Rheumatoid arthritis (RA) is best known for causing painful, swollen joints. But many people with RA say they also have to deal with symptoms like forgetfulness, trouble concentrating, and difficulty thinking clearly.
A sense of mental slipping is known as “brain fog.” Although brain fog isn’t a medical term, doctors have recognized that many people with chronic inflammatory conditions like RA have experienced it.
Research is finding that people with RA have more trouble with memory and the ability to think. In a 2012 study, nearly a third of people with RA scored low on a series of mental tasks.
Earlier research found that people with RA had more trouble on tests of memory, speaking ability, and attention than people who didn’t have RA.
Thinking issues may also affect physical function, making it harder for people with RA to go about their daily activities.
There are a lot of possible causes of brain fog with RA. However, no one cause has been proven.
In a 2009 study of mice, researchers found evidence that swelling in the body’s tissues, or inflammation, may be to blame.
In diseases like RA, inflammation triggers signals that affect brain chemicals, which may make people with RA feel tired or unable to concentrate.
Another possible cause of brain fog is the medicines people with RA take to reduce pain and inflammation and bring down joint swelling.
A study in Arthritis Care & Research found that people with RA who were taking corticosteroid drugs were more likely to have trouble with mental tasks.
However, it is not exactly clear how these drugs might affect the ability to think.
Another possible culprit behind brain fog is depression. It’s common for people who are in chronic pain to feel depressed.
Depression can affect the ability to think clearly. And pain on its own may also affect mental function.
A 2010 study in The Clinical Journal of Pain found that people with RA who were in a lot of pain scored poorly on tests of planning, decision-making, and working memory.
One way to combat brain fog is by taking medicine for RA. Biologic drugs, called TNF inhibitors, block inflammation. These drugs include etanercept (Enbrel) and adalimumab (Humira).
These drugs may also improve or prevent brain fog. By relieving pain, these medicines also provide relief from the constant distraction it causes.
People with RA may feel sharper and more alert once they don’t have to focus on their pain.
A lack of sleep can make your brain feel foggy. Fatigue can also make your pain and other RA symptoms worse.
Fight brain fog by getting a full night’s sleep every night. Go to bed and wake up at the same times each day. Exercise, but don’t work out too close to bedtime because it can make you too energized to sleep.
Keep the bedroom cool, dark, and comfortable. And, avoid caffeine and alcohol before bed.
If you’re feeling foggy, try a few tools to help you stay organized. Write down important meetings, events, and to-do list tasks in a day planner or in your smart phone or tablet.
Have a set routine that you follow each day, and keep a record of all the steps. Try to save the most brain-intensive tasks for times of the day when you know you’re most alert.