Why Do Allergies Cause ‘Brain Fog’?


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Q. When I have allergies or a cold, I find it difficult to think. How does sinus congestion affect the brain?

A. The short answer is no one really knows why people often report feeling “fuzzy headed” when they have allergies or a cold.

“It’s not something you could demonstrate on a test or scan,” said Dr. Richard Lebowitz, a rhinologist and otolaryngologist at NYU Langone Medical Center.

But the condition is real. Children with untreated allergies perform worse in school than others, research has found, in part because allergies can interrupt sleep and make children feel tired, but other factors may be involved as well. Young students’ grades improve when their allergies are treated with nonsedating, long-acting medication, studies suggest.

“The thought is allergies are essentially inflammation in the nose and sinuses,” said Dr. Mark Aronica, an allergist at the Cleveland Clinic. This inflammation triggers the release of proteins called cytokines as part of the immune response.

The same process happens when you have a cold. “These cytokines are there to help fight infection, and also have an impact on our ability to think and function and perform,” Dr. Aronica said. The result is that people with allergies or a bad cold often feel as if they are seeing the world through cheesecloth.

The immune response can also contribute to fatigue. With allergies that are triggered for weeks or months at a time, “sleeping off” that exhaustion isn’t feasible, so treating the allergies is the best approach, Dr. Aronica said. “If you control the symptoms, that brain fog may go away.”

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