Overcoming chemo brain

Figure of a man sitting next to a question mark

For a good couple of years after completing chemo, my head was all over the place. My memory was pretty poor, I found it really difficult to focus, and my ability to figure things out was quite badly affected.

I vividly remember travelling to Sydney (3.5 hours’ drive away) for an overnight appointment at the hospital. I packed my suitcase and hung the clothes I wanted for the next day on the bedroom door. My husband was keen to make an early start to avoid traffic, so we rushed to load the car. We were an hour up the road before I realised that I didn’t have my clothes in the car. Hubby was not best pleased!

I know that I’m not the only one: between 20 and 30% of people who undergo chemo have problems with cognitive impairment. Radiation therapy for brain tumours and some immunotherapies can also cause it.

Causes of chemo brain

So what causes chemo brain? You might be thinking that it’s just one of the side effects of the drugs that are used. They certainly have a part to play. They’re highly inflammatory and many of them can cross the barrier into the brain. An inflamed brain doesn’t work well.

Sometimes it isn’t the chemo drugs that are the problem but some of the others used alongside treatment, like anti-emetics, which are also inflammatory.

But cognitive impairment can happen during and after cancer treatment without chemo too. Stress plays a big part. We’ve all experienced our minds going blank when we’re anxious, I’m sure, and a cancer diagnosis is a very stressful experience. I cover lots of ways to reduce stress in my book. You can check it out using the button at the bottom of the page.

Sleep plays into it as well. I don’t know about you, but my sleep patterns were all over the place for a long while after treatment. I certainly don’t function well without a good night’s sleep. Again, my book outlines many remedies for poor sleep.

Low blood counts, particularly haemoglobin, mean that the brain is effectively starved of oxygen, which has an inevitable impact on its function.

Fatigue plays a part too. None of us functions at our best when we’re feeling exhausted.

Cancer treatments also affect our hormone levels, which can have knock-on effects on our mood and energy levels. In women, it often leads to early menopause and one of the symptoms of that is depression. Depression is very common in men going through treatment too, particularly for hormone-dependent cancers.

How to reverse chemo brain

Time often, but not always, sees our cognitive function return after treatment. But most people are keen to get back to ‘normal’ as quickly as possible. Sadly, you can’t just take a pill and reverse it. But there are some natural treatments that can make a significant difference.

Phosphatidylserine

Phosphatidylserine is a lipid (fat) that the body produces itself, but it is also found in organ meats (liver, kidneys, heart, brains) and white beans. It’s available in supplement form too, derived from soy lecithin. It’s needed for making cell membranes and is a major building block for nerve cells.

Research shows that it helps to benefit learning, concentration, memory, word choice and other cognitive factors, as well as improving symptoms of depression and stress levels (1). It’s also been shown to help older people with mild to moderate dementia and those with age-related cognitive decline (1). It has even helped children with ADHD (1).

It’s very safe. It can cause mild digestive problems, but clinical trials show that it’s safe to use it for up to 6 months at doses of 100 mg, 3 times a day.

Acetyl-L-Carnitine (ALC)

ALC is needed to convert fatty acids into energy and is also used to produce acetylcholine, which is an important neurotransmitter that is involved in the transmission of nerve impulses. It’s well absorbed, better than carnitine itself, and it can reach the brain better through the blood-brain barrier.

Trials show that it can help improve the brain function of Alzheimer’s patients (1), (2). It seems to work by reducing stress hormone levels. In the second paper, the trial used intravenous ALC  for the first 10 days, and followed with another 50 days of oral ALC using 1.5 grams per day.

It’s also been trialled successfully in ex-alcoholics ranging in age from 30 to 60 who have cognitive problems. At 2 grams a day over 3 months, it improved their word recall and memory (1).

In another piece of research, ALC improved depression, sociability, cooperation and attention to personal grooming (1).

Dosage needs to be fairly high. Most clinical trials use between 2 and 3 grams of ALC a day, but these levels have been used safely for up to 33 months (3).

Most people have no side effects with ALC, but the more common ones include headache, insomnia, dry mouth, agitation and loss of appetite. A few people find it can cause their breath, sweat and urine to have a fishy smell (3).

L-theanine

L-theanine is an amino acid that is found in green tea and mushrooms. There has been quite a bit of positive research into its effects on brain, improving its function and lifting mood. This is a supplement that I use regularly because I can’t tolerate much caffeine. It’s a lifesaver when I need to focus.

It’s been shown to protect nerve cells and improve their ability to regenerate, and to suppress the death of nerve cells after a mini-stroke (4).

A recent trial looked at its effects on a group of healthy middle-aged and older men and women to see whether it affected their brain function. It ran over 12 weeks. They took 100 mg each day of l-theanine or a a placebo. After the first dose, they were given a standardised test of their brain function. That one dose showed that their working memory was better and their reaction times were significantly faster than the placebo group. It increased the number of correct answers in the test and reduced the number of errors caused by missing answers. Taking it on an ongoing basis didn’t seem to improve on that, though (4).

A review of studies into l-theanine found that it helped young people with ADHD, helps with stress-related disorders, reduced the symptoms of depression and improved cognitive performance (5). It’s also an antioxidant, improves sleep, has anti-cancer properties, reduces anxiety, protects the heart, kidneys and liver, and is anti-inflammatory (5).

Most people have no side effects from it, although it can cause drowsiness in some people. It could lower blood pressure, so if you take medication for high blood pressure it might increase its effects (6).

The usual dose is 200 – 400 mg per day and it’s been used safely in trials for up to 8 weeks (6).

Bacopa (Bacopa monniera)

Bacopa, also known as Brahmi, has been used in Ayurvedic medicine (Indian traditional medicine) for centuries to boost memory, reduce fever, and as a painkiller, anti-inflammatory, sedative and anti-epileptic medicine.

A full double-blind placebo-controlled clinical trial has also shown that it’s a powerful antioxidant and that this helps to boost cognitive function (7). The participants took 300 mg of a standardised capsule that contained the equivalent of 3 g of the dried herb over a 12 week period.  It significantly improved their visual information processing, memory, and ability to learn. They also had a reduction in anxiety, although they didn’t start with any diagnosed psychiatric condition.

Most people have no problem with taking bacopa, but some experience dry mouth, nausea, stomach cramps and diarrhoea. If you have hyperthyroidism, take care with it because it may worsen it. Also, it may interfere with a range of drugs, so check with a qualified health professional before you use it along with any medication (6).

So if you are going through a difficult time remembering things or finding the right word, these are a few options that you might want to try.

If you have other side effects, I cover them in my book. Find out more here by clicking the button below.

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Resveratrol’s benefits for cancer patients