make sure we take care of the brain 1st.
• 20:42
  And although it wasn't today's topic, remember to get the lead
• 20:45
  out, lead damages brain and go to my podcast on that topic.
• 20:50
  I'll be talking about it again in the future.
• 20:52
  Until then, keep a brain sharp. Keep watching this podcast so
• 20:56
  you can get all the information you need to avoid doing harm to
• 21:00
  yourself or having others do harm unto you.
• 21:05
  My, my colleagues in medicine sometimes are well-intentioned
• 21:09
  but tend to be a little bit too confident and their procedural
• 21:12
  dynamics and their drug therapy dynamics, right.
• 21:17
  We're overdrugged and we're unhealthy.
• 21:19
  So let's stop being victims to the system as it is.
• 21:23
  Until next time, folks. Wishing you 100 healthy years.
• 21:27
  I'll talk to you then.