Here’s how to know if your brain is firing on all cylinders

You can also watch the full episode on Rumble and Odysee and Bitchute!

Brain fog isn’t a diagnosis. It’s a warning sign. If you’ve been feeling off lately—forgetful, distracted, or mentally dull—you’re not alone. Brain fog now affects up to one in three people. But what causes it? What can you do about it? 

Listen now on Apple Podcasts and Spotify too!

Before you go further, I want you to have this:

I created a special breakdown called Brain Hijackers. It reveals 10 hidden neurotoxins in everyday products—foods, medications, cosmetics, and even your water. You won’t find it on YouTube. It likely wouldn’t stay up. That’s why I made it available here: andrewkaufmanmd.com/brain-hijackers

If you’re dealing with brain fog or subtle cognitive changes, this is the place to start.

In this episode of The True Health Report, I take a deep dive into the real reasons behind chronic mental fog. I’ll explain why most conventional approaches miss the mark. You’ll learn how to start investigating your own cognitive function using simple, practical tools.

"Brain fog is not a medical term. But that doesn’t mean it’s not real or reversible."

What Is Brain Fog, Really?

Brain fog is a term people use when they feel mentally cloudy. Slower thinking, forgetfulness, trouble concentrating, or feeling like they’re not fully "online." While it’s not a formal diagnosis, it often points to deeper imbalances:

• Exposure to environmental toxins
• Reaction to pharmaceutical interventions
• Chronic stress or nervous system dysregulation
• Nutritional deficiencies
• Neurological inflammation

Many of these causes are overlooked by mainstream medicine or dismissed entirely. That’s why I believe it’s important to take a closer look for yourself.

A New Way to Assess Mental Clarity

In this episode, I introduce a simple cognitive performance self-assessment. It’s called the Montreal Cognitive Assessment (MoCA). It’s typically used in clinical settings, but I’ll show you how to use it at home. It gives you a better picture of your own mental sharpness.

Instead of accepting cognitive decline as “normal,” I encourage you to ask better questions. Track changes over time.

The Hidden Triggers No One’s Talking About

We also explore several under-the-radar contributors to brain fog that don’t get enough attention:

• Artificial food additives and emulsifiers
• Prescription drugs like antidepressants and PPIs
• Heavy metals and flame retardants
• Fluoride and other contaminants in tap water

This episode doesn’t offer a full protocol. But it lays the groundwork. You’ll know what to notice and what to start avoiding if you want to restore mental clarity.

If you’re serious about protecting your cognitive health, start here.

• Understand the real causes of brain fog
• Self-assess your cognitive performance
• Learn what to start avoiding today

Subscribe to The True Health Report podcast so you can become your own health authority.

Resources

Montreal Cognitive Assessment

What is Brain Fog

Evaluation of extent and pattern of neurocognitive functions in mild and moderate traumatic brain injury patients by using Montreal Cognitive Assessment (MoCA) score as a screening tool

The unedited podcast transcript for this episode of the True Health Report follows

You're not lazy, you're not broken, and you're definitely not imagining it. Brain fog hits one in three people, and today I'm going to show you the signs that it might be affecting you.

Welcome to the True Health Report. I'm Dr Andy Kaufman, recovering physician, pandemic, whistleblower, natural healing, pedagogue and legal code talker. You can call me the truth doctor. My mission is to shift your paradigm as we dive into radical forensic dissections, discerning fact from fiction, science from pseudoscience, medicine from poison law from legal fiction and individualism from collectivism. This podcast is your channel for unraveling the truth about health and science together, we'll challenge the narratives, expose the fallacies, and empower you to become your own health authority. 

This is the true health report where critical appraisal fuels true freedom. You and hello everyone. I'm Dr Andrew Kaufman, and today I'm going to talk to you about a somewhat nebulous subject, brain fog. Now, brain fog is not exactly a medical term. It's more of a lay term, and it only came into existence in the past couple of decades. Now, if you look in on the internet now or in the medical literature, you'll often see brain fog associated with COVID, specifically with long COVID and post immunization syndromes. 

However, this term, as I said, is not well defined and applies to many, many different situations, and it may, in fact be the only thing that you're dealing with. So let's take a closer look at how we can figure out if this is something that we are in fact dealing with by looking at what other people say about it. Now I just want to start off first and say that there are many well established causes of cognitive deficits, meaning impairments in your thinking, reasoning, memory, attention and those domains that are known as your cognitive functioning, or your intelligence, your smarts, your basic abilities with respect to that, that, of course, mostly are far ahead of the animal kingdom. 

