Post COVID Brain Fog: The Consistent Mystery

Aug 1, 2022 | Greg Vanichkachorn | @drvan | Comments (43)

In the early days of the pandemic, patients with Post COVID Syndrome (PCS) reported troubles with their thinking. This came to be known as brain fog, and since then the term has become of permanent part of the PCS discussion. Yet, if you look up the word brain fog in a medical dictionary, you won’t find any information. That’s because brain fog is not a medical term and it does not have a set definition. However, if we go past the term brain fog and ask patients with PCS what specific thinking problems they have, patients describe amazingly similar troubles.

The most common complaint is trouble finding words during speech. Patients often describe feeling the word they want to say is on the tip of their tongue, but they just can’t proceed.  This makes communicating very difficult, which is quite frustrating, especially when suffering a medical condition.

The next frequent problem involves short term memory. The classic story we hear from patients is that they will go into a room to find something, and not remember what they were looking for when they get there.  Or they will listen to new information, such as driving directions, and not be able to retain the details.

Finally, patients have problems with multitasking.  Doing even simple things at the same time are much harder with PCS. A common example is having troubles grocery shopping while having a conversation.

This pattern of thinking difficulty PCS is surprisingly consistent. It is also not rare. In fact, 45% of our patients in the COVID Activity Rehabilitation Program (CARP) report suffering from brain fog.  And unfortunately, of all the symptoms we get to help patients with, thinking troubles are often one of the most stressful symptoms, because it causes problems with work and relationships.

Fortunately, we are now starting to unravel the mystery around brain fog.  For example, there are now studies showing that after COVID, there can be brain structure changes, explaining the dysfunction we see.  We are also making progress in how brain fog is objectively described. For example, a research study at Mayo Clinic is currently trialing a new virtual test for brain fog. This 25-minute test allows our team to identify specific areas of troubled thinking in patients with PCS. This is important because once we know the problems, we can help patients develop specific strategies to overcome their troubles. And with each test, we are contributing to a growing database that helps describe brain fog in PCS more accurately.

What should you do if you feel you have troubles with thinking after a COVID infection? First, take care of yourself.  Eat well, hydrate, and get good sleep.  If that doesn’t help, reach out to your treatment provider. We have found that patients that are able to get help sooner, get better faster and more completely.

Together, we can help clear out the brain fog of PCS, and shed more light on the path to better health.

Read more about managing symptoms through early care. Learn tips on talking with your health care provider about post COVID syndrome, and connect with other people in the Post-COVID Recovery & COVID-19 support group.

Interested in more newsfeed posts like this? Go to the Post-COVID Recovery blog.

@colleenyoung

BBA, have you looked at the Survivor Corps website? They list Post COVID Care Clinics available across the nation and world wide
- PCCC https://www.survivorcorps.com/pccc

@bennu007, you hit on several key points, i.e., getting help early and getting validation. These are so important. Many patients feel they are not being taken seriously and often providers don't recognize brain fog. I think this earlier post from Dr. Van will also resonate with you:
- Early Care Tips for COVID Longhaulers https://connect.mayoclinic.org/blog/post-covid-recovery/newsfeed-post/early-care-tips-for-covid-longhaulers/

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Thank you, Colleen. I've been following this group for a while now. I had what I presume was Covid 19 early on, in March 2020, before testing was widespread. I have since developed the onset of migraine headache, brain fog, periods of anxiety, tinnitus, and nearly constant altered smell (the smell of something burning). Lung CT at Mayo revealed ground-glass opacities in my lungs which the pulmonologist said can be a sign of previous Covid infection. So, even without the proof of a positive test, I am quite convinced I am suffering the effects of long-covid. I found this recent article to be interesting and validating, and others might be interested. https://medicine.wustl.edu/news/covid-19-infections-increase-risk-of-long-term-brain-problems/

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@bba3

Hello Bennu007,
I am sorry you have been dealing with the brain fog and were unable to get treatment sooner.
But I am happy that you found a neurologist and team of medical providers that are pro-active in your case!
I am looking for a physician for my daughter which is experiencing these same issues and extreme fatigue (where she'll be in bed for days at a time unable to stay awake).
I would appreciate any information you are willing to share about your physician(s), as we are uncertain as to how to find one that will deal with her symptoms (and not just say it will take time).
Thank you.

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For your daughter, you can try giving her B-3 (high quality, single supplement, niacinamide form). Niacinamide is the pre-cursor needed for your body to make more NAD again. NAD is absolutely stripped from the body with Covid infection and it's the reason why "it takes time" for people to recover. When given B-3 the body can make more NAD quickly and effectively. And you'll potentially see a variety of symptoms clear up from this.

I've had Covid 3x now (or twice, with severe long haul) and I know what works -- trust me. I had terrible brain fog, fatigue, dizziness, ringing in the ears, etc. etc. What is also really crucial is an anti-inflammatory diet, and also low-histamine diet, if you can manage it. This is how you reduce inflammation quickly within all systems, and allow the body to recover (rather than react). I wish you and your daughter all the very best!

