Episode #221: Brain Fog: The Warning Sign You Shouldn’t Ignore

In this episode of the Berman Method Podcast, Dr. Jake Berman and physician assistant Jenni Berman dive into a topic many people experience but rarely understand—brain fog.

They discuss why brain fog is often dismissed as a normal part of aging and why that belief may be completely wrong. Instead of accepting fatigue, forgetfulness, and lack of focus as inevitable, they break down the real physiological causes behind brain fog, including blood sugar instability, cortisol imbalance, and nutrient deficiencies.

Jake and Jenni also explore how the modern healthcare system often overlooks root causes due to time constraints and specialization, leaving patients without clear answers. They explain how nutrition, gut health, and blood sugar stability play a critical role in cognitive clarity and overall health.

Throughout the episode, they share practical insights on how monitoring tools like continuous glucose monitors (CGMs), balanced nutrition, and a step-by-step health roadmap can help restore mental clarity and energy.

If you’ve ever struggled with afternoon crashes, forgetfulness, or feeling mentally “foggy,” this episode will help you understand why it’s happening—and what you can start doing about it.

Check Us Out On Social Media - 

Facebook: @bermanhealthclub , @physicaltherapynaples, @Berman Golf 

Instagram: @bermanhealthclub, @bermanphysicaltherapy , @Berman Golf 

Youtube: Berman Golf, Berman Physical Therapy

TikTok: Bermangolf, bermanhealthclub

Email us - 

drberman@bermanpt.com 

jenni@bermanwellness.com 

Check out our website - 

www.bermanpt.com 

www.bermanhealthclub.com

www.bermangolf.com

Transcript

Taking On The Medical Goliath

Speaker 1 0:00

And we're rolling, baby, with the Berman Method Podcast. Dr. Jake Berman here with my beautiful co-host.

Speaker 0:06

Jenni Berman, physician assistant.

Speaker 1 0:08

We are David going against Goliath. Goliath being the corporate medical system, big pharmaceutical companies, your health insurance companies, they do not have your best interests in mind. They will choose profits over patient outcomes every single time. And they're literally trained to deny your health insurance company on day one. Here's how you do your job. Deny the first attempt.

Speaker 0:31

And second.

Speaker 1 0:33

And third, and fourth, and fifth. You didn't put a period in the right place. Deny it.

Speaker 0:39

Right.

Speaker 1 0:39

You didn't put a comma in the right place. Deny it.

Speaker 0:42

Right. You didn't have seven forms of identification.

Speaker 1 0:49

It's like, what? Wait a minute. I heard that you don't even need an ID to vote in certain states, but now I need to submit 17 forms of identification for you to cover this medically necessary procedure?

Speaker 1:02

Your name, your date of birth, your social security number, your mom's maiden name. The most previous address that you lived from where you're at now.

Speaker 1 1:12

It's like, wait a minute, my mom's maiden name?

Speaker 1:15

What world are we living in? The best was when when you called and they were like, what is your what is the uh account holder's mother's maiden name? So that was my mother's maiden name that you had to tell them.

Speaker 1 1:30

I'm like, wait a minute. And they go, yeah, you're not a pri you're not a primary account holder. Yeah, I'm like, yeah, now you're wrong. I'm gonna just go ahead and say this bluntly. You are wrong. We are both on the account as primaries. That's funny. So, anyways, that's what's we're what we're going up against. And you just gotta educate, you gotta keep asking your questions. You gotta become an asshole. You gotta ask, ask, ask, ask, ask, ask, ask, ask, and ask again. Just like Vera, three years old now. Can I have a cookie? No. Can I have a cookie? No, can I have a cookie? No, can I have a cookie? No. Dad, I'm gonna die if I don't have a cookie. Okay, here's a damn cookie. That's not a true story. But you do have to be an asshole. You have to ask questions and you have to get more information, and it has to make sense to you. And if it doesn't make sense to you, go ask somebody else.

Speaker 2:22

Get second opinions, yeah. Be your own self-advocate. You have to these days if you're in their traditional Western medicine world. I mean, even with us, though, you should ask questions and challenge

System Limits And Nutrition Blind Spots

Speaker 2:35

us or look make us look up things to treat you the best way.

