"Brain-fog" treatment

I’m more of a lurker than a poster on this site. I typically check-in every now and then to keep pace on what’s happening with PFS and if any new developments are taking place. My biggest issue is on the cognitive side. I’ll just refer to it colloquially as “brain-fog.” Since I crashed in 2016 (after being on Fin for over 10 years), I’ve had 24/7: fogginess, slowed thought processing, impaired problem solving, major short and long term memory recall issues, Anhedonia, loss of interest, and this lingering heavy headedness in the front of my brain. The list goes on…

I guess my question is, has anyone with similar symptoms experienced any relief? If so what have you done to curb it (protocols, supplements, etc.)? If you could share your experience I would appreciate it. I’ve been on TRT for about 8 months now to try to combat it, my initial total T was around 400, I’m now slightly into the 1000s. I hit the gym 5 days a week and really try to push myself to the limits. I do very vigorous high-intensity weight training, hit each body part twice a week to failure, progressive overload, etc. and have made insane progress in terms of lean body mass gains, and fat loss. I’m 45, 5’7 hovering around 155 with 10% BF. My diet is solid (organic everything – grass-fed meats, etc.), I don’t drink/ smoke, and stay clear of sugar/ gluten. The reason I’m bringing this all up is with all that sort of “good” stuff to come out of being on TRT/ lifestyle changes, I haven’t put a single dent in this brain-fog. I have yet to move the needle. It’s a persistent 24/7 cloud that never goes away. My baseline is volatile at best. There are only “okay” days and “bad” days never any real “good” days. When anxiety kicks in (a result of Fin) it just exasperates the fogginess to unfunctional levels. I have a very demanding corporate job (and have become a very good delegator) as trying to problem solve and think through things is a friggin’ exercise in futility!

Anyway, I would love to hear any solid suggestions you may have. Hoping 2020 will bring us closer to a cure. All my best!

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All I can suggest is that some people have improved by eliminating carbs all together to get into ketosis. Eliminating sugar and gluten may not be enough

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Maybe the brain fog is due to low levels of nuerosteriods, if that’s the case then I’m hopeful sage 217 can help are case. Your lucky you even respond to TRT to some degree I tried with no success.

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Has your libido improved on TRT? May ask what your protocol is? Are you managing estradiol well?

I have two theories on brain fog, although there may be two different types of brain fog. One is a cognitive one and it has to do with lack of libido. The other one is neurological and may depend on neurosteroids.

I am thinking if trying 5a-DHP soon.

Have you noticed an improvement in baseline as a result of exercise?

I’ve read good things about Lactoferrin to help cognitive issues.

But I know your feeling OP, I have the same problems. Finding the right words, fast enough is a big problem for me, especially in the day to day life.

When I first crashed I went on a Ketogenic diet for about 2 months. My carb intake was less than 20g per day. In terms of brain-fog there was no improvement.

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TRT protocol:

  • Compounded cream (200 mg/ ml), 3-clicks (.75/ ml) applied to the scrotum in the morning, once per day. I’ve had 2 adjustments to that protocol since I started (2 clicks: 1 applied to the scrotum 1 to skin, and 2 clicks: applied to the scrotum about 6 months in).

T cream, unlike injections, will spike your DHT levels. Prior to starting TRT my DHT was 37, the last round of labs put me at 400. No ‘significant’ sides especially with regard to hairloss!-- exactly how I got into this mess with Fin in the first place. Ironically higher levels of DHT zero hair loss! I recently started to get acne on my shoulders and some on my back, nothing to complain about.

  • Estradiol:13.8 (prior to TRT), latest labs: 26.7 (no estrogenic side effects)

TRT massively improved libido/ ED issues. I never really had sexual sides save for in the beginning when I crashed. I couldn’t get an erection and had no interest in sex. That went away about 3-4 weeks after the crash. What persisted afterward was maintaining an erection, which TRT had a hand in fixing. I also attribute TRT in helping with fatigue. When I crashed I was in a slump all day, felt weak, had sore muscles, and was prone to injuries, TRT has massively improved those symptoms, although I still hit that 3PM mark and feel fatigue kick-in. My Dr. suggested Pregnenolone as a possible fix (haven’t tried it yet).