Now these can include, of course, things like dementia and mild cognitive impairment, which is the beginning stages of dementia, but also things like attention deficits, concentration problems, brain injuries and many, many other conditions that can result in some form of cognitive decline. So without figuring out all the details about what is the specific cause of your condition, I want to give you a way that you can first understand exactly what brain fog means, at least to most people, and then also a way that you can ask yourself some questions. And I'm even going to go over a standardized assessment instrument to determine if you are not performing at your best with respect to your cognitive abilities. 

And this, of course, will be very important, because in almost all cases, there is a lot you can do about it to recover those mental capacities that may have been slipping due to a variety of causes. So I'm going to discuss two papers today, and if you go to the link in the show notes and go to my blog page, you'll see that all of the references are displayed there as well as the transcript of this episode. So that's a great place to go for additional resources. It's very important that everything that I talk about is referenced. So this first paper is entitled, What is brain fog, and this is a very interesting kind of exploratory study, because what they did is went on a social media platform, specifically Reddit, and they searched for posts that contained the words brain fog. And then what they did is they did an analysis to see what types of experiences people report. Now they found 1663 posts. That met the criteria. And out of those, they actually analyzed 717

so that would be included in these numbers. And there are various experiences that I'll discuss, one at a time, that were reported, and the most prevalent 51% of these posts contain depictions of forgetfulness, or obviously memory problems. And this is, of course, what I was alluding to in the intro to the show, that we might be more forgetful, misplace things, forget names, appointments, places and things like that. And so this is the most common experience that people have. Now, of course, you may in your own recollection, of your own forgetfulness, you may be misled, because you may sort of, we have a tendency to hide some of our weaknesses, so doing an objective test for memory is very helpful to make a more objective determination and see how your memory stacks up against the average individual. 

Now the second most common reported symptom is difficulty concentrating, and this, of course, is something that we've all experienced from time to time, but has it interfered with your ability to learn things or get things done? And I think it's important that when we think about these types of symptoms that we always consider, has it resulted in a functional impairment, like, are we unable to do something that we perhaps were able to do before, or are we unable to meet our own objectives, goals or the expectations, perhaps of our boss or of the workplace as a result of a lack of being able to concentrate? 

So if you are unable to sit down and think about a complex problem and make decisions. It could be that your concentration is affected. Now, there are a couple of symptoms here that are not typically associated with cognitive decline, but are somewhat unique to this amorphous term of brain fog, and one of those is dissociative phenomena. Now I want to explain what dissociative episodes or dissociation is, because this is a term that actually comes from psychology, and it was something that I have seen a lot in my psychiatric practice, because it is associated with severe trauma, but it is normal that we all dissociate to some degree. And what it's literally referring to is that our senses become disassociated from our internal mental experience. 

So if you ever did an activity that you sustained your attention for a long period of time, like, for example, a long trip in a car where you were driving, you may notice at certain times that you suddenly kind of think, oh, was I just sleeping? Am I not paying attention to what's going on? And you realize that, oh my god, you kind of lost attention. Maybe you even missed your exit. But all of that time, your senses and muscles were working together that you were driving safely, you were staying on the road, you were staying in your lane, you were obeying the speed limit, or at least you maintained a consistent speed. 

Perhaps it was above the speed limit, but nevertheless, your mind and your mental experience were separate from what was going on with your body and your senses driving the vehicle, and that is a dissociative episode, or a dissociative experience. Now, when this happens more often than it should, or if it interferes with you completing tasks and activities, and you might even think about this similar to daydreaming, or even more seriously, if you end up in a different place while you're dissociating and you don't know how you got there, then this could be a more serious issue. 

But certainly, if this happens, you know more than on occasion, or if it notably interferes with anything, it's definitely an issue that was in 34% of the respondents. The next most common symptom is cognitive slowness and excessive effort. So in other words, you're not able to do complex tasks or problem solving or things that require a lot of thinking, planning, organizing, perhaps as quickly, and it requires more effort. And I think that this is. 

The closest to what is known as executive functioning, which is a higher level cognitive domain which involves planning and organization. And we're going to look at how to assess that more objectively as well. But this is one of the ones I think you can know from your experience. If this is a problem for you, pretty easily, and that was present in 26% of the posts that were analyzed. Now the next ones were at a lower frequency. 

