“I am probably about to lose my third job due to fatigue and brain fog. I wake up feeling hung over. Just today I slept 18 hours.”
“I kind of hate this symptom [brain fog] the most. I’m a scientist and losing my mind is scarier than losing control of my body.”
“When I tried to bring it [brain fog] up with a specialist, they said they’d never heard of it as a Crohn’s symptom… So disheartening to hear, when you’re experiencing something that’s very real and frustrating.”
“The brain fog has basically put my entire life on hold. I can’t really follow an in depth conversation, my ability to communicate drops; I am basically a shell of myself.”
“This is one of those things that even those closest to you don’t give you much sympathy for, usually feeling it’s laziness or some[thing] like that.”
But what is brain fog, really?
According to WebMD, brain fog isn’t a condition unto itself, but rather a set of symptoms that reflect an inability to think coherently.[ii] Frontiers in Psychology describes it to be a kind of mild cognitive impairment in which there is a forgetful, muggy-headed confusion that makes interacting and decision making more challenging – or in some cases, impossible. Other characteristics of brain fog can include:[iii],[iv]
- Slow thinking and reduced ability to understand
- Easily interrupted
- Difficulty focusing
- Confusion and/or disorientation
- Lack of concentration
- Forgetfulness (both short and long term memory issues)
- Hazy thought processes
- Inability to multitask
- Low (or no) motivation
This article is intended to be an investigation into the phenomenon of brain fog as it relates to inflammatory bowel disease (IBD), and what current methods of treatment exist in traditional allopathic as well as complimentary and alternative therapies. Finally, a new solution will be introduced that has the potential to not only clear the mind, but elevate the consciousness. Not only support the gut, but rejuvenate every aspect of our lives.
Overview of Inflammatory Bowel Disease
Inflammatory bowel disease consists of two distinct pathologies: Crohn’s disease and ulcerative colitis. Both are characterized by chronic and prolonged inflammation in the digestive tract, and long term damage to the tissues.[v] Both also exhibit similar symptoms, such as:[vi]
- Persistent diarrhea
- Abdominal pain
- Rectal bleeding/bloody stools
- Weight loss
Clinical Medical Journal: Gastroenterology states: “IBD is thought to result from the interaction between a genetically-susceptible host and environmental factors which influence the normal gut flora and trigger an inappropriate mucosal immune system response.”[vii]
The result? Inflammation.
Chronic inflammation is a serious issue, no matter where it appears in the body. When it shows up as Crohn’s, it “can cause serious complications such as bleeding, holes in the intestinal wall (perforation), pockets of infection (abscesses), and abnormal connections between the digestive tract and other parts of the body (fistulas). Crohn’s disease also can cause inflammation and damage to other parts of the body, such as the joints, skin, eyes, mouth, liver, and bile ducts.”[viii] In fact, in 2016 a groundbreaking study confirmed the gut-brain connection between IBD and brain fog, stating that those suffering from Crohn’s had slower driving response times than drunk drivers. Dr. Danielvan Langenberg,lead researcher in the study, states: “The findings appear consistent with experiments that have shown that bowel inflammation results in an upregulation of inflammatory hippocampus activity in the brain. This, in turn, might account for the slower response times that were observed in the study.”[ix]
Ulcerative colitis (UC), no less serious, can progress to the point of bowel rupture, of needing surgery to remove or repair the affected part of the colon, or even far enough that current medical drugs are ineffective and the person’s life is at risk. In both Crohn’s and UC, there can be blood loss that results in anemia, and in both, people tend to have low Vitamin D.[x]
As similar as these two conditions may seem, there are marked differences as well. In Crohn’s, the impacted area of the intestine tends to be patch-like in nature, and abut healthy surrounding tissues. In ulcerative colitis, the damaged area is continuous and starts at the rectum and then moves further inward to the colon. In Crohn’s, the inflammation can spread across various layers of the intestine, whereas in UC, the inflammation is only in the innermost lining of the colon.[xi]
According to the Centers for Disease Control and Prevention (CDC),[xii] there were approximately 3 million Americans diagnosed with IBD in 2015. This number was drastically larger than the previous statistics, which were gathered in 1999, which reflected only 2 million people. According to the Center of Disease Control (CDC), people at higher risk for IBD include those who are:
- Over 45 years in age
- Hispanic or non-Hispanic white
- Lower level of education
- Born in the US
- Living in poverty
- Living in the suburbs[xiii]
Most disturbing of all, the “over 45 years in age” estimate from 2015 is rapidly changing, with children and adolescents becoming the largest percentage of those currently being diagnosed with IBD. A full 30% of Crohn’s diagnoses, and 20% of UC diagnoses are currently falling on those who are under20 years of age.[xiv] Given that those who suffer with IBD are more likely to also suffer from cardiovascular issues, respiratory diseases, cancer, arthritis, kidney disease, and liver disease,[xv] this is a sobering trend indeed.
