Brain Fatigue 101

Monday, August 25, 2014
By: Linda J Dobberstein, DC, DACBN, DCBCN

Are you feeling foggy or exhausted? Drained, overwhelmed, or burned out? Are you forgetting what’s on your grocery list or falling asleep when working on a project or reading? These are symptoms of brain fatigue. Brain fatigue is something that everyone has experienced on some level. It doesn’t matter what age one is; we all need to pay attention to it. The more that it goes on, the more one needs to do something to support a healthier brain. This is especially applicable if you are falling asleep after reading a couple of paragraphs of this article or if you just forgot what your spouse told you to get at the grocery story, and you had the list in your pocket.

What is Brain Fatigue?

Brain fatigue can be described as mental fatigue, burnout, or feeling tired. Some may write it off as depression or simply getting old. Some individuals may find it easier to recognize brain fatigue in others. We can look at our loved ones or coworkers and see that they aren’t as sharp as they used to be. We see how stress makes them forgetful or less efficient. We see emotions that aren’t normal for them. It is sometimes harder to recognize or admit those same concerns for ourselves. We attribute loss of memory to old age or to “just one of those days.” We don’t remember how easy it was for us to think and create when we were not stressed, so it is harder to compare. It is important to be able to see these symptoms in ourselves and to address them properly. It is not just old age for why you don’t feel as sharp as you did when you were in your 20s. These are all ways that brain fatigue manifests. 

Brain fatigue is a symptom. It is a symptom of your brain reaching a point of dysfunction. Brain fatigue happens on a large spectrum of dysfunction. The spectrum ranges from momentary blips on the radar of simply needing a break, or needing to eat lunch, to more severe, devastating, life-altering, neurodegenerative disorders. Brain fatigue, when it is not managed well, or goes on for too long, reflects wear and tear or neurological oxidative stress. In essence, brain fatigue is a symptom of neurodegeneration.

Common Situations of Brain Fatigue

Here are some common life examples of brain fatigue:

A high school honors student enters a top level college and takes some tough classes. While studying for class, she finds that she needs to take naps in the library, or have several cups of coffee to make it through the first several weeks. As the semester wears on, she finds that she needs fewer and fewer naps to make through all of the material. By the end of the college year, the student has been able to get through the class without any naps and does well on the exams. This is a very positive outcome with brain fatigue and reflects the brain’s ability to handle the stress and accommodate it without serious consequences.

A middle age adult is having a mid-life crisis and decides to change careers and go back to school. This once busy executive, who could multi-task without crashing, now finds that going back to school full-time in a new area of study is exhausting. He has to read the material a number of times to understand it. He comes home after a full day at school, and he is exhausted, having to go to bed by 8:00. He finds that home life starts suffering, and he is not able to maintain the school schedule as he had been when he was in his twenties. This reflects ongoing wear and tear, brain fatigue that the brain is not able to compensate for or manage well. This reflects more significant difficulties and reflects a growing problem with the brain.

Your aging, but active parents decide to take a trip across country to do some sight seeing. They normally are active in the local area, have no problems driving or doing light activity. However, the five hour drive to their destination in decent weather and traffic leaves them completely exhausted for the next day or two. In that car ride, they did nothing but maintain alertness to drive and navigate. There was no significant engagement in physical activity. This is brain fatigue.

A preteen child who has a poor diet, little exercise, and plays video games for fun for several hours per day needs to read a book for a book report. He engages in it, but soon becomes distracted, irritable and has poor focus. He eventually gives up on reading the book because he says that it is too hard. Keep in mind, this child can focus for several hours a day on playing videogames and has mastered internet skills quite well. Learning and doing something beyond what the brain is accustomed to causes the true health of the brain to be seen. This child’s brain is out of shape and not very healthy.

A middle age woman with fibromyalgia decides to start a Tai Chi class and also to start knitting again. She completes her first Tai Chi class and subsequently crashes, unable to process information, or do her daily tasks for the next three days. She then decides that she is going to knit a scarf for herself. She used to knit when she was a young girl, but has not done any knitting for three decades. She starts the project and finds herself engrossed in it for an entire afternoon. The next day she wakes up and is completely exhausted and not feeling well. This is brain fatigue. Or more aptly put, brain degeneration.

Your elderly parent no longer wants to watch TV, read the newspaper, or engage in conversation because it is too fatiguing or no longer enjoyable.  Maybe he/she no longer speaks, or engages only with body language or hand signals. He/She would rather look at the wall or a window with little activity for several hours each day. His/Her walking is slow and labored with a walker, or perhaps he/she can no longer transfer or walk. He/She needs to be told or shown how to do basic daily activities or needs complete assistance from nursing staff. This is the end stages of brain fatigue. Final end stages of brain fatigue are shown in the poor functioning states of Alzheimer’s disease, other dementias, or other neurodegenerative disorders. This is what we all want to avoid. 

