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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12816
Experience:  GP with over 27 years experience including emergency medicine
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Hello, I am 37. Since I was 17 I have had a recurring group

Customer Question

Hello, I am 37. Since I was 17 I have had a recurring group of symptoms that includes brain fog, fatigue, mild depression, cattarh, bloating and gas. It usually lasts about 3 weeks and then passes for about the same amount of time before returning. It does not seem to be getting any worse or better with age. I have suspected hypoglycaemia, allergy and/or a food sensitivity and consulting with a nutritionist has suggested the same, however blood-sugar testing (using a self-testing kit) has not shown excessive dips or  fluctuations and food-group exclusion experiments have proven similarly inconclusive. Increased responsibilities in my work and family life mean that the condition has become more difficult (and stressful) to live with as the brain fog part, in particular, slows down and impairs my judgement, which is not ideal when looking after my small children or a business and it also causes tension in my marriage (as my wife understandably struggles to deal with the inconsistencies in my mental alertness). Any suggestions or help would be truly appreciated!


Other considerations:


I had a head injury when I was 15 - I fell over skiing and the back of my ski struck the lower back of my head, right at the bottom of my skull, where it meets the back of the neck, which bled a lot and I still have a bump today. I did not receive medical attention for it at the time but have always wondered if it could have caused any lasting damage.


Also I am very dependent on caffeine (especially during the bouts of brain fog - it does help to an extent). I only drink 3 cups of tea or coffee per day, as any more than this keeps me awake all night and makes me feel shaky - at the same times every day (first thing in the morning, 10am and after lunch) but I suffer bad slumps if I miss (or delay one of these). 


Thanks! SJ

Submitted: 5 years ago.
Category: Medical
Expert:  Family Physician replied 5 years ago.
Thank you for your question:

I'm sure you understand that it is not possible to make a diagnosis or specific treatment recommendations over the internet.

Based on the information that you have provided, I have 2 suggestions:

First; The caffeine may be contributing to some of your symptoms. Unfortunately stopping caffeine can be difficult as you have discovered. I often suggest a method of slowly reducing the caffeine over 3-4 weeks. Instead of eliminating the caffeine immediately, you reduce the concentration. The first week, you use 1/4 decaffeinated and 3/4 regular coffee or tea. The second week 1/2 and 1/2, the third week 3/4 decaffeinated and 1/4 regular and then eventually 100% caffeine free. You need to do the same with any caffeinated sodas.

Second: You may have bipolar disorder. This condition can vary from severe forms where someone has alternating periods of depression to manic episodes where they are overly energetic and "hyper". Other patients experience primarily "down" symptoms that are milder, but continue with the cycling episodes; essentially going from "normal" to depressed or "down". There are a number of treatments that can help stabilize the mood including lithium. Here is some information on this condition.

I hope this information is helpful to you.