There is currently no known cause for IBD, or explanation for why the intestines become inflamed and then stay inflamed over time. Clinical Medical Journal: Gastroenterology[xvi] states, “UC and CD disorders have distinct pathologic and clinical characteristics, but their etiology and biopathogenesis remains poorly understood. Although IBD susceptibility genes (such as NOD2 gene variants)have been identified, advances in defining specific environmental risk factors involved primarily include abundant indirect evidence suggesting that smoking, oral contraceptives, diet, appendectomy, breast feeding, antibiotics, vaccination, infections, and childhood hygienemay be involved. However, to date, none of these factors completely explain the environmental determinants of IBD and most studies report inconsistent observations, making additional studies necessary to better understand the etiology and bio-pathophysiology of IBD.”
Current Treatments for IBD
Traditional treatments for IBD include various drugs,[xvii] including anti-inflammatories to bring down existing inflammation, as well as immune suppressants to repress further inflammation. These two drug therapies are often used together.
Anti-inflammatories may include drugs such as Asacol HD, Delzicol, Colazal, or Dipentum, depending on where in the colon the inflammation is happening, and immune suppressants can include Azasan, Imuran, Purinethol, Purixan, Gengraf, Neoral, Sandimmune, or Trexall.[xviii]
Biologics are another class of immunosuppressant in which a certain protein created by the immune system (which increases inflammation) is suppressed. These biologics include Ramicade,Humira, and Simponi.[xix]
Antibiotics such as Cipro or Flagyl may also be necessary when infection is present. Other drugs that may be necessary include anti-diarrheal and acetaminophen-based pain relief medicines like Tylenol. Ibuprofen products like Advil or Motrin are contraindicated because not only do they not help with the pain of IBD, they actually make the overall condition worse.[xx]
Speaking of making things worse… The anti-inflammatories used for IBD are potent drugs, with potent side effects. Weight gain, mood swings and memory lapses are some of the side effects of taking these drugs. Given that brain fog is already a symptom of the imbalance in the gut, taking drugs which increase the potential for memory lapses can have serious consequences for quality of life and productivity. Further, osteoporosis and overall weakening of the bones, high blood pressure, high blood sugar, glaucoma, and cataracts are all serious long term side effects that need to be taken into consideration before starting treatment.[xxi]
In addition to considerations regarding the judicious use of anti-inflammatories, immunosuppressant’s also come with grave risks, including increased risks for “infection, bone marrow suppression, and malignancy.”[xxii]
Supplements and Diet
Suggested supplements often include iron, given that people may be losing blood through their stool, as well as calcium and Vitamin D. The calcium and Vitamin D are important for several reasons. Those with IBS, especially Crohn’s, have been found to be chronically low in Vitamin D, which is necessary in order for the body to absorb calcium. Given that anti-inflammatory drugs are known to cause “bone softening,” the need for Vitamin D is an important consideration.[xxiii]
Another treatment for IBD consists of a Low Residue Diet. Residue is defined as the undigested food that comprises the stool.[xxiv] This diet eliminates grains and legumes, as well as fruits and vegetables (with the exception of bananas and peeled potatoes), dairy, and fibrous meats.[xxv]
While the intent of the low residue diet is to help avoid obstructions in the intestines and relieve the pain of digestion in IBD, there is evidence that a low residue diet is actually harmful and counterproductive. In 2017, Nutrientspublished a review stating that low residue diets are intended to be used short term only, however in clinical practice it is often seen as a long term method. However, a “prospective study in subjects with active CD that compared a low-residue diet to an unrestricted diet found no differences in outcome including symptoms, need for hospitalization, need for surgery, new complications, nutritional status, or postoperative recurrence,” and that “a low-residue diet could potentially have negative consequences on IBD, therefore prolonged avoidance of fiber is discouraged.”[xxvi]
Stem Cell Transplants
Stem Cell Transplants[xxviii] are currently in clinical trials at Queen Mary University of London. “In the trial, patients undergo chemotherapy and hormone treatment to mobilize their stem cells, which are then harvested from their blood. Further chemotherapy is then used to wipe out their faulty immune system. When the stem cells are re-introduced back into the body, they develop into new immune cells which give the patient a fresh immune system.” While this technique shows promising results, it is still fraught with the intensity and side effects of chemotherapy drugs.