Speaker 1 2:40

Here's the reality, and it's getting more and more black and white, more and more explicit, more and more to where you can say, if you're going to a healthcare practitioner who is in an in-network provider, an in-network clinic, chances are they're gonna give you an answer that's generic and not specific. Correct. I mean, that's you call it what it what it is. Of course, there's some great healthcare practitioners out there that are still working at in-network clinics, but it's not their fault. It's the system's fault. When you have to see 110 patients, 110 billion patients a day, you don't have time to sit here and say, wait a minute, maybe you don't need to take this statin. Maybe you should look at what you're putting into your pie hole.

Speaker 3:28

Right. Well, yeah. And, you know, unfortunately, a lot of practitioners don't even know the food part of it, the nutrition practices. Like they don't learn that in school.

Speaker 1 3:43

That's a fact right there, where you look at a doctor, uh an extremely prevalent orthopedic surgeon, neurosurgeon, uh primary care physician in this town, and you would think that they know these things. And the reality is they don't, because that's not their expertise.

Speaker 3:59

Right. Even treating doctors, I mean, I've treated ER docs, trauma surgeons, primary care physicians, orthodox, spine docs, I've treated all of them. And when I go into talking about insulin resistance and I start talking on high-level medical terms, because they're a physician, and I don't want to um, I don't, you know, I'm trying to lose the word. I don't want to embarrass them by saying they don't know something. So I'm talking to them in terms that I would understand in medical terms, and they're like, I have no idea what you're talking about. And I'm like, insulin resistance? They're like, nope. I'm well, okay, so I need to treat you as if you're not a doctor and start at the at the basics.

Speaker 1 4:45

That's the reality. I mean, take an orthopedic surgeon, for example. They are an expert in orthopedics, they are experts in replacing your knee or your hip. They're not experts in how to control your diabetes or your blood sugar with proper diet.

Speaker 5:01

Right. They're just not. Just don't have the the time or the education behind the nutrition piece. I mean, no events to them, but they haven't used the stethoscope in however many years since they graduated med school. That was when I took my first ortho job, and I showed up with the stethoscope in my white coat pocket, and they were like, uh no, you're not gonna need that as long as you work here. I'm all oh, okay. Well, there goes half of my medic medic medicine that I learned for the past 10 years. Uh but anyway, yeah, that they just get into their own little specialty and they don't have to worry about nutrition. So they think, but how nutrition plays so much into joint health, too. And that's the sad part behind it is that these doctors are they're surgeons, they are there to treat a problem that is surgically necessary. Maybe should not use the word necessary, but surgical.

Speaker 1 5:59

Yeah, give it the benefit of the doubt. Let's say it is surgically necessary.

Speaker 6:02

So, but nutrition plays such a big role in inflammation of the joint and bone density and osteoporosis and osteopenia and these diseases that are causing the joints to degrade and break down and to have damage to them. Nutrition, the right, the right balance of your nutrients and actually absorbing your nutrients, um, the body's ability to actually stabilize vitamin levels and nutrient levels coming from your food, your gut health coming from your food, all plays into the joint health and bone health.

Speaker 1 6:39

It's all connected, it's all tied together. You can't just have knee pain and go get a knee replacement and say, okay, I went through my cookie cutter rehab and think that the problem's gone. There's a reason why your knee degenerated.

The Real Role Of Nutrition In Joints

Speaker 1 6:55

Knee degeneration, joint arthritis, it's not a normal part of aging.

Speaker 7:01

Right.

Speaker 1 7:01

If it was, everybody would have it. But then you've always got these outliers where it's like, wait a minute, he's 97 years old and has zero knee pain, zero back pain. You're telling me that he's just that genetically gifted, and I got the shitty hand of cards. Like, that's your response.

Speaker 7:20

Right. And people all the time go into, oh, it's genetic, oh my parents had it. And I'm like, yeah, but look at the lifestyle that you share with your parents or with your family members that all have the same problem as you. We have the ability to turn genes on and off. It's you know, we have the ability to undo this quote unquote hereditary genetic problem if you're treating your body the right way. It's called epigenetic expression. Read it in my book. But, anyways, that's not even we don't even want to talk about genes today. Or or arthritis or any of that. That wasn't the point of today.

