Can The Fog Be Lifting?

At some point in our journeys with RA, we all come across the term "brain fog". I for one had never heard it before I was diagnosed but now it seems to come up in articles, support groups, blogs, etc. There is now some interesting research out there that discusses this rather odd and often disconcerting problem. You may be surprised by some of the studies so check them out.

Brain fog manifests in different ways

For me, brain fog comes and goes, often connected, but not always, to my flares. Even how it manifests is different from one experience to the next. Sometimes I just feel blah with no energy and little incentive. Other times, I feel like I lack concentration. Forgetfulness is sometimes part of the picture as well.

The fact is, brain fog can be any one of a combination of symptoms all of which result in some level of cognitive dysfunction. It is not pleasant and sometimes comes on with little or no warning. For me, I tend to have a day or so where I just feel like I am not "on my game"; but thankfully, it tends to pass. While it is around, though, I feel really disconnected and almost weary.

Theories on brain fog in rheumatoid arthritis


Experts have no definitive answer for why this happens, but there are some theories out there. One centers around the notion that, because RA involves inflammation, this response may trigger the brain to release chemicals that inhibit our cognitive functioning making it difficult for us to concentrate as well as feel more tired than usual.

Treatment for rheumatoid arthritis

Another theory is connected to the various and potent medications many of us with RA take. Although there is no definitive proof of this, some studies have shown that people have more difficulty with mental tasks when taking certain medications.

Depression and anxiety

Yet, another possibility is depression and anxiety, both of which are common with people dealing with RA. When our brains are in a depressed state, we simply do not function mentally as well as when our mental health is tip top!


Pain is another potential trigger for brain fog. The brain's response to pain and the way we cope with it can lead to a lack of mental clarity. When we are in pain, that tends to preoccupy our thoughts, crowding out the ability to concentrate on other matters.

How can we alleviate brain fog?

There are some things we can do to alleviate this annoying and at times overwhelming issue. One possibility that has worked for people is taking biologic medications available to RA patients. Because these drugs block inflammatory chemicals and relieve pain and swelling, this may relieve brain fog by going after the distraction often associated with pain and discomfort. When you are no longer focused on pain and swelling, you may feel sharper and more alert and attentive.

Getting good sleep and exercise when possible

Lack of sleep and fatigue can be contributors too. Getting a good night's sleep will help us to not have that "hungover" feeling associated with brain fog. Going to bed at the same time each night and ensuring your sleep environment is cool, dark and peaceful will help as well.

Of course exercise for all the reasons we already know helps with brain fog too because of the endorphins released that counter the cortisol associated with brain fog, depression, and anxiety.

Other tips to help with brain fog

If I feel foggy (and even when I don't), I try to stay especially organized.  I am a firm believer in lists and calendars and having everyday tasks and appointments all accounted for on a list and/or in my calendar is very helpful to keep me on point.  

When I am feeling "foggy", I try to do the most mentally challenging work when I am my most rested and pain-free. That helps in avoiding the frustration I would feel otherwise which would only serve to intensify the brain fog!

The fact is we can deal with this just as we do the other issues we handle around having a chronic disease like RA. With planning and some strategic responses, brain fog can be an infrequent as well as uninvited guest.

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