Why Your Brain Fog Won't Lift: The Six Mechanisms of Cognitive Dysfunction in Chronic Illness, and Why Standard Interventions Keep Failing — What This Means in Practice

Several practical implications follow. First, the search for a single explanation for your brain fog is unlikely to succeed. Brain fog is the integrated expression of multiple mechanisms operating against shared upstream nodes. The question to ask is not what is causing my brain fog, as a single answer. The question is what configuration is my brain fog in, and what is the upstream state that is generating that configuration. Second, the proliferation of single layer treatments will produce a series of partial responses that plateau on the two week wall pattern. The integration of the interventions is the work. The integration requires reading the case at a level the standard appointment does not support. Third, the timescale of meaningful improvement is months to years, not weeks. The gut epithelial state recovers slowly. The mitochondrial network recovers slowly. The inflammatory drive resolves over the timescale of the upstream lesions that generate it. A patient expecting a six week protocol to resolve chronic brain fog has misunderstood the biology. Fourth, the order of intervention matters. Capacity layer work that addresses the upstream nodes (gut epithelium, mitochondrial state, inflammatory drive) is generally upstream of symptom layer work that addresses the six mechanisms directly. Both layers usually need attention. The sequence and the relative emphasis are patient