Speaker 1 7:57

No, we spent the past five weeks going over the five most important physical components to contributing to your ability to thrive as you get older, dominate the second half of life, show up or arrive at 80 feeling 40 even. 40. Yeah, or if you're in your 80s, kick 90s ass. That's what we spent the last five weeks doing, talking about all the physical components. So now, the next five weeks, we're gonna shift gears into the chemical component. So this is now Jenni's world.

Speaker 8:26

My world. And I love it. Yeah, I live it every day. You better love it. Yeah, I do. So, first things first that we're gonna talk about is brain fog. How many of our I almost forgot what we were gonna talk about? Because you have brain fog because you did not treat your body well over the weekend. Is that why you have brain fog today?

Speaker 1 8:46

Yeah, I definitely did not.

Speaker 8:48

Uh it happens sometimes. We don't we don't have to be perfect.

Speaker 1 8:52

Yeah, we had a wedding and it was a fun wedding.

Speaker 8:55

It was fun, yeah. But definitely can feel the repercussions when we get off track a little bit.

Speaker 1 9:02

Big time. Yeah, this one's workout sucked.

Speaker 9:05

Yeah, energy, recovery, brain function, remembering things. Anyway, talking about brain fog. So so many of our clients are do complain of brain fog. It's one of my primary questions on my questionnaire, my medical history that I go through with clients at their very first appointment, is talking about the differences between brain fog and memory decline, um, even irritability and anxiety as a part of how the brain is functioning, just being forgetful. Like all those things are have a little bit differences in their explanations. Um, but brain fog is one of these things where you're like, I just don't think as clearly. I have to write everything down. Uh, I'm

Shifting To Chemical Health Focus

Speaker 9:45

just feeling like I'm losing on my word finding. It takes me longer to think of certain words. I'll walk into a room, don't remember where I'm going. I'm driving and I turn right when I'm supposed to be going left. I just, you know, different things where we're not thinking as clearly or as sharp as we did in the past. And so many think, ah, it's just normal aging. Oh, I'm in my 60s, it's bound to happen. It just is what it is. And unfortunately, that's a lot of what your doctors will tell you is like, oh yeah, you're just getting a little bit older. Um, and it doesn't have to be that way.

Speaker 1 10:19

Really?

Speaker 10:20

Really? The other thing I always ask, and people actually have to sit down and think about it when I ask them, they've never thought of this before. But is your brain fog worse in the morning or in the afternoon, or is it there all day? And I very typically will get the answer of, oh yeah, until I get my cup of coffee or two in the morning, so eight or nine o'clock,

Defining Brain Fog Vs Memory Loss

Speaker 10:40

maybe it gets a little bit better. But then somewhere around that two to four p.m. time, I feel like it comes right back.

Speaker 1 10:48

So the afternoon crash.

Speaker 10:50

Yeah, but I wouldn't call it a crash. You know, some people experience the brain fog but still have good energy. They're not like, oh, I need to go take a nap. Some people do. Um, but they just feel like they're just not as clear, they're not as sharp in the afternoons. If they want to get their work done, they have to get their work done, whether it's reading emails or responding to messages or doing any research, working on their investments, whatever it is, they need to do it to do it between like nine and twelve because that's their sharpest moments. They're not sharp before nine, and then after twelve, somewhere in the around that two o'clock time, they just feel like their sharpness declines.

Speaker 1 11:27

Well, that's kind of like me. I I need to get things done between nine and twelve, and I don't know that I would say that I have brain fog.

Speaker 11:36

Yeah, I think you have a different problem. However, it comes back to really the same basics, right? So when we're talking about brain fog, it's not that you're the the matter of your brain is changing, right? Which is what happens certainly as we age, the matter of the brain does change, but that's where the dementia and the Alzheimer's come in. That's how they diagnose by looking at the matter of the brain through MRI um scans of the brain. So it's not that you're that's the reason

Morning Clarity And Afternoon Dip

Speaker 12:05

for the brain fog happening morning and afternoon, and again, your energy that you're explaining, your energy and recovery and drive is not brain fog, I don't think. I don't think you're forgetful or foggy. No, no, you have a different problem, which we'll talk about here over the next couple of weeks. I'm excited, but they do really come down, all the the five things that we're gonna be talking about over the next five weeks really come down to the three bottom basics. And with the brain fog, the most common problems creating the symptom of brain fog are gonna be blood sugar instability. So your blood sugar is normal, but it's just unstable throughout the day, it's going high and low. So when you do your blood tests in the morning and your doctor checks your fasting blood work and your glucose comes back at 89, and he's like, Oh, that's wonderful. Well, that's great, but that's just a single snapshot of what your blood sugar does, and probably because you were well behaved the night before you had to go in for your blood test, right?

