Studies have shown that approximately one-third to one-half of all people who have chronic hepatitis C (HCV) experience neuropsychiatric symptoms, commonly referred to as brain fog. These studies indicate that an HCV infection can impact a patient’s cognitive ability and leave them with a feeling of mental fogginess, often reported as problems with reading, memory, concentration, forgetfulness, confusion, and a general state of disorganized thinking. Additionally, some people who have reported experiencing brain fog have accompanying symptoms of weakness, irritability, or fatigue.
Although these symptoms might seem like minor inconveniences while living with a long-term infection, they can make performing daily-tasks difficult, and they can alter an individual’s overall quality of life. When someone has symptoms of brain fag, thinking and psychomotor skills are impaired, and everyday tasks that are usually performed without extensive thought become challenging and elicit frustration.
Why Does Hepatitis C Cause Brain Fog?
Chronic hepatitis C impacts the healthy functioning of the liver. Among a myriad of other duties, a healthy liver removes harmful toxins and substances from the blood. When a liver is compromised by the hepatitis C virus, it can no longer remove those toxins efficiently, and an abundance of those substances left in the body can negatively affect all of the body’s systems, including the brain, which is responsible for cognitive functions, thinking, and motor skills.
When researchers looked closer at the neural pathways in the brains of people with HCV, they noticed poorer cognitive performance, and there appeared to be a breakdown impeding the brain’s ability to send messages back and forth from the basal ganglia to the prefrontal lobe. The patient’s studied were also at a higher risk of increased symptoms of fatigue.
While we don’t know the exact contributors to brain fog symptoms – other HCV symptoms and treatment can both contribute to brain fog – researchers have found that hepatitis C impacts the brain, as brain scans of people without hepatitis C compared to those with the virus show distinct differences. It’s also been found that symptoms of brain fog appear more often in individuals who have advanced stages of hepatitis C and/or have cirrhosis of the liver.
The good news is that research tells us the symptoms of brain fog in patients who have successfully cleared HCV with treatment improves over time. Many patients who have cleared the virus remark that it feels as though a cloud was lifted when they obtained a sustained virological response (SVR).
Researchers are constantly looking for additional insight related to HCV brain fog – studies have confirmed that brain fog exists and that factors can increase one’s risk for daily complications related to brain fog symptoms – but additional studies are necessary to pinpoint the exact cause and to make treatment recommendations.
Factors Contributing to Brain Fog
Fatigue – Fatigue is one of the most common and most pervasive symptoms of HCV. Patients also undergoing interferon or ribavirin therapies can experience insomnia or sleep disturbances, those sleep disturbances often lead to headaches or moodiness, which can worsen symptoms of brain fog.
Anxiety – Often, those who are diagnosed with hepatitis C experience anxiety about the infection, symptoms, and/or treatment. That anxiety can cause a patient to feel edgy or irritable, which can worsen symptoms of brain fog.
Sadness or Depression – Sadness or depression are common symptoms of being diagnosed with and/or undergoing treatment for hepatitis C, and it’s also a common side effect of many HCV treatment regimens, which can worsen symptoms of brain fog. While those feelings typically subside soon after treatment ends and an SVR is achieved, it’s important you talk to your doctor if you are sad or depressed, because they may be able to prescribe antidepressants or suggest alternative therapies.
Although brain fog is common among folks with chronic hepatitis C and those who are undergoing treatment for chronic hepatitis C, it’s important that you notify your doctor of any and all changes to your symptoms.
When the liver is unable to remove certain toxins from the blood, harmful chemicals build up in the blood stream, and a more severe version of brain fog can develop, called hepatic encephalopathy. Hepatic encephalopathy typically occurs when someone has an advanced stage of hepatitis and/or cirrhosis of the liver.
Symptoms of hepatic encephalopathy can include musty or sweet breath, trouble with coordination and small hand movements, hand or arm shaking, slurred speech, major personality changes, sluggishness, and an overall worsening of brain fog symptoms. These symptoms indicate a medical emergency, and a patient will require immediate hospitalization, because they may become unconscious or slip into a coma.
Dealing with Brain Fog
Sometimes relief is as simple as a change in medication or dosage to additional therapies and approaches, which may include:
Better Sleep Habits – Poor sleep quality, insufficient sleep duration, and sleep disturbances all interfere with brainpower. Try getting 6-8 hours of uninterrupted sleep per night.
Exercise – Regular, daily exercise naturally increases cognitive ability. Try getting twenty to thirty minutes of light exercise daily.
Stress Reduction – Meditation, mindfulness practices, yoga, deep breathing exercises, and other complementary, holistic therapies all reduce stress and improve mental functioning. Try a couple of those activities, and pick which one is right for you.
Diet – Eating a diet rich in whole grains, fruits, and vegetables while avoiding things that are hard on your digestive system such as sodium, sugars, and fat improve your body’s ability to function effectively. Try adding more plants, lean meats like chicken and fish, beans, nuts, and seeds into your diet.
Hydration – Getting 6-8 8oz glasses of water daily is key to helping your body flush toxins and operate efficiently. Try increasing you water intake or replacing other beverages with a glass of water.
As is the case with any new or increased symptom you’re experiencing, always contact your healthcare provider before altering your regimen. Your practitioner will be able to determine the best course of action to help reduce or alleviate your symptoms of brain fog.1-4
Hepatic Encephalopathy. (2011, October 16). MedlinePlus. Retrieved August 10, 2015, from http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm
Hepatitis C Treatment. (2013, September 10). National Health Service, U.K. Retrieved August 10, 2015, from http://www.nhs.uk/Conditions/Hepatitis-C/Pages/Treatment.aspx
Senzolo, M., Schiff, S., D’Alosio, C.M., Crivellin, C., Cholongitas, E., Burra, P., & Montagnese, S. (2011, August 7). Neuropsychological alterations in hepatitis C infection: The role of inflammation. World Journal of Gastroenterology, 17(29), 3369–3374. Retrieved August 10, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160562/
Viral Hepatitis Side Effects Guide: Entire lesson. (n.d.). U.S. Department of Veterans Affairs. Retrieved August 10, 2015, from http://www.hepatitis.va.gov/patient/hcv/treat/side-effects-single-page.asp