Brain Fog & Cognitive Issues
Root-Cause Functional Care at Keystone Total Health
Brain fog can feel frustrating and honestly a little scary. You might notice slower thinking, trouble focusing, memory lapses, word-finding issues, mental fatigue, or a sense that your brain just isn’t “online” the way it used to be. For many people, it comes with fatigue, headaches, dizziness, anxiety, low mood, insomnia, or digestive symptoms, making daily life harder than it should be.
A National Destination for Brain Fog
& Cognitive Issues
Reviewed by Dr. Martin Hart & Dr. Koji Aoki
Personalized Care for Brain Fog & Cognitive Issues
At Keystone Total Health, Dr. Martin Hart, DC and Dr. Koji Aoki, DC approach brain fog as a meaningful signal, not a character flaw, not “just aging,” and not something you should have to push through forever. Our job is to investigate why cognitive symptoms developed, identify the drivers that are keeping them going, and build a personalized plan that supports clearer thinking and better day-to-day function.
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If you’ve been told your labs are “normal,” you’ve tried supplements that didn’t move the needle, or you feel like your symptoms don’t fit neatly into one diagnosis, you’re not alone. Many people with chronic cognitive issues are dealing with overlapping stressors such as immune activation, inflammation, environmental exposure, gut dysfunction, infections, and nervous system dysregulation, often all at the same time.
What Brain Fog Can Look Like
Brain fog is not a single diagnosis. It’s a cluster of symptoms that can show up in different ways, such as:
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Difficulty concentrating, staying on task, or reading without re-reading
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Short-term memory issues (forgetting names, appointments, why you walked into a room)
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Slower processing speed, feeling mentally “behind”
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Word-finding issues or feeling less verbally sharp
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Feeling overwhelmed by noise, screens, or busy environments
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Mental fatigue that worsens after exertion or stress
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Mood changes that feel tied to cognitive overload
If your symptoms fluctuate, better some days, worse others, that pattern often provides clues about triggers like sleep quality, blood sugar stability, environmental exposure, inflammation, or immune flares.
When Brain Fog Might Be a Sign of Something Deeper
Brain fog deserves a thoughtful workup—especially when it’s persistent, worsening, or paired with systemic symptoms. We commonly see brain fog alongside:
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Chronic fatigue and low stamina
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Headaches or migraines
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Dizziness, light sensitivity, sound sensitivity
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New or worsening anxiety or low mood
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Digestive symptoms, food sensitivities, or bloating
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Pain, tingling, or inflammatory flares
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Symptoms that worsen in certain buildings or environments
If you’ve been cycling through short-term fixes without durable progress, a root-cause approach can be a turning point.
What Is Brain Fog?
Brain fog is a non-medical term used to describe a collection of cognitive symptoms that affect mental clarity, focus, memory, and processing speed. Rather than a single condition, brain fog reflects how the brain responds to underlying physiologic stress. People experiencing brain fog often say they feel mentally “slowed,” disconnected, or unable to think as clearly as they once did—even when they are motivated and trying their best.
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From a root-cause perspective, brain fog is rarely the primary problem. It is more often a downstream effect of inflammation, immune activation, metabolic stress, nervous system dysregulation, or impaired energy production within the brain. These disruptions can interfere with neurotransmitter signaling, blood flow, cellular energy, and the brain’s ability to recover during sleep.
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Brain fog can be temporary, such as during acute illness, severe stress, or sleep deprivation. However, when it becomes persistent or recurrent, it may signal deeper imbalances involving gut-brain communication, hormone regulation, environmental exposure, chronic infections, or immune system strain. In these cases, simply trying to “push through” or rely on stimulants rarely leads to lasting improvement.
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At Keystone Total Health, brain fog is approached as an important clinical clue. By understanding when symptoms began, how they fluctuate, and what systems are under stress, practitioners can identify the underlying drivers and create a personalized plan that supports cognitive clarity, resilience, and long-term brain health.
Why Brain Fog Happens
Common Root Causes We Evaluate
Cognitive symptoms usually reflect stress on multiple systems rather than a single issue. At Keystone Total Health, we assess brain fog through a root-cause lens that considers how the immune system, nervous system, gut, hormones, and environment interact.
