Battling the Brain-fog of chronic fatigue

All of suffer from lapses of memory from time to time but when true brain-fog hits its normally accompanied by some other underlying problem such as chronic fatigue. However, if you can say yes to 7 or more of the 10 key features of brain-fog you may find some value in reading on.

1. Forgetfulness, especially with short term memory
2. Lack of focus with occasional disorientation
3. Difficulty in finding the right words and loss of mental agility
4. A reduced ability to problem solve and learn / retain new skills
5. Poor concentration
6. Phases of confusion
7. Aspects of depression / anxiety
8. Occasional feelings of ‘being spaced out’
9. Difficulty in judging depth and distance
10. Reduced ability to thing creatively or plan for the future

For sufferers of chronic fatigue syndrome (and fibromyalgia) one of the most difficult aspects to deal with is the issue of bran-fog. So many sufferers experience a severe impairment of their cognitive (thought processing) functions to the point where they fear they are loosing their minds. There are as many theories as there are remedies for the brain-fog issue but one theory that looks to stand the test of science relates to an enhancement of the cognitive functions by improving the ability of neurons (nerve and brain cells) to communicate with each other. For this to happen, tiny gaps between nerve cells, known as synapses, require chemical messengers to be released that bridge the gap to allow nerve-to-nerve communication to occur. These chemical messengers are called neurotransmitters and the most abundant neurotransmitter in the body is known as acetylcholine (Ach). Because Ach is not exclusively found within the brain it also influences many aspects of nerve and muscle activity as well as organ and blood vessel function. Within the brain itself Ach is a vital neurotransmitter involved in the formation and maintenance of memory and the ability to learn. It has also been associated with influencing maintaining emotional health.

Overcoming a biological barrier

A problem faced by many key nutrients required by the brain and nervous system is actually getting to the brain to start with. The internal brain environment is protected from toxins by a special circulatory system that forms a selective biological sieve known as the blood-brain-barrier (BBB). In essence, this is composed of a tightly fitting cell lining within the blood vessels of the brain that does not occur in other regions of the body. The end result is an ingenious way of keeping certain chemicals and other compounds within the circulation and available to the body but away from the delicate environment of the brain. Getting substances to cross the BBB has presented drug developers with considerable challenges but many naturally occurring nutritional compounds appear not to be affected by this toxin filter. One such nutrient, known as acetyl-L-carnitine (ALC), happily crosses the BBB and has been attracting considerable attention from researchers because of it’s ability to improve certain aspects of energy metabolism as well as enhancing neurological and brain functions. Interestingly, ALC is structurally very similar to the bodies own Ach and it is known that the neurons that respond to Ach are also receptive to direct ALC stimulation. Because ALC crosses the BBB it’s potential to assist brain function is now becoming apparent. Another key aspect of ALC’s ability to assist neurological health lies in it’s ability to supply the required building blocks for Ach production. Supporting this is a controlled study in which 481 elderly people with memory impairment showed improvement after 90 days of 1500mg ALC. While no one is saying that this is a cure for age related memory loss or Alzheimer’s, the study did illustrate the ability of ALC to enhance cognitive function, an action that may benefit those with CFS/FM related brain-fog. Keeping in mind the observation highlighted by the CFS/FM expert Dr Jacob Teitelbaum who reported on the discovery of low ALC in the blood and muscle of CFS/FM sufferers by two independent research centers, a case for a trial of ALC supplementation may be reasonable.

Acetyl-L-carnitine vs placebo

In the spirit of good science what people report and what can be proved to actually happen needs testing using a placebo study. In this type of study, a non-active but otherwise identical pill is given to one group while the other group takes the real pill. However, none of the subjects know is they have the ‘read deal’ or the dummy (placebo) pill!
The study, using 102 patients who met the criteria for being diagnosed as having fibromyalgia, looked at the effects of a course of acetyl-L-carnitine (ALC) over 10 weeks compared to placebo. To establish the effects of ALC the researchers measured tender points and assessed fatigue, depression, sleep and other common FM symptoms using well established and tested questionnaires. At the end of the 10 week trial the total number of tender points had declined significantly along with an improvement in overall pain and mood in the group taking the ALC supplement. In their conclusion, the researchers commented; “The results indicate that ALC may be of benefit in patients with fibromyalgia, providing improvement in pain as well as the general and mental health of these patients.”

Intake and safety

From the literature there has been a wide range of intake levels recommended, ranging from 1000mg (1 x 500mg taken 2 x day) up to 2000mg (2 x 500mg taken 2 x day) taken in divided doses twice a day. As a supplement, it should not be used by anyone taking drugs that alter blood clotting such as warfarin or acenocoumarol. Because of the lack of data ALC can’t recommended during pregnancy or breast feeding and there has been some cautions against using if you suffer from seizures or take thyroid hormones.

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