Brief Answer:
I want you to be back to your old self as well.

Detailed Answer:
Good evening from the North compared to where you're at....I'm a neurologist and familiar with "brain fog"....not because I either have it or have to drive through it in the mornings!....HA! (minor joke)...but because my patients often refer similar symptoms. So a question for you....as I read your symptoms and descriptions I'd like to ask you if you might have a possible eating disorder? Brain fog is commonly experienced by athletic types (especially women in whom this can occur) who stay very fit but have situations where they may have either anorectic, bulimic or combination issues. I ask only because your weight of 118 at 64" for a 25 year old female who "eats well" is a set of parameters that I see commonly in my patients who do have eating disorders. When you tell me that you could eat an entire pizza by yourself and felt fine....I'm wondering about things. I can't remember the last time I saw a woman with your constitution eat an ENTIRE PIZZA (probably a Papa John's large Deluxe, right? LOL) and not have some kind of issue....So please answer that for me and I can give you more specific information regarding what we can do to "lift that fog." I wanna be sure that you're doing safe things and not abusing laxatives or causing yourself to purge, etc.

Now, are you CERTAIN that all of these symptoms were not present AT ALL prior to May 2015? My guess is that there were some things going on before May...possibly as far back as your youth or late teens that you possibly just didn't pay too much attention to until symptoms simply couldn't be ignored anymore. If you still believe that all symptoms came on in May 2015 then, please tell me what was going on in your life prior to May 2015?

Do you work, go to school, got a family, boyfriend or S.O., did you lose a close friend or family member....I know you said your dog....is it possible that you are still grieving that loss and that at least some of your symptoms are related to that situation? I know you said you thought you were coping or somewhat dealing with things...but often we think that something is being dealt with...but in fact, it's still affecting us much more than we can actually see. Are you Ex-military by any chance? Do you suffer from nightmares and if so, how many days a week, and for how long have you had them?

If this is DEFINITELY NOT related to any form of eating disorder or mental anguish then, the other thing I am noticing is that again, for an athletically inclined young lady who stays fit you're seeing an awful of doctors and different types of doctors. That suggests someone who is anxious, nervous, or suffering from depressive mood disorders with a hyperactive component. Have you had labs done involving your thyroid and adrenal glands? I'm particularly concerned for HYPERTHYROIDISM as well as possible pituitary dysfunction. Have you had those types of problems screened for? Has enough done nutritional assays such as serum Vitamin B12, folate, Vitamin D, D2, and D3? How about Magnesium (Mg), Calcium (Ca), and then, Total protein as well as serum Albumin?

When you mention a time component of 3hrs. then, back to normal....that could correspond to rising glycemic indices in blood as well.....do you possibly have some type of either glucose intolerance or insulin resistance....perhaps not to the point of being diabetic...but perhaps getting there? Brain fog is a term I hear often in pre-diabetics. Have you had basic chemistries done recently such as serum glucose, electrolytes, and kidney function tests? How about a Hemoglobin A1C (HbA1C)?

Can you upload a picture of yourself...a full body would be good to illustrate muscle mass and proportions. I believe that would help us think about certain types of nutritional or metabolic deficiencies....also, photos that are close up of your fingernails and the back of your hands would also be helpful....don't need toe nails. Also, if possible a picture of the tongue as well as teeth and gums as you're smiling brightly.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

I'm not able to address your question on spine adjustment since I am an allopathic doctor (neurologist) and not trained or well versed in the technique or physiological effects of internal organs following "spinal adjustments." We don't utilize such techniques.

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 30 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Thank you for your clarifications

Detailed Answer:
Thanks for those clarifications because that helps narrow down the potential list of problems. My daughter is heavy into Crossfit. She is a little shorter than you are....works at least twice daily....she competes constantly (wish she would give me more of a heads up so I can come to all her competitions instead of....."Oh, BTW, I've got this competition today...just so you know...."Really?" I say, "Seriously?...I've got patients in the office, got things scheduled....how about a heads up next time?" She says, Oh, I just decided to go yesterday....