Neuroinflammation and Immune Stress
Inflammatory signaling can directly affect cognition, mood, and energy. Immune activation—whether from infections, gut inflammation, toxin exposure, or chronic stress—can disrupt neurotransmitter balance, sleep quality, and mental clarity. This pattern is commonly seen in individuals with autoimmune and inflammatory conditions, which we address through our focus on inflammation and immune dysregulation.
Mold Exposure and Environmental Stressors
Exposure to water-damaged buildings can contribute to immune dysregulation and inflammatory responses that impact memory, focus, and mental stamina. Brain fog is one of the most frequently reported cognitive symptoms associated with mold-related illness patterns. Keystone Total Health frequently works with individuals navigating complex cases involving environmental exposure.
Lyme Disease and Chronic Infections
Certain infections can place prolonged stress on the immune system and nervous system, leading to fatigue, cognitive slowing, and difficulty with focus or memory. Brain fog that occurs alongside pain, post-exertional crashes, or autonomic symptoms may point toward infection-driven inflammation.
Gut-Brain Dysfunction
The gut and brain are closely connected through immune signaling, nutrient absorption, neurotransmitter production, and the vagus nerve. Imbalances in gut bacteria, intestinal inflammation, or impaired digestion can contribute to cognitive symptoms even when digestive complaints are mild. Supporting gut health is often a key step in improving clarity.
Blood Sugar Instability and Stress Physiology
Fluctuating blood sugar levels can cause mental crashes, irritability, anxiety, and difficulty concentrating. Chronic stress can further disrupt cortisol rhythms and impair restorative sleep, both of which are essential for memory consolidation and mental performance.
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Hormone and Thyroid Signaling
Hormones influence cognition more than most people realize. Suboptimal thyroid signaling, adrenal stress patterns, or sex hormone shifts can all contribute to brain fog, especially when layered on top of inflammation or gut dysfunction.
Nutrient Depletion and Cellular Energy
The brain is highly energy-dependent. Chronic illness, inflammation, malabsorption, or restrictive diets can deplete key nutrients needed for mitochondrial energy production. When energy supply falters, cognitive stamina often suffers.
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Sleep Disruption and Recovery Deficits
Sleep is when the brain clears metabolic waste and repairs neural connections. Fragmented sleep, circadian rhythm disruption, airway issues, or histamine-related insomnia can all present as persistent brain fog. Addressing sleep quality is foundational for cognitive recovery.
What Improving Brain Fog Often Requires
Lasting improvement rarely comes from a single supplement or quick fix. In most cases, progress depends on addressing the drivers that keep the brain inflamed, under-fueled, or stuck in stress physiology. Sleep quality, immune load, gut health, environmental exposure, and metabolic stability all play critical roles in restoring clarity.
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For individuals who feel like they are “doing everything right” yet remain stuck, a deeper root-cause approach can help uncover what is being overlooked.
Our Approach at Keystone Total Health
How Dr. Hart and Dr. Aoki Evaluate Cognitive Symptoms​
Our Root-Cause Evaluation Process
Keystone Total Health uses a structured, root-cause approach designed for individuals with complex or chronic symptoms, beginning with the Keystone Root Cause Analysis. This analysis is the foundation of care and is used to identify why symptoms such as brain fog, cognitive dysfunction, fatigue, and inflammation persist despite prior treatment.
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The Keystone Root Cause Analysis starts with a comprehensive clinical timeline. Practitioners evaluate when symptoms began, how they have progressed over time, and what factors may be contributing to them. This includes a detailed review of environmental exposures, infections, stress patterns, sleep quality, medical history, and previous interventions. By organizing this information into a clear framework, underlying patterns and primary drivers can be identified.
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When appropriate, targeted functional testing is incorporated into the analysis. Testing is selected based on individual presentation and may assess inflammation, immune activity, gut function, nutrient status, metabolic balance, and physiologic stress responses. Results are interpreted within the context of the full clinical picture rather than in isolation, allowing for a more accurate understanding of root causes.
