Brain Fog in Hypothyroidism: Understanding the Patient’s Perspective

Most individuals that experience brain fog from synthroid, notice it most significantly at the start of treatment; this may be caused by too high/low of a dose. Too high of a dose and you run the risk of sporadic, fast-paced, unfocused anxious thinking. Some researchers believe that oxidative stress and inflammation play a role in these symptoms. “Brain fog” is not a medical condition but a term used for a group of symptoms that can affect your cognition, mood, and energy. Euthyroid sick syndrome, also known as non-thyroidal illness, is a condition in which people with a functional thyroid gland have low thyroid hormone levels. This situation is most common in people who are starved, severely ill, or have undergone major surgery 84.

Have you experienced Synthroid side effects?

At lower doses, it is easier for the body to accommodate the non-bioidentical, synthetic material and tolerate some hormonal stimulation. That said, when a certain threshold of hormonal stimulation is surpassed with high-dose synthroid – side effects are virtually guaranteed. synthroid keppra Lack of energy, forgetfulness and feeling sleepy are the most common symptoms adults with hypothyroidism face with “brain fog,” a phrase patients use to describe a type of cognitive dysfunction, according to a speaker. The study findings suggest that, for a subset of patients with hypothyroidism, a multipronged approach may be required to achieve a euthyroid state and reduce the symptom severity. Future studies should focus on further understanding the impact of lifestyle and behavioral modifications on improving symptoms such as brain fog in patients with hypothyroidism while maintaining biochemical euthyroidism.

Frequency, Onset, and Duration of Brain Fog Symptoms

Focusing specifically on LT4-treated hypothyroid people, the literature regarding HRQoL, mood, and cognitive outcomes is divergent and inconclusive. Some studies have shown that people treated with LT4 have decreased psychological well-being or cognitive function compared with control groups, while other studies report no differences (34). In studies when LT4 doses were altered in a blinded manner in euthyroid LT4-treated people, maintaining TSH levels in the reference range, there were no changes in HRQoL, mood, or cognitive outcomes (45,46). There is significant variation in how brain fog is studied and what outcome measures are used. This lack of consistency across studies is a challenge since little research has been conducted specifically in hypothyroid people reporting cognitive symptoms. Based on research in other areas, some reasonable parameters include cognitive involvement, persistence over some period of time, and association with the onset of disease or treatment (although there may be a delay).

A study on 70 people with a family history of Alzheimer’s disease found a high prevalence of autoimmune hypothyroidism (41%), suggesting that the genes responsible for both conditions might be inherited together 125. 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. For instance, a study on over 100 people found reduced memory and attention despite following this therapy for 5.5 years 38, 39. Low thyroid hormone levels also increase protein levels in spinal fluid, suggesting they may damage the blood-brain barrier 18. Brain fog may occur with hypothyroidism because the brain requires adequate levels of thyroid hormone to function properly. We thank the American Thyroid Association for its participation in survey development and distribution.

Because brain fog is not specific to one particular medical problem, it is difficult to manage. Indeed, brain fog may persist after the other symptoms of hypothyroidism resolve on thyroid hormone therapy. Unique to this study, Ettleson et al go beyond just characterizing brain fog to identifying potential strategies to mitigate this multisystem condition from the perspective of patients with hypothyroidism. The most common alleviating factors for brain fog identified were more rest, which was reported by 51.7% of participants, followed by the adjustment of thyroid hormone replacement (28.3%) and more exercise (10.4%).

For a bulk of synthroid users, constipation and bloating are unlikely severe enough as to cause functional impairment. Furthermore, after several weeks of synthroid treatment, some users may find that constipation subsides. A study on almost 2k elderly people found it increased the risk only in women, while 3 other studies on almost 2k found no link between both conditions 126, 127, 128, 129. The current management guidelines for subclinical hypothyroidism recommend using LT4 preferably in younger people and those with more severe conditions (higher TSH levels) 110.

• Have your doctor reassess your synthroid dosage and reevaluate your TSH plus other thyroid parameters.
• Lack of energy, forgetfulness and feeling sleepy are the most common symptoms adults with hypothyroidism face with “brain fog,” a phrase patients use to describe a type of cognitive dysfunction, according to a speaker.
• However, the available questionnaires do not address all concerns exhibited by the medical-centric patients.

Fatigue common with ‘brain fog’ among adults with hypothyroidism

Have your doctor reassess your synthroid dosage and reevaluate your TSH plus other thyroid parameters. If your doctor determines that your dosage was too high, a reduction may mitigate various synthroid side effects. If you never had joint problems prior to taking synthroid, and suddenly noticed muscle weakness, swelling, and pain – there’s a good chance that it’s the medication.

• However, if you’re taking synthroid and a cornucopia of pharmacological and/or supplemental agents – it is necessary to consider that there may be interactions.
• Low thyroid hormone levels also increase protein levels in spinal fluid, suggesting they may damage the blood-brain barrier 18.
• That said, it is possible that some users may experience anxiety even after the synthroid dosage is calibrated to an optimal level.
• If you’re experiencing severe anxiety and/or panic attacks from your synthroid, talk to your doctor about a dosage adjustment, alternative intervention, and/or concurrent usage of an anxiolytic.
• The World Health Organization regards synthroid as an “essential medicine” or among the most important pharmaceuticals necessary in a basic health system.

This section collects any data citations, data availability statements, or supplementary materials included in this article. T4 is then broken down to its more active form T3 by a group of enzymes called deiodinases and mainly found in the liver and kidneys 1, 3. First For Women does not endorse the opinions and views shared by our readers in our comment sections. Our comments section is a place where readers can engage in healthy, productive, lively, and respectful discussions. Offensive language, hate speech, personal attacks, and/or defamatory statements are not permitted.

Cognitive Symptoms in Hyperthyroidism

People with undiagnosed or poorly managed hypothyroidism often report forgetfulness, difficulties finding the right words, and lack of attention. In fact, thyroid brain fog is a common symptom of hypothyroidism and may even be one of the first clues that your thyroid isn’t functioning as it should be. Atypical symptoms that raise the question of alternate etiologies or structural neurological disorders should be evaluated as potential separate diagnoses. If symptoms are more severe, appear progressive, or are interfering with activities of daily living, referral to a neuropsychologist is an underutilized approach that should be considered.

In most cases, brain fog symptoms and perceived cognitive impairment resolve along with other hypothyroid symptoms with thyroid replacement therapy. However, brain fog symptoms persist in about 10% of patients who receive hypothyroidism treatment with levothyroxine. If you’ve been taking synthroid, it is necessary to track whether the therapeutic benefits attained from the medication outweigh side effects and adverse reactions.