Brain Fog in Lyme Disease: You Can Fix It

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How to treat brainfog in Lyme disease by Marty Ross MD image

Updated: 11/9/23

How to Fix Thinking Problems and Brain Fog

Many people with Lyme, Bartonella, other tick-borne infections or mold toxicity have brain fog. Brain fog is a sensation of cloudiness or fuzziness around the brain. It also means problems with thinking and cognitive function like memory, processing, and organizing.

Brain fog and cognitive dysfunction have a number of causes which I address in this article. These include:

  • cytokine inflammation caused by infections like Lyme and/or mold toxicity,
  • mitochondria cell energy factory dysfunction caused by oxidative stress from infections or direct damage from mold and other toxins,
  • excess histamines due to allergies or Mast Cell Activation Syndrome (MCAS),
  • nerve tissue injury or damage,
  • decreased blood flow in the small blood vessels of the brain due to Bartonella swelling the cells lining blood vessels, biofilms, and/or Babesia/Bartonella fibrin nests,
  • decreased neurotransmitters in the brain due to cytokine inflammation. This can cause depression related cognitive dysfunction or even Alzheimer’s like cognitive dysfunction.

Menu of Options—What & Why

Below are a number of things you can take to support healthy cognitive function. This list is quite extensive. After I review these options, in Putting It All Together—Brain Fog Thinking Improvement Action Plans below you will find an approach I have used successfully in my practice to improve brain fog and thinking problems. If you are looking for what to do with reading why to do it, skip ahead.

One. Take Coconut Oil or MCT Oil

By far, my favorite therapeutic food is coconut oil. I now start out each day by putting 1 tablespoon in my morning coffee or tea. Coconut oil is direct brain fuel. It is rich in medium chain triglycerides (MCT) and the brain superfuel known as beta-hydroxybutyrate. It is shown to improve brain function and improve mitochondrial energy function too. Another option is to use MCT oil instead of coconut oil.

Two. Eliminate Infections or Mold Toxins

Actions: lowers inflammation cytokines, decreases mitochondrial injury, decreases MCAS and excessive histamines, decreases nerve injury, improves blood flow, improves healthy neurotransmitter levels.

Determine which infections you have, or if you have mold toxicity, and treat them to lower inflammation and to stop nerve injury. For information about how to diagnose Lyme, yeast, bartonella, or mold toxin problems see:

For more information about treating Lyme, yeast, bartonella or mold toxicity see:

Three. Use Supplements to Lower Cytokines

Cytokines are inflammation chemicals made by white blood cells when they see mold toxins or infections. They are good and bad. On the good side, they help the immune system work better to get rid of the problem. But they are often made in excess in tick-borne infections and mold toxicity leading to a host of problems including cognitive dysfunction. There are a number of supplements that support lowering cytokines during treatment.

  • Curcumin. Curcumin is a component of turmeric that lowers both cytokines and quinolinic acid which improves brain fog. Take a liposomal form of curcumin to increase the absorption. Liposomal means that it is microscopically wrapped in fat to increase its absorption.
  • Quercetin. Quercetin is a bioflavonoid that has two potential benefits. First it blocks enzymes in white blood cells that are used to produce cytokines. Second it stabilizes mast cells and can decrease histamines in MCAS.

For more information about cytokines and additional supplements see Control Cytokines: A Guide to Fix Lyme Symptoms & The Immune System. For more information about curcumin see Curcumin.

Four: Fix Mitochondrial Damage with Supplements

Mitochondria provide power to cells in the body. This cell power provides energy to function and to heal. In mitochondria dysfunction, infections and mold toxins cause the immune system to make excess oxidizing agents that damage the covering of the mitochondria. This leads to poor uptake of sugar and fat into the mitochondria and damages chemical reactions in the mitochondria. Because of this brain cells cannot function nor do they have the energy to heal causing cognitive dysfunction.

