so if I'm sitting in this computer chair all day right and I'm not like exercising or anything like that if I'm not physically active what I've actually seen an alarming amount of is young people that have like blood pressure problems so I'm talking about 20 year olds 25 year olds that will have symptomatic dizziness when they stand up from their computer chair because they've been sitting in the computer chair all day there are many people who will offer solutions for life do this and you will be happy do that and be happy it is my
opinion that you must understand yourself first that is why we made Dr K guide check it out nah so let's talk a little bit about brain fog so I think brain fog is an increasingly important thing to discuss because it seems to be like rapidly Rising so we know that for example uh 19 out of 20 people on the planet now have basically had kovid we also know that about 10 percent of people or up to about 10 the numbers probably closer to seven or eight percent are people who have covid have brain fog but
we also know that brain fog seem seems to be increasing like across the board and the reason that this is such a big problem is because brain fog is one of the worst things to have for a couple of reasons the first is that if you have brain fog and you go see a medical professional chances are they'll like punt you somewhere like they'll tell you to go see a therapist or they won't really give you any sort of constructive help right so if you go to a doctor and you say well like I've got
you know my my brain doesn't seem to be working quite right well first of all like what does that even mean and then the doctor May order some kinds of tests right they may sort of check to see if you have an infection they may sort of check your blood counts they may check a couple of things but at the end of the day brain fog really isn't a diagnosable condition and it also appears to not really be a treatable condition so a lot of times what happens when people struggle with brain fog which by
the way can be like incredibly debilitating so when we talk about rain fog what we're sort of talking about is like difficulties with concentration difficulties with short and long-term memory usually more short-term memory so people are incredibly forgetful people tend to find that they require lot more effort to do like basic cognitive tasks so studying is harder work is harder it just seems to be kind of like incredibly debilitating without sort of having any kind of like um you know Smoking Gun in terms of what's causing it so oftentimes we sort of accept that like
okay yeah like if I've got the flu or covid that's the reason it's hard for me to work but the problem with brain fog is that it tends to persist for very long periods of time doesn't have a clear cause and then even if we go seek help from medical professionals oftentimes they'll order some tests or maybe evaluate us but then they don't really have any sort of like treatment or anything significant they can do to help us which is exactly why it's so frustrating the other thing that tends to be kind of unfortunate in
a lot of ways is that a lot of times if you go see a medical doctor and they can't find something wrong with you but you are still struggling and those the ways in which you are struggling are not testable right so this isn't something like I've got wheezing in my chest or my blood pressure is very high or my heart rate I've got an arrhythmia I have a rash or something like that if it's something like cognitive what usually medical doctors will do is if they can't sort of find something very specific what they're
going to do is send you to a mental health professional they'll refer you to a psychiatrist because if we can't find what's wrong with your body it sort of must be in your head or the best doctors will still sort of acknowledge that it's psychosomatic which we'll get to in a minute but they'll sort of send you to a mental health professional and then the problem kind of becomes okay so let's say I go see a therapist whereas like if you I don't know if you guys know this but as as you've trained to become
a therapist you get a total of zero hours of training in how to deal with with brain fog right it's like it's not a DSM diagnosis so it's not like a psychiatric illness which is what people are trained in we're trained in stuff like trauma and anxiety and depression but brain fog really isn't something that we're taught about and so then the problem is that the answer that you're kind of given is mental health help which can be helpful in some ways but then the other problem is that as we learn learn as we'll sort
of discover today brain fog actually is not a psychiatric illness there's a lot of strong evidence that it is actually physiologic in nature and neurologic in nature so the solutions that people with brain fog are being given are ones that are actually like not very useful like scientifically so let's kind of tunnel down into this and understand a little bit more about what brain fog is and what we can do about it so the good news is that we do have a lot of research recently into sort of what causes brain fog or what are
some of the culprits and the neat thing about that is as we discover what the mechanisms of brain fog are will also naturally start to discover what are some potential Solutions so let's kind of dive into this okay so brain fog first of all appears to be increasing so as we kind of tunnel down into this people as brain fog has been sort of On The Rise and as people have been sort of getting covered what we've discovered is that like the interest in brain fog is increasing the research in brain fog is increasing and
