From Foggy To Focused: Lifestyle & Hormone Keys for Brain Vitality
Sep 22
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In my mid to late 30s, I started to feel incredibly foggy.
Every night at dinner I would have a glass of wine. I felt so foggy during bath time and bed time for my first kid that I stopped drinking. It helped and I’m happy to no longer have that habit but it didn’t completely clear the fog.
When I would pour milk for one of my kids and have to put the lid back on, I’d mix up the lid for the milk and the lid for the cup and have to correct myself. I was very aware of how unusual that was.
I used to be sharp as a tack. What happened?
I know women don't want to be told that they are "too young” to be having perimenopausal symptoms, but I actually believe I was too young and reproductive hormones were not the issue for me (though it may be for some).
Ultimately, chronic stress finally caught up to me and I needed to be intentional about my physical, mental, and spiritual health.
This has been a journey and it’s been a great one.
I still get extraordinarily exhausted from work. I feel tired, but I don’t feel foggy. There's a big difference.
Here's what I've done over the last year to improve this for myself, and I’ll explain some of the strategies below.
Stopped drinking alcohol
Prioritized sleep (started taking magnesium; I still have external factors that keep me from sleep like work and young kids, but I can sleep when I’m able which wasn’t always the case. In the past, even if I had time to nap, I wouldn't be able to because I was so stressed.)
Increased fat intake
Increased intensity of exercise (again, I know no one wants to be told to do more. But you can probably do more. Walking is excellent, I love walking. But I will walk on an incline and 1-2 times per week I jog or row)
Started creatine
Increased sun light (This is the most sun I've seen in probably a decade. And it feels good)
Decreased blue light (I leave my phone in another room when I'm not on call. That way, I’m not looking at it even for the time if I wake up in the night)
What do I mean by brain health?
When we hear “brain health", we mostly think of Alzheimer's. This is a devastating disease which disproportionately affects women.
Alzheimer’s isn't the whole story though.
Brain health is really trying to describe a process called neurogenesis. This is how the brain uses stem cells to make new neurons, or brain connections.
This was previously thought to NOT happen in adults. I think we've all seen the rapid learning abilities of children and understand how amazingly they develop.
It wasn't until the 1990s that stem cells were found in the adult brain, showing that we can (and should) adapt, learn, and grow.
Neurogenesis in adults can increase with exercise and decrease with depression.
Why care about brain health?
Dementia is a unique type of disease. It’s terrifying to think we live our lives and at the end, lose our memories and awareness of who we are.
On a practical level, if the brain isn’t able to function, the body isn't able to function. This includes daily tasks like making food, grocery shopping, and paying bills. This is a common reason for adult admission to assisted living or other facilities.
What Are Important Interventions for Brain Health?
Omega 3 Fatty Acids:
I’ve previously written about omega 3's here. The omega 3 fatty acids are EPA, DHA, and ALA. DHA is the dominant omega 3 fatty acid in the brain. If we think about infants and their rapid brain development, DHA particularly plays a large role in that process. That doesn't disappear in adulthood. These important nutrients protect against neurodegeneration in adulthood.
Where to find:
Eat seafood! (Or lake food) Easy for me because I love it. Trout, mackerel, salmon, tuna are highest on the list of omega 3 content (see the list here)
Supplement like this from Thorne (omega 3 supplementation is evidence-based for improving cognitive function)
Creatine:
A new study published in 2025 specifically looked at perimenopausal and menopausal women to study the effect of creatine supplementation on brain health. This was a small study of just 36 women, however it did show improved reaction time and creatine levels in the brain with daily supplementation (a little higher than the usual dose) for eight weeks.
Creatine has also been shown to help the effects of antidepressants for those that are depressed using medication.
I use this from Thorne
Ketosis:
One of the least discussed methods to improve women's health is ketosis. I really got more interested in this by following Dr. Courtney Hunt, an obgyn who utilizes lifestyle changes and hormone therapy to lead people to better health.
The popular discussions of intermittent fasting are partially aimed at ketosis.
Ketosis is the body’s metabolic state of burning fat, rather than carbohydrates. As fat is burned, ketones are produced. A main ketone is beta-hydroxybutyric acid. This is highly anti-inflammatory.
Ketosis is used in many settings, including other conditions of brain health. Ketosis is well-known to treat epilepsy.
It’s also evidence-based for PCOS (polycystic ovary syndrome), where it helps to lose weight and correct hormonal abnormalities.
You can achieve ketosis (with supervision or a doctor) by decreasing carbohydrate intake as well as exercise and fasting.