Speaker 1 13:08

Isn't that what we usually do? Is we study before the test.

Speaker 13:12

Doesn't tell us the full picture though, versus some other lab testing. You can't lie about it when you have it done and the the levels are elevated. So blood sugar instability, not that it's high all the time, not that you're a pre-diabetic, but you're just unstable or it's rising and falling throughout the day. The other thing, and that typically is gonna come from not eating enough protein and vegetables, fiber, right? So our carbohydrates are outweighing our protein, which is very common in the US, and that is a contributing factor to this blood sugar instability and the brain fog.

Speaker 1 13:49

My favorite part to, or my favorite way to watch this is with the CGM continuous glucose monitor. And we've been both you and I have both been meaning to put another one on for the past two weeks, and life has just been happening. But it's so simple or so black and white, it's clear as day when you put one of those monitors on, you look at the app on your phone, and it's like, wow, that's what that cookie did to me. Or man, I haven't eaten in three hours. Look at that thing drop. Yeah, you can you can just see it now. You can start to correlate these feelings that you're having as far as energy, not energy, brain fog, not brain fog. You can correlate it with what you're seeing on your

Blood Sugar Instability Explained

Speaker 1 14:30

app.

Speaker 14:30

Right, right, exactly. And having our team, of course, be able to help you analyze it and make the changes that are going to fix the actual problem of this instability. So, yes, when it comes to brain fog, most of our clients are not eating enough, specifically protein throughout the day. Um, and so a lot of times your brain fog today will be reflective of the blood sugar instability yesterday. So, how you fueled your body yesterday is affecting your brain health today. And so, yesterday, if we didn't eat enough protein, we didn't get enough fiber, we didn't eat every two to three hours, which is what's recommended, then we are likely going to experience more brain fog today. And in general, for our population of clients that we're seeing, that is one of the most common things I see regularly. When we can get them eating more protein throughout the day and stabilizing their blood sugar, the clarity that they have within their brain and their function just exponentially improves. Now, the other thing when it comes to brain fog could be a cortisol problem, which I think we'll talk about more throughout the next four four weeks past today. Uh, I don't know that we need to get into that black hole today. But cortisol, which is your your stress response, it's on an axis internally inside your body and it's a curve. And again, that will play a significant role in how our body is actually resting and recovering at night, and it will make a difference in how we're feeling throughout the day, um, especially because it is our fight or flight hormone. So if that cortisol level is not stable or the curve is not the way it should be, then our body's in that constant state or fight or flight, and that's exhausting. That's like running a marathon

CGMs And What They Reveal

Speaker 16:15

all the time.

Speaker 1 16:17

Or it's over and over and over. Yeah, all the time, and then you don't see him anymore, but he could be anywhere, so you're always on guard. So you never, ever, ever get to come back down to that restful state. I mean, think about that. If you're walking in the woods and you know that there's a saber-toothed tiger somewhere close by, you you're different.

Speaker 16:41

You just reminded me that I had a dream last night that there was a really massive um saber-toothed tiger? No. Panther in our yard. Like, really massive. Well, there was. Which is not an uh atypical for our house.

Speaker 1 16:58

Yeah, five years ago we got a massive one on camera.

Speaker 17:00

Yeah. But yeah, you just reminded me of that. I've forgotten about it. So, anyways, but things like that, like that means I wasn't getting quality restful sleep last night, and then Stella comes in the room at 3 30 and the alarm's gonna go off in 30 minutes, and I'm like, God, be joking me. So these are the things like that that change of cortisol will certainly impact my brain function today. Now, I can't, you know, prevent Stella from walking into our bedroom at 3 30, but there are ways to regulate the stress response, the cortisol response when these types of things happen, when life happens. So that's a big contributing factor. And in the cortisol, you know, so much goes into it. It's not just external stressors, it's not just things waking you up at night, but blood sugar also affects our cortisol. So we have to go back to that kind of step one that we talked about already.