Communication difficulties at 22% fuzziness at 10% and fatigue at 9% now, communication difficulties is quite a vague and vast possible issue, but if we assume that it is language related, then we definitely can think about some specific issues with language, like word finding difficulties might be a common One that you're talking about something, maybe from your memory and you can't remember a particular word, or in some other context of a conversation, when you're always having difficulty finding the right word. Would be one kind of example. Another would be, is if you are putting sentences together in in awkward ways, or having difficulty explaining yourself that the other person is commonly confused, honey. Yes,

I wanted to tell you about this watch that I saw when I was out of town. You know, I found this really cool store and went and saw this watch, and it had a silver dial, and, gosh, I can't remember what it was called, like, what, wait, what? What brand was it? Oh, man, I think it starts with A, B. Does that sound familiar? You know, any b watch bands, brands? I can't think of any No. Well, I mean, it was at this great store. It was called, gosh, I can't think of a name, you know, but I first heard about this watch on that YouTube channel, you know, the really popular one that I always talk about with the watches. But do you remember what that's called?

No, oh, man. What is going on with me? You seem to be having a lot of trouble lately remembering certain things.

Did we talk about that before? I think that looking really at who you're communicating with and asking them about it might be really helpful to assess if this is really an issue for you now, fatigue, which was only present in 9% of the posts, is certainly something different, and that refers more generally to the Body, because this wasn't specifically cognitive fatigue, but fatigue in general, or a lack of stamina, and this may be something that is more common with people who are also suffering from another other health problems that may not be able to be assessed from the way that they conducted 

This particular analysis, because there are many other health conditions associated with brain fog, and some of them came up in the posts on the study, including, for example, psychiatric conditions and fatigue is often associated with depression and is one of the symptoms. Or low energy is how they describe it there. 

But I think we're really splitting hairs to say that fatigue and low energy are different things also autoimmune disorders is another type of illness that they've commonly found in these posts, and that also can be associated with substantial fatigue, not just from the medications, but from the illness itself as well. So I think we have a variety of domains to think about that are associated with brain fog. And I've given you a little information how to think about these things in terms of assessing yourself. 

And this would be a good time, perhaps, to pause and consider some of these things or make a few notes to yourself, which are the symptoms that you want to look at or think about a little bit more carefully. Now I want to bring up one additional study that is about a particular instrument. Now this assessment or screening tool really is what it is, is called the Montreal cognitive assessment, and I learned about this initially during my psychiatric training. 

And it is a pretty short test that is free, and in fact, in the show. Notes on my blog site, there is a link to the PDF, including the instructions. So it's a very short screening tool, and it has really, really excellent psychometric properties, or in late term statistics. So when it has been administered to people with even very, very mild impairment in their cognitive abilities. It has shown that it can do a very good job of differentiating those folks from people who have normal cognitive functions. 

So this has become a gold standard to assess people with, you know, very, very mild cognitive impairment, and which is technically called mild cognitive impairment, or MCI. And this, you know, condition is thought to be the beginning stages of dementias like Alzheimer's disease. However, in other areas with different types of cognitive impairment, it is also shown to be just as good at helping you figure out if this is a real impairment or perhaps you're a little bit just worried about nothing. 

And so this study that I'm going to bring up is called the evaluation and extent and pattern of neurocognitive functions in mild and moderate traumatic brain injury patients by using the Montreal cognitive assessment score as a screening tool. And this study actually was done in India, but which I think is good that a Canadian instrument is being studied in India, but it's because it's a very valuable instrument. 

Now, earlier my career, actually did research with this particular assessment, looking at competence to stand trial. So these are criminal defendants who may be suffering from an a mental illness or a developmental issue that they are of low intelligence, and there is a legal standard that someone has to be able to understand their court case and their charges in order to go through trial. If they're not competent to do that, there has to be some other type of remedy, because it would not be fair. They wouldn't be able to stand up for themselves and understand what they're agreeing to. 

And it's very challenging to evaluate these people, and there's no systematic way to screen jail inmates for competence to stand trial. So I studied a population of jail inmates and who are having competence assessments done by two independent psychiatric experts. And I compared the results of the Montreal cognitive assessment to that, and it turns out it was also good at predicting that. So it is a very good screening tool. And in this study that I'll describe here, it was very, very helpful with traumatic brain injury as well. 

So what they did is that they recruited a number of individuals with traumatic brain injury that had already been fully assessed by other methods and was categorized as mild or moderate, because, like I was alluding to earlier, one of the difficult things with a test like this is to detect a very, very mild impairment. So this has been shown over and over again in different contexts to be good at that, and this was no exception. And so there were a very statistically significant differences between the mild and the moderate group in terms of their impairment. 

And as well as differentiating the people with a mild traumatic brain injury versus people without any brain injury, who have full normal cognitive function, and they found that a couple of the same areas that I talked about that were present in brain fog also were able to be discriminated very well using this instrument, and that includes executive functioning, memory and attention, which were really among the most common of what we saw with brain fog from the other study. So the Montreal cognitive assessment, in my opinion, is the perfect instrument, and it only takes about 15 minutes to do to figure out definitively if you have a cognitive impairment that you should investigate further. 

