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People with ‘brain fog’ suffer from unexplained memory lapses, mental fatigue, lack of focus or confusion. They may suddenly find themselves unable to remember a familiar phone number or perform simple mental arithmetic. Fortunately, brain fog doesn’t necessarily signal the onset of dementia. Here are eight alternative explanations for cloudy thinking.

1. Medications

Many prescription drugs and over-the-counter drugs can cause forgetfulness and attention problems. The effects are more pronounced in people who are older, below average weight, or have liver or kidney problems. Brain fog is common amongst people taking pain relievers, antihistamines, decongestants, muscle relaxants, sleep medications, migraine medications and antidepressants. It can also be a side effect of drugs for arrhythmia, high blood pressure, incontinence and digestive disorders. Even antibiotics and antivirals can dull your alertness. People who are taking medications for more than one complaint are at greater risk for cognitive impairment.

2. Menopause

Menopause symptoms

Up to two thirds of women report forgetfulness and other cognitive problems as the menopause approaches. In a study published in the journal Menopause, 75 women aged 40 to 60 took a series of cognitive tests and had their blood tested for menopausal hormones. Researchers found that the women who complained of poor memory didn’t actually have trouble recalling learned information. They were more likely to do poorly at tasks that involved taking in new information and manipulating it in their heads. For example, they might struggle to calculate a tip in a restaurant. They also had difficulties staying focused on challenging tasks.

Must Read: 13 Most Common Symptoms of Menopause

3. Mood Disorders

People with depression or bipolar disorder often complain of fuzzy thinking. Researchers at the University of Michigan Medical School conducted a large study involving 266 women with major depression, 202 women with bipolar disorder and 150 healthy women. All participants took a test that measured the ability to stay focused and respond quickly. Then 52 of the women repeated the test while brain scans were conducted. On average, the groups with mood disorders performed worse than the healthy participants. Scans revealed that they had abnormal levels of activity in an area of the brain involved with working memory, problem solving and reasoning.

4. Iron Deficiency

Women of reproductive age are especially vulnerable to iron deficiency, which can disrupt brain functioning. Researchers from Pennsylvania State University tested the blood of female volunteers aged 18-35. The women were classified as iron sufficient, nonanemic but with iron deficiency or with iron deficiency anemia. All participants were randomly assigned to take iron supplements or a placebo. The women completed tests of attention, memory, and learning at the start of the study and again 16 weeks later. Women who were iron sufficient outperformed those with deficiencies in the first round of testing. After supplementation, significant improvement in blood iron levels was associated with a five-fold improvement in cognitive performance.

5. Stress

Prolonged stress can cause confusion and forgetfulness. Researchers at Johns Hopkins University examined the impact of stress on cognitive function. They took saliva samples from approximately 1000 men and women to measure levels of the stress hormone cortisol. The participants were then given a wide range of tests. The most highly stressed people performed worse than calmer subjects on tasks which assessed visual memory, verbal memory, hand-eye coordination, processing speed and the ability to make and carry out plans.

Also Read: 8 Signs You Are More Stressed Than You Think

6. Celiac Disease

Celiac disease is an inflammatory autoimmune disorder that can only be treated with a gluten-free diet. Patients often report that exposure to gluten causes problems with memory and concentration. An Australian study recruited patients who had been recently diagnosed with celiac disease and put them on a gluten-free food plan. At the start of the study and at various points over the following year, the patients took cognitive tests, were examined by a gastroenterologist and were assessed for dietary compliance. After 12 months free of gluten, patients significantly improved on four tests of cognitive ability. Moreover, the improvement in brain function correlated with the extent of intestinal healing.

7. Chronic Fatigue Syndrome

What Causes Fatigue and Bad Mood

People with myalgic encephalomyelitis, also known as chronic fatigue syndrome, typically have problems with concentration, memory and thinking. In a study published in Molecular Psychiatry, researchers measured levels of immune biomarkers called cytokines in cerebrospinal fluid the cerebrospinal fluid of 32 people with ME/CFS, 40 people with multiple sclerosis and 19 healthy controls. Levels of most cytokines were lower in people with ME/CFS compared to the other two groups. Scientists concluded that changes to the immune system associated with ME/CFS affect the central nervous system. The same immune problems that cause symptoms such as muscle weakness could be contributing to brain fog.

8. Multitasking

Multitasking negatively affects attention, learning and memory. Psychologists at UCLA asked study participants to learn a simple classification task that involved dividing cards into two categories. They were then given a second set of cards and asked to classify them while simultaneously keeping a mental count of high pitched beeps played through their headphones. The beeps did not affect their ability to perform the card task. However, when they were asked to recall things about the cards in a follow up session, they were much more accurate concerning the ones they classified on the first task without distraction. Functional magnetic resonance imaging revealed that different parts of the brain were involved in learning with or without multitasking.