For brain fog and cognitive dysfunction, I find there are two important steps to repair the mitochondria damage.

  • First, fix the outside of the mitochondria by repairing the damaged phospholipid fat covering. This is called phospholipid repair.
  • Second, repair the inside of the mitochondria using the antioxidant called glutathione.

Phospholipid Repair

There are two products I suggest to support phospholipid membrane repair. These products are both manufactured by Researched Nutritionals. These products are NT Factor Energy* and ATP 360*. The main difference in these products is that ATP 360 includes CoQ10 and NT Factor Energy does not. ATP 360 is the newest product. CoQ10 should not be used in Babesia treatments that include atovaquone (Mepron and Malarone) because it interferes with their ability to kill this germ. For more information see A Comparison of ATP Fuel, ATP 360 & NT Factor Energy by Researched Nutritionals.

Increase Glutathione

Glutathione is a powerful antioxidant that repairs cell injury and mitochondria energy from the inside. It is made in every cell. Liposomal glutathione is best. This type of glutathione is microscopically wrapped in phospholipid fats which increases its absorption. One can also breathe glutathione using a nebulizer or take it by IV. The nebulizer and IV versions may work more effectively in some than the liposomal oral form. Read more about the nebulizer and IV versions including dosing and how frequent to take them in the article Glutathione: The Great Fixer.

An alternative to glutathione is to take a building block of glutathione called N acetyl-cysteine (NAC). Inside cells NAC is used to make glutathione. My preference is the liposomal glutathione but in some it does not work or is too expensive.

  • Liposomal Glutathione 500 mg/5 ml take 5 ml 1 or 2 times a day, or
  • N Acetyl-Cysteine (NAC) 500 mg 1 pill 3 times a day.

See How to Fix Mitochondria & Get Energy in Lyme Disease for additional steps you can take to repair the mitochondria.

Five: Take Additional Steps to Improve Mitochondrial Function

The suggestions in Step Four are designed to repair damage to mitochondria.  Sometimes it is necessary to take steps that improve mitochondrial function as well.

  • At three to six months if you have not had any major improvements, then consider adding methylene blue.
  • At 12 months or more consider adding hyperbaric oxygen.

Methylene Blue. Methylene blue is a medication that is re-purposed to treat Lyme disease. It is shown to have antimicrobial effects on growing and persister forms of Borrelia and Bartonella. It can also decrease biofilms. But one of its more interesting functions is that it helps improve electron transfer in mitochondria through a process called oxidative phosphorylation—giving a rapid fix to energy production even when the mitochondria are damaged.

This is a medication that has to be made by a compounding pharmacy. If you add it, be aware that it could cause a Herxheimer reaction by killing Borellia or Bartonella. It may also raise serotonin. If you are on an anti depression medicine that raises serotonin, you may need to decrease or stop the anti-depression medication after discussing it with your healthcare provider. In addition, check glucose 6 Phosphate dehydrogenase (G6PD) blood levels first. If you have low G6PD, this could lead to red blood cell breakage. For more information see Methylene Blue for Lyme and Bartonella: The Ins and Outs.

Hyperbaric Oxygen. At times even the methylene blue, supplements, and antimicrobials are not effective. In these situations treatment with hyperbaric oxygen can be helpful. This requires a minimum of 40 dives to a depth of 2.4 atmospheres. Hyperbaric oxygen

  • lowers brain inflammation cytokines,
  • promotes neuroplasticity improvements in nerve function and connections in the brain, and
  • improves mitochondria (cellular energy factories) function.

Hyperbaric oxygen improves oxygenation of mitochondria which can lead to better energy production. Its drawback is the cost and number of treatments that are required.

Six: Lower Histamines

Histamines are made in excess in allergies and in a condition called Mast Cell Activation Syndrome. If you have either one of these conditions, then you should work to stabilize the cells where histamines are made. These cells are called mast cells.

