Written by Dr. Savannah Muncy, Pharm.D on
September 21, 2022
Reading Time: 9 minutes

Medically Reviewed by our Medical Affairs Team

Written by Dr. Savannah Muncy, Pharm.D on:

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Do you feel like you’re in a fog? Are your thoughts cloudy and all over the place? If so, you might be experiencing a foggy brain.

Brain fog or cognitive fog is a common symptom of multiple sclerosis. It can make it difficult to think clearly, concentrate, and remember things. For some people, a foggy brain can be debilitating.

If you are living with multiple sclerosis and are experiencing brain fog, don’t worry—you are not alone.

In this article, we will explore multiple sclerosis, what causes brain fog, and provide tips on how you can manage MS brain fog. We hope that this information will help improve your quality of life.

Let’s get started.

What exactly is multiple sclerosis?

Multiple sclerosis (MS) is a medical condition, a debilitating disease that attacks the central nervous system (CNS). The CNS includes the brain and spinal cord, and optic nerves.

MS is a type of autoimmune disease—this means that the body’s immune system mistakenly attacks healthy tissue. In the case of MS, the body attacks the myelin.

Myelin is a protective coating that surrounds and insulates the nerve fibers in the CNS.

When the myelin is damaged, it causes communication problems between the brain and the rest of the body. This can lead to a wide range of symptoms, including brain fog.

Generally, brain fog affects your daily life, especially when it comes to concentration, decision-making, and problem-solving.

Types of Multiple Sclerosis

As of this writing, there are four known types of MS, and these are the following:

Clinically Isolated Syndrome (CIS)

CIS is the first stage of MS. It is characterized by a single episode of neurological symptoms that last for at least 24 hours.

Common CIS symptoms include:

  • Sexual dysfunction
  • Numbness or tingling
  • Shakiness
  • Vision problems, such as double vision
  • Brain fog
  • Dizziness
  • Spasticity or stiffness of the muscles
  • Paralysis
  • Difficulty controlling the bladder or bowels
  • Muscle weakness
  • Difficulty with walking and coordination

The symptoms are due to inflammation and demyelination of the central nervous system.

The episodes, each lasting a minimum of 24 hours, are common in those with multiple sclerosis but don’t necessarily mean that the person has MS. In order to be diagnosed with MS, people must experience certain symptoms for at least six months.

Relapsing-Remitting Multiple Sclerosis (RRMS)

RRMS is the most common type of MS. It is characterized by episodes of neurological symptoms called relapses, followed by periods of remission.

During a relapse, the symptoms get worse quickly, lasting for days, weeks, or even months. The symptoms eventually go away entirely or lessen. This is known as remission.

Remission can last for months or even years. However, over time, the relapses tend to become more frequent and the periods of remission shorter.

The symptoms of RRMS often include:

  • episodic bouts of fatigue
  • cognitive problems (information processing, learning, cog fog, and memory)
  • numbness
  • bladder and bowel problems
  • vision problems
  • stiffness or spasticity

Eventually, most people with RRMS will develop secondary-progressive MS (SPMS).

Secondary Progressive Multiple Sclerosis (SPMS)

SPMS is characterized by gradually worsening symptoms, with or without relapses and remission.

SPMS generally begins with a relapsing-remitting course. However, some people diagnosed with RRMS will eventually enter into a secondary progressive stage characterized by increased neurological deterioration over time.

Secondary progressive MS can be further classified as either active (with relapses and new MRI activity during a set time) or not active, as well as progressive (evidence of disability accumulation over time, with or without relapses or recent MRI activity) or non-progressive.

Common symptoms of SPMS include:

  • Difficulty with walking and coordination
  • Fatigue
  • Memory problems and other cognitive issues
  • Brain fog
  • Slow reaction time
  • Decreased learning ability
  • Bowel issues
  • Bladder problems
  • Double vision or other optic issues
  • Muscle stiffness

The majority of people with RRMS will eventually develop SPMS.

Primary Progressive MS (PPMS)

The hallmark of PPMS is worsening neurological function (accumulation of disability) that begins with the onset of symptoms and does not have early relapse or remission.

PPMS is either classified as active, meaning that the person has relapses or new MRI activity over a set period. Or it is classified as not active.

Approximately 15% of people diagnosed with MS will have PPMS. It is more common in men than women and generally affects people over the age of 40.

