Clearing Up the Fog: Insights Into Brain Fog Experienced by Patients With Hypothyroidism

If you’re experiencing memory problems, it may be necessary to have your doctor reassess your TSH levels and synthroid dosage. That said, a small percentage of synthroid users truly believe that the drug has permanently damaged and/or modified their ability to recall memories. Most participants provided at least 1 lifestyle or pharmacologic factor that affected brain fog symptoms (Table 2). Getting more rest and more exercise were the most commonly reported lifestyle factors to improve symptoms (51.7% and 10.4%, respectively). A total of 28.3% of participants reported that adjustment of thyroid hormone helped their symptoms. Liothyronine (LT3) was reported to help symptoms of brain fog more frequently than desiccated thyroid extract (8.3% vs 4.0%).

Have you experienced Synthroid side effects?

An advantage was that people on this therapy tended to be more satisfied, possibly because it made them lose weight 122, 123. It doesn’t typically show “brain fog” symptoms, but people with this condition often have ADHD or an IQ below average. Your thyroid gland, which is located in your neck, produces hormones that regulate growth and development. In a recent online survey of hypothyroid patients, 969 patients were queried on potential issues related to treatment dissatisfaction (6). Seventy-eight percent were dissatisfied with treatment, 93% expected their hypothyroid-related symptoms to resolve within three months of starting therapy, and 26% expected all their symptoms to disappear with LT4.

• It is possible that your dosage may need adjusting and/or that a different medication may reduce the occurrence of tremors.
• Limitations include the survey instrument was not validated, it was not known whether symptoms were related to underlying hypothyroidism or other medical or psychiatric comorbidities, and lack of information on thyroid hormone levels.
• It may be necessary to consult your doctor, as well as an ophthalmologist (or optometrist) for further information.
• Despite the popular belief that adding T3 may increase its effectiveness, the combination wasn’t better than LT4 alone in 3 clinical trials on almost 300 people 111, 112, 113.

By Esther Heerema, MSWEsther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer’s disease and other kinds of dementia. The limitations in our current knowledge and questions presented throughout this review highlight the major need for clinical research in this important area. Guidance for research includes areas listed in Table 2, as also discussed in the recent ATA/BTA/ETA joint conference (16).

• Counseling patients with hypothyroidism who complain of brain fog has traditionally been challenging for clinicians, as there are limited data on effective treatment options.
• If you’ve been taking synthroid along with food and/or later in the day than is medically recommended, it may decrease the likelihood that you’ll attain therapeutic benefit.
• Dr Chen receives support from grant T32 DK07245 from the National Institutes of Diabetes and Digestive and Kidney Diseases.
• Unlike most other conditions which cause brain fog, a close temporal relation between symptom onset and the diagnosis of hypothyroidism is often not the case.

What are treatment options?

Numeric variables were compared using the t test statistic to identify differences in means. Multivariable logistic regression analysis was utilized to calculate the odds ratio (OR) of a participant aged ≥50 years associating brain fog with each symptom, adjusting for covariates including sex, etiology of hypothyroidism, and onset of symptoms. To create binary groups within symptom domains, “never” and “sometimes” responses were categorized as low frequency responses, and “frequently” and “all the time” were categorized as high frequency responses. Similarly, multivariable logistic regression was used in the analyses of factors modifying brain fog symptoms and classification of the open-ended responses. Doctors can identify patient-reported factors and perform a physical examination and laboratory evaluation to differentiate between thyroid disease (hypothyroidism) and other conditions that can cause brain fog symptoms. A survey on brain fog symptoms adapted from thyroid-specific patient-reported outcome was distributed online.

• While it is usually possible to mitigate brain fog with thyroid replacement therapy, these symptoms do not always completely resolve.
• Since synthroid is a synthetically engineered form of T4, it is necessary to consider that for some users, increased bodily temperature may also be a result of inability to tolerate a non-bioidentical (synthetic) hormone.
• Additionally, the doctor will have had adequate time to pinpoint a precise synthroid dosage for optimal TSH levels.
• Those categories that contained at least 50 individual responses were included in the final analysis.
• Too high of a dose and you run the risk of sporadic, fast-paced, unfocused anxious thinking.