Other symptoms associated with brain fatigue, reflecting brain wear and tear or neurodegeneration may include:

• Memory loss – where did I put my keys? Where did I park my car? I forgot to pay the utility bill or to let the dog back in the house.

• Brain fog: you are trying to follow your physical therapist’s instructions to do two exercises while you are working with her, and you need the activity demonstrated several times. You have to have your spouse, doctor, friend, etc., explain something to you many, many times and still it doesn’t click…

• Depression and anxiety: Yes, brain fatigue will affect the mood in a negative manner. Just think of “Grumpy Old Men” for an example or more serious situations of Major Depression or Post Traumatic Stress Disorder.

• Difficulty learning at any age.

• Lack of motivation, drive or passion: This goes hand in glove with brain fatigue, burn-out, depression, and aging. How has your motivation been? Do you feel like you need a vacation on an island for a year just to recover from daily life?

• Fatigue or tire easily working, reading, or driving: When was the last time you were able to read more than just a few pages in a book without falling asleep?

• Poor focus and concentration: You have to read the same page over and over again and still you don’t remember or understand it. How many times have you read this article?

• Fatigue in response to certain foods and chemicals. How about the child who eats Chicken McNuggets or pancakes and within an hour, they have a melt down and then crash. Or how about sitting next to someone wearing cologne or perfume, and you end up with a bad case of brain fog, migraine, and feeling sick for the next several hours.

• Fatigue after meals. You have to take a nap after meals in order to function. The digestive process is robbing the brain of energy when this occurs.

• Unable to clearly form thoughts, losing track of conversations, rambling, repeating one’s self over and over again.

• Emotional melt downs, social isolation, frequent crying.

• Feeling tipsy, off-balance, frequently bumping into things.

• Chronic pain and physical fatigue.

• Many digestive problems.

• Many other symptoms….

These symptoms are reflective of neurological stress, brain fatigue and inflammation. This reflects lack of brain health. They are also symptoms of varying levels of neurodegeneration.

Illness associated with brain fatigue and neurodegeneration has a wide spectrum of interpretation. Often the first sign of neurological dysfunction and brain fatigue is a minor change in mood, energy, or sleep. More serious illnesses associated with brain fatigue include various dementias and Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, Fibromyalgia, Major Depression, Bipolar Depression, anxiety disorders, various sleep disorders, Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, mitochondrial disorders, PTSD, ADD/ADHD, Autism Spectrum Disorders, various headache disorders, visual processing disorders, sensory modulation disorders, seizure disorders, Postural Orthostatic Tachycardia Syndrome, and many other autoimmune disorders. Even chronic gut problems are related with brain fatigue and brain dysfunction. The list goes on. When the command center of the body, the brain, starts to falter, fatigue, or breakdown, it affects everything.

Key Players in Basic Brain Health

There are three major players that affect the brain. The first two items affect the brain in the most profound manner and can affect it within seconds, minutes, or hours, even to the point of life or death situations. However, chronic, low grade problems with lack of oxygenation or poor blood sugar regulation frequently lead to a slow process of chronic inflammation. This is the more typical pattern we face. The third factor is all about life management. With any of these, too much or too little are problems. The brain needs balance.

1. Oxygenation – how well is the brain getting and using oxygen?
2. Blood Sugar – how well is the brain getting and using blood sugar?
3. Stimulation/Activity – is there too much or too little stimulation present?

Poor Oxygenation Causes

There are many reasons for poor brain oxygenation. It can be related with any type of anemia. It can be related with low iron, zinc, vitamin C, copper, B12, folic acid, and B6 or issues related to blood production or blood loss. Blood sugar disorders can impair blood oxygenation. Blood pressure problems, both low blood pressure and high blood pressure, impact blood flow to the brain. In fact, having too low of a diastolic blood pressure has been shown to be related with brain atrophy! Cardiovascular problems such as cardiomyopathy, congestive heart failure, atherosclerosis, arteriosclerosis, and aortic stenosis, etc. all affect oxygenation. Lung problems, including emphysema, COPD, asthma, lung cancer and others, also impact brain function. Sleep apnea is a common problem that clearly affects oxygenation.

There are other less serious concerns that affect brain oxygenation. It can simply be due to lack of physical activity or sedentary lifestyle. It can even be related to the habit of short, shallow, breathing through the chest rather than the diaphragm or belly. 

