How to Beat Brain Fog: Why Does It Happen and What Can You Do About It?

Written by Deirdre Nazareth, DO, ND, IFMCP, Osteopath and Functional Medicine Practitioner

Does your brain feel like it is wrapped in cotton wool? This is a common description of brain fog, which many women experience during the journey from perimenopause to menopause. It can accompany other temporary brain changes such as forgetting simple things like your keys or people’s names, needing an array of post-it notes for endless to-do lists, and finding it difficult to concentrate or retain information.

These brain changes can be so severe that they might cause worry and fear of the onset of dementia, especially if there is a family history. Women are more likely to suffer from neurological sequelae such as depression, anxiety, strokes, migraines, and even dementia or Alzheimer’s disease. The extra X chromosome has a powerful impact in differentiating us from men and should not be viewed or treated the same way.

Oestrogen and testosterone are two main female sex hormones that impact normal brain function and play a big role in cognition and memory. Oestrogen is primarily produced in the ovaries, while testosterone is made in both the ovary and adrenal glands. During perimenopause, the ovaries’ ability to produce these sex hormones diminishes.

Our master regulator, oestrogen, is neuroprotective. It stimulates the brain, keeps neurons firing, grows new ones, and helps regulate neuroplasticity—the brain's ability to form new connections. Oestrogen stimulates the brain to burn more glucose, its main energy source.

Testosterone strengthens neurons, sharpens mental acuity, and improves blood flow to the brain. It strengthens the brain’s arteries, helps maintain brain tissue health, and supports memory function. Testosterone also influences glucose metabolism through its effects on glucose and insulin receptors.

The brain, despite accounting for only 2% of total body weight, consumes more than 20% of the body’s glucose-derived energy, making it the most metabolically active organ. Glucose metabolism not only fuels brain function through ATP production but also supports communication between neurons and non-neuronal cells. It is essential for generating neurotransmitters, making tight control of glucose metabolism critical for brain health.

As mentioned earlier, sex hormones have a significant influence on glucose in the brain, so treatment options should be brain-focused.

Whole, non-processed foods that are anti-inflammatory—like the Mediterranean diet—have the most evidence-based support. This diet, rich in colour, polyphenols, flavonoids, protein, healthy fats, and complex carbs, supports glucose metabolism, the gut microbiome, and overall brain health. Key cognitive-supporting foods to focus on include:

• Omega-3 fatty acids: Particularly DHA, which improves brain function and memory.
• Omega-6 fatty acids: These also play a crucial role in brain function, growth, and development.
• Choline: Vital for maintaining cognitive function and acts as a precursor to acetylcholine, a neurotransmitter essential for memory and learning.
• Dark leafy greens: Rich in antioxidants like folate, carotenoids, polyphenols, and flavonoids, they support glucose metabolism and reduce free radicals.
• Probiotics: These may boost mood, cognitive function, and reduce stress and anxiety by influencing the gut-brain axis.
• Nitric oxide-rich foods: Such as beets, garlic, and leafy greens, which improve blood flow and exercise performance.
• Foods rich in vitamins A, D, E, and K: Essential for bone and oestrogen metabolism, particularly vitamin D, which helps regulate vaginal epithelial cells and alleviate genitourinary tract problems in menopausal women.

It's important to limit sugar, alcohol, processed foods, and refined seed oils, as they negatively impact the gut-brain axis.

Exercise has a global impact on all areas of the brain. It improves mood, memory, and overall brain health by promoting blood flow and stimulating the production of neurotransmitters.

While food should always be the first source of nutrients, supplements can help address deficiencies during menopause:

• Magnesium: Can alleviate sleep problems, improve mood, reduce anxiety, and support bone density.
• Zinc: Anti-inflammatory and regulates cortisol, stabilising mood and alleviating period pain.
• Iron: Low oestrogen can affect how the body uses iron, making low iron levels common during the menopause transition.

The role of minerals in menopause: When oestrogen levels drop, minerals drop too. I like to suggest Valerie Daily Essential as it provides a blend of minerals and vitamins in liposomal form for better absorption.

• Myo-inositol: Maintains metabolic health, improves insulin sensitivity, and promotes better sleep.
• B Complex Vitamins: These vitamins are crucial for energy metabolism and maintaining nervous system function.
• Creatine: Helps increase muscle and bone mass. A daily dose of 5g is recommended.
• Hydration: Keeping hydrated is one of the simplest ways to combat brain fog. It’s a good practice to drink water upon waking and ensure you have electrolytes throughout the day.

Developing coping strategies and identifying stress triggers are essential for managing stress. Some helpful practices include:

• Regularly checking in with your physical health
• Practising mindfulness and pacing yourself with tasks to avoid overwhelm
• Engaging in brain endurance activities, such as reading, learning new skills, and memory games

Written By Deirdre Nazareth, DO, ND, IFMCP, Osteopath and Functional Medicine Practitioner
Osteopathy, Acupuncture, Functional Medicine, Pain Neurophysiology

A special thank you to Deirdre for her invaluable contribution to this article. Her expertise has provided invaluable insights on so many levels.

To learn more or get in touch, you can visit her website at The Functional Osteopath or follow her on Instagram at The Functional Osteopath.

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