Now let me just say that the dissociative episodes and the fatigue are not going to be assessed with the Montreal cognitive assessment. So if those are the primary issues that you're dealing with, I think that it would probably be a good idea to do a little bit more research about those experiences and consider speaking with a health professional. Okay, so I'm going to share. Share my screen here. So this is the document that you can download from the link on my blog website. And what you'll find in this document is the Montreal cognitive assessment version 8.1 in English. 

Now it is available in other languages as well. Now this is the actual test form, but what we also have in this document are the instructions, the administration and the scoring instructions. That's version 8.2 and this is for version 8.1 so you need one other person in order to do this, and what you should instruct them to do is give them the instruction sheet and just ask them to follow it to a T now what they're going to do is they're going to give you instructions of how to complete this test so you want to don't read it ahead of time after you complete it and get a score, if you want to read it, that's fine, but what you should do is don't read the instructions, don't look at the test, but print it out, and then, you know, ask someone to administer it to you and tell them to just follow the instructions, word for Word. 

Now, in the instructions. It actually tells the whoever's administering the test, the Proctor, exactly what to say to you in quotes. So they'll give you the they'll read the exact instruction for each thing, and then in there, it even says that you can repeat the instruction up to two times upon request, but you're not allowed to answer any questions or give any other kind of feedback, and it's really important that you just follow the instructions. So because this is standardized to those instructions, and this is one of the things I really love about this instrument, because other instruments don't have specific instructions to administer it, and you have to wing it, and I think that creates a lot of variability in the score. 

This one is much more scientific, in my opinion. Now I just wanted to go through the different domains that are assessed here, and then talk a little bit about the level of education and why that matters as well. So we have here the visuospatial and executive functioning, and those are kind of related, because it's assessing your executive functioning, partly in a visual spatial domain. So it's going to test your sensory integration as well as your planning and organization. And it has this is called a trail making test. And then there is the cube test as well, and the clock drawing test. And many people who have practiced in psychology or psychiatry know about the clock drawing test because it's kind of a classic. 

So this top is going to assess those higher functioning areas in your cognitive domain, the executive functioning, which we saw, was well represented in the reports on brain fog. Now, now we're going to go into some naming, and that is going to cover some language as well as memory. So some of those communication difficulties may be assessed in there. Then we're going to go into a specific memory test, and that is a very sensitive test. So if you have objective memory problems, you'll have some difficulties there, most likely, as well as on other areas of the test, then you have a test for attention,

then some additional language testing, then we have abstract reasoning. And this may not apply as much, but it could be related to concentration and dissociation can disrupt this. And then we have the the second half of the memory test, the delayed recall. And lastly, orientation. And now, if anyone is not getting all the points for orientation, then you definitely need to undergo some additional evaluation. Now, the last thing I want to point out here is that and it tells you what a normal score is, and it tells you, then to add one point if you did not complete high school. And this is actually important, because it's been shown in the testing data that people with higher levels of education have higher scores. 

So one time in a forensic setting, I was evaluating a math professor in graduate school, someone who was very advanced now he would score a perfect score on an. Assessment like this, and he scored, I believe, a 28 now that is not low enough to be the cutoff for a problem, but because he was so highly educated and intellectually advanced in his career, that 28 for him was very significant. And when we did more in depth testing, it showed the true level of deficits that he had, especially with his memory, and he couldn't really go on as a professor. So I just want to caution you that if you are among those who are highly educated and in a very advanced intellectual pursuit, that you should expect to get. You know, nearly a perfect score on this, and you might want to change your cut off a little bit. 

But I think for most of you, whether you went to high school or not, it's probably not going to make a big difference. Because I think if you're listening to this video, most likely, even if you didn't have a formal education, you had an auto didactic education, and that really counts just as well. All right. Well, today I introduced the topic of brain fog, that it is a nebulous term difficult to define, but we looked at what the common experience actually consists of for people based on their social media posts. And then I gave a discussion about how to think about those issues for yourself and to assess if it's really a problem. And finally, I presented an excellent assessment tool that can help you get a more objective answer to see if you really have a deficit there that is consistent with brain fog and should motivate you to take further action. 

Now I don't want to leave you all worried that if you do have a problem, there's nothing you can do about it, because there are many, many things that you can do about it, from nutrition to detoxification, cognitive exercises and rehabilitation. And of course, I try to identify the cause and make sure that you remove it and reconcile it. I offer many educational resources to learn more about these techniques, and I encourage you to go onto my website to check them out and get yourself some free educational materials. I look forward to seeing you again on the next true health report.