Tiny Habits against menopausal brainfog?

An interview with Dr. Shabnam Das Kar MD – Specialist in functional and metabolic medicine

The connection between brain health and menopause deserves greater attention. Brain fog, mood swings, and hormonal fluctuations are not just inevitable but manageable challenges that women face. In an interview with Dr. Shabnam Das Kar, a pioneer in functional and metabolic medicine, vital strategies for navigating this phase were revealed. Dr. Das Kar’s expertise sheds light on how functional medicine can transform women’s health during menopause and beyond.

Dr. Shabnam Das Kar is a leading expert in functional and metabolic medicine, specializing in women's health and brain health. With extensive training and certifications from prestigious institutions like the American Academy of Anti-Aging Medicine, she brings a wealth of knowledge to her international speaking engagements and patient care.

Conventional medicine to functional wellness

Dr. Das Kar’s career began in obstetrics and gynecology (OBGYN), where she spent over two decades delivering babies and addressing women’s health. Her perspective changed dramatically when she encountered bioidentical hormones, a revelation that led her to functional medicine. Unlike conventional medicine, which often focuses on isolated systems, functional medicine views the body as a network of interconnected systems. This shift was pivotal in her understanding of how hormonal changes influence brain health.

Understanding menopause and brain health

One of the most intriguing topics discussed was the hormonal changes during menopause and their impact on brain health. Menopause isn’t just about reproductive changes; it profoundly impacts the brain. Dr. Das Kar explained that during the menopausal transition, the brain can lose its efficiency in using glucose for energy, a condition called brain glucose hypometabolism. This could partly explain why women are more likely than men to develop Alzheimer’s. 

Thankfully, the brain has a backup fuel source: ketones. These can be generated through methods like intermittent fasting or a low-carbohydrate diet. Understanding this metabolic shift is crucial for managing cognitive health during menopause. Moreover, fluctuating estrogen and progesterone levels during perimenopause can cause symptoms like anxiety, memory lapses, and sleep disturbances. Addressing these fluctuations is key to improving quality of life.

Hormone therapy: Is it safe?

Dr. Das Kar addressed misconceptions about hormone therapy (HT), a topic that outdated studies have clouded. She clarified: that modern HT, using bioidentical hormones like transdermal estrogen and micronized progesterone, is significantly safer and more effective than earlier formulations. These advances offer relief for more than 60 menopause-related symptoms, including hot flashes, brain fog, and muscle loss. While HT is not suitable for everyone, such as women with hormone-dependent cancers, it is a game-changer for many. The outdated fear stemming from the 2003 Women’s Health Initiative study—which used synthetic hormones derived from horse urine—has caused unnecessary suffering. Today’s evidence-based treatments are a safe and effective option for most women.

Behavior change: The Tiny-Habits-Method

A certified Tiny Habits coach, Dr. Das Kar underscored the importance of sustainable lifestyle changes in health management. This method, developed by Dr. BJ Fogg, anchors new habits to existing routines, making them more attainable. For instance, answering phone calls while walking instead of sitting combats the harmful effects of prolonged idleness, often dubbed "the new smoking."

Celebrating small successes, like imagining fireworks after completing a tiny habit, is key to wiring these changes into long-term behavior.

Brain fog can also be triggered or worsened by other health issues.

• High blood pressure: High blood pressure puts a strain on the blood vessels in your brain.
• Diabetes: Uncontrolled blood sugar damages nerves and blood vessels in the brain.
• Smoking and alcohol: Smoking constricts blood vessels, and alcohol impairs brain function.

Redefining preventative care

Functional medicine’s focus on upstream interventions—identifying and addressing potential health issues before they become critical—is a cornerstone of Dr. Das Kar’s practice.

• Proactive blood glucose management: Instead of waiting for blood sugar levels to reach diabetic thresholds, functional medicine explores dietary and lifestyle strategies to prevent escalation.
• Nutritional and lifestyle factors: High-quality protein, balanced macronutrients, and proper sleep are essential for mitigating symptoms like brain fog and supporting hormonal balance.

While lifestyle changes like improved diet, sleep, and exercise are crucial, they cannot replace declining hormone levels during menopause. Dr. Das Kar stressed that these approaches support overall health but cannot address the root causes of symptoms like brain fog or mood swings. Hormone therapy, when appropriate, is essential for restoring balance and ensuring long-term well-being.

Common signs of brain fog include:

• Short-term memory issues: Names, appointments, and tasks are forgotten more easily, creating challenges in both daily life and work.
• Concentration difficulties: Tasks that were once easy may now require more time and focus.
• Word-finding problems: Finding the right words can be tough, especially in group discussions or presentations.
• Reduced multitasking ability: Doing several things at once becomes harder or even impossible.
• Confusion or disorientation: Familiar situations may suddenly feel strange.

Why Brain Fog is more than "Mommy Brain"

Brain fog: often described as difficulty focusing, forgetfulness, or mental "fuzziness"—can result from hormonal changes, sleep deprivation, or nutrient deficiencies like iron. 

“I don't feel the clarity of thinking. I feel my thoughts are going through a thick liquid like honey.”

As Dr Shabnam states Brain fog, while not a formal medical diagnosis, is a common concern that can stem from various causes. She highlights that hormonal changes, such as those during menopause or from birth control use, lack of sleep, thyroid hormone issues, and nutrient deficiencies, especially iron deficiency, are frequent contributors. Iron deficiency, often linked to inadequate dietary intake or excessive bleeding during menstruation, is a major yet frequently overlooked cause, particularly in adolescent and young adult women. Simple hemoglobin tests may not always detect it, necessitating more specific investigations. Other lifestyle factors, like poor dietary habits, late meals, alcohol consumption, and insufficient protein intake, also play a role. Addressing these can significantly improve cognitive function and clarity.

Dr. Das Kar also underscores the importance of addressing chronic insomnia, which affects 60–70% of menopausal and postmenopausal women. Cognitive Behavioral Therapy for Insomnia (CBTI) is the most effective treatment, far surpassing sleeping pills. She advises women to make informed choices about food, alcohol, and sleep hygiene, such as prioritizing protein and healthy fats before drinking and avoiding carbohydrate-heavy meals late at night. More so, she advises women to take a holistic approach that ensures symptoms are managed effectively and sustainably. Additionally, she notes that for women in perimenopause or menopause, symptoms like “brain fog” may resolve naturally over time, though targeted treatments for underlying issues, such as thyroid imbalances or hormone therapy, may be necessary.

Conclusion: An empowered approach to women’s health

The insights from this discussion underscore the need for a paradigm shift in how we approach women’s health. By integrating functional medicine, evidence-based hormone therapy, and sustainable lifestyle changes, women can navigate menopause and beyond with improved clarity, energy, and overall well-being.

Dr. Das Kar’s dedication to education and holistic care reminds us that understanding and addressing the nuances of women’s health is incredibly important for a healthier, more empowered future.