Histamines in the right amount actually help brain function. But in excess they can shut down brain function. Excess histamines cause a brain immune cell called microglia to make too many cytokine inflammation chemicals. As I note above, cytokine inflammation is a cause of brain fog. In addition the brain has an H3 histamine receptor that shuts down brain function when there are too many histamines.

To treat this condition, work to stabilize your mast cells so they do not produce or release as many histamines. The bioflavonoids quercetin and luteolin stabilize mast cells. You can use one or both of these.

  • Quercetin 250 mg 2 pills 2 or 3 times a day
  • Luteolin 100 mg 1 pill 2 or three times a day.

See Mast Cell Activation Syndrome & Lyme for additional steps you can take to treat this condition.

Seven. Repair Nerve Damage with Peptides and/or Hyperbaric Oxygen

At 9 to 12 months of treatment using many of the ideas above, if a person is still having significant cognitive dysfunction, then I consider adding peptides or hyperbaric oxygen to repair nerve damage. 

Peptides are short strands of amino acids. By comparison, long strands of amino acids of 40 or more are called proteins. Peptides occur naturally in our bodies. Some of these peptides have various healing properties. Below, I list the major peptides that are currently found in, or related to, oral products offered by Integrative Peptides.

BPC-157. Think of BPC-157 as the Swiss army knife of peptides. The key ingredient may:

  • aid in tissue repair of joints, tendons, ligaments, and nerves,
  • promote healthy intestinal function,
  • improve leaky gut,
  • modulate healthy Th1 and Th2 immune function,
  • promote healthy mitochondria (cell energy factory) function,
  • balance mast cell activation, and
  • have antimicrobial effects.

Cerebrolysin. The key ingredient may:

  • promote healthy cognitive function and brain health,
  • repair brain injury due to stroke, infection, or trauma, and
  • promote healthy immune function in the brain.

Hyperbaric Oxygen. At times even the methylene blue, supplements, and antimicrobials are not effective. In these situations treatment with hyperbaric oxygen can be helpful. This requires a minimum of 40 dives to a depth of 2.4 atmospheres. Hyperbaric oxygen

  • lowers brain inflammation cytokines,
  • promotes neuroplasticity improvements in nerve function and connections in the brain, and
  • improves mitochondria (cellular energy factories) function.

Hyperbaric oxygen improves oxygenation of mitochondria which can lead to better energy production. Its drawback is the cost and number of treatments that are required.

Eight. Improve Brain Blood Flow

Bartonella infection can limit blood flow in three ways.

  • First, Bartonella biofilms can clog blood flow into the very small blood vessels of the brain.
  • Second, Bartonella can form fibrin nests of germs and the blood clotting protein called fibrin. These fibrin nests attach to blood vessel linings narrowing the area for blood flow.
  • Finally, Bartonella infects the endothelial cells lining the blood vessels leading to swelling of these cells into the opening of the blood vessel, narrowing blood flow.

Babesia infection can limit blood flow in one way. Like Bartonella, Babesia also forms fibrin nests. If a person has Bartonella and Babesia, these nests can include Bartonella and Babesia organisms. These nests attach to blood vessel linings and limit blood flow.

Lumbrokinase is a group of enzymes that come from earthworms. These enzymes break down the fibrin in nests and in biofilms. So, lumbrokinase can help with biofilms and fibrin nests.

There are a number of products that also target biofilms by limiting their ability to form, function, and adhere to surfaces. While lumbrokinase is helpful alone, some of these combination products go a lot further. An example of a product approaching biofilms from multiple angles is Researched Nutrionals BioDisrupt*. This product has research funded by Researched Nutritionals suggesting benefit at breaking down biofilms. It is all right to take both the BioDisrupt and Lumbrokinase together.