I continue to be competitive also in the sport of wrestling (collegiate and Freestyle/Greco Roman)...training is 4-6x/week on the mat, near daily, weights and cals....my diet sucks....but I can lose up to 10 lbs. in a day if I have to for weighins.....so, I think I understand your physical activity level.....and I'm relieved you don't have an eating disorder.

Now, tell me about the supplements you take....(do you....??). I'm also the Asst. Coach for the University Varsity Wrestling Team and every season I have to deal with guys who think that Supplements= Food. I have guys who crash and dehydrate and they also get Brain Fog episodes...

What labs are you waiting on? I think it's possible that if you're lifting schedule is getting heavier compared to your caloric intake that you could be mismatched metabolically and you're basically pushing your body to more anaerobic levels than you should. As a result you may be accumulating more ketone bodies than your liver and kidneys can handle (depending on your supplemental use....I'm definitely NOT A FAN of supplements).

I know you said you study nutrition so that's very good....but I'm a doctor and I told you how sometimes I cut up to 10 lbs. by working out all day long (no plastics, no saunas, all totally naturally...but of course, I dehdyrate myself too during 6 hard hours of continuous wrestling, running, lifting, whatever it takes).

Bottom line is just because somebody has a certain special skill set or knowledge base.....doesn't mean they use it to THEIR benefit all the time...you know what I mean? You could use a set of orthostatic blood pressures, urinalysis, and the labs that I told you about....you said you were waiting on blood work so we'll see exactly what you got done but I can tell you that the general rule of thumb in someone such as yourself with the complaints you have who is training at that high level complaining of mental status issues needs to be checked for:

1. HYDRATION
2. Electrolytes
3. Hormones (Thyroid, cortisol, etc.)
4. Nutritional status (Total protein, albumin, and of course, PRE-ALBUMIN.....as someone studying nutrition you probably know that PRE-ALBUMIN is a much more sensitive indicator of overall body protein stores than ALBUMIN)
5. Blood gases
6. Cardiac Function (EKG, Stress Test, Echocardiogram) needs to be fully assessed looking for congenital anomalies, pump efficiency, and overall heart health

Bottom line is that if you don't have an eating disorder and there are no PHYSICAL PROBLEMS so far as you know and all this Brain Fog just started happening over the past few months then, METABOLIC/ENDOCRINOLOGICAL until proven otherwise.

I think you would be wise to cut back on the number of different physicians that you are dealing with and/or asking about what's going on. You may think that you will "find" the right answer but often times that strategy ends up creating more questions and issues that you need to deal with which reduces the chance of finding a definitive answer. I won't even be offended if you'd like to cut me loose as the first one.....narrow your field down to the bare minimum (1 would be ideal) since too many cooks in the soup...yada yada....

I would definitely be interested in any photos of the parts of the body as I mentioned before to look at proportions, nailbeds and hands (back mostly), skin texture, color, etc.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 58 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Thanks for the added information and photographs

Detailed Answer:
Do you have a glucometer because obviously from what you're relating it's becoming a pattern that every time you eat things that are carb containing you have symptoms. Blurry vision that you describe can happen in either diabetic conditions for example or other metabolic disorders where sugars rise precipitously. The fact, that things resolve after several hours suggests to me that SOMETHING in your bloodstream is falling...presumably sugar and that some type of insulin resistant state may be occurring.

Any family history of diabetes or glucose intolerance or any type of metabolic disease state?

So in actuality if we were to simply take your symptoms at face value then, my guess is that you're suffering from what we term a REACTIVE HYPOGLYCEMIA. You really have some of the classic symptoms of blurry and unfocused vision, unclear or "foggy" thinking, and these happen after carb ingestion. What happens in these patients is a carb load triggers a HUGE release of insulin and this causes a tremendous drop in blood sugar which causes the symptoms.

