Lupus is an autoimmune disease that damages all the organs in your body, including the brain. Lupus brain fog refers to cognitive problems, mood imbalances, and the fatigue people experience. It’s common but infrequently talked about. Continue reading to learn more about its symptoms and science-based natural strategies that can help.

What is Lupus Fog?

Many people with lupus suffer from brain fog, mood disorders, and fatigue. The term lupus fog was coined to describe all these symptoms [1].

About 10% to 80% of people diagnosed with lupus experience cognitive problems at some point. The range is so large partly because different criteria are being used to define cognitive decline and low mood [2, 3, 4, 5, 6].

Lupus

Systemic lupus (systemic lupus erythematosus or SLE) is a chronic autoimmune disease that often affects women more than men [7].

In lupus, white blood cells incorrectly identify the body’s own tissues as a threat. These cells become hyperactive and produce antibodies against healthy tissues. The tissues under attack – including the brain, skin, muscles, bones, and lungs – become inflamed and less functional [7].

Symptoms of lupus vary from person to person and include fatigue, fever, and weight loss [7, 8, 9, 10, 11, 12].

When lupus affects the central nervous system – spinal cord and brain – people may begin to experience lupus brain fog and/or headaches, depression, anxiety, seizures, and strokes [7].

Lupus fog is brain fog experienced by people with lupus. It’s thought to be a result of autoimmune inflammation.

Brain Fog

Brain fog is a broader term used to describe a constellation of cognitive symptoms, the most common ones being [13, 14]:

  • Reduced mental clarity (“mental fogginess”)
  • Slower thinking
  • Inability to focus
  • Reduced ability to multitask
  • Long- and short-term memory loss

People subjectively describe feeling forgetful, confused, and scattered – enveloped in what is felt as a “thick mental haze.” They feel their brain is slower and less agile than it should be. Thoughts become sluggish, blurred, and draining [15].

Brain fog might be caused by inflammation in the brain (as in lupus). It can be triggered by [14, 13, 16]:

It’s important to uncover the underlying causes for you and dig into the possible ways of fixing your condition

Brain fog is so frustrating because, for one, it is not a diagnosis. It’s a set of subjective symptoms. You may have brain fog, but it could be too “mild” or “unspecific” for your doctor to call it cognitive impairment. Likewise, lupus fog is not a diagnosis, though doctors don’t deny its existence.

While only people with lupus get “lupus fog,” anyone can experience brain fog. Inflammation is often the underlying cause, though the triggers can vary.

Symptoms of Lupus Fog

The main symptom of lupus fog is cognitive dysfunction: you may experience long- and short-term memory problems, have difficulty forming abstract thoughts, and feel like your sense of judgment is off [1, 17].

Some people also feel like they can’t understand and express speech (aphasia) or plan movements. Others find it difficult to recognize familiar objects (agnosia) and may also undergo personality changes [1, 17].

Lupus fog can take a large toll on your day-to-day life. It may reduce productivity by 20-80% [1].

It often arises alongside depression, fatigue, and anxiety early on – each of which can worsen brain fog [1].

If you have lupus fog, you may also experience a “clouding of consciousness” that intensifies at night. People find it hard to focus and have reduced awareness of their physical environment. It can get frustrating, and you may feel like you’re losing control, becoming agitated, or even aggressive [18].

Additionally, about 5% of people diagnosed with systemic lupus will experience episodes of psychosis. These episodes can cause a loss of self-control, delusions, and hallucinations [1, 17].

The main symptoms of lupus fog evolve around difficulties remembering, thinking, focusing, understanding language, and recognizing familiar objects.

Why Does Lupus Brain Fog Happen?

Lupus brain fog happens when your immune cells attack your brain and cause inflammation. Inflammation slows down or stops your brain cells from working [19, 3].

1) Blood-Brain Barrier Breakdown Lets Toxins In

One of the reasons lupus brain fog happens is blood vessel disease. The barrier between the bloodstream and brain starts breaking down (i.e. “leaky brain”), allowing harmful substances to sneak in. Antibodies enter the brain this way, increasing inflammation, damaging your brain cells, and triggering memory problems [20, 21].

