Dealing with Fibro-Fog

by Karen Lee Richards Patient Advocate

My best friend from Florida came to visit me here in Tennessee so she could take fall leaves back for the children in her Montessori pre-school. In our quest to find the most beautiful leaves, we headed for the Blue Ridge Parkway, well known for its stunning scenery. No sooner had we gotten on the parkway than we found ourselves in the midst of one of the worst fogs I ever experienced. We could literally only see about three feet in front of the car. I was struck by was how similar it felt to being in the midst of a severe bout of fibro-fog!

The cognitive dysfunction so many of us with fibromyalgia deal with daily is aptly described by the term "brain fog," or by my favorite pet name "fibro-fog." Our minds feel clouded by a thick fog. We are unable to see (or think) more than a few feet (or minutes) ahead.

See if any of these fibro-fog experiences sound familiar. Do you ever...

...get ready to walk out the door and realize you have no idea where the car keys are?

...put the milk in the cabinet and the cereal in the refrigerator? into an old friend and forget her name?

...find yourself driving down a road unable to remember where you are going? something, not remembering that you bought the exact same think a week ago?

...try to describe or explain something but you cannot think of the word you want to use?

...stop in the middle of a conversation because you cannot remember what you are talking about?

...forget when you last took your meds?

...bounce a check because you added instead of subtracted? up for your doctor appointment on the wrong day?

The forgetfulness, difficulty concentrating and confusion characteristic of fibro-fog is occasionally amusing and often frustrating. But sometimes it can be downright dangerous -- like forgetting that you have chicken frying on the stove or not noticing that a traffic light has turned red. While it is good to be able to laugh at yourself over the little incidents of forgetfulness, it is important to take steps to improve your cognitive functioning so that you do not jeopardize the safety and well-being of yourself or your loved ones.

Increase Blood Flow

Although a clear-cut cause for fibro-fog has yet to be identified, various brain-imaging techniques have clearly shown that the majority of people with fibromyalgia and/or chronic fatigue syndrome have decreased blood flow, and thereby decreased oxygen, to specific areas of the brain. Therefore, the first step in dealing with fibro-fog is to try to increase blood flow and oxygen to the brains. Here are a few tips to get your blood flowing northward:

  • Exercise -- Exercise increases blood flow and oxygen to the brain. Exercising with music doubles the effectiveness. Charles Emery, Ph.D., a clinical psychologist at Ohio State University in Columbus, conducted a research project in which participants were tested for mental performance after exercising both with and without music. Participants performed more than twice as well on a verbal fluency test when they exercised with music.

  • Sleep - Getting enough sleep is critical for good brain function. Not coincidently, getting good restorative sleep is one of the major problems for people with FM. The foods you eat can have a significant effect on how well you sleep. Some foods, like milk and turkey, can help you fall asleep. Others, like caffeine-laden drinks, chocolate, excessive sugar, and MSG, can cause agitation and keep you awake. For additional information about improving sleep, go to the National Fibromyalgia Associations website, If you do a search for "sleep," you will find several helpful articles.

  • Breathe -- While breathing seems like a normal, involuntary action, the fact is that most people with FM actually hold their breath much of the time. Although holding your breath is a natural reaction to pain, it deprives your body of necessary oxygen. Try to make yourself aware of times you are unconsciously holding your breath and make a conscious effort to take two or three deep breaths several times a day.

  • Check medications -- Certain drugs can increase brain fog. Some of the medications that may make your memory worse are: calcium channel blockers (for hypertension), analgesics (for pain), hypnotics (for sleep), and antihistamines (for allergy or sinus problems). If you suspect that one or more of your prescriptions are increasing your fibro-fog, talk with your doctor to see if a lower dosage or a different medication might help.

  • Improve nutrition -- Recent research suggests that getting enough of certain nutrients -- particularly iron, zinc and B vitamins (especially folic acid, B6 and B12) -- may help cognitive functioning...or at least prevent it from getting worse. Iron and zinc are found in meat, poultry, seafood, whole grains and dried beans. The B vitamins are found in whole grains, meat, poultry, seafood, eggs, dairy products, leafy green vegetables, beans, peas and citrus fruits. Additionally, it is important to fight the free radicals seeking to damage our brain cells by eating a diet rich in antioxidants. Antioxidants are found in fruits and vegetables, especially those with the darkest and brightest colors, like spinach, carrots, tomatoes and red bell peppers.

  • Consider supplements -- If you feel your diet is not supplying adequate amounts of the nutrients mentioned above, you might consider adding one or more vitamin and mineral supplements. Other supplements that some have found helpful in lessening fibro-fog are Coenzyme Q10, Gingko Biloba and NADH (a coenzyme made from vitamin B2). Always check with your doctor or pharmacist before taking any supplement to make sure there are no dangerous interactions with medications you may be taking.

Mental Exercise

In addition to physical exercise, emerging evidence is showing that mental exercise can also help improve memory, concentration and problem-solving abilities. Mental exercise can be any activity that causes your mind to think logically, focus, strategize, sort, calculate, or create. Choose at least one mental exercise that you enjoy and spend some time each day "working out" your brain. Following are examples of a few brain-exercising activities:

  • Work a challenging crossword puzzle.

  • Solve a word search puzzle.

  • Put together a difficult jigsaw puzzle.

  • Play a game that forces you to think or strategize, like Scrabble, chess or bridge.

  • Make up a fairy tale.

  • Choose a Norman Rockwell painting and create a story about it.

  • Memorize a poem, proverb or Bible verse.

  • Read a book.

  • Play a musical instrument.

  • Learn a new language.

If you find yourself in the midst of a thick mental fog, do not allow yourself to get lost there. You can work your way through it and find some clarity again. It is ironic that for about a month prior to writing this article, I went through one of the worst bouts with fibro-fog I have ever experienced. I felt like I was living in la-la land. But, using many of these tips, I found my way through the fog...and so can you.

Reprinted with permission of the National Fibromyalgia Association from Fibromyalgia AWARE, December 2004 - March 2005.

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.