Now, the pain in the eye is a bit less common in this syndrome but let's take one thing at a time.

Find out what your lab results were and find out if they got a Hemoglobin A1C on you. If they did what was the number. What was your glucose level when they drew the blood and was it a FASTING specimen or not? If you get a hold of a glucometer I can tell you how to do a quick and dirty test at home for reactive hypoglycemia which is safe and will virtually give us the diagnosis if present.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 98 minutes of physician specific time to read, research, and compile a return envoy to the patient.

P.S. I looked at all the photos and I agree that you do not seem to have any type of eating disorder. I wish it were as hot as wherever your picture on the beach was taken... XXXXXXX Ohio would be even NICER with a solid 2 months of really HOT weather! LOL....

Your nails have vertical lines and what appear to be ridges which at first I thought might represent something...and they still might...but in actuality vertical lines and bands are generally benign....



Still I'd love to see the lab results they got.

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Brief Answer:
Glucose meter? Terrific--

Detailed Answer:
Hey, that's great....so I'll ask the next stupid question? What's a 25 year old healthy and fit gal doing with a glucose meter? Office equipment, you say? LOL.... So, what about your family history a little? Any diabetes, hypertension, hyperglycemia without diabetes (insulin resistance?). If any of those are present in any family members at about what age did either symptoms or a diagnosis get placed.

So, in your case the symptoms you describe seem to be stereotypical and are clearly occurring within 4 hrs. of having a carb loaded type of meal, right? Then, the symptoms of blurry vision, unclear thinking, brain fog, dizziness, lightheadedness, maybe a little sweating, and so forth, and then, resolution? The diagnosis could be what's referred to as REACTIVE HYPOGLYCEMIA if we can show that at the point where you are having your symptoms your sugars go down to their XXXXXXX (lowest point) but then, if you'll eat something sugary or sweet....the symptoms get better.

So, here's the quick and dirty way of doing the test....

1. Have your glucose meter standing by.....take a baseline reading before meal time

2. Eat yourself a meal with lots of carbs (we're trying to stimulate insulin production). Get a quick reading of your blood sugar say within 1-2 hrs. or sooner if you think the sugar will get into your system faster...maybe 30-60 min. We're looking for a spike, right?

3. Then, wait to see if you get symptomatic within 4 hrs. of the meal...sounds like it happens pretty quickly in your case. Take your sugar with the meter and document it.

4. Make sure we're documenting everything as it happens, carb load you took in (you're a nutritionist...I should be able to ask you for the glycemic index and evrything else as well! LOL)

5. Document the times that you are taking the readings, etc.

6. Next, when you start to get the symptoms of blurry vision, fuzzy thinking, etc. quick get another glucose reading.

7. Then, bolster up with some good Orange Juice or a candy bar...(I know you probably don't do those do you?). My friend bet me that I couldn't stop eating chocolate for the REST OF MY LIFE......ANY TYPE of chocolate.....I told I could do anything I wanted to do....so it's been 6 years since I took that bet.....NO CHOCOLATE has ever passed willingly by my lips.....

8. And that's the test. If you improve with your symptoms then, again, measure your sugar with the meter....

9, Finally report results.

That my dear is the "poor" man's version of the REACTIVE HYPOGLYCEMIC or IDIOPATHIC POSTPRANDIAL SYNDROME diagnostic hub bubb or whatever we should call it....protocol, I guess if we want to be scientific....HA!

So you wanna try that? It's easy, don't have to go to any doctor...EXCEPT me...and it really doesn't cost much. In your case, it may be over within a couple of hours or less....I have a feeling because your athleticism and build you'll have a fairly fast absorption rate and your sugar will start to spike quickly with insulin stimulation almost instantly as the sugar hits the bloodstream....that's what youth does for you....HAHA!