2) Antibodies Against Brain Cells Worsen Cognition

Directly connected to blood-brain barrier damage, one analysis of 41 studies compared antibody levels in lupus patients with and without brain fog. Patients experiencing lupus fog had more antibodies targeting brain cells and their key components (i.e. ribosomes) [22].

In another study, 45% of people with lupus fog had antibodies targeting brain cells. These same antibodies were found in only 5% of individuals who had lupus and intact cognition [23, 24].

Another study confirmed the association: among samples from 44 patients with lupus, more antibodies targeting brain cells were found in people also experiencing cognitive disturbances [25].

Autoimmunity-triggered antibodies can sneak through the brain’s leaky barrier and worsen cognition in people with lupus.

3) Damage to the Brain’s White Matter Impairs Learning

In one analysis, 51 people with lupus underwent brain scans (MRI) and had greater damage to the white matter than the general population. The authors didn’t consider this to be the cause of brain fog. However, similar changes have been linked to worse cognitive function in diabetes. White matter is your brain’s wiring, it forms circuits that enable you to learn new things [26, 27, 28].

Other Factors

Other studies suggest that 50-78% of lupus fog episodes are caused by the following “secondary” factors [3, 29]:

  • Infections (as a result of SLE therapies that reduce immune function)
  • Damage to other organs (i.e. kidney damage leads to toxin buildup)
  • High blood pressure
  • Toxic effects of SLE therapy (i.e. steroids)

Effects of Lupus on Memory & Brain Health

Lupus fog can change your personality and make you extremely forgetful. Cognitive impairment not only impacts your everyday life, it may also increase your risk of mental health disorders [30, 31].

1) Cognitive Decline

Lupus fog starts early on but may improve with time

Cognitive dysfunction or brain fog is at least five times more common in lupus patients than in healthy people, according to analyses of over 78 studies [32, 33, 30, 34].

Although brain fog surfaces early on in the disease, it may get better with time – unlike some other forms of brain fog [35, 36].

When a group of researchers followed 43 people with systemic lupus over 10 years, cognitive impairment improved in 50% of them, while it got worse in only 10% [37].

Cognitive problems are widespread

Lupus fog can impair all the following aspects of cognition [38, 36]:

  • Environmental awareness: not understanding where you are relative to objects around you; you may find yourself confused or bumping into things.
  • Cognitive function: slow thinking, narrow attention span, difficulty focusing.
  • Short-term memory: not being able to remember new and recent information or thoughts; completing everyday tasks can feel extremely difficult;
  • Verbal Reasoning: inability to analyze information and problems from pieces of text; you may find it harder to think about what you read in books and newspapers.
  • Other: problems with vigilance, visual memory, and reaction time

Your coordination of movements may also be affected. This may play into the fatigue and “slowness” people with lupus fog experience [39].

Multiple Sclerosis Brain Fog is Worse

Although lupus fog can be severe, brain fog from multiple sclerosis is much worse. Nerve and brain damage – especially to the white matter that creates the brain’s circuits – is more severe in multiple sclerosis [40].

Lupus can cause severe brain fog and memory problems. Lupus fog can get better with time, but it may also progress into severe dementia.

2) Memory Loss

Of all cognitive issues, lupus has the greatest impact on memory. Memory loss from lupus may eventually lead to dementia [41, 42, 43, 44, 45, 46].

Lupus is strongly linked with both dementia and cognitive impairment (“pre-dementia”), according to an analysis of 11 studies and almost 82,000 people in total [41].

Memory loss can be severe enough to reduce your work capacity. One survey revealed that people with systemic lupus suffering from severe memory impairments are less likely to be employed [47].

3) Depression

People with lupus often suffer from depression, which is tightly linked to brain fog. Your mood imbalances may be from the shock of being diagnosed with the disease, on the one hand. But the disease itself also worsens mood. Depression might be six times more likely in people with systemic lupus than in healthy individuals [48, 49, 50].

