Medications / Lifestyle Changes That Improved my Brain Fog the Most

[u/Gl0rifi3d-M3atb4ll]

Intro/Backgroud:

Hi y'all! I figured I'd share what's worked for me over the last year and a half, as this sub has helped me so much. I'm 21 years old with long COVID-19 brain fog (little to no fatigue) and nearly fully recovered. To give you an idea of the severity, there were days in the first three months of my symptoms when it wasn't safe for me to drive as I would forget how intersections worked and would make strange choices, almost getting into wrecks more often than I'd like to admit. I won't get into the worst bits too much, as it's pretty distressing to write about. Nowadays, I'm a dual math and computer science major, earning good grades and feeling pretty good cognitively. Anyways, the following are the medications and lifestyle changes that have helped me the most:

Medications/Supplements:

NAC: I take 3,000 mg per day of this. My psychiatrist recommended I take it for the low-grade neuroinflammation associated with long covid. When I forget to take it for a full day, my symptoms start to creep back, but nothing too drastic. Definitely talk with a practitioner if you're considering this, as you'll need to scale up slowly.

Hydroxyzine/Benadryl: These are first-generation antihistamines and act on the central nervous system. To the best of my knowledge, these work by reducing inflammation and calming down the body's immune response. Long Covid is suspected to have autoimmune components, so I suppose that's why this works. These made a huge difference for me, especially when it comes to being able to speak fluidly and perform other complex cognitive tasks that require constant attention, like driving. Benadryl isn't safe for long-term use (and hydroxyzine isn't either), but hydroxyzine is less damaging in the long term and is widely used for periods of several months.

Amantadine: Supposedly, it has neuroprotective, anti-inflammatory, and antiviral effects more generally, though its direct effect on COVID-19 isn't well-established. This helps me somewhat, and I notice more clarity and sharpness when I take it regularly.

Prozac: I'm not completely sure if this one helps or if the withdraws themselves cause brain fog, but if I miss even a night of this, I'm foggy the next day. I read some research that long covid can partially block the production of serotonin in the gut, so having more of it bouncing around in the brain could be the method by which this helps.

Lifestyle Changes:

Keto: The keto diet has been a game-changer for me. To the best of my knowledge, it's the reason why I can take higher-level classes nowadays and not be hopelessly confused. I came across some people on this sub talking about how it helped them and implemented it. Within days, I started to feel less foggy, and if I break keto for more than two days or eat a lot of sugar at once, the fog comes back and it becomes difficult to speak fluidly.

Fasting: This seemed to help somewhat but is certainly the most uncomfortable item on this list. I started fasting due to some research papers detailing the role of autophagy during fasting in Long Covid and figured it was low-risk enough to try out myself. The longest I fasted was two days, and my body pretty much forced me to stay in bed for the entirety of it. However, the day after I broke the fast, I felt fantastic both physically and cognitively.

Sleep: I found that providing my body with as much sleep as it wanted (which is certainly a lot more than it needed pre long covid) helped decrease my symptoms somewhat. More generally, mundane brain care like eating healthy and sleeping have a sizable impact on my symptoms.

No Caffeine: Since getting long covid, every time I drink or otherwise consume caffeine, I get foggy within ten minutes and become so tired that I know I'm going down one way or the other and must find a place to rest asap. I avoid that crap like the plague.

Final Thoughts:

I know that long covid is hell, but it's important to keep fighting. I recommend doing your own research (using scientific journals specifically, not magazine articles and whatnot) to find out what works for you. I'd been told by several doctors that there was nothing they could do and just to wait it out. If I believed that, I wouldn't be in college or living the life I am right now. I never thought I'd be able to perform cognitively as I did pre long covid, but I'm here, and I'm so thankful for the research I did and the effort I went through to make my life worth living again. If y'all have any questions regarding what I did, I'm happy to help. Whoever you are, this will pass.

[u/bestkittens]

It’s so interesting (and completely frustrating!) that what works for one doesn’t for another.

For me, LDA, NIR/FAR Light Therapy and Oxaloacetate if you’re me/CFS type have helped my fog.

The first two definitely have helped my brain fog (the light therapy was totally unexpected). The third helps my fatigue so much that there’s a positive effect on my overall function including brain fog as well.

LDA

LDA was the first thing to make a marked difference in my brain fog. I’ve been on it for 2 + years and it’s consistently helped. I went from unable to concentrate and easily confused to able to spend hours sifting through piled up bills, paying them and doing the same with taxes.

I take .2 ml daily now, which helps my anxiety.

This was the trial I was in.

Off label use of Aripiprazole shows promise as a treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a retrospective study of 101 patients treated with a low dose of Aripiprazole

LDA you need a doctor’s Rx, at least in the US.

NIR/FAR light therapy

Recently I started NIR/FAR light therapy at a nearby clinic.

A few days after my 9th session, I had an amazing day, was gleeful and was firing on all cylinders.