Other things I’m doing:

  • Intermittent fasting (18:6) daily for over 4 years now. Probably the best thing I’m doing. Mainly for cognitive benefits and autophagy. Slight improvement in baseline brain-fog, and helps with anxiety.
  • Vitamin D + K2 (MK7): 5K IUs OPD
  • DHEA: 25mg OPD (evening)
  • Magnesium + Zinc: 400mg + 50mg OPD
  • Creatine: 5g OPD
  • Vitamin C: 6K mg OPD
  • Grass-fed Protein powder + Collagen: (varies)
  • Biotin: 10K IUs
  • Fish Oil: 500 EPA/ 250 DHA

Hope this helps.

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It’s like trying to think through a plastic bag. I can watch a movie walk away and have no idea wtf I just watched. The amount of concentration and effort required to recall information is staggering.

Haven’t thought of Lactoferrin. Though, I’ve heard positive things about it. Are you giving it a shot?

5a dhp was a waste for me.

I’m waiting on sage 217.

Keto has helped some folks- takes about a month for the brain to fully adapt to it so be patient and consistent if you try

I realized I didn’t quite answer this question you had. I don’t think I need to sell you on the benefits of exercise. My routine is very vigorous. I’m in the gym 5 days a week, and I’m assaulting my body. I don’t do any cardio, I’m lifting heavy weights mostly in the range of 80-90% of my 1RM, in the 4-5 rep range for 3-4 sets typically 3 lifts per body part (EX: chest). On the second day, I hit that same body part I drop the weight (70-75% 1RM) and crank out more volume (10-12) reps., upping the sets to 5-6, and reaching failure on each lift. Total volume for the week per body part is around 20 sets. Interestingly enough my baseline brain-fog gets worse as you can imagine. The stress you put on your body from lifting heavy weights is significant and you get a large spike in cortisol (which most likely contributes to my brain-fog). However, after a training session, the spike in fogginess disappears and my baseline improves. There are times when I think I’m going to pop out of the fogginess but it never quite happens. I keep thinking if I stay with it, I’ll put a dent in this! Hope this helps.

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Did you have any sexual improvements or any other improvements from your time in the keto dit?

I’m one of those PFSers that fall into the cognitive/ neurological camp. Sexual sides were short-lived. After I crashed in 2016 I finally made the connection between Fin and my symptoms. It only took me 10+ years to figure that out. For years I was spiraling, had memory issues, couldn’t concentrate, major anxiety, I had no idea wtf was going on. It wasn’t until I crashed did the sexual sides come about. I suddenly had no desire for sex and couldn’t get an erection. As I mentioned in a previous thread, that last for 3-4 weeks. During this time I was on a Keto diet and also made other major lifestyle changes, I started exercising, stopped drinking, etc. I was also incredibly depressed because I couldn’t shake the persistent brain-fog no matter what I did. And I was coming to terms that this wasn’t going to go away any time soon. So to answer your question, I really don’t know if going low carb contributed to improvements in sexual sides and other overarching benefits of just trying to maintain a healthy lifestyle. The sexual sides just came back to near normal, albeit I had continued issues with maintaining an erection long after (something I never had pre-crash). It wasn’t until I got on TRT (8 months ago) did I see improvements in that department. It did, however, boost my libido into space and improve sexual pleasure. Not the result I was really hoping for but I’ll take it.


The reason I ask is to see if maybe you weren’t on keto long enough to improve mental sides. I’m in a similar boat as you. I still have sexual sides but anxiety has been the most debilitating side effect for me and I just started keto to see if it can help with my anxiety and depression

You could be right. I abandoned keto because I became incredibly frustrated with the cognitive sides I was experiencing from having just crashed. I was expecting to see some improvement after a month, kept at it for another month and still nothing, so I dropped it. I would say keep at it but don’t let my personal experience derail you. What has worked for my anxiety/ depression – and I used to have very high levels like panic attacks that used to mirror the flu and I would be tied up for days – is intermittent fasting and TRT. I’m sure I don’t have to explain “the reasons why” behind either, you’ve probably done your research. More on the depression front, exercise was and still is key for me. I had a major body transformation that certainly added to my self-esteem and feeling a lot better about this whole PFS mystery.

By chance do you have performance anxiety? And I don’t just mean when you are having or anticipating sex. Things like public speaking, and anything where you need to step up to the plate and perform? The reason why I’m asking is I used to have that same problem (I’m about 80% improved). There were times when, if I knew I was about to hit the sack I would buildup so much anxiety I couldn’t get an erection. This was during the 10+ years on Fin. I’d have waves of that and couldn’t understand where it was coming from.

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I used to and still have performance anxiety but it doesn’t affect erection

Yeah I have horrible performance anxiety. Terrified of public speaking so I take propranolol for that.


had you try wellbutrin/buproprion?
for someone work.