there are a couple of key things that we've learned the first is that brain fog seems to be associated with inflammation and specifically Mast Cell inflammation okay now this is important for a couple of reasons the first is that if things are inflammatory in nature first of all we sort of can kind of infer that they're not psychiatric in nature or there's that gets a little bit complicated but there seems to be a physiologic cause and specifically the target seems to be mast cells so there's a lot of evidence that shows that mast cells are
actually correlated with the extent of brain fog and what we sort of have discovered is that brain fog appears to be like inflammation specifically within our central nervous system or brain so I don't know if you guys have sort of felt that like you know if you get the flu or covet or some kind of infection and you have this whole body inflammation or if you have something like lupus what you're going to experience is some amount of cognitive impairment right you don't feel quite as energetic it's hard to study it's hard to focus your
short-term memory will be negatively impacted and so we sort of know that inflammation can cause these problems and we also know from lots of research that mast cells seem to be in implicated the other thing that's kind of interesting is that this inflammation also seems to be associated with obesity now I know that there's a lot of tension on the internet nowadays around fat phobia and things like that I'm not trying to be fat phobic or or place value judgments on people who are overweight but what we do know this is something that a lot
of people don't realize is that adipocytes or fat storage cells in our body are not just storage they're actually endocrinologically active and immunologically active so that means is that the number of adipocytes or the size of adipocytes that we have in our body correlates with a certain amount of inflammatory activity or correlates with some amount of endocrine activity so we know that these are not just benign storage parts of our body they're actually physiologically active and can actually lead to inflammation okay and we also know that obesity is actually correlated with brain fog a couple
of other things that we sort of have discovered is that when it comes to the Mass cells the mast cells are actually either on themselves or right next to the mess mast cells we have these things called crh receptors and crh is essentially a stress uh it's not a stress hormone itself but it's a it's a signal that causes the release of a stress hormone so what we sort of know is that here we've got our crh receptor and let's say here's a mast cell and so in crh comes in over here it activates the
Mast Cell the key thing here is that if we say Okay inflammation is one of the causes of brain fog and it's mediated through the mast cell what triggers the Mast Cell well it seems that stress specifically crh is one of the key things that induces Mast Cell Activation which then in turn leads to brain fog symptoms okay you may say well like what's the point of all this all right like I don't understand why we're learning this science well the reason we're learning the science is because hopefully as we start to understand the mechanisms
this will also open the path to understanding how we can sort of combat brain fog okay the next thing that's kind of really interesting is that brain fog is also associated with a condition called pots so pots is postural orthostatic hypotension syndrome which is essentially a condition that has to do with low blood pressure specifically that is postural in nature so if you want to get kind of a quick understanding of what it feels like to have Pots if you are laying down in bed and you jump upright out of bed first of all don't
do this if you've got blood pressure problems because you could fall over but if you jump right up what you'll sometimes notice is that if you stand up Suddenly you'll start to get a little bit of dizziness and what this sort of what was responsible for the dizziness is that as we stand up the blood flow to our brain actually decreases and it takes a few seconds for our heart and our our vasculature to kind of adjust to the effect of gravity because remember that when we're laying down right so we're not really fighting against
gravity but when we stand up now our heart and blood vessels actually have to pump blood this way to sort of get to cerebral to increase cerebral perfusion or to get blood flow to our brain so some of y'all may have experienced that if you stand up Suddenly you'll feel dizzy for a second or two and then your body essentially compensates what happens in people with pots is that their ability to compensate is somehow impaired so when they stand up or sit up they tend to have low blood pressure which impacts their cerebral blood flow
the key thing here is that we know that brain fog is associated with low cerebral perfusion which is a fancy way of saying we know that people with brain fog actually have less blood going to their brain okay so there's or it requires more blood flow to complete particular cognitive tasks so the other way to kind of think about it is if you've got one person with brain fog and one person without brain fog the amount of blood that this person needs to complete a memory task is higher versus the amount of blood that this
person needs is relatively lower so people with brain fog there seems to be be something around cerebral perfusion as a cause of brain fog another thing that's really interesting is that as people have sort of looked at certain chemical compounds and they've essentially found that flavonoids and specifically something called luteolin seems to reduce inflammation has a neuroprotective fact and appears to improve brain fog okay now we got to talk about flavonoids and ludiolin for a second something has been happening recently with our diet so we know that for example people are eating more processed foods