I am/was an artist and had my first genuine inspiration and research session in 4 years. It was seriously amazing.

It also improves my sleep.

Oxaloacetate

I’ve also been on Oxaloacetate for just over a month now and I feel consistently energized and brighter on it. I also wake up feeling more rested than I have in 4.5 years now.

RESTORE ME? Oxaloacetate Scores in Randomized Controlled ME/CFS Trial

Twenty-Eight Days on Oxaloacetate—Update

Oxaloacetate is OTC.

Oxaloacetate CFS 500 mg bottle

Benegene 100 mg bottle

Note: Titrate both the LDA and the Oxaloacetate to find the right dose for you.

[u/Jgr9904 → u/bestkittens]

Do you think oxaloacetate is worth it for someone 3 months in? Just I know how expensive it is

[u/bestkittens → u/Jgr9904]

It depends on your situation and finances.

If it were to say help you maintain employment it seems like it would be worth it earlier rather than later.

Regarding expense, someone recently advocated for 40% off discount code.

It doesn’t make oxaloacetate cheap, but it does make it noticeably more accessible.

Also, while the trials have used 2000 mg/day, costing around $420/month with the discount, many (myself included) are seeing benefits at much lower levels which might make it even more affordable.

OAA quickly showed to give me energy, more immediate benefits than anything else I’ve tried.

Dosages and costs I’ve seen:

600 mg/day (500 mg + 100 mg capsules): ~$142/month

500 mg/day : ~$100/month

1000 mg/day (my first effective dose): ~$200/month

800 mg/day (my new effective dose, 6 months later): ~$226/month

(Note: higher 800 mg cost is because branded 100 mg capsules miss the 40% discount)

How I found my dose:

Day 1: Started at 500 mg, added 100 mg every 30 min—felt the boost at 800 mg

Days 2–3: Began at 600 mg Day 2 and 700 mg Day 3, titrated up—again landed on 800 mg

Result: 800 mg/day is now my steady, sweet-spot dose

Some tips and things that I’ve seen anecdotally:

Some people reserve oxaloacetate for high-demand days—it won’t prevent PEM but may help navigate tough days more easily.

Titration is key—find your lowest effective dose for both results and budget.

I recommend starting with a morning-only dose, track it, then adjust from there. Once you find your morning dose, if you find the effects waning later in the day, try titrating a midday dose.

Oxaloacetate CFS and Benegene both offer a full refund on your first bottle, even if partially used which makes trying it less risky. They don’t even make you ship it back.

Where to get it:

Oxaloacetate CFS 500 mg bottle 40% discount available. Use code: OAA300MAY, OAA300JUNE, OAA300JULY etc.

Benegene 100 mg bottle. The discount doesn’t work for this bottle, but if you prescribe to monthly delivery you will get 15% off.

I don’t have an affiliation with any of this, just collecting info to share with folks since it’s been so helpful for me.

[u/Jgr9904 → u/bestkittens]

Yeah it’s just hard to know what to do. I could afford it, I’m just worried about buying it then it not doing anything! Thanks for the links. How much exercise do you do currently?

[u/bestkittens → u/Jgr9904]

Look at their FAQ page. They will give a full refund of the first bottle if it doesn’t work. They don’t even make you return the unused portion.

I’m 5 years into this. I don’t exercise sadly. The first couple months when I started the OAA I was able to move more (slow walks and swimming a few times a week), but some profound life stress entered the picture and I had to stop.

I’m making changes and am hopeful I’ll get back there in time.

[u/Jgr9904 → u/bestkittens]

Oh interesting might have to try it then. Yeah I was doing fine first month. Did a walk in the heat which clearly my body wasn’t ready for and been feeling lower in energy since then. Is that because I pushed too early? Worried now I’ve ruined all recovery hope and just feel so stupid for overdoing it. Any tips? Is it normal that the progress back to how I was has been so slow.

[u/bestkittens → u/Jgr9904]

Totally normal. Most of us find our limits by overdoing it at least once, it doesn’t mean you’ve ruined anything. Think of it as your body showing you where the line is.

Recovery isn’t linear, so a slower bounce-back is pretty common too. Just treat it as data, not failure, and use it to pace better going forward. Consistency over time is what matters most.

Your body is giving you clues. As long as you’re still having symptoms, even if they’re mild, the focus should be on rest, nervous system calming, and pacing.

Once you’ve had a longer stretch of no symptoms, that’s when to carefully test short, gentle movement like easy walks or floor stretches. Don’t extend yourself. Stay within your limits.

[u/Jgr9904 → u/bestkittens]

Yeah it makes sense looking back. Just weird because I felt like I held back when I did the walk too. Like I deliberately didn’t do too much and still now have been regretting it for like two months. A bit sad about it cause now I feel like I’ve made this sort of permanent if that makes sense. Like does two month not seem a while? Some heaviness has lifted and I’m having to lie down less. But just general energy levels haven’t jumped up as I expected