If you feel as if synthroid has sapped every last ounce of physical and mental energy, and as if you can barely roll out of bed in the morning – it is important to understand that fatigue is a side effect. In some cases, the fatigue and/or lethargy may be transient and only occur during early stages of treatment when dosing isn’t fully calibrated. Some speculate that improper dosage of synthroid and/or abnormal TSH levels may be the cause of dizziness. Upon adjustment of synthroid dosing and with continued treatment, most individuals notice a significant reduction and/or complete cessation of dizziness. If you feel hungry all day, have more food cravings, and cannot stop eating – it may be a result of the medication. Anytime appetite increases/decreases are substantial and/or sustained for a prolonged period – they should be discussed with a medical professional.

Most synthroid users will fall in between the extremes of “intolerability” and “optimal tolerability.” You may find that synthroid treats your hypothyroidism, but also causes dry skin, moodiness, and modest weight changes. Assuming that the medication is effectively treating your medical condition with just a few unwanted side effects, it is usually worth continuing. Many people find it difficult to distinguish long-term side effects of synthroid from normal aging. You may notice the onset of achy joints, swelling, memory problems, cognitive deficits, and/or weight changes. Assuming you’re taking a properly-adjusted dose of synthroid, symptoms of brain synthroid sinemet fog will likely improve.

Synthroid Dosage (Sensitivity)

Levothyroxine (LT4) monotherapy is standard of care for hypothyroidism, and most hypothyroid patients are satisfied with LT4 treatment. However, 10–15% report residual symptoms, poor quality of life, and dissatisfaction with LT4 treatment despite normal thyrotropin (TSH) levels (1–3). Common symptoms are fatigue, depressed mood, and cognitive difficulties, including problems with memory and word-finding, and these symptoms tend to cluster.

In some cases, it can take awhile for your body to fully adjust to synthroid and for the hair loss to subside. Since synthroid is a synthetically engineered form of T4, it is necessary to consider that for some users, increased bodily temperature may also be a result of inability to tolerate a non-bioidentical (synthetic) hormone. Should you experience an incessant fever that fails to subside after weeks of synthroid treatment – it may be a sign that your body is unable to tolerate it. Depression is a serious medical condition in and of itself, and should be interpreted as a sign that something is either amiss with synthroid dosing and/or that alternative options should be pursued. Anecdotal reports indicate that depression may become so severe (as a result of synthroid), that it may prompt suicidal thoughts and feelings of hopelessness. In many cases, constipation caused by synthroid goes hand-in-hand with the aforementioned side effect of bloating.

According to the Mayo Clinic, this is a condition in which the immune system attacks the thyroid gland. Women are much more likely to get Hashimoto’s disease than men, and the condition occurs most commonly during middle age. According to the National Academy of Hypothyroidism, the thyroid is a small gland located in the front of the neck. It controls the body’s production, regulation, and distribution of thyroid hormones, which regulate the body’s metabolic rate as well as heart and digestive function, muscle control, brain development, mood, and bone maintenance. If you’re experiencing forgetfulness or difficulty concentrating along with your thyroid issues, be sure to alert your healthcare provider. Thyroid problems can cause mild thinking, memory, and concentration issues, and an adjustment of your medications may help.

Dementia refers to several conditions that cause a decline in memory and cognitive skills needed to perform the basic activities of daily living. Future studies should clearly segregate symptomatic people to avoid diluting potential positive findings with large numbers of relatively asymptomatic people (16). While corroborative cognitive testing and functional imaging is labor-intensive, expensive, and not always available, efforts should be made to incorporate such techniques in subsets of symptomatic people in research trials. Synthroid is recommended to be taken at least 30 to 60 minutes before breakfast in the morning. If you’re experiencing side effects from taking synthroid 30 minutes before breakfast, you may need to increase the gap between synthroid ingestion and food consumption to 60 minutes. Additionally, if you’ve been somewhat inconsistent in timing of administration – this could increase side effects.