Alternative and Complimentary Therapies
Dennis Kucinich claims he healed his Crohn’s disease through a vegan diet and traditional Chinese medicine herbs. No matter what you think of the man’s politics, his personal recovery story is compelling. The Washington Post states: “In 1968, the year after Kucinich lost his first campaign, a race for the Cleveland City Council, he became so sick from complications of Crohn’s disease that a priest gave him last rites in the hospital. The surgeon removed eight feet of his small and large intestines and recommended against the stress of a career in politics.”[xxix]
Kucinich himself states: “I had Crohn’s disease as a child and a young adult and even as a good part of my adult life. I was told, “There’s nothing you can do about this. There’s no cure for it. You’re stuck.” So I was on all kinds of medications. Finally, through beginning a vegan diet, I started to learn that the effects of Crohn’s started to dissipate, and that, with some Chinese herbs, Crohn’s disappeared. It was extraordinary. There are doctors who say, “That can’t be.” But it is.”[xxx]
In fact, there is evidence to back Kucinich’s claim that diet plays an important role in IBD. Nutrients states that there is “compelling evidence for the role of food in IBD pathogenesis. Furthermore, the rise in incidence of IBD in countries that previously have had a very low incidence suggests that industrialization and adoption of the westernized diet may be a risk factor in the development of IBD. Reduced consumption of fruits and possibly vegetables, resulting in a reduced overall intake of fiber, with high intake of meats, fast foods and trans-fatty acids appears to be associated with an overall increase in the risk of developing IBD.”[xxxi]
It makes sense then, that to reverse the condition, one might opt out of the traditional western diet and embrace veganism, vegetarianism, or even semi-vegetarianism. In a ground-breaking study done in Japan, it was found that, of those who maintained a semi-vegetarian diet (lacto-ovo, with small allowances for eggs and dairy, and small portions of meat every two weeks) the remission rate over the course of a full year was 100%, and after 2 years, 92%.[xxxii] This certainly points to diet as a better maintenance program than drugs and surgery.
The discussion of diet here leads to deeper questions about the relationship of brain fog to IBD and gut health. If IBD is a disease process that is interrelated with – and precipitated by – the typical western diet of red meats and lots of processed food, coupled with lack of fresh fruits and vegetables, will those suffering IBD necessarily experience less brain fog with a vegan diet? Is there a direct connection between gut health and mental clarity, and have we so mangled our healthy gut flora that we can no longer think straight? Have you ever seen a vegan who didn’t have clear skin, clear eyes, lots of energy, and a sharp mind?
Apparently, there are scientists who have. Studies indicate that a vegan and/or vegetarian diet is not the be-all, end-all when it comes to clearing brain fog and healing IBD, however this may very well depend upon exactly what kinds of vegetarian foods one is eating.
Enter the Plant Paradox diet.[xxxiii] Renowned heart surgeon, Dr. Stephen Gundry, has discovered a link between gut health and lectins. Lectins are a plant protein found in the skin and seeds of certain fruits, vegetables, and legumes which create inflammation. When avoided, not only is there is significant anecdotal evidence that people suffering from chronic inflammatory diseases like IBD experience dramatically reduced symptoms, there is promising scientific data to back this up.[xxxiv][xxxv]
Overall, the link between the microbes in the gut, called the microbiome, inflammation, and mental clarity is a fascinating new and upcoming field of research.
Many people with IBD turn to supplements like pre- and probiotics to support healthy gut flora, fish oil, and herbs.[xxxvi] Turmeric, in particular, has been extensively studied and found to be a powerful natural anti-inflammatory herb. Cannabis, in particular CBD oil, is also being studied (and used by patients) as an anti-inflammatory, though it is still considered controversial.[xxxvii]
The Trivedi Effect®
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If you or someone you know is struggling with IBD and/or brain fog, there is a new scientific paradigm available today which can directly access the root causes of digestive and cognitive imbalances and correct them naturally, without drugs or surgery.
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[iii]Ocon, A. J. (2013). Caught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome. Frontiers in Physiology,4, 63. http://doi.org/10.3389/fphys.2013.00063. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617392/
[iv]Theoharides, T. C., Stewart, J. M., Hatziagelaki, E., & Kolaitis, G. (2015). Brain “fog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin. Frontiers in Neuroscience, 9, 225. http://doi.org/10.3389/fnins.2015.00225. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490655/
[ix]Daniel R van Langenberg, Greg W Yelland, Stephen R Robinson, Peter R Gibson. Cognitive impairment in Crohn’s disease is associated with systemic inflammation, symptom burden and sleep disturbance, United European Gastroenterology Journal 2017, Vol. 5(4) 579–587. DOI: 10.1177/2050640616663397. http://journals.sagepub.com/doi/pdf/10.1177/2050640616663397