Speaker 1 17:50

So, what I'm hearing you say is brain fog is most directly uh associated with or affected by blood sugar stability.

Speaker 18:00

Yes.

Speaker 1 18:01

And blood sugar stability is one of those things where a lot of people don't really know what that means because most of the time it's not as dramatic as one might think, meaning that diabetic, when a diabetic's blood sugar drops, they're visibly shaking, right? They they fall on the ground, they faint, and you have to

Protein, Fiber, And Eating Timing

Speaker 1 18:20

get them a glass of orange juice and they get back up. That's an extreme example of blood sugar instability. Versus majority of the time when I've got that stilo on, that CGM on, I don't realize that my blood sugar has dropped until I look at it and I'm going, oh wow, it's dropped. I need to bring it up. Or oh wow, it's spiked. Like it don't, you don't really know that it's spiked.

Speaker 18:43

Right. But then you're you start to make the correlations to it, and you're like, okay, every time it happens, this is how I feel. But you always just kind of thought that was normal. Like you didn't realize you were abnormal until you are normal once we fix it. And then the energy is so much better, the clarity is so much better, the focus. Like, we don't have this questioning of do I have ADD, ADHD, right? Like, some people feel that way. They're like, I just don't focus well. I'm constantly doing 86 tasks, I can't finish a task. Like that's brain fog. That's a blood sugar problem or a cortisol problem. Vitamin deficiency. And that's the next thing that we'll talk about too, is just the gut health and the impacts of vitamin deficiencies on all these things. Could brain fog be a magnesium deficiency?

Speaker 1 19:32

I don't know.

Speaker 19:33

Yeah, certainly.

Speaker 1 19:34

This isn't my world, is it?

Speaker 19:36

Could it be a B12 or folate deficiency? Most definitely. But all these things, again, are coming from your gut health and the body's ability to absorb your nutrients, and we have to have a stable, optimal blood sugar to have a healthy gut to absorb our nutrients. So it really is it's in depth, right? It's not just one thing. We can't look at you and be like, okay, fix this and your brain fogs better. But that's why our team works with individuals systemically to fix all three of these avenues the gut health, the blood sugar, the cortisol, through like simple tactics on a week-to-week basis. We don't flip your lifestyle upside down.

Cortisol Curves And Sleep Quality

Speaker 20:15

No and I purposely will only test people on some things to start out with because I don't want to flip their world upside down. If I do blood testing and food sensitivity testing and saliva testing for cortisol, if I do all this testing, then we're like, okay, we have to change all these things. You're like, yeah, right, no way. So we start one at a time. Yeah.

Speaker 1 20:42

Isn't it most of the time that let's just for simple numbers, ten you did all the testing and ten things show up that need to be fixed. Isn't it true that most of the time that if you fix the major two or three things, some of the other ten will fix themselves?

Speaker 21:03

Yeah, for sure. And that's again why where I tell our clients, like, okay, we're gonna start with stabilizing your blood sugar through getting the right nutrients. You're probably gonna have to eat more, not less. And they're like, what? You want me to eat more to lose weight? Yes, I do. I want to balance your nutrients appropriately to where your body's actually utilizing your food as fuel, as energy, to be able to burn fat and gain muscle and to provide brain function and to make sure your organings your organs are doing what they're supposed to be doing. So, first and foremost, we have to balance your macronutrients, your proteins, your carbs, and your fats for your body to make sure you're eating enough and giving your body the energy it needs to actually be able to heal. So that would be step one.

Speaker 1 21:49

And that step is really freaking difficult, especially when you're trying to lose weight. I mean, me myself, I'm I'm fluffier now than I've ever been. I'm 40 years old. And it's such a mind game for me. And I live in this world. I live with you. This is my world. I know that I should be eating more, but it's that mental, mental barrier, that mental block where it's like, ah, but I'm fluffy. That's why when you put that CGM on, it's black and white. It's like, okay, I see a direct correlation with eating more protein and more veggies, directly correlated with my blood sugar stabilizing and not spiking. Okay, I know that if I can stabilize my blood sugar, the fluffiness will take care of itself.