  • Lumbrokinase 16 to 20 mg 1 pill 2 times a day. Take this on an empty stomach or with water only for one hour either side.
  • BioDisrupt by Researched Nutritionals 1 pill 2 times a day

Nine. Fix Neurotransmitters

Increased cytokines and inflammation can lead to depression with abnormal levels of serotonin, dopamine, epinephrine and/or norepinephrine. Depression is associated with cognitive dysfunction. There are a number of anti depression medications, herbal medicines, counseling, and exercise that can help with this.

Tick borne infections may also change levels of acetylcholine and glutamine used for thinking. These same chemicals are altered as part of Alzheimer's disease. So using Alzheimer's medicines like Memantine and Donezepil can help. 

Putting It All Together—Brain Fog Thinking Improvement Action Plans

As you can see from the discussion above, there are a lot of things you can do to improve brain fog and cognitive dysfunction. Here is an approach I have used successfully in my practice.

Basic Approach

  • MCT or Coconut Oil 1 tbsp a day
  • Treat mold toxicity with binders and/or infections with herbal or prescription antibiotics
  • Liposomal curcumin 500 mg 1 pill 3 times a day or Quercetin 250 mg 3 times a day if you also have MCAS
  • Liposomal glutathione 400 to 500 mg 1 time a day
  • Treat depression with medications, herbal antidepressants or exercise if a person has moderate to severe depression. Work with your health care provider to find the right approach for you.

Basic Approach Plus

At three to six months if you have no improvements in your brain fog and thinking, add steps to repair the mitochondria, improve mitochondria function, and to improve brain blood flow. Take all of the steps outlined in the Basic Approach and add:

  • ATP 360 3 pills 1 time a day or NT Factor Energy 2 pills 3 times a day for 6 months to fix mitochondria damage. Both of these products are made by Researched Nutritionals. I prefer the ATP 360, but if you are on atovaquone to treat Babesia, use the NT Factor instead because it does not contain Coenzyme Q 10.
  • Methylene Blue 50 mg 2 times a day for improved mitochondrial function. You may need to adjust your herbal or prescription antibiotics if you add this.
  • Lumbrokinase 16 to 20 mg 1 pill 2 times a day (add this is you have Bartonella or Babesia)
  • BioDisrupt 1 pill 2 times a day (add this if you have Bartonella)

Advanced Approach

At nine months to one year, continue all of the steps in the Basic Approach Plus approach above and add peptides to repair nerve damage. In addition, consider a trial of Memantine or Donepezil if cognitive dysfunction is severe.

  • Start with BPC-157.  A good place to start a peptide support program is to take BPC-157 500 mcg 1 pill 2 times a day. Over a month, a person can increase this up to 3 pills 2 times a day if needed, but usually 1 pill 2 times a day is enough.
  • Add Cerebrolysin. After a month of BPC-157, consider adding Cerebrolysin if significant thinking problems remain. Cerbrolysin is found in CerbroPep by Integrative Peptides. Start at 1 pill a day and increase to 1 pill 2 times a day if needed. You can take this with other peptides.
  • Consider Donezepil or Memantine. Work with your prescribing health care provider to see if these medications are right for you.

Super Advanced Approach

Hyperbaric Oxygen. After 3 months of trying the Advanced Approach, if you still have significant brain fog and cognitive dysfunction add hyperbaric oxygen. This requires a minimum of 40 dives to a depth of 2.4 atmospheres.


The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.

* These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.


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About The Author

Marty Ross, MD is a passionate Lyme disease educator and clinical expert. He helps Lyme sufferers and their physicians see what really works based on his review of the science and extensive real-world experience. Dr. Ross is licensed to practice medicine in Washington State (License: MD00033296) where he has treated thousands of Lyme disease patients in his Seattle practice.

Marty Ross, MD is a graduate of Indiana University School of Medicine and Georgetown University Family Medicine Residency. He is a member of the International Lyme and Associated Disease Society (ILADS), The Institute for Functional Medicine, and The American Academy of Anti-Aging Medicine (A4M).

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