This is something I've more recently started checking. I use this monitor to check my glucose and ketone levels
Generating ketones via supplementation is being studied particularly for brain health, including traumatic brain injury. This is ripe for patenting which can then be sold at very high prices when you can actually achieve it yourself for free.
Peter Attia discusses one such supplement here. To me, it doesn't make sense to supplement with ketones if you’re still over-ingesting carbohydrates and making the brain insulin resistant. Alzheimer's has been called "type 3 diabetes” for this reason.
Hormone therapy:
Like I said, I did not believe that it was my time for hormone therapy when I was feeling foggy. There was a whole lot more to my story.
But there is absolutely evidence for hormones being beneficial for brain health. These are very important, protective, and anti-inflammatory substances for the brain.
Just like with heart health, timing matters. Starting HRT (hormone replacement therapy) earlier into menopause has great benefit: a 22-32% decrease in Alzheimer’s.
If dementia has already begun, hormone therapy is not going to reverse it.
I think we will only continue to see more great work in this area.
Exercise:
Why? A substance called brain-derived neurotrophic factor (BDNF) is one molecule that helps brain health. This is released with various types of exercise and helps memory and learning.
Types of exercise that release BDNF and VEGF:
moderate intensity aerobic exercise (Think: brisk walk)
high intensity interval training (HIIT) (Think: sprinting intervals)
resistance training: think weights or bands (I use these) with increasing difficulty. This is also great for muscle and bone building.
Intensities are defined by each individual person. See here for how to estimate yourself.
No smoking or drinking:
Chronic cigarette use is associated with impaired brain function, learning and memory. This is due to overall shrinking of the brain and neuronal changes.
Alcohol and menopause is like walking uphill both ways. Menopause is associated with depression and anxiety which can lead to substance/alcohol abuse and vice versa.
Alcohol is disruptive to sleep, despite the “night cap” initially. Sleep will have less REM (rapid eye movement) and lighter sleep, meaning less memory consolidation and more waking up.
I fell for the marketing schemes and thought wine was healthy, carefree and luxurious. Don’t fall for it. Alcohol should be occasional to rare, if not absent.
Both alcohol and cigarettes are linked to the reward pathway, making them addictive and powerful.
Natural light:
Light drives our circadian rhythm, our internal clock. Light in the morning is what tells our bodies to wake up, through the suprachiasmatic nucleus in the brain and ultimately melatonin is suppressed.
In the evening, natural light tells our bodies to rest.
Artificial light is very new to human history but we are surrounded by it. We hold it in our hands and stare at it.
Artificial light in the evenings makes it harder to fall asleep, decreases melatonin, and wakefulness the next morning. Sleep studies have shown a change in depth of sleep with this light exposure within three hours of bedtime.
I leave my phone in another room if I'm not on call. If I’m on my phone before bed for some reason, I absolutely can tell the difference in the morning.
I used to use it as my alarm clock. Now I use a sunrise clock like this.
I’m considering some other light changes in my house and I need to investigate whether they more closely align with the natural light spectrum.
Sleep:
Sleep is worth mentioning in its own section rather than just downstream of alcohol use because it's that important.
Sleep is necessary for brain functions like reasoning, decision-making, learning and memory. It’s how we recall memories and can store new memories. Isn’t that amazing?
These can be small changes with big impact, and pretty inexpensive. Make some changes now before expensive medications are marketed to you for things you can do yourself.
I’m all about it.
Resources:
Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.
The author can earn commissions through affiliate links.
Disclaimer: This is not medical advice. This is for educational purposes only. Discuss with your doctor.
https://qbi.uq.edu.au/brain-basics/brain-physiology/what-neurogenesis
https://espace.library.uq.edu.au/view/UQ:286854
https://seafood.oregonstate.edu/sites/agscid7/files/snic/omega-3-content-in-fish.pdf
https://www.powershealth.org/about-us/newsroom/health-library/2025/09/17/timing-of-menopause-hormone-therapy-key-to-protecting-brain-from-alzheimers#:~:text=Researchers speculated that hormone therapy,in a peer-reviewed journal.&text=The Mayo Clinic has more on hormone therapy for menopause.
https://ima-files.s3.amazonaws.com/401570_7ae7eaea-a18b-4ded-a39d-e1422324ad2b.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC2996190/#:~:text=Chronic cigarette smoking appears to,recovery with sustained smoking cessation.
https://www.sciencedirect.com/science/article/abs/pii/S0378512217311027
https://pmc.ncbi.nlm.nih.gov/articles/PMC6751071/