which is a part of the problem but one of the reasons why I think that brain fog is actually getting a lot worse is because of the the way in which our food is actually grown so over the last let's say 20 to 50 years we've started to use a lot of fertilizers and I'm not like anti-gmo or anything like that but we have selected for vegetables and so flavonoids are oftentimes found from green leafy vegetables so the the rate at which vegetables are being grown is actually increasing so you used to take let's say
like six months to grow a crop of spinach and now we've really accelerated their growth rate using certain kinds of genetic modifications and fertilizers and the result of that is that sure it grows really quickly but the nutrient density is actually decreasing so we know that with some kinds of food specifically so in some ways the nutrient density is exactly the same that it used to be but in other kinds there are some kinds of nutrients which the faster you grow the plant the less the plant kind of absorbs particular things or is able to
create particular things and so what we're actually finding is that there's a correlation between rapid growth or rapid growth of a plant is inversely correlated with its nutrient density and this is something that I sort of discovered kind of in an interesting way so I went hiking last year in Alaska and I found some wild raspberries and the wild raspberries were like really really small they're like not nowhere near the size of like the raspberry that you get you know at a grocery store and so we were picking wild raspberries and eating them and like
they were super sour like they didn't taste you know as they didn't look as beautiful people they sort of like tasted like incredibly sour but there was something oddly delicious about the wild raspberries that when I went back and like got my my Supermarket raspberries like sure they were big and they were juicy and they were sweet but there was something that I could almost like tell a difference between like the nutrient density between the wild raspberry and the one that I could get at the supermarket so there is some evidence that as um you
know we're sort of having more and more rapidly growing foods that there's a correlation with sort of a decrease in nutrient density and this becomes really really important because when it comes to absorption we only absorb about 10 percent of flavonoids from our diet so what that means is that our body is very very inefficient at absorbing some of these compounds which in turn means that if we're reducing the nutrient density from our Foods it makes it like sort of like since our our absorption is so low if we kind of cut the nutrient density
in half we're ending up with a lot less of these compounds in our diet and then as a result we're sort of having less of this inflammatory protective effect in neuroprotective effect a couple of other things that we've sort of found that are associated with brain fog are poor sleep so about 90 percent of people with brain fog will uh report having poor sleep or insufficient sleep and then the last thing that's kind of interesting is that we also know that dehydration appears to be correlated with brain fog as well and in one study 88
percent of people who had brain fog qualified or reported some degree of dehydration so this is kind of interesting right because now we're starting to see that first of all and I want to show you all one other thing just directly from a paper there's also um some evidence that so just to kind of the last thing is what about things like depression so there's actually some studies that have specifically examined psychiatric comorbidities and uh brain fog and what they've actually found is that psychiatric comorbidities are not a associated with the cognitive impairment of brain
fog at least in certain inflammatory conditions this is a paper about Cog chronic fatigue syndrome so we know that brain fog that's sort of caused by these like a sort of mysterious inflammatory conditions appear to be not psychiatric in nature which is really really important I think this is actually what's really unfortunate is because like a lot of times doctors will send people to mental health professionals to deal with brain fog because they sort of don't know what else to do and if we can't figure out what's wrong with you let's send you to a
therapist because they'll be able to sort it out but as we take a look at this what we actually find is that there's a lot of physiologic sources of brain fog so now let's take a look at these six things and try to understand a little bit about okay like if these are the causes of brain fog and that's it you know we're not quite there yet so this is just some evidence that implicates these are some of the mechanisms what does that tell us about why brain fog is getting worse now that we sort
of know these are the things that are involved with brain fog you know what's going on in our society with all these things the first thing is that obesity is on the rise okay so what we're going to do is just take a quick look at these and very simply try to figure out is this this getting worse in society or not is obesity getting worse absolutely is General inflammation getting worse absolutely is stress getting worse absolutely now here's an interesting one what about blood pressure right is blood pressure on the whole getting worse and