The Keystone Root Cause Intensive™ Care Model
Findings from the Keystone Root Cause Analysis guide entry into the Keystone Root Cause Intensive™, a personalized care process designed to address identified drivers in a structured and sustainable way. Care plans are phased and individualized, with the goal of improving function while avoiding unnecessary overwhelm.
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Treatment commonly begins by stabilizing foundational systems such as sleep quality, blood sugar regulation, and nervous system balance. Once stability is established, care may progress to addressing deeper contributors including gut dysfunction, mold exposure, chronic infections, immune dysregulation, or hormone-related stress patterns. This stepwise approach supports better tolerance and more consistent progress in complex cases.
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Education is a core component of the Keystone Root Cause Intensive™. Patients are guided to understand how their symptoms connect, what their findings mean, and why each phase of care is important. This emphasis on understanding empowers individuals to participate actively in their care, track meaningful changes, and build long-term strategies that support cognitive clarity, resilience, and overall health.
Who This Approach Is Best Suited For
This root-cause approach is best suited for individuals experiencing persistent or recurrent symptoms—such as brain fog, cognitive fatigue, or mental clarity issues—who have not found lasting answers through conventional or symptom-focused care. It is particularly appropriate for those with complex health histories, overlapping conditions, or symptoms that fluctuate and do not fit neatly into a single diagnosis. Many individuals who benefit from this approach have already tried multiple interventions, supplements, or treatment plans without sustained improvement and are seeking a clearer understanding of why their symptoms continue. This process is designed for people who want a thorough evaluation, are open to a structured and phased care plan, and value education as part of their recovery so they can make informed, long-term decisions about their health.
Brain fog and cognitive symptoms often raise a lot of questions, especially when they persist despite normal test results or prior treatment. Many individuals wonder what is causing their symptoms, whether they are related to stress, inflammation, environmental exposure, or chronic illness, and what steps actually lead to improvement. The following frequently asked questions address some of the most common concerns we hear from patients exploring a root-cause approach to brain fog. These answers are intended to provide clarity, context, and education so you can better understand potential contributors to cognitive symptoms and what a structured evaluation process may involve.
Can mold exposure cause brain fog?
It can in some individuals, particularly when exposure is ongoing or when immune-inflammatory responses are strongly activated. Cognitive symptoms are commonly reported in mold-related illness patterns, and it’s one reason Keystone Total Health evaluates environmental history and exposure risk when brain fog is persistent.
Is brain fog just anxiety or stress?
Stress and anxiety can absolutely worsen cognition, but they’re often not the entire story, especially when brain fog is paired with fatigue, sleep disruption, inflammation, gut symptoms, or symptom flares tied to exposures. A root-cause approach looks at nervous system load and the underlying physiologic drivers.
Why do my symptoms come and go?
Fluctuating symptoms often reflect triggers like sleep, blood sugar swings, exertion, inflammatory load, histamine patterns, hormonal shifts, or environmental exposure. Identifying your pattern is part of building an effective plan.
What if my standard labs are normal?
That’s common. “Normal” ranges don’t always reflect optimal function for cognition, and many drivers of brain fog involve systems that aren’t fully assessed with basic screening labs alone. A deeper, targeted approach can uncover patterns that standard testing misses.
How long does it take to improve brain fog?
It depends on what’s driving it and how long it’s been present. Some people notice improvement quickly once sleep, blood sugar, and inflammatory triggers are addressed. More complex cases often require a phased plan and consistent follow-through.
Here’s How We’ll Do This Together
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Book Your Keystone Root Cause Analysis™
During your initial one-hour appointment with one of our practitioners, the Keystone Root Cause Analysis™ provides a comprehensive, root-cause evaluation that reviews physical, environmental, and social factors to understand your symptoms and identify personalized next steps.
Chronic Fatigue Care in Columbia, TN
Serving Nashville and Clients Nationwide
Ready to Address the Root Cause of Your Brain Fog?
If brain fog is limiting your focus, productivity, or quality of life, Keystone Total Health can help you move forward with clarity. Work with Dr. Martin Hart, DC or Dr. Koji Aoki, DC to identify the drivers behind your symptoms and build a personalized plan that supports cognitive function, energy, and long-term resilience.