Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Frequently Asked Questions
People withfibromyalgiaormyalgic encephalomyelitis/chronic fatigue syndrome(ME/CFS) experience a specific kind of cognitive dysfunction called fibro fog orbrain fog. It involves:
Some researchers suspect that pain, fatigue, and the need to constantly monitor your symptoms may prevent you from effectively directing your attention to things outside of yourself.
This article explains ME/CFS and fibromyalgia brain fog, the mechanisms behind them, and how medications and other treatments can help clear the fog.
South_agency / Getty Images
Symptoms of Brain Fog
Symptoms of fibro fog or ME/CFS brain fog differ from person to person and can range from mild to severe. Severe brain fog can have a tremendous impact on quality of life—as much as pain or fatigue. The effects of brain fog can be so significant that it can even be mistaken forADHDordementia.
Symptoms of fibro fog can vary from day to day, and not everyone has all of them.
Executive Function Deficits
Executive functionis a higher-level cognitive ability involving:
Though executive function deficits have been reported in both fibromyalgia and ME/CFSsome ME/CFS research disagrees.
These deficits may play a role in many of the cognitive problems associated with these conditions.
What Is Executive Dysfunction?
Memory Problems
Memory problems are an extremely common issue in fibromyalgia and ME/CFS. These seem to primarily involve short-term and working memory, but other types of memory may be affected as well.
Short-Term and Working Memory
Short-term memoryis the ability to temporarily store a small amount of information.That may be something like a short set of instructions or a phone number.
Working memory is the ability to process, manipulate, and use information in your short-term memory. This involves your brain’s executive function.
So, executive dysfunction could help account for working memory problems, which have been noted in both conditions.
With these memory issues, you may frequently forget things like:
It can also be hard to learn new information.
ME/CFS and Other Memory Deficits
Some ME/CFS brain fog research has pointed to problems with several other types of memory. These include:
These deficits may explain ME/CFS brain fog symptoms such as:
The Role of Depression in Memory Deficits
If you havedepression, it may cause or exacerbate these problems. A 2021 study looked at the possible role of depression in memory issues of fibromyalgia and other chronic pain conditions.
In people with otherchronic painconditions, the problem appeared to come from depression, not the pain. However, in fibromyalgia, pain intensity appeared to make memory problems worse.
Similar findings were reported in a 2018 study.
4 Types of Memory
Attention Deficits and Cognitive Inhibition
Medically speaking, attention is the ability to focus on certain things in your environment and filter out other things.This could mean listening to a teacher while tuning out the students talking behind you.
Some research, including a 2022 study, suggests ME/CFS involves problems with attention.The same issue has been found in fibromyalgia brain fog,with some noting deficits specifically in visual attention.
Symptoms of attention deficits include:
These symptoms can lead to problems with learning, much as they do in ADHD (attention deficit hyperactivity disorder.)
Fibromyalgia symptoms like pain and fatigue can keep you from focusing on other things. This may help explain:
Cognitive Inhibition
The filtering ability that’s involved in attention is called inhibition. It “edits out” unimportant things in your environment so you can focus on those that are more important.
Some fibromyalgia and ME/CFS research has focused on inhibition because it’s common for people with the conditions to “tune out” background noise, pain, and other sensory input. Deficits have been noted in both conditions.
Researchers found the participants with fibromyalgia:
Researchers noted differences in brain activity in the fibromyalgia group, as well. At least two regions—thehippocampusand caudate nucleus—showed less activation than in the control group.
Word Use and Recall
One of the more common complaints of people with fibro fog or ME/CFS brain fog is a language deficit that involves:
One study showed that people with fibromyalgia had slow word recall and that they also had deficits in other areas of cognitive measurement.
Recognizing Facial Expressions
A 2021 study suggests that fibromyalgia brain fog may impair your ability to recognize facial expressions that show emotions.
Participants with fibromyalgia were less able to classify facial expressions that showed:
Recognizing these expressions is a complex mental process that involves executive function. Researchers believe deficits in executive function are responsible for this inability.
