Of all the hepatitis C symptoms, the most disabling for me were brain fog and fatigue. Brain fog was overwhelming. It was as if my thoughts were enveloped in a dense fog and I couldn’t access them. I could apply all the willpower, effort, and positive thinking I wanted, but it was impossible to think.
Fatigue is that feeling of being exhausted. There is no energy to do anything. Fatigue and brain fog often occur simultaneously, and when they do, forget about functioning. When fatigue and brain fog are severe, driving is unsafe, working is impossible, and life feels difficult to navigate. 
Brain fog affects approximately one-third of hepatitis C patients. Studies have presented evidence about hepatitis C’s impact on cognitive ability.  Hepatitis C patients report problems with memory and concentration. Thinking and psychomotor skills are slowed. Performing certain tasks can be frustrating. Some patients have trouble reading or remembering what they read. 
Brain fog and fatigue are real, and researchers are constantly gathering more insight about the cause. There are quite a few studies affirming our experiences of brain fog. In this blog, I’ll briefly mention some recent research that found neurologic complications in people living with hepatitis C. 
Briefly, there appears to be a breakdown in the neural pathways in the brains of people with hepatitis C. This impedes the brain’s ability to send messages from the prefrontal lobe to the basal ganglia. The study subjects were at higher risk of increased fatigue and poorer cognitive performance.  (Neuroimaging Abnormalities, Neurocognitive Function, and Fatigue in Patients with Hepatitis C - April Thames, et al. American Academy of Neurology, January 2015)
Although HCV-related brain fog is real, there are things we can do about it. Cognitive impairment has many causes, and we can improve our quality of life by reducing our exposure to variables that may worsen fatigue and brain fog. Here are a few tips:
Talk to your health care provider and rule out other causes of fatigue and brain fog. Hearing loss, sleep problems, thyroid disease, psychiatric disorders, stress, vitamin deficiency, alcohol, and drugs can make us feel fuzzy. Aging and menopause may also affect cognitive abilities.  
  • Hepatitis C Treatment - Successful hepatitis C treatment is associated with improved cognitive function and decreased fatigue. I have noticed a definite improvement. However, I do experience fatigue and brain fog occasionally, just like other human beings. Most of the time, a nap or a good night’s sleep will fix the problem.
  • Sleep - Poor quality or insufficient sleep interferes with cognitive ability. Aim for 7 to 8 hours of sleep a night. 
  • Exercise - Physical activity is the best brain boost there is. Regular daily exercise is best, and even a mere ten minutes can be beneficial. Make exercise fun, and you are more likely to do it. 
  • Stress Reduction - Too much stress is unhealthy, and it feels awful. Sometimes stress is unavoidable, but that doesn’t mean that you have to let it kidnap your brain. Learn stress reduction techniques, such as meditation and mindfulness practices. Find techniques that work for you.    
  • Diet - Eat a low fat, high fiber, low sodium, no sugar diet. Include fruit, vegetables, and whole grains. Avoid trans and saturated fats. Choose lean animal or plant-based proteins, such as chicken, fish, beans, nuts, and seeds. 
  • Hydration - Be sure to drink plenty of water throughout the day.
  • Laughter - Don’t forget to have fun in your life. The health benefits of laughter are numerous. Pleasure releases healthy chemicals in the brain, and let’s face it, laughing feels good. Laughter needs no prescription and you can start right now.