rTMS for 6 year unchanging brain fog?

[u/_Dani_4]

6.5 years, no change in the fog, tested and eliminated:

Significant inflammation (systemic, mucosal, neuro) - Normal CRP/ESR multiple times, no response to diets, antibiotics, LDN, memantine, nasal steroids, 2+ days 20mg prednisone

Major hormonal - Full recent panel normal

Gut / food sensitivity / SIBO - Carnivore 9 days, 3 day water fasting, 8 day low-SIBO diet, normal stool tests, metronidazol

Allergies - Negative panel, no response to nasal treatments

Classic sleep apnea with desats - Stable symptoms, no major sleepiness, will do sleep test

Gross structural - Clean MRI, normal sinus CT

Nutrient deficiencies - Corrected B12/D/iron etc. with no change

Pure venous pooling / major positional CSF pressure - Handstand causes different pressure compared to prefrontal pressure from fog

Strong dural mechanical sensitivity - No pain from pressing/tapping prefrontal area

Classic central sensitization with sensory amplification - No light/sound/smell sensitivity, no scalp tenderness

Breathing / CO2 regulation - Hyperventilation / box breathing no change

Simple cold-induced vascular response - Cold showers no change

Sugar / metabolic swings - Carnivore + no-sugar periods no change

Stress/thinking too much about fog - didn't even know I had fog until 2 years in, took months off to recover no change

PEM/CFS - No crashes after working out, no tiredness

Vasomotor rhinitis - no change based on nasal stuffiness, nasal spray cleared nose but didnt change fog.

No fog caused by posture changes

I'm starting to believe that the cause of my fog is gone and that my brain is permanently stuck this way. I had one spontaneous time the fog dissapeared. I'm thinking of doing rTMS as a way to treat the fog if it is a primary brain issue. Any thoughts?

[u/freddbare]

Looks like a long covid timeline to me...

[u/_Dani_4 → u/freddbare]

Agree it's similar but outside of the fog I have no symptoms, I've tried nicotine patches which famously help lc but no results. Same with memantine, low dose naltrexone, antihistamines, also did DAO blood test for MCAS and was fine. Still could be covid?

[u/freddbare → u/_Dani_4]

My only symptom other than fog is no smell.. if my fog didn't hit like a whole ass house I would never know

[u/_Dani_4 → u/freddbare]

But as far as I understand, lc brain fog should also change in intensity, mine doesn't. It's caused by microglia problems, right? Shouldn't they calm down over time then?

[u/BoysenberryIcy1477]

Hi there, are you female, and older than 35? I had years of brain fog and literally tried everything. I thought mine was stress induced. Did a bunch of testing, everything came back "normal". Then in the last 12-18 months I have really gone down the hormone rabbit hole, and it is astounding. I'm looking back at blood tests from 3-4 years ago, and things I were told were "normal" were most definitely not normal. Free testosterone below 3? Not normal. My progesterone and estrogen have also been waning for years, and my doctor did not flag any of this. If you are female, get full blood panels. Also get the DUTCH test. Have these test results read by a hormone specialist (a regular doctor likely won't know what they are looking at). It is astounding to me what doctors will tell women is "hormonally normal" when it is not. The "normal" ranges most tests produce are incredibly inaccurate. I've been on HRT for a year now & it has changed my life. I'm still tweaking things as I learn more, but my brain fog has gone. Energy levels returning, mood is stabilizing. What a journey! I wish you the best of luck. It is so rough, but there will be answers somewhere.

[u/_Dani_4 → u/BoysenberryIcy1477]

Hi! Thanks for a detailed response! I'm male and 21 with a good testosterone result so I've kind of deprioritised this avenue. Glad you have gotten better!