The Brain Fog Issue
The Brain Fog Issue
You Know the Word. You Just Can’t Reach It.
By Andrea Nacca, PA-C, FMACP
There is a particular kind of frustration that comes with brain fog. You know the answer is there. A name, a thought, the reason you walked into the room. You simply cannot reach it as quickly as you once could.
Most people compensate for a while before they mention it.
They make more lists. They reread emails before sending them. They check the calendar three times. They reach for another cup of coffee and tell themselves they are tired, distracted, or simply getting older.
Then the worry starts.
Is this normal? Am I losing my edge? Why does everything feel harder than it used to?
Brain fog is common, but that does not mean it should automatically be dismissed.
What Brain Fog Can Feel Like
“Brain fog” is not a medical diagnosis. It is a phrase people use to describe changes in attention, memory, concentration, processing speed, or mental clarity.
It can feel like:
Losing your train of thought in the middle of a conversation
Struggling to find familiar words or names
Reading the same paragraph several times
Forgetting why you walked into a room
Feeling mentally drained after ordinary tasks
Needing more time to make simple decisions
Having difficulty switching between tasks
For some people, it comes and goes. For others, it settles in gradually and begins to affect work, relationships, confidence, and daily life.
The symptom may sound the same from one person to the next, but the reason behind it may be completely different.
The Pattern Often Tells Us More Than the Symptom
When someone tells me they are experiencing brain fog, I want to know when it began and what else was happening at the time.
Did it start after an illness?
Has sleep become lighter or more fragmented?
Did symptoms appear during perimenopause or another hormonal transition?
Was there a medication change?
Is the fog worse after meals, during stressful periods, or following physical or mental exertion?
Are fatigue, headaches, dizziness, mood changes, or exercise intolerance also present?
These details matter because mental clarity depends on several systems working together. Sleep, hormones, blood sugar regulation, thyroid function, nutrient status, circulation, medications, inflammation, and stress can all affect how clearly the brain functions.
Sometimes the first useful step is not another supplement or another cup of coffee. It is slowing down long enough to notice the pattern.
It Is Not Always “Just Aging”
Normal aging can bring subtle changes in recall and processing speed. That is different from a noticeable or persistent change that interferes with daily life.
New brain fog deserves attention, especially when it appears suddenly, continues to worsen, or develops alongside other symptoms.
That does not mean something serious is necessarily wrong. It means the symptom is worth understanding rather than dismissing.
A thoughtful evaluation may include a discussion of sleep, stress, hormonal symptoms, recent infections, medications, nutrition, and overall health. Depending on the situation, a clinician may also consider laboratory testing or further evaluation.
The goal is not to chase every possible explanation. It is to identify the most likely contributors and begin there.
Why Post-Viral Brain Fog Is Different
Brain fog is also commonly reported after COVID-19 and other illnesses.
The CDC includes difficulty thinking or concentrating among the neurological symptoms associated with Long COVID. These symptoms may fluctuate and can occur alongside fatigue, sleep problems, headaches, dizziness, or symptoms that worsen after physical or mental activity.
People experiencing this pattern are sometimes told that their testing looks normal or that they simply need more rest. Normal routine testing can be reassuring, but it does not make the symptoms imaginary.
Post-viral recovery can be complicated. Pushing harder is not always helpful, particularly when activity consistently causes symptoms to worsen later that day or the following day.
Where Oxygen Enters the Conversation
The brain uses a significant amount of oxygen and energy. That is one reason oxygen delivery, circulation, inflammation, and cellular energy have become areas of interest in brain fog research.
Hyperbaric oxygen therapy, or HBOT, involves breathing oxygen in a pressurized chamber. Under pressure, more oxygen can dissolve into the plasma and reach tissues through the circulation.
Researchers is promising showing controlled exposure may influence processes involved in recovery, including tissue oxygenation, blood vessel signaling, inflammation, and neuroplasticity.
A randomized, sham-controlled study published in 2022 followed people with ongoing post-COVID symptoms. After a 40-session protocol, researchers reported improvements in several cognitive and symptom measures in the HBOT group.
A later randomized trial evaluated a shorter 10-session protocol. In that study, HBOT did not outperform the sham treatment on the primary measures of physical function and limitations related to physical health.
These studies used different treatment protocols and measured different outcomes, so they cannot be compared as if they asked exactly the same question. Together, they show why protocol, patient selection, and treatment goals matter.
HBOT is not a guaranteed treatment for brain fog, and brain fog by itself is not an established indication for hyperbaric treatment. Whether it is reasonable to consider depends on the person’s history, possible causes, health status, and expectations.
Start With What You Can Observe
If your thinking has felt different lately, spend one week tracking what is happening around the fog.
Write down:
How you slept the night before
When the fog feels strongest
Whether meals affect your energy or concentration
Any headaches, dizziness, fatigue, or other symptoms
Your menstrual cycle or hormonal symptoms, when relevant
Recent illnesses or medication changes
What happens after exercise or a demanding day
What seems to improve the feeling
You do not need a complicated tracking system. A few notes each day may reveal a pattern that is difficult to see in the moment.
Know When Not to Wait
Sudden confusion or a rapid change in mental status requires urgent medical attention, especially when it occurs with trouble speaking, facial drooping, one-sided weakness, severe headache, fainting, chest pain, or difficulty breathing.
Persistent or worsening brain fog should also be discussed with a qualified healthcare professional. This is particularly important when it is affecting your ability to work, drive, manage medications, or complete normal daily activities.
The Bottom Line
Brain fog is not a character flaw, and it is not proof that you are losing yourself.
It is a symptom.
Sometimes it reflects a period of poor sleep or prolonged stress. Sometimes it appears during hormonal change or after an illness. Sometimes several factors are overlapping at once.
The goal is not to force your way through it. The goal is to understand what changed, what else is happening, and what kind of support makes sense for you.
The fog is not your identity. Your experience is information, and the pattern can help show us where to begin.
Curious Whether HBOT Belongs in Your Recovery Plan?
At HBOT Lounge, we begin with your health history, symptoms, goals, and possible contraindications. We can discuss what the research currently shows, and whether hyperbaric oxygen therapy is appropriate to consider as part of a broader plan.
EXPLORE HBOT AT THE LOUNGE
This article is for educational purposes and is not a substitute for individualized medical evaluation, diagnosis, or treatment.
