Dr. Paul: You know, brain fog, head fog, people describe it differently.
Dr. Kyle: This is probably our most common “Brain Complaint.” People describe it very differently.
Dr. Paul: Decreased mental clarity, lack of mental clarity.
Dr. Kyle: They tell people, “I used to be smart, now I'm not...”
Dr. Paul: I feel like I'm not as focused, I feel like I know the word, it's on the tip of my tongue, I just can't say it…
Dr. Kyle: This is particularly troublesome for a lot of women. They kind of have to pass themselves off as more of a “ditz” when it really bugs them on the inside.
Dr. Paul: I feel like I can't engage in a conversation because I can't maintain eye contact.
Dr. Kyle: I remember I had a woman come in and tell me “I used to have a steel trap mind.” She goes, “and now I feel like everything just slips away.” Another person said she used to deal with a lot of different clients in her business and she used to always remember all these, you know, little things about each person that came in. And when that stopped happening it actually made a big difference in making those personal connections with all her clients. It actually really affected the success of her business.
Dr. Paul: I feel like I'm always in a fog or I'm looking through like a thin layer of plastic, nothing's really crystal clear. Spacey, cloudy thinking, lack of memory. And where are my keys, my wallet, my phone? Why'd I come in the kitchen again? What's her name again? I've met you before, but no idea what your name is. The word’s on the tip of my tongue; that kind of stuff.
Dr. Kyle: And it's something, they can't quite put their finger on it. And this gets lumped under “Depression” a lot or gets lumped under “Anxiety,” but so much of brain dysfunction doesn't really fit great under that glove. It's a little bit of a stretch to say “its depression.” It's really just my brain not clicking right, people use those kind of words. And they just go, “I don't know what's wrong but, it's not me…it's not right.”
Dr. Paul: You know, in the field of neurology, the things that we pay attention to, too, are more of the things that the patient used to be very good at and it's now difficult. That's more concerning to us then, “I was never good at math and I wasn't good at math when I was a kid I'm still not good at math.” I'm not…my job is not to make that person good at math. But if they're like, “I was really good at math or calculating or balancing my checkbook” or doing whatever, “and now that's really challenging.” “This part of my job used to be super enjoyable and it wasn't difficult at all, and now it's really hard!” Those are the things that are more red flags to us and to investigate, like, why is that patient having that?
Interviewer: Do you have people that come into your office that don’t even know that they’re experiencing brain fog...
Dr. Kyle: Sure-
Interviewer: ...and you’re running tests on them you ask them questions and then you report back to them?
Dr. Paul: Yeah- so for example, say we do labs and the patient, you know, their blood sugar doesn't look great, whether it's fasting glucose hemoglobin A1C, insulin, you know, whatever markers we’re looking at. Or if they have a high homocysteine level in their blood, which anything over “7” in homocysteine inflames the neurons in the brain, is what the research says. So that involves particularly the hippocampus, it can be a problem. And that's where memory comes into play. Now if a spouse is with, right, they may be like “yes they have brain fog!” And the patient's just totally unaware of it.
Dr. Kyle: Modern neurology really looks at, you know, vestibular or vertigo, you know, your “falling over” kind of disorder. Or it looks at, Alzheimer's or mild cognitive decline and some memory issues. But really, when you have more mild brain dysfunction, we don't really have a good category for that. It's described in functional medicine really as, kind of, “brain fog.” And that's the most common term people use for it.
Dr. Paul: The biggest thing that I always express to patients, what I already talked about, was, you know, if something was easy before and now it's a problem, those are the things that we really want to investigate because you were good at it before. Why is it any different now? What was the thing that made you have that problem and now it's a challenge? Those are the big things that we try to communicate to patients.