Speaker 22:38

Right. Because you're active and we stay active and we're exercising, which is a big part of it, you're balancing your nutrients, you're taking your vitamins, you're not typically eating a bunch of inflammatory foods, so gut's overall pretty good. So yeah, again, right? Like, yes, you can focus on your macros, but you're already doing X, Y, and Z, which will help complement your macros. Right. And that's where our team will come in to help with

Gut Health, Vitamins, And Absorption

Speaker 23:05

these clients is to say, okay, you cannot fix all these problems by yourself. It's, I mean, even for you or me, it's overwhelming to look at to look at my own food sensitivities. I'm like, not treating myself. No way. There's no way I can do it. But I can do it. I do it every day for other people. I just need someone else to look at it objectively and be like, okay, Jenni, you can do it. You're really not that far off, right? So when it comes to our clients, like you need a team to be able to look at it objectively and give you, okay, here's step one, step two, step three, step four, step five. We're gonna do this over the next five weeks, one thing at a time, and hold you accountable to doing it.

Speaker 1 23:42

It's a roadmap, is all it is. It's a very clear as day roadmap. This is how you get to point A, or this is how you get from point A to point B. It's the simplest explanation or correlation or analogy that you could possibly use where because you and your team do this every single day, you've got all of this data. You guys are the experts, you guys are the guide. You have seen this time and time again. I've walked this trail a million times, like me growing up in the Everglades airboating. It's a 20-something mile ride from the boat ramp to the middle of the Everglades. And every time I bring somebody out there for the first time, whenever we get to our destination, they always ask, How in the world do you know where you're going? Well, I've done it a million times. Same thing at night when we go out in the middle of the night frogging with one little headlamp riding around in circles, literally riding around in circles in the dark for hours, and then find your way back home without even no GPS. Right. This is before GPS. There's no there's no service out there. There's no service. How do you do it? Well, it's because I grew up doing this thing. That's you, the listener, is you need somebody

Start Small: Roadmap Overhaul

Speaker 1 25:00

who has done this time and time again, and that's what the wellness team does here. This is the quickest way to get from the middle of the woods back to the camp. I mean, you could figure it out, right? You could wait for the sun to come up and find your way back there, or we could just be back there in 10 minutes.

Speaker 25:17

Right. Exactly. Having have a team to support you, have a roadmap on okay, what we're gonna do, when we're gonna do it, and the ability to adjust as necessary because it's not always gonna be perfect, it's not gonna be linear, we know that, but sometimes we're gonna take take a U-turn.

Speaker 1 25:35

Yep. Sometimes there's a tree that fell down in the middle of the trail. All right, well, can't take that trail anymore. Let's go to a different trail.

Speaker 25:43

Right.

Speaker 1 25:44

Still know how to get there.

Speaker 25:45

Right.

Speaker 1 25:45

I was actually thinking about that in Key West, where I don't know any of the street names in Key West, but I could figure out how to get all around that island.

Speaker 25:53

That's true.

Speaker 1 25:53

Versus you, you know every street name because you run the thing every time we're down there.

Speaker 25:58

Yeah. And that's the that's anywhere we go. I will usually know way more about landmarks and streets just because I run it all the time and I can see it and learn it, versus you just have a photographing memory and just know where to go.

Speaker 1 26:14

Yeah, I just we'll get there.

Speaker 26:15

Yeah.

Speaker 1 26:17

Cool. So step number one, I don't know. I think maybe we should make this step number one. Put a CGM on.

Speaker 26:24

Uh yeah, absolutely. Everybody should wear one.

Speaker 1 26:27

Yeah.

Speaker 26:27

No doubt.

Speaker 1 26:28

Right after we press stop, we're gonna go down and put ours on.

Speaker 26:31

Okay.

Speaker 1 26:31

Deal?

Speaker 26:32

Already, yeah.

Speaker 1 26:33

Anything else you want to say on number one?

Speaker 26:35

I think that's it. So brain fog. If you have brain fog, it's not a normal part of aging. It doesn't have to be a normal part of aging, anyways. There's usually something else uh causing it between blood sugar instability, abnormal cortisol response, or a vitamin deficiency. Or a combination.

Speaker 1 26:54

Love it.

Speaker 26:55

All right, ciao for now.