Ok...so we are to the end of the message string for this particular question....I guess if you'd like to continue with this "protocol" you'll need to CLOSE THIS QUERY and reopen another set of questions. I hope you decide to keep me in the loop because I'm sure we're on the right path and if you'll follow those steps and document everything we can look at the numbers and make some decisions.

Cancun? You're in Cancun? Whoa...never been there....Lived in Mexico for 7 years, Puerto Vallarta, a few times....but mostly up on the border or in Guadalajara...do you have any Latina in you? Speak Espanol per chance? We speak Spanish here at home with the kids as the first language....and then, of course, they have the English as an automatic. Would've loved to teach them my heritage's language of my parents, Farsi....but that never came to pass.....

So, also see if you can get copies of your lab results. I want to see if there's a HbA1C that they got. Also, do mention if you can get those labs and upload them to me whether or not they were done while fasting or not.

Well, my dear time is nigh...and I must get ready to do much more mundane things than get to the beaches of Cancun this morning! But you have a great time and a safe trip home if that's what's happening. Hope to hear back soon from you...if not, at least you've got something you can take to your doctor and show them to give them some ideas.....I would avoid all the other expensive and potentially unnecessary tests of MRI's of the brain,etc. until this gets done....

Please keep me updated at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

And don't forget the STAR RATING and comments if you could...keeps them feeding me my peanuts if I do GOOD! HA!.

The query has required a total of 158 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Almost certain you have REACTIVE HYPOGLYCEMIA

Detailed Answer:
Hey there....I've been looking at your charting and I'm almost positive you have REACTIVE HYPOGLYCEMIA. I've also been looking at certain numbers as being critical which tend to place you into the RED ZONE meaning the onset of brain fog and other symptoms (RED ZONE is my terminology, it's not formal medical lingo). Why this is happening now as opposed to before is an interesting question and I have my theories but there is the very real possibility that you may have to rethink how you participate in these sorts of competitions where you will have to maintain such low caloric intakes in order to be competitive. I've had wrestlers competing who I've had to take out of weight classes and even out of national tournaments which they simply could not handle due to similar circumstances for their own medical wellbeing. I'm not saying you have to do this but keeping you healthy and safe in this sort of thing is going to be a challenge and I believe if you are going to continue this type of activity you should undergo some rather comprehensive overall cardiovascular and cerebrovascular axis testing. We should be absolutely as sure as sure can be that you are not risking sudden or unexpected complications because there may be some hidden systemic problem that may be unmasked because of how low you are keeping your weight. I don't know how serious you are about the competitions but are you willing to undergo thorough testing and examination to the extent necessary and then, go on a plan in order to optimize your caloric and food quality intake while you are in competition? Your thoughts?

Having said that I'm fairly certain about the diagnosis based on your charting let me add that we'd need to rule out a few additional things but that's not hard to do and I'm sure we can nail this diagnosis down with some simple other tests.

As an aside I'd like to respond to your comment on the # questions per thread as you said that the system is telling you that there are still 1-2 questions pending for what you've prepaid, however, my understanding has always been, and the website publishes on its charge page, a maximum of 3-4 total questions before a thread would be expected to be closed (depending on the type of question). It could certainly reopened under a new charge/new thread. I have placed an inquiry on this topic to those in charge because I believe it's important everyone be on the same page and not have to be bothered by differences of interpretation between what's published vs. individual understandings based on either outdated or incorrect information.

I would love to continue working on this problem with you because I believe it is important to you and FOR you and more importantly for your health so I hope you'll choose to return to me for questions and I can then, share some other ideas so that you remain safe and happy in your competitive career.

For the amount of time spent thusfar of nearly 4 hrs. I would greatly appreciate your closing this query and reopening under a new set of questions.

If you choose to keep me updated please use the following portal to communicate with me:

bit.ly/drdariushsaghafi

And don't forget the STAR RATING and comments.

The query has required a total of 215 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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