According to an analysis of over 10k adults, depression and anxiety were much more common in people with lupus (up to 30%). Both low mood and anxiety can impact your energy levels, adding to the brain fog [48].

Other studies involving hundreds of adults with lupus found up to 20-45% had episodes of depression [51, 52, 53, 54].

People with lupus are much more likely to suffer from depression, which additionally worsens brain fog.

4) Fatigue

Lupus fog is almost always accompanied by fatigue, and all the following can contribute to it [55, 56, 57, 58]:

  • Reduced physical activity
  • Obesity
  • Sleep disorders or poor sleep quality
  • Depression and mood imbalances
  • Anxiety
  • Vitamin deficiencies
  • Pain
  • Other health problems

In a study of 60 childhood-onset cases of lupus, 65% had fatigue. According to a study of 59 people with lupus, over half said fatigue was the worst symptom that they were experiencing. In a similar study, 81% of 120 people with lupus had fatigue [56, 57, 58, 59, 60, 61, 62].

Fatigue is extremely common in lupus; for most people, it’s the toughest symptom to handle.

5) Mood and Personality Disorders

Some people with systemic lupus develop “manic” behavior, which doctors classify as an organic personality disorder. The term refers to personality disorders caused by physical changes to your brain [63].

Mania is often a result of lupus treatment with steroid drugs [63].

In mania, your energy increases; you become irritable and feel like you don’t need any sleep. It may seem like you’re not quite yourself. The following personality changes are also possible [63]:

  • Apathy
  • Indifference
  • Rapid changes in mood
  • Sexual indiscretion
  • Wordiness when speaking
  • Aggression

All mood disorders, including mania, worsen brain fog [64].

According to a 10-year study of almost 2000 people with systemic lupus, 13-18% had mood disorders [65].

In another study of 45 people with lupus, about half had a mood disorder (depression, anxiety, or OCD) and over a third had a personality disorder, compared to 60 healthy people [66].

In one study, 65% of 326 women had a mood or anxiety disorder, including [67]:

  • Major Depressive Disorder (47%)
  • Specific Phobia (24%)
  • Panic Disorder (16%)
  • Obsessive-Compulsive Disorder (9%)
  • Bipolar Disorder (6%)

In another study of 71 women with SLE, the life-long prevalence of mood problems was [68]:

  • Mood disorder (69%)
  • Anxiety disorder (52.1%)
  • Adjustment disorder (8.4%): long-term stress, sadness and hopelessness caused by major life events
  • Alcohol abuse (1.4%)

Overall, it seems like women with lupus fog are more likely to develop mood disorders than men. They are especially at risk of depression and anxiety.

Lupus increases the risk of mood disorders. Women are especially vulnerable and often suffer from anxiety and depression alongside lupus fog.

Limitations and Caveats

Not a lot of research has specifically focused on “lupus brain fog.” A lot of the research out there are observational and cohort studies. While these do show strong evidence and associations, additional clinical trials would provide stronger evidence.

Many of the studies used questionnaires, surveys, interviews, and other means of collecting data. However, different studies used different methods of measurement, which creates inconsistencies in studies evaluating the same variables – especially lupus fog.

More research about the cognitive impacts of SLE is needed.

14 Natural Strategies for Coping with Lupus Fog

Despite the variety of available medical treatments for systemic lupus, none focus on tackling lupus brain fog. Below is a list of lifestyle changes, psychological strategies, and natural remedies that may help with lupus fog [55, 69, 70, 71, 72].

Psychological

1) Peer Mentoring

Peer mentoring provides psychological relief for people with lupus fog. If you have lupus fog, getting the right information from people who have been through the same can lower your anxiety and depression. It also equips you with coping mechanisms and makes you more independent [69].

2) Stress Reduction & Psychotherapy

Psychological interventions – such as stress reduction and psychotherapy – can reduce your anxiety, stress, and disease activity levels. This was shown in an analysis of 537 people with lupus across 6 different studies [73, 74].

