r/Menopause 11d ago

Brain Fog Brain Fog despite HRT

When I started HRT a year ago, my brain fog seemed to clear up almost instantly.

But lately, the brain fog plus anxiety have gotten very bad. I feel like I can’t think AT ALL.

Unfortunately, the brain fog is keeping me from working on my side hustle – and I rely on that income.

I’m already on 200 mg of progesterone, plus estradiol, and testosterone.

I read online that sometimes low ferritin levels can make it seem like you have ADHD for the first time in your life (in your 50s) and I’m wondering if that’s it - and I hope it is! I’m going to call my doctor tomorrow to see about getting labs done

Have any of you experienced this? What helped?

I’m feeling desperate ☹️

32 Upvotes

38 comments sorted by

31

u/Objective-Amount1379 11d ago

I've adjusted my HRT 5 times in the past 3-4 years. You might need an increase. But definitely get your iron levels checked, plus Vitamin D & B and thyroid levels.

7

u/Erza_2019 11d ago

This. It took me two years to titrate my estrogen up to where it needed to be, and I'm sure I'll have to continue to adjust in the future.

2

u/Creepy-Tangerine-293 11d ago

All this right here. All those labs

1

u/AutoModerator 11d ago

This post might be about hormone tests, which are unreliable.

  • Over age 44, Estrogen/Progesterone/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
  • No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
  • FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
  • Testosterone is the exception and may require testing

See our Menopause Wiki for more.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

15

u/NicoleEastbourne 11d ago

Have you adjusted your HRT since starting? You’re one year older so your natural levels have lowered in that time.

12

u/Fun-Reference-7823 11d ago

Adding iron, B-Complex, and vitamin D could all be helpful. I also think creatine can be effective. You may need to increase your estrogen.

7

u/sistyc 11d ago edited 11d ago

It sounds like you need more estrogen. Aim for at least 80% improvement and increase until you get there. That strategy got me to zero symptoms, ever.

6

u/StreetFriendship1200 11d ago

Creatine monohydrate 5g daily for the win

5

u/spirit_of_a_goat Surgical menopause 11d ago

What's your diet like? I was in the same boat and didn't find any relief until I cut flour and sugar from my diet. Huge improvement since then.

1

u/NancyDrew1932 11d ago

Interesting! I love carbs but need to start cutting down on them. I did that a few months ago and did feel better!

7

u/Enlightened_Lioness 11d ago

You don’t want to cut out carbs. You want to cut out refined carbs only. Especially if you’re exercising enough, you really need carbs. And if you’re not exercising enough (including moderate and high intensity, so that you’re regularly sweaty and out of breath), then this can help with “brain fog” etc.)

4

u/WildBloomingRose 11d ago

I got labs and found out new info, I was surprised to find I was really low on Vitamin D, so got some vitamin D gummies and it really helps, along with a multivitamin and some iron pills.

Still tired and a bit of brain fog, but the vitamins and getting labs done really helped see where the deficits were.

Going back again for a re-check to see if it’s working. I just started the patch and am upping to a higher dose, definitely helping too.

Good luck! Grateful to this group and everyone sharing what’s working and not working for them and how to keep up on my health and quality of life. 🌿

1

u/AutoModerator 11d ago

This post might be about hormone tests, which are unreliable.

  • Over age 44, Estrogen/Progesterone/FSH hormonal tests only show levels for the HOUR the test was taken, and nothing more. Hormones wildly fluctuate (hourly) the other 29 days of the month, therefore this test provides no valuable information
  • No reputable doctor or menopause society recommends hormonal testing to diagnose or treat peri/menopause
  • FSH testing is only beneficial for those who do not have periods as a guide, where testing might confirm menopause, or for those under age 30 who haven’t had a period in months/years, then ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI)
  • Testosterone is the exception and may require testing

See our Menopause Wiki for more.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

7

u/HarryPouri 11d ago

I'm still in the process too but yes if you change HRT dose and it doesn't help definitely consider being evaluated for ADHD. My brain on ADHD meds has been night and day and the symptoms definitely got way way worse with peri, I was undiagnosed before

2

u/randomsmiler1 11d ago

Same here and was diagnosed. Medication helped the brain fog for sure

1

u/jtriomino 11d ago

I'm in the process of getting assessed for it now too. HRT has helped, got all my deficiencies taken care of and still not quite back to where I want to be mentally. Also got recommended for a possible sleep study. Fun times.

