When brain fog isn't "just" ADHD
Updated: Aug 4, 2020
A 19 year old girl came to see me because she was struggling with her grades at school. She said that she cannot focus on anything for more than 10 minutes, her mind wanders, she daydreams in class, and struggles to complete her homework on time, or even stay focused in exams. Her concentration was non-existent, and she needs to use a headset to play music to drown out the "white noise" in the background. On top of that, she has terrible insomnia and has never had a "good night's sleep" for as long as she can remember.
However, her mother said that she used to be an avid reader as a child, sitting by herself for hours at end absorbing anything she can get her hands on, and her grades only started suffering in the past couple of years. She changed school one year ago as she wasn't coping well in her previous, more academically minded school doing the IB curriculum, and now she's taking A-levels which she feels she "should" be able to cope with, but just somehow can't seem to manage well.
There was a suspicion of Attention Deficit Hyperactivity Disorder, which would have helped her to apply for extensions to deadlines and get extra time in exams. It would also have "justified" a prescription of stimulant medications used to treat ADHD. I performed a CNS Vital Signs test on her to assess her cognitive functioning, and the results are shown here:
Her overall score (Neurocognition Index) was in the very low range compared to her age matched peers, and the domains that are typically affected in ADHD, such as processing speed, executive function, complex attention, cognitive flexibility, were what dragged her score down. So, yeah, even her cognitive profile looks like ADHD, so why are we talking about a straightforward diagnosis?
But I had a gut feeling that there was something more to this than what meets the eye. For a diagnosis of ADHD, you really need to have exhibited symptoms of either hyperactivity, impulsivity and/or inattention as a child, and her mother's account just didn't seem to fit the picture.
So I dug around the history a bit more, and queried about any other physical symptoms that seems out of place. Turns out, she has a lot of "weird" symptoms such as extreme fatigue, aches and pains, light sensitivity, shortness of breath, cough, excessive thirst, appetite swings, feelings of hot and cold for no reason, blurred vision, night sweats, mood swings, ice-pick pains, dizziness and a funny taste in her mouth. She said she's had some of these symptoms for a while but no doctor could tell her exactly what was wrong with her, so she just learnt to "live with them".
Huh, I thought, very interesting. I wonder if all these seemingly random symptoms could be caused by some underlying inflammatory process as a result of exposure to toxins? She has been living in a dormitory at the new boarding school, but didn't report any musty smell or seeing any visible mould. She couldn't tell if her previous abodes were water damaged either. So then I asked her to do a Visual Contrast Sensitivity Test as a screening assessment to see what it might reveal. The VCS test measures your ability to see details at low contrast levels and is often used as a nonspecific test of neurological function. Lo and behold, this was what we got:
Yikes!! Pretty much all her "columns" were below the average population standard (grey line), and her scores (red line) suggested that she may be suffering from some kind of biotoxin (columns C and D), and probably nutritional deficiency as well (column A).
So we decided to further investigate the possible source of biotoxin and what other inflammatory markers in the body has been disturbed by it. It turns out to be.... mould! She had the unfortunate genetics of not being able to detoxify and get rid of these mould toxins from her system well enough, and her exposure to mould in the environment kept building up until it triggered the immune system to react and go haywire. In addition, there were chemicals such as those from car exhaust fumes, organophosphates from pesticides, and various derivatives from plastics.
She began a series of treatment that involved medication and natural binders, liver support and gut repair to open up the drainpipes, and detoxification such as using the sauna regularly, sweating it out, Epsom salt baths, lymphatic drainage, and coffee enemas (that was a tough sell!) Then we moved onto treating other aspects of this condition in a step-wise fashion under medical guidance.
Slowly but surely, she started to feel better - her energy improved significantly, her brain fog lifted, she started to feel more engaged in everyday life, and some of her physical symptoms like the aches and joint pain, insomnia, and eyesight improved. Her appetite was more consistent and she showed an interest in food, which means it was easier to engage her into a discussion about healthy eating.
Want to know what her cognitive profile looked like after 6 months of treatment? Here is the second, post-treatment CNS Vital Signs report:
Much better looking brain! Most domains have improved and even reaction time went up a quintile (she admits she likes to take her time with most things in her life). And this was not because she took an ADHD medication.
In fact, I've seen a number of children and adult who have been asked to see a psychiatrist to "get a prescription" for their ADHD, but it turns out to be all sorts of other reasons why they have brain fog. Having a "health detective" on your team would help you look deeper into any causes which can be identified and remedied, which may be helpful in relieving some of the symptoms you're experiencing. (Note: this is not a medical claim to be curing ADHD, we're just talking about other possible factors why people have brain fog)