Poor Blood Sugar Causes

Blood sugar regulation is affected by many different factors. It can be simple dietary imbalances to full blown concerns with insulin and leptin resistance and diabetes. Here are some additional factors that affect blood sugar function. These include a high carbohydrate diet or high glycemic index/high glycemic load intake, consuming poor quality foods or the “Standard America Diet”, skipping meals, low protein, low fat/no fat diets, or the wrong types of fats in the diet. Adrenal fatigue, adrenal insufficiency, or the opposite, with elevated cortisol levels (Cushings) or chronic stress induced elevated cortisol causes poor blood sugar regulation. Pancreatic pathology from autoimmune disorders like type 1 diabetes or chronic infections like Chronic Active Epstein Barr Virus, or pancreatic cancer all affect blood sugar regulation and the brain.

Poor Stimulation Balance: Too much or too little. Where do you lie?

The 21st Century offers a plethora of stimuli for the senses. There is no other time in history that one is exposed to a chronic state of being “on.” For the average individual, it is a matter of being mindful about behaviors and patterns and taking a break. For others who are more neurologically fragile, these concerns or even intrusions can make or break daily function.

Too much stimulation can occur as a result of being “plugged in 24/7.” It may be that you live in a noisy apartment building and have noisy neighbors. It can be living near a freeway or airport where there is a constant stream of noise and stimulation. Maybe you work at a sports stadium, bar, daycare, a call center, or a busy mall. Perhaps you are on call as a nurse or physician or a stock broker on the floor of Wall Street. It can be related with constant exposure to the TV, iPod, radio or videogames. Mechanics and road construction workers deal with all kinds of intense stimuli with their jobs, i.e. sounds, vibration, and odors. Many times it is simply doing more than you can realistically handle. Simply being “on,” plugged in, or “ready to act a moment’s notice” provides chronic stimulation and stress. It can even be a factor with wireless/EMF exposure. Recent research is questioning the effects of EMF technology on autism as an intolerable source of stimulation.

Other times, it is not a job or environment that causes stimulation. Sometimes it is related with foods, chemicals, medications, or addictions. Food intolerances like gluten or gluten associated cross reactive foods that can cause neurological injury like MSG, caffeine, nicotine, Red Bulls or other energy drinks, and stimulant type drugs create adverse stimulation to the brain. Lack of sleep or insomnia contributes to excess stimulation.

On the other hand, having a sedentary lifestyle, no physical activity and little mental activity, also cause the brain to become stressed or flounder. There has to be a balance with stimulation for the brain to thrive.

The good news with either too much or too little stimulation is most individuals can change these dynamics or the balance of them with some basic choices. One of the best things to realize is that a little time spent outdoors enjoying Mother Nature provides marvelous health benefits. It doesn’t have to be a lot of time, but it does require making an attempt at being outdoors in a non-industrial, non-business type environment OR looking at pictures of beautiful gardens and parks. Your brain loves nature. It literally gives a big sign of relief to be outside. Multiple immune inflammatory markers have been shown to decrease in response to spending time outdoors. Thus it is vital to take a break and reconnect with the great outdoors. Obviously do it within your limits. If weather or other things do not permit being outdoors, then go to a conservatory, a planetarium, a green house, or pick up a picture book about the outdoors. Think about the picnic that you had near the waterfalls or babbling brook. Think about the feeling of warm earth or sand and grass on your bare feet. All of these things, whether envisioned from a picture book, memory, or actually experiencing them, change our brain waves and give our brain some positive balance and a pleasant stimulation. This is especially vital when dealing with chronic pain and illness. Too much negative stimulation is already present.

Other Factors that Compromise Brain Health

There are many other factors that compromise brain health beyond oxygenation, blood sugar and stimulation. Here are some of the risk factors.

Neurotransmitter imbalances – too much and too little are problems. GABA is the only neurotransmitter that functions as an inhibitory neurotransmitter. All of the other neurotransmitters function as stimulatory agents. When the brain is dealing with constant stimulation, high levels of the serotonin, dopamine, acetylcholine, etc. are released in response to the stimulus. GABA has to try and balance these out. GABA is the relaxed reserves of the nervous system. When we lose this balance, the brain becomes hot, inflamed, fatigued, depressed, anxious and struggles.

Microglial cells are the major supporting tissue to brain neurons. When they become inflamed, brain health is compromised. Many things affect microglial cell health. These include chronic infections, severe chronic stress, chronic poor blood sugar regulation, any type of traumatic brain injury, autoimmune reactions and disorders, gluten intolerance and gluten associated cross reactive foods, and low levels of glutathione and other brain antioxidants.