Comparing Fibro Fog and ME/CFS Brain Fog
While fibromyalgia and ME/CFS are different conditions, they’re closely related and have a lot in common. However, their cognitive dysfunction symptoms appear to be somewhat different.
A 2016 study suggested that:
Central Sensitization
One research team explored the connection between cognitive ability andcentral sensitization—an overly sensitive central nervous system.
Central sensitization is believed to be a key underlying feature of fibromyalgia, ME/CFS, and related conditions such asmigraineandirritable bowel syndrome.
They found that cognitive impairment appeared to be linked to:
Central Sensitivity Syndrome: Treatment and Symptoms
Multitasking Difficulties
Multitasking is performing more than one activity at a time or switching rapidly between activities. It relies on executive function and cognitive inhibition.
Both fibromyalgia and ME/CFS can impair your ability to multitask.You may not be able to pay attention to more than one thing, or you may forget aspects of the original task when trying to switch to another.
Some researchers believe this may be linked to internally directed attention, which impairs your ability to pay attention to external factors in your environment—and especially multiple external factors.
A Link to Learning Disorders?So far, fibro fog and ME/CFS brain fog are not tied to known learning disorders. However, some symptoms are similar to those associated withdyslexia(reading and interpretation problems), dysphasia (word-recall problems), and dyscalculia (math/time/spatial problems).
A Link to Learning Disorders?
So far, fibro fog and ME/CFS brain fog are not tied to known learning disorders. However, some symptoms are similar to those associated withdyslexia(reading and interpretation problems), dysphasia (word-recall problems), and dyscalculia (math/time/spatial problems).
What Does Fibromyalgia Feel Like?
Causes of ME/CFS and Fibromyalgia Brain Fog
Researchers have a lot of theories about things that may contribute to fibro fog and ME/CFS brain fog, including:
Fibromyalgia Symptoms and Complications
Brain Fog Treatment
If you’re concerned about your mental abilities, talk to your healthcare provider. You can have cognitive testing to:
Proper testing and treatment could help you function better.
Cognitive testing that shows deficits could help you get reasonable accommodation at work or strengthen a disability benefits claim.
For some people, fibro or ME/CFS brain fog resolves when pain or sleep problems are effectively treated.
Common medications for these conditions, which may improve brain fog, include:
If you need additional help with sleeping, your healthcare provider may prescribe:
You may also be sent for a sleep study to see whether you have any sleep disorders.
These medications don’t help everyone with fibromyalgia and ME/CFS. Be sure to tell your healthcare provider what treatments do and don’t work for you.
Can ADHD Drugs Help Chronic Fatigue Syndrome?
Supplements for Brain Fog
While there’s little evidence to support their use, some healthcare providers and people with these conditions believe supplements may help improve cognitive function in fibromyalgia and ME/CFS.
Common supplements for this include:
Talk to your healthcare provider before taking any supplements. They can help determine whether it’s the right treatment for you and won’t have negative interactions with other medications or supplements you’re taking.
Food for Combatting Brain Fog
Some healthcare providers recommend dietary changes to include foods that are natural sources of the supplements listed above.
Some of these foods are:
Some research suggests that a Mediterranean diet can lead to better cognitive function.This diet emphasizes:
A few studies have been done on this diet for fibromyalgia. So far, none has focused on cognitive symptoms, but one noted improvements in fatigue and depression—both of which may contribute to fibro fog.
Exercise and Brain Fog
These conditions, especially ME/CFS, have a complex relationship with exercise. It can both help and harm.
When it comes to exercise and cognitive function, there may be a benefit:
However, in the ME/CFS study, the benefits were only seen in a small number of study participants. Some people simply didn’t respond to exercise. Many others couldn’t or wouldn’t complete the program due topost-exertional malaise (PEM).
PEM is a defining symptom of ME/CFS. It means that even mild exertion can lead to symptom flares that may last for days or weeks.
