Why Your Brain Fog Won't Lift: The Six Mechanisms of Cognitive Dysfunction in Chronic Illness, and Why Standard Interventions Keep Failing — How to Read Your Own Brain Fog

If the framework above describes your case, the practical question is how to identify which of the six mechanisms are dominant in your specific presentation, in what order they developed, and how they interact. Several common configurations are worth distinguishing. The post prandial gut dominant pattern. Brain fog intensifies thirty to ninety minutes after meals, especially protein meals. Often accompanied by gut symptoms. Often relieved partially when fasting. Often associated with food reactivity and SIBO history. Fits cleanly into mechanism one, with mechanism two often present secondarily. The post exertional mitochondrial pattern. Brain fog intensifies twelve to seventy two hours after physical or cognitive exertion above a patient specific threshold. Associated with fatigue, post exertional malaise, exercise intolerance. Often present in long COVID and ME/CFS. Fits cleanly into mechanism three, with mechanism two typically present. The inflammatory pattern. Brain fog with slow onset and persistent quality. Worsened by anything that increases inflammatory load. Often associated with low grade fevers, swollen lymph nodes, joint aches. May follow viral illness, mold exposure, or systemic infection. Fits cleanly into mechanism two, often with mechanism three present. The reactive mast cell pattern. Brain fog triggered by specific exposures (foods, temperature, fragrances, ho