what we actually discover is that as we are getting to a more and more sedentary lifestyle what we're starting to do is have a deconditioned cardiovascular system so if I'm sitting in this computer chair all day right and I'm not like exercising or anything like that if I'm not physically active what I've actually seen an alarming amount of is young people that have like blood pressure problems so I'm talking about 20 year olds 25 year olds that will have symptomatic dizziness when they stand up from their computer chair because they've been sitting in the computer
chair all day and so we're seeing that this kind of stuff this sedentary lifestyle is actually getting worse as well um the other thing that we sort of mentioned already is that there's let's say vague non-conclusive but strongly suggestive data that our diet as a whole is getting worse and this isn't just about processed foods this is also about the lack of nutrient density in a lot of our fruits and vegetables is sleep getting worse absolutely right so as technology usage gets worse we've got issues with blue light impaired melatonin production low quality sleep right
not to mention all these other things like lack of physical exercise and and stress and stuff like that that sleep on the on the hole is getting worse and what about dehydration are we as a whole getting dehydrated and this is one where I'd say like I'm not really too sure so we do know for example that um in one study specifically on pots that 88 of people are associated or who have brain fog also will sort of endorse some degree of dehydration and this is also important from a blood pressure standpoint because proper hydration
is one of the most important ways to keep our blood pressure up specifically when someone has been in like a car accident or something like that to keep blood going to people's brain what we'll sort of do is is use two wide bore IVs to pump in Saline or blood products into people so one of the ways that we maintain blood pressure in the brain is by actually like injecting people with saline right so we sort of like give them bunches and bunches of fluid and as we increase their fluid it maintains their cerebral perfusion
so what we're sort of seeing in in society today is I think we're seeing an increase in caffeine intake which is dehydrating and this is especially a problem for people with brain fog because what we sort of found is that some people will treat brain fog with things like stimulants but what I've really found is that a lot of people who are struggling to focus what are they going to do they're going to drink coffee right so we see that brain fog is oftentimes associated with a higher level of caffeine intake and generally speaking a
lot of our diet has become unhealthy and people may not be drinking enough water it kind of depends on who you are where you are but one of the things that I've definitely seen with brain fog is an increase in caffeine intake that's almost compensatory that can result in some amount of dehydration and as we get dehydrated what we're actually doing is potentially making our blood pressure worse okay so now the question becomes all right so if this is like what's associated with brain fog like the quick question is okay what do I do about
it right and this is where the sort of frustrating thing sometimes when you go to a medical professional and they don't know what's wrong with you is they'll tell you to just be healthier right they'll say okay if you've got brain fog like why don't you just just do the diet and exercise right just exercise more diet more spend less time on your screen just get better sleep we're kind of giving these like General like ideas about you know like what you should do to get healthy like those are just the generally healthy things to
do and it can be quite devastating because a lot of people will have brain fog and they'll go to doctors and they'll go to therapists and people aren't really able to help them much um the good news this is good or bad news depending on how you look at it is that a lot of times you know when people have brain fog they actually end up in my office because you know so prior to doing this whole healthy gamer thing my primary area of Interest was actually evidence-based complementary and alternative medicine so I was focused
a lot on sort of scientifically valid meditation techniques yoga techniques herbs things like that so I had a clinic where people would refer their patients to me who were interested in like more natural remedies so what I sort of found as a clinician is that when people would people would get referred to me a lot right so what would happen is like someone some doctor would be like okay okay oh yeah like this person is complaining of these vague stuff like let's send it to Dr kenoja because Dr kenoja handles these people well so there's
a psychiatrist this person has something wrong with their head right so let's send them to a psychiatrist they would come to me and the thing is I'm a psychiatrist right so I'm a psychiatrist so I'm trained in evaluating people for mental illness and as these people come to my office and I kind of evaluate them and they've got this vague like brain fog sort of stuff what I sort of quickly conclude is that I don't think this person has mental illness I don't think this person is like ill in their mind I don't think they
have anxiety I don't think this is a depression this isn't bipolar disorder it's not like their mood is very bad kind of is the root cause oftentimes what we'll see in brain fog is that their mood is bad but that's secondary to being unable to do things so it's hard for me to study it's hard for me to work I you know I'm not doing as well I'm not progressing my energy levels are low I can't think I can't concentrate that's what causes the low mood it's not like the low mood comes first it's a