The fibromyalgia response to exercise is less extreme, but it can also cause a symptom flare if you do too much.
You should only attempt an exercise program with help from your healthcare provider. Even then, it must be tailored to your fitness level and ability to tolerate exercise.
Exercising With Fibromyalgia and ME/CFS
Cognitive Training
Research on aging brains and some degenerative brain conditions shows that cognitive training can slow, stop, or sometimes even reverse cognitive dysfunction.
Some healthcare providers use cognitive training programs that may include software that you use at home. Video game companies and websites offer games they claim can improve cognitive function, as well.
Specific games haven’t been evaluated for improving cognitive function. However, some evidence does suggest that virtual reality games improve memory and critical thinking skills.
Because this is an emerging area of science, researchers are likely to learn more about cognitive training in the years ahead.
Summary
Fibro fog and ME/CFS brain fog can include deficits in executive function, several types of memory, attention, and cognitive inhibition. Symptoms include forgetfulness, confusion, directional disorientation, and word-recall problems.
Medications, supplements, dietary changes, and specially tailored exercise may help improve symptoms of fibro fog and ME/CFS brain fog.
A Word From Verywell
Meanwhile, talk to the people in your life about your cognitive dysfunction and how it affects you. They may be able to help with things that are difficult for you or just offer understanding. Either of those can be a big help.
Frequently Asked QuestionsAddressing pain and sleep problems often goes hand in hand with reducing fibro fog and ME/CFS brain fog. Standard medications, supplements (5-HTP, B-complex vitamins, and omega-3 fatty acids), and a Mediterranean diet may be helpful.Yes, medication can relieve pain and improve focus in people with fibromyalgia brain fog. In addition to medications used to treat pain and insomnia, studies suggest ADHD medications like Ritalin (methylphenidate) can help improve concentration and energy in people with fibromyalgia.No, but they both involve attention deficits, so some of the symptoms are similar.It’s possible that, in some cases, fibro fog symptoms come from undiagnosed ADHD. More research is needed.Learn MoreAn Overview of ADHDFibromyalgia fog can cause symptoms that seem similar to early dementia (e.g., short-term memory loss, confusion), but these conditions are not the same.Even so, they may be connected. Research shows people with fibromyalgia have an increased risk of dementia.Learn MoreSigns and Stages of Dementia
Addressing pain and sleep problems often goes hand in hand with reducing fibro fog and ME/CFS brain fog. Standard medications, supplements (5-HTP, B-complex vitamins, and omega-3 fatty acids), and a Mediterranean diet may be helpful.
Yes, medication can relieve pain and improve focus in people with fibromyalgia brain fog. In addition to medications used to treat pain and insomnia, studies suggest ADHD medications like Ritalin (methylphenidate) can help improve concentration and energy in people with fibromyalgia.
No, but they both involve attention deficits, so some of the symptoms are similar.It’s possible that, in some cases, fibro fog symptoms come from undiagnosed ADHD. More research is needed.Learn MoreAn Overview of ADHD
No, but they both involve attention deficits, so some of the symptoms are similar.It’s possible that, in some cases, fibro fog symptoms come from undiagnosed ADHD. More research is needed.
Learn MoreAn Overview of ADHD
Fibromyalgia fog can cause symptoms that seem similar to early dementia (e.g., short-term memory loss, confusion), but these conditions are not the same.Even so, they may be connected. Research shows people with fibromyalgia have an increased risk of dementia.Learn MoreSigns and Stages of Dementia
Fibromyalgia fog can cause symptoms that seem similar to early dementia (e.g., short-term memory loss, confusion), but these conditions are not the same.Even so, they may be connected. Research shows people with fibromyalgia have an increased risk of dementia.
Fibromyalgia fog can cause symptoms that seem similar to early dementia (e.g., short-term memory loss, confusion), but these conditions are not the same.
Even so, they may be connected. Research shows people with fibromyalgia have an increased risk of dementia.
Learn MoreSigns and Stages of Dementia
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