Increased gut permeability or Leaky Gut Syndrome will affect brain health. The gut is considered the second brain. Many in the field of clinical nutrition use the adage “leaky gut, leaky brain”, which presents symptoms of brain fog and fatigue. These concerns are often intertwined with food allergies and intolerances. Gluten and gluten associated cross reactive foods are proven factors that contribute to neurological changes of brain fatigue and inflammation.

Chronic stress of any type, but especially psychological stress, is highly inflammatory to the brain. Remember the last bad argument you had with your spouse and didn’t sleep and then felt like a wreck the next morning. That is brain stress, wear and tear. If it goes on for too long, it leads to more wear and tear than the brain can keep up with.

Chronic pain is a major road block to healthy brain function. It is a chronic, negative stimulation that is highly depleting to the body. Do what you can to manage the cause of the pain and level of the pain before it change brain health. If you don’t, your brain will atrophy!

Obesity has clearly been shown to be linked with brain atrophy. This is multifactor, but clearly indicates that high levels of inflammation are present and are damaging the brain.

Alcohol: Alcohol is a toxin. No matter how little a person consumes, it still has to be detoxified and uses nutrients that protect the brain from chronic daily wear and tear. If there is poor detoxification, poor body clock rhythms, or leaky blood brain barrier, problems are compounded.

Chronic environmental toxins and hormonal imbalances, i.e. too much or too little estrogen, progesterone, testosterone also impact the health of the brain and lead to fatigue.

Virtually anything in excess or insufficiency will affect the brain, i.e. water, air, food, movement/exercise, touch, sound, sight, smell, taste, and emotions, etc. The brain needs balance.

There are many lab tests that can be utilized to determine neurological health and fatigue. These include hemoglobin A1C, thyroid and cortisol markers, iron levels, CBC, carbon dioxide, GFR, homocysteine, hs-CRP, 8-OHdG, Myelin Basic Protein, Cerebellar IgG and IgA, Synapsin IgG and IgA, Blood Brain Barrier Protein IgA, IgG, IgM, GAD-65, Phospholipase A1, TNF alpha, various cytokines and interleukins and many others. Low levels of glutathione and various nutrients are also regulators of inflammation. Many functional medicine based tests provide tremendous insight into methylation, neurotransmitter balance, ATP/Kreb’s cycle and gut inflammation that all impact brain health. If you are having problems and it is not resolving with simple strategies, work with your health care professional.

How to Improve Brain Health

If you have checked off every single factor above as a problem, you have a major problem and need to work a lot to turn things around. Even if there are just a few things that you think are a minor problem, you still need to do something. Once the brain ages, it takes a lot of effort and hard work to regain health. If any of the above categories or issues are present in any amount, do what you can to change the circumstances, the behaviors, and the internal and external environments. Not doing anything will ensure a ride down the unhealthy road of more rapid brain aging and neurodegeneration.

There are so many wonderful things that one can do or use to support health brain function. These are just some of them. Try creating your own tool box of brain health tools of stimulation and relaxation.

General Support

• Belly breathing
• Laughter
• Being in nature
• Walking barefoot in the grass or sand
• Being with a friend or family member who is positive and listens
• Spending time with your pet
• Massage
• Yoga
• Tai Chi, Qigong, etc.
• Spinal care through chiropractic, osteopathy, or physiatry
• Talking with a friend(s) or a trusted counselor
• Prayer/meditation
• Spending time looking a pictures of nature
• Listening to rain drops, waterfalls, babbling brooks, thunderstorms
• Breathing in air near waterfalls, streams, or oceans
• Playing a musical instrument
• Listening to classical instrumental or Gregorian chants music
• Knitting/crocheting, other craft type work
• Carpentry or woodwork
• Gardening
• Aromatherapy
• Spending time with babies and children
• Acupuncture
• Cleaning the house (helps bring a sense of control if cluttered or release frustration when done in moderation)
• Getting organized
• Unplugging from the computer, laptop, phone, iPad, iPod, etc.
• Resting in a peaceful environment
• Turning off the TV, radio, CD player
• Dancing
• Drum Circles
• Brain puzzles – online brain games, Sudoku, crossword, word search, optical illusion, regular puzzles
• Reading
• Writing/Journaling – hand written, not typed
• Drawing, painting
• Humming, whistling
• Sitting by a warm fireplace or bonfire.
• Balance exercises


Next week’s article will focus on targeted nutritional support for these concerns.

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