Common symptoms of PPMS include:

  • Difficulty with walking and coordination
  • Fatigue and brain fog
  • Muscle weakness
  • Spasticity (stiffness and muscle spasms)
  • Numbness or tingling sensations
  • Bladder problems
  • Vision and cognitive issues

Common Causes of Multiple Sclerosis

The cause of MS is still unknown. However, it is believed to be an autoimmune disease in which the body’s immune system attacks healthy tissue in the central nervous system.

There are a number of factors that trigger this disease, including:

Immunologic Factors

An abnormal immune response in MS inflicts damage to the CNS through inflammation.

This abnormal immune response involves many different cells, primarily the T and B cells, two important types of cells in the immune system.

The T cells, also known as T lymphocytes, are a type of white blood cell.

When you have MS, these cells get activated in the lymph system and enter the central nervous system through the blood vessels; once in the CNS, these T cells produce chemicals that cause damage and inflammation.

B cells, on the other hand, are activated with the help of T cells. Antibodies cause MS damage in the CNS and other proteins stimulated by B cells.

Scientists are still uncovering new cells and processes that might play a role in multiple sclerosis. By continuing to research the immune-related process of MS, we can gain more insight into this complex condition.

Environmental Factors

There are certain environmental factors that may increase your risk of developing MS. These include:

  • Low vitamin D levels: People who don’t get enough vitamin D are at a higher risk of developing MS. Vitamin D is found in fatty fish, eggs, fortified milk, and cereals. It can also be made by your body when your skin is exposed to sunlight.
  • Smoking: Smoking cigarettes has been linked to an increased risk of developing MS.
  • Obesity: Being overweight or obese increases your risk of developing MS, especially if you are a woman.
  • Infections: There is evidence that certain infections can trigger the development of MS. These include the Epstein-Barr virus, which is the virus that causes mononucleosis, as well as other viruses.

Genetic Factors

There is evidence that multiple sclerosis can run in families, which suggests that there may be a genetic component to the disease.

If you have a family member with MS, your risk of developing the condition increases. However, it’s important to keep in mind that most people with this condition don’t have any family members with the condition.

It’s estimated that genetics account for about one-third of the risk of developing MS.

Infectious Factors

It’s believed that certain infections might play a role in the development of MS.

For example, the Epstein-Barr virus, which is the virus that causes mononucleosis, has been linked to an increased risk of developing multiple sclerosis.

Other viruses that have been linked to MS include:

  • Human herpesvirus-six
  • Human endogenous retrovirus-W
  • Cytomegalovirus

These viruses might play a role in the development of MS by triggering an abnormal immune response.

While the cause of MS is still unknown, researchers have identified a number of risk factors that may play a role in its development.

By understanding these risk factors, we can gain a better understanding of the disease and how to prevent it.

Testing for Multiple Sclerosis

There is no one test that can diagnose MS. Instead, doctors will use a combination of tests to rule out other conditions and make a diagnosis.

These tests might include:

  • Medical history assessment: Your doctor will ask about your medical history, including any family members with MS.
  • Neurological exam: Your doctor will test your vision, reflexes, and muscle strength. They may also ask you to walk or stand to see if you have any balance problems.
  • Blood tests: Blood tests can help rule out other conditions that cause symptoms similar to MS.
  • Imaging tests: An MRI or CT scan can help show lesions on your brain or spinal cord.
  • Spinal tap: A spinal tap, also called a lumbar puncture, involves taking a sample of cerebrospinal fluid for testing. This test can help rule out other conditions that cause similar symptoms.

After ruling out other conditions, your doctor may diagnose you with multiple sclerosis if you have two or more episodes of neurological symptoms that last for at least 24 hours and are separated by at least 30 days.

Your doctor may also use a scoring system called the McDonald Criteria to diagnose MS.

The McDonald Criteria include:

  • Medical history
  • Neurological exam
  • Imaging tests
  • Spinal tap results

If you think you may be at risk for MS, talk to your doctor. They can help you determine if you should be tested for the condition.

Areas of the Brain Impacted by MS

Multiple sclerosis can affect any area of the brain or spinal cord. The symptoms you experience will depend on which areas are affected.

For example, if MS affects the area of the brain responsible for vision, you may experience blurred vision or blindness.

Additionally, MS affects the more well-myelinated portions of the brain, known as white matter.

Cortical gray matter is less myelinated regions closer to the surface of the brain, which has also been shown to be influenced by MS.

Cognitive problems, such as brain fog and other severe issues, are linked with both white matter and gray matter damage.

When damage occurs to specific areas of the brain, it can result in cognitive difficulties with corresponding motor skills.