consequence of then I'm kind of stuck in the situation where these people are coming to me for help and it's like you know I'm kind of the last stop right on the train to Nowhere let's say and so so I'm I'm sort of trying to figure out okay how am I going to help these people and the good news is that actually like I've had really good success I can think of maybe one or two patients and if you're watching this I'm still sorry about not being able to help you substantially but for the most
part I'd say about 80 to 90 of the people that I've worked with who have brain fog I've actually been able to help pretty substantially and it wasn't like I therapized them what we actually found is that by targeting all of these different dimensions it can be actually you could sort of figure out a good plan to sort of improve your brain fog so a couple of other things so another medical disclaimer that this is something that what I'm going to share with you all now is stuff that I have found useful in my clinical
practice I myself used some of these uh interventions like so I had pretty bad covet about a year ago and was also noticing some amount of brain fog so I kind of went through my own like brain fog regimen and I found that like I basically am completely recovered from that but remember that this is not medical advice and that each and every one of you should really talk to a dog doctor about all of these things and sort of try to figure out a customized plan but here are a couple things that work the
first is yoga or Tai Chi and specifically I found sheer shasan to be very effective so sheer shasan is a headstand pose so it's this particular asan where you're upside down right so it's a yoga posture where you're upside down it's definitely something that requires some degree of training so I wouldn't try that at home you really need a good teacher to teach you how to do it but cheers is literally like you're just doing it a headstand right so your head is at the bottom and your feet are at the top and the cool
thing about cheersen is that it it really trains your body to maintain blood pressure to your brain so it really like work wreaks havoc on your cerebral vascular system and your vascular system not in a in a negative way but it sort of trains you to be like upside down and as you're upside down it trains your body a little bit to handle blood flow a little bit better so sheer shawson or any kind of yoga or tai chi I think will probably be effective there's also good evidence that yoga and Tai Chi are have
like anti inflammatory and stress reducing effects so I'd recommend yogurt or Tai Chi specifically probably slightly more recommend yoga over Tai Chi and that too some of the yoga postures that you should do are ones that have postural changes so bending down and touching your toes you know doing your the hand above your head maybe doing something like downward dog or parvatasan or things like that but yoga is actually really good at like having your body move in particular ways that require you to maintain blood pressure so yogurt Tai Chi is number one second thing
that we have to consider is obesity so this is where some amount of exercise is actually really important but we're going to Tunnel down into what kind of exercise so it's not just reducing obesity for its own sake although we do know that adipocytes are pro-inflammatory right so we talked a little bit about that but specifically the kind of exercise that we want to do is going to be cardiovascular in nature and ideally has you using your legs and why is that so there are a couple of really important things to understand about sedentary lifestyle
and the impact of sedentary life Style on specifically our leg muscles our our heart is here okay and our heart pumps things and generally speaking our blood tends to pull at the bottom of our feet right because of the effect of gravity so there's one really interesting thing if you look at your body what you'll sort of find is that even if you look at the back of your hand okay it's kind of out of focus but if you look at the back of your hand you can see veins right even if you look at
like your head or your neck you can see veins so veins tend to be pretty peripheral when it comes to the top half of your body but if you look at your legs it can be very hard to see your veins and the reason for that is because a lot of times our major veins in the legs are actually on the inside of the leg and we actually rely on our skeletal muscle the muscles in our legs to pump blood back to the heart so anytime I walk what the contraction of the skeletal muscle anytime
I take a step is actually helping Blood come back to the heart so one of the things that I found is that with a Century lifestyle we're walking less as we're walking less we're getting more blood kind of pooling in our lower extremities so we're seeing increases in stuff like varicose veins and stuff like that and all of that is associated with a sedentary lifestyle so any kind of exercise specifically that involves walking and a high level of cardiovascular like workout is actually really good so this is one of the situations where you know I
wouldn't recommend specifically like bench pressing so bench pressing will increase your cardiovascular weight but like getting gigantic muscles on your arms is not actually or your chest is not actually what we're really shooting for here what we really want to do is engage that skeletal muscle in our legs and ideally start to exercise and get to a decent heart rate right so essentially cardiovascular activity using the legs is what we want to Target so that'll also have the added effect of hopefully reducing our obesity and a couple of other things the next thing that we