The following can help with lupus fog are [70]:

  • Cognitive behavioral therapy
  • Counseling
  • Psychotherapy

These therapies focus on minimizing how much lupus impacts your daily living. Three clinical trials showed that these interventions can also reduce fatigue, but a few other clinical trials didn’t consider them beneficial enough [70].

3) Social Support

Having strong social support is important for reducing depression, pain, and fatigue. An observational study involving 127 people with lupus attest to the benefits of social support [57].

Lifestyle Changes

4) Exercise

Exercise is very helpful in increasing energy levels if you are fatigued because of lupus. Clinical trials involving people with lupus showed that the more you exercise, the more energy you will have! [75, 76].

5) Stop Smoking

If you want to reduce lupus fog, you shouldn’t smoke. An analysis of 21 studies determined that cigarette smoking increases the disease activity of lupus, which will make your lupus fog worse [77].

6) Lose Extra Weight

If you are overweight, it is important to lose the extra pounds. Observational studies show that weight loss will improve your lupus fog [78].

Diet

The right diet can minimize the impact of lupus on your life. Each person needs a personalized plan based on what their needs and food sensitivities are.

7) Caloric Restriction

Restricting your calories boosts your immune system, gives you energy, and reduces the impact of lupus. People who are obese experience more severe effects of lupus [71, 70].

8) Low Glycemic Index Diet

Regulating your sugar levels will give you more energy and help you lose weight. While that goes without saying, clinical trials show that a low-glycemic-index diet is just as effective as a low-calorie diet in boosting energy and weight loss [70].

9) Improve Your Nutrient Status

More dietary changes that will reduce your lupus fog are [71]:

  • Eating whole grains instead of refined grain
  • Using sea salt instead of refined salt
  • Rice, barley, or maple syrup instead of sugar
  • Daily consumption of fresh vegetables
  • One fruit per day
  • Include fresh fish in diet
  • Add flaxseeds, pumpkins, carrots, nuts, oranges, and apples to your diet

Supplements

Certain supplements will improve your lupus fog. The supplements emphasized by an analysis of 11 studies are [71]:

10) Get More Omega-3 Fatty Acids

Omega-3 supplementation reduces inflammation, disease activity, oxidative stress, and blood vessel damage (endothelial dysfunction) caused by lupus.

11) Increase Vitamin D

Vitamin D supplementation increases your blood volume and reduces inflammation. Sun exposure is an even better way to increase vitamin D levels.

12) Turmeric

Turmeric will improve your kidney function (reduces proteinuria and hematuria) and blood pressure.

13-14) DHAE & Thunder God Vine

While not fully researched, other potential beneficial natural supplements are DHEA (dehydroepiandrosterone) and some Chinese medicines (thunder god vine). Safety and long-term effectiveness of these are still unknown [79].

Want More Targeted Ways to Enhance Brain Function?

If you’re interested in natural and targeted ways of improving your cognitive function, we recommend checking out SelfDecode’s Limitless Mind DNA Protocol. It gives genetic-based diet, lifestyle and supplement tips that can help improve your cognitive function. The recommendations are personalized based on your genes.

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Takeaway

People with lupus who suffer from brain fog have lupus fog. They often also experience low mood, anxiety, fatigue, and personality changes.

Lupus fog impairs memory, learning, focus, and attention. It slows your thought process and makes your brain feel sluggish.

The underlying cause of brain fog is often inflammation. Similarly, lupus fog is caused by autoimmunity-triggered inflammation that breaks down the brain’s protective barrier. As a result, toxins enter the brain and cause damage.

Lupus fog often arises early on and it may go away on its own. In other cases, it progresses into full-blown dementia.

If you have lupus fog, look to get psychological and social support. Aim to exercise regularly, lose extra weight, and consider a low-calorie or low-carb diet. Turmeric, omega-3 fatty acids, and thunder god vine supplements may also help.

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