How long does brain fog last with MS?

The answer may vary depending on the individual, as some people with MS report experiencing brain fog all the time, while others only have episodes of brain fog that come and go.

There are a number of different factors that can contribute to MS brain fog in people with MS, including:

  • Fatigue
  • Depression
  • Anxiety
  • Sleep problems
  • Certain medications

Brain fog can also be a symptom of relapses or periods when MS symptoms get worse.

If you’re experiencing brain fog, talk to your doctor. They can help you identify the underlying cause and recommend treatment options.

How to Deal with Brain Fog from Multiple Sclerosis

There are a number of things you can do to help manage brain fog from MS.

Here are some tips:

Get enough sleep.

Fatigue can worsen brain fog, so it’s essential to get enough rest, especially for someone dealing with MS.

However, studies show that sleep disorders are common in patients with MS. So, it’s vital to implement coping strategies that will help MS patients sleep better, such as the following:

  • Establish a regular sleep schedule
  • Avoid caffeine and alcohol before bed
  • Create a relaxing bedtime routine
  • Make sure your bedroom is cool and relaxing enough for sleep

Get regular exercise.

Exercise can help improve brain function and reduce fatigue. It’s crucial to find an exercise routine that works for you and stick with it. Start slowly and gradually increase the intensity as your stamina improves.

If you’re not sure where to start, talk to your doctor or a physical therapist. They can help you create an appropriate exercise plan.

Additionally, yoga and meditation have been shown to be helpful in managing fatigue and brain fog for people with MS.

Yoga can help improve your strength, flexibility, and balance. It can also help reduce stress and promote relaxation.

There are many different types of yoga, so it’s important to find one that you enjoy and that fits your fitness level.

If you’re new to yoga, consider taking a beginner’s class or working with a yoga instructor one-on-one.

Meditation can also help reduce stress and promote relaxation. It’s essential to find a style of meditation that works for you.

There are many different types of meditation, so it may take some trial and error to find one that you enjoy and that fits your needs.

Guided meditation may be an excellent place to start, especially if you’re new to meditation. There are many different apps and websites that offer guided meditations.

Eat a healthy diet.

Eating a healthy diet can help improve your brain function and energy levels.

It’s essential to eat plenty of fruits, vegetables, whole grains, and lean protein.

It’s also important to limit your intake of processed foods, sugary drinks, and saturated fats.

If you’re not sure where to start, talk to a registered dietitian. They can help you create a healthy eating plan that fits your needs.

Additionally, there are a few specific nutrients that have been shown to be helpful in managing brain fog and other cognitive problems in people with MS.

These nutrients include omega-three fatty acids, vitamin D, and magnesium.

You can get omega-three fatty acids from fatty fish, such as salmon, tuna, and sardines. You can also get them from flaxseeds, chia seeds, and walnuts.

Vitamin D is found in fortified milk and orange juice, eggs, and fatty fish. You can also get vitamin D from exposure to sunlight.

Magnesium is found in dark chocolate, nuts and seeds, tofu, legumes, and whole grains.

If you’re not getting enough of these nutrients from your diet, you may need to take supplements.

Talk to your doctor before taking any supplements. They can help you choose the right products and dosages.

Manage stress.

Stress can worsen brain fog and other cognitive symptoms. It’s important to find ways to manage your stress.

There are many different stress management techniques, so it’s essential to find one that works for you.

Some people find that relaxation techniques, such as deep breathing or progressive muscle relaxation, help reduce stress.

Others find that exercise, journaling, or spending time in nature helps them manage stress.

If you’re not sure where to start, talk to your doctor or mental health professional. They can help you find the right stress management technique for you.

Enrich your intellect

Keeping your mind active and engaged can help reduce brain fog and improve cognitive function.

There are many different ways to enrich your intellect. You can read books, listen to podcasts, take classes, or play games that challenge your thinking.

Find an activity that you enjoy and make it a part of your daily routine.

In Conclusion

Multiple sclerosis is a serious condition that can be debilitating as it progresses. Brain fog is only one of its frustrating symptoms that can make your daily life a struggle.

Thankfully, there are steps you can take to manage and alleviate the symptoms, such as working with your doctor or medical provider team and improving your lifestyle choices.

Getting enough sleep, regular exercise, eating a balanced diet, and enriching your intellect are some things you can do that can improve your brain function and overall health significantly.

If you want to learn more about clearing brain fog effectively and improving your overall brain health in the long run, we have plenty of resources on our blog

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