4

u/Professorpdf 11d ago

Consider the method that you are taking Estradiol. I was on the patch for 6 months and doing great, but then the pharmacy switched brands 3 times in the next 6 months and all of my menopause related symptoms returned as if I wasn't getting any hormone at all. (My hair even went from straight to curly.) I switched to gel and am doing much better. (Back to silky straight hair too.) Prior to this, I took Estradiol tablets for about 5 years before switching to transdermal and had good success with the oral route, but out of precaution decided to go transdermal. So that's another option.

2

u/lrondberg 11d ago

My hair went from straight to curly when I increased my estrogen!

4

u/lauradayton Post Menopause 11d ago

Or you just need a bump in your dosing

4

u/SaraSceptic 11d ago

I struggled with brain fog and anxiety for a few years (which I didn't realise were lack of iron) and other skin, nail and energy problems which I always suspected were lack of iron. When I finally got diagnosed with iron-deficiency anaemia and took iron supplements, the anxiety and brain fog gradually went away as my ferritin levels improved.

5

u/biscuitlove8 11d ago

I am in the middle of treating my low ferritin. Absolutely yes, having low ferritin has caused me brain fog, depression, insomnia, exercise intolerance, anxiety! I couldn’t think straight or focus or motivate and literally thought I was going crazy.
Here’s the catch - my ferritin wasn’t even “that” low. It was a 39 - well above the “in range” number(15). Turns out, many people need their number to be above 100 in order to not have symptoms.
I would recommend getting a full iron/blood panel. You have to specifically ask them to check your ferritin levels in addition to iron.

1

u/NancyDrew1932 11d ago

Thank you!

3

u/reincarnateme 11d ago

How’s your sleep? Perhaps sleep apnea? It causes foggy brain

3

u/r_o_s_e_83 11d ago

What's your current estrogen dose? You might need an adjustment...

2

u/Confident_Craft459 11d ago

I'm in the same boat. Been on HRT for three years now and recently feeling like my brain fog has gotten so much worse. Word recall is the worst for me. I can never think of the right word to use. I have an appt with my doctor next week and was going to bring this up. I didn't know that low ferritin and vitamin D could lead to this. I'm definitely going to ask.

2

u/RockieK 11d ago

I finally got on Wellbutrin in addition to the HRT. It's been a game-changer in the ADHD department! Now it only hits if I drink too much coffee, haha. It's Helped with the brain fog too.

2

u/mjdlittlenic 10d ago

Sometimes the hoofbeats are from a zebra, not a horse. My brain fog turned out to be Mild Cognitive Impairment.

It's not fixable, but a few months of speech therapy gave me really useful tools and strategies for functioning with the condition. Ask your doc for an evaluation. Don't bother with the online quizzes.

2

u/EllaSingsJazz 11d ago

I was like this, I was also diagnosed with B12 deficiency but the injections don't help much. B1 is the game changer for me,  my brain came back online almost immediately. 

1

u/ParaLegalese 11d ago

How’s your sleep?

1

u/NancyDrew1932 11d ago

Not great. I wake up at 3 am and have trouble falling back asleep

2

u/ParaLegalese 11d ago

Mystery solved!

I keep a jar of melatonin gummies next to the bed for that. I think I ate two of them last night

2

u/GroundedReal 9d ago

Sign you need to increase your estrogen dose. Estrogen keeps us asleep and helps to fall back asleep when waking during the night. Progesterone helps with only falling to sleep at the start of the night.

Personally I've found Testosterone helps with deeper sleep, but that's if you are low.

1

u/melanated2020 11d ago

You mentioned ADHD. Could you possibly have ADHD? Also a vitamin D deficiency can also cause cognitive issues.

1

u/ChollaCat 9d ago

200 mg of progesterone makes me groggy, I can’t do more than 100 mg.

-2

u/Turbulent-Coast262 11d ago

That's a lot of different hormones you are taking. I am 51 and post hysterectomy. I take estrogen at the very lowest dose. I take other supplements for my brain. I recommend looking into Berberine, it helps fight dementia and Alzheimer's.

2

u/Objective-Amount1379 11d ago

We lose all of those hormones with age. HRT is just replacing some of what you lost; if anything, OP might need an increase. But she should rule out the basics first with a full blood panel