Editor's Note:
See the Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/

Guideline number 1 states:
Be careful about giving out medical advice
- Sharing your own experience is fine, but don't tell other members what they should do.
- Experiences and information shared by members on the Mayo Clinic Connect are not a substitute for professional medical advice, diagnosis or treatment.
- Never disregard professional medical advice or delay in seeking it because of something you have read on the community. See the full Disclaimer.

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@bennu007

Hi, thank you! I’m sorry to hear about your daughter. What State are you in? I’m certain there has to be some team of COVID doctors, finding them is the challenge. The only thing that has helped with my fatigue was Modafinil. This helped clear the brain fog making me super focused but also hit me going. I was the same with fatigue. It was horrible. I wish your daughter well.

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I highly suggest that you do not just use prescriptions to treat symptoms, though they may help reduce some symptoms and discomfort they are not treating the ROOT CAUSE of Covid and long-haul. Many people have had really excellent results with holistic practitioners who look at the body as one WHOLE UNIT. And treat the underlying causes of long-haul symptoms. For brain fog and fatigue, taking B-3 (single supplement, niacinamide form only, 500mg 2-3x per day is what I used) will allow your body to make more NAD quickly and effectively. NAD is needed for absolutely all bodily functions/systems to work properly. This alone works very well for many people. I wish you all the best!

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To denglish19
Thank you so much for your advice.
I have a B-complex but I see you recommend a single supplement.
What strength would you recommend?

I am glad that you have benefitted from this and greatly appreciate you sharing it with others.
I wish you continued benefits and good health.
Thank you.

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@bba3

To denglish19
Thank you so much for your advice.
I have a B-complex but I see you recommend a single supplement.
What strength would you recommend?

I am glad that you have benefitted from this and greatly appreciate you sharing it with others.
I wish you continued benefits and good health.
Thank you.

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Yes, absolutely. The single supplement, stronger dose is needed. I took 500mg 2-3x per day (must be niacinamide form), but I am a grown adult weighing 145 pounds. I believe, with B vitamins, your body will take what it needs and the rest will be removed in the urine, since B vitamins are water soluble. Thank you! And I wish you all the best as well.

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@shan77

Thank you, Colleen. I've been following this group for a while now. I had what I presume was Covid 19 early on, in March 2020, before testing was widespread. I have since developed the onset of migraine headache, brain fog, periods of anxiety, tinnitus, and nearly constant altered smell (the smell of something burning). Lung CT at Mayo revealed ground-glass opacities in my lungs which the pulmonologist said can be a sign of previous Covid infection. So, even without the proof of a positive test, I am quite convinced I am suffering the effects of long-covid. I found this recent article to be interesting and validating, and others might be interested. https://medicine.wustl.edu/news/covid-19-infections-increase-risk-of-long-term-brain-problems/

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Shan, what follow-up protocol has been suggested to monitor your lungs? Have the other long-covid effects improved over time for you?

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@denglish19

I highly suggest that you do not just use prescriptions to treat symptoms, though they may help reduce some symptoms and discomfort they are not treating the ROOT CAUSE of Covid and long-haul. Many people have had really excellent results with holistic practitioners who look at the body as one WHOLE UNIT. And treat the underlying causes of long-haul symptoms. For brain fog and fatigue, taking B-3 (single supplement, niacinamide form only, 500mg 2-3x per day is what I used) will allow your body to make more NAD quickly and effectively. NAD is needed for absolutely all bodily functions/systems to work properly. This alone works very well for many people. I wish you all the best!

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Hi who carries the b3 niacinamide 500 mg ..where can you get it? Thanks kitty2

REPLY

A reminder to review the Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/

Guideline number 1 states:
Be careful about giving out medical advice
– Sharing your own experience is fine, but don't tell other members what they should do.
– Experiences and information shared by members on the Mayo Clinic Connect are not a substitute for professional medical advice, diagnosis or treatment.
– Never disregard professional medical advice or delay in seeking it because of something you have read on the community.

When considering complementary treatments or supplements, be open-minded yet skeptical. Learn about the potential benefits and risks. Here is an article from Mayo Clinic about evaluating claims made by the producers and/or sellers of supplements, natural products and other alternative medicines.
- Herbal supplements: What to know before you buy https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/herbal-supplements/art-20046714

Your pharmacist can be a useful guide when considering supplemental vitamins, dosage and possible interactions.

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@kitty2

Hi who carries the b3 niacinamide 500 mg ..where can you get it? Thanks kitty2

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Hi there. It can be found anywhere where vitamins are sold; I have taken the NOW brand myself, for their quality. Can be found online at Amazon, or iHerb, or a natural market such as Vitamin Cottage.

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@denglish19

Hi there. It can be found anywhere where vitamins are sold; I have taken the NOW brand myself, for their quality. Can be found online at Amazon, or iHerb, or a natural market such as Vitamin Cottage.

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Hi..thanks for your reply..I live in minnesota..I will have to check and see if whole foods or a nutrition store carries it..thanks so much for your reply..Kitty2

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