want to do is really think a little bit about our diet so remember that there's actually studies that show that let me just show you all a quick paper so brain fog inflammation and obesity key aspects of Neuropsychiatric disorders improved by ludiolin so we know that some of these flavonoid compounds specifically something called ludiolin which I think is and extracted from usually olives and this is a potentially another reason why the Mediterranean diet um has like positive anti-inflammatory effects is because of the prevalence of olive oil so you may have ludiolin in the Mediterranean diet
at a high level as well so people can also supplement with ludiolin but this is definitely something that I would encourage you to talk to your doctors about because luteolin can be biologically active with other compounds like medications and things like that but we sort of know that supplementing with flavonoids and ludiolin can actually have a positive effect on brain fog so the other simple way to kind of think about this though is that if you eat nutrient dense greens that'll also do the trick so it's not just healthy diet in general it's sort of
thinking a little bit about okay what are the dietary inputs that I need to kind of compensate for the brain fog and the specific thing about ludiolin and flavonoids is that they seem to have very positive effects on the parts of our brain that appear to be affected by brain fog so remember this this Mast Cell active Innovation this high level of inflammation there's very strong anti-inflammatory anti-oxidation and neural protective effects of flavonoids and ludiolin so that's something that I would definitely recommend that you all talk to your doctor about the last thing to generally
consider um is to remember like two super basic things the first is sleep and caffeine so sleep is incredibly important so just about every person that I've worked with with brain fog has needed to have some kind of improvement in their sleep so if you're not sleeping properly sleep is just the general time that our brain uses to heal itself right so if we're like not sleeping properly or our sleep is Disturbed or we have too many substances on board if we use marijuana to help us sleep if we use alcohol to help us sleep
even if we take exogenous melatonin I'm sometimes a little bit concerned about the high level of exogenous melatonin use even though from a medical standpoint it's very very safe but I think good sleep is huge for brain fog the last thing to consider is once again hydration so this is where you just got to be drinking lots and lots and lots of fluid so if we're talking about this blood pressure effect we got to remember that like fluid intake is very very important for maintaining a healthy blood pressure so you've got to really look at
what what's your liquid intake over the day are you drinking lots of soda are you drinking lots of caffeine are you drinking enough water how often are you urinating what is the color of your urine you generally want to be urinating like a light yellow color if your urine is completely clear your fluid intake may actually be too high if your urine is very concentrated or you're not urinating very frequently there's a decent chance that you're not drinking enough so these are the last kind of two things to consider so it's unfortunate that brain fog
has been really like expanding very rapidly I almost get the sense that there's like a silent epidemic of brain fog that's happening in our society today and the most devastating thing about that is that as it's affecting more and more people the solutions that we're offering people with brain fog don't seem to be working very well so if you go see a medical professional it's a good thing to do by the way because they can rule out other causes right so if it's something like anemia Mia or vitamin B deficiency there are a lot of
things that can kind of contribute to brain fog-like symptoms the downside is that if it's true brain fog then chances are it's not one of those vitamin deficiencies and you should rule all those things out but then your doctor has sort of left it like kind of like I don't know what to do and then sometimes what they'll end up doing is just referring you to a therapist or just telling you like oh eat healthy and exercise which is actually part of the solution don't get me wrong but then the other problem is that once
you get referred to a therapist the therapist may be able to help you in some ways but the real problem is that brain fog is not a psychiatric Condition it's actually a physiologic and neurologic condition and so oftentimes what our medical system actually does is sends people to the wrong professionals and then when therapy or Psychiatry kind of doesn't work for you then you're sort of left feeling like okay well I've tried everything where it was it turns out that you actually tried you started with the worst thing right because it's not a mental illness
and then people feel really really hopeless then you kind of come back to your your doctor and you say hey the therapy isn't working and then they're kind of like shrug their their shoulders and we don't really know what to do so my hope today was to share share with you all a little bit about you know what are the mechanisms of brain fog what are we sort of what are we starting to understand about it and some of the stuff that I found to be somewhat useful for some of my patients as well as
for myself in terms of my own post covid recovery remember that your mileage may vary and that this is absolutely a situation where you want to talk to a medical professional first to get evaluated for all kinds of these other things right and if you do that hopefully what we'll we'll start to see is that your brain fog will actually get better and I would say that like 80 to 90 percent of the people that I've worked with with brain fog with some combination of the stuff that we just talked about will actually get better
so hopefully that helps you foreign
