Understanding Brain Fog in Hypothyroidism

brain fog and confusion are symptoms of thyroid

Many thyroid patients -- especially when untreated or undertreated for hypothyroidism -- complain about a little understood symptom: brain fog. Brain fog is a term used to describe a number of symptoms that can include:

  • difficulty concentrating; short-term and long-term memory problems;
  • forgetfulness;
  • feeling "spaced out;"
  • confusion;
  • feeling inexplicably anxious or irritable; and
  • feeling tired and unmotivated.

    The brain -- along with its many neurotransmitters and hormones -- requires sufficient levels of thyroid hormone in order to function properly, so it's no surprise that a symptom like brain fog is often reported by patients who have an underactive thyroid and are either not being treated, or who are not receiving sufficient or optimal treatment. 

    Amy's Experience With Brain Fog

    Here is personal experience of a reader, Amy,about her own battle with brain fog and hypothyroidism.

    Since being diagnosed with hypothyroidism, I have experienced a few very disturbing episodes of "brain fog." I was noticing that my short term memory was getting significantly worse over about a two month period. The other symptoms are bad enough, but I absolutely cannot abide my brain going on the blink. I mentioned it to my doctor and he ran my blood. Thyroid numbers were in "normal" range. The memory problems continued and got worse; including a real difficulty concentrating.

    One day at lunch I realized that I just could not focus on what the person with me was saying. I could not even figure out how to respond to her when she spoke to me. I heard what she was saying but could not concentrate on how to respond. I FREAKED! In a total panic, I got back to work and immediately called my doctor. I was sure that something dramatic was wrong...tumor....alien implantation...what the heck was going on? After a doctor ordered CAT scan (nothing wrong there) and a lot of web surfing I came across some references to anemia in hypothyroid patients and some symptoms of anemia similar to what I was experiencing. So....

    I asked my Dr. if he had run a red blood cell count on me. Of course the answer was "NO"....so I asked politely if he would please run a CBC. Sure enough, my numbers were "slightly" low. After a week of prescription iron, taken at the opposite end of the day from my thyroid meds, it was like a light switch was flipped. My brain snapped back on and my short term memory and concentration problems were gone.

    Now if I feel a real slip in my memory/concentration I get a CBC and pop the iron. For me, a "little low" equals big problems. I could not have survived and finally thrived without sites and info such as yours. Educate yourself folks and know your body. It makes a world of difference.

    Brain Fog Causes and Solutions

    In Amy's case, her brain fog was related to iron deficiency, a condition that is more in people with thyroid conditions. Low iron levels can also contribute to fatigue and hair loss, other common complaints of thyroid patients. 

    In some cases, in someone being treated for a thyroid condition, brain fog may be a symptom that the treatment is not optimal.

    The concept of "optimal" hypothyroidism treatment is not one that is generally recognized by mainstream physicians and endocrinologists. They consider hypothyroidism treatment to be complete when medication returns thyroid blood test levels -- usually the TSH level -- to the reference range, or what is referred to as the "normal range."

    Integrative and functional physicians, however, focus on several goals of hypothyroidism treatment:

    • Improvement or resolution of symptoms (among them, brain fog) 
    • Restoration of blood test levels -- including TSH, Free T4, and Free T3 at minimum -- to optimal levels, rather than simply levels within the reference range.

    For these physicians, optimal levels tend to be as follows:

    • A TSH below 1.5 to 2
    • Free T4 and Free T3 levels that fall within the top half of the reference range

    What Should You Do?

    If you have brain fog -- or other potential thyroid symptoms -- and are not diagnosed or treated, your first step is to see your physician for a complete thyroid evaluation.

    If you are a thyroid patient experiencing brain fog, you should first discuss it with your physician, and consider asking for testing to evaluate your iron levels, as well as thyroid levels, to determine if you need iron supplementation, or a change in your thyroid treatment.


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