Cognitive dysfunction is among the most difficult and challenging of Lyme conditions to treat. Slow mental processing, short-term memory loss, confusion, trouble with analysis, spatial issues, trouble with word finding, multi-tasking, and so on, are common symptoms of cognitive dysfunction. Lyme has even been associated with dementia, so restoring cognitive function should be a top priority in recovery. It’s essential to remove microbes, but also to repair any damage that the infections may have done to the brain and nervous system.
The good news is, inflammation and neurotoxins are often largely responsible for the brain and cognitive symptoms of Lyme, which means that once these things are removed, the brain can heal and cognitive symptoms will dissipate. In the meantime, following are some tools that I have personally found to be helpful for restoring my cognitive function in chronic Lyme disease , and which studies show may also heal the brain.
Lyme Disease and Cognition
All cell membranes are largely composed of choline, and the body uses it to make a neurotransmitter called acetylcholine, which studies have shown to aid in cognition, mental processing, memory, and other functions. I have personally even found it to improve my mood, and help me work faster and with greater mental acuity. Choline is available in capsule form, as well as transdermally. I use a compounded transdermal crème and find that it absorbs better into my body and is more powerful than oral choline, although it is more expensive. Choline is also found in eggs, many meats (especially shrimp), and sunflower lecithin. If you battle cognitive symptoms from Lyme disease, you may find that food sources are insufficient but can be a helpful addition to your diet . Choline also helps to repair the brain and nervous system from damage caused by toxins, microbes and other factors, and helps the cells to detoxify .
2. Omega-3 EFAs from Cod Fish Liver Oil
The brain is comprised of at least 60% fats, and many studies have shown omega-3 EFAs to help prevent dementia and restore cognitive function in neurological disease, particularly Alzheimer’s , but also other illnesses. This is partly because omega-3’s reduce inflammation and also help to repair damaged brain tissue. There are both plant and animal sources of omega-3 EFAs, but many people with chronic illness are unable to utilize the EFAs in plant sources. Fish oil is a rich source of omega-3 EFAs and I especially like cod fish liver oil because it is also a good source of healthy cholesterol, which is often lacking in those with chronic Lyme. The body uses cholesterol to create hormones and repair the brain, so it’s important to have enough good healthy cholesterol in your body. In fact, cod fish liver oil has more cholesterol than almost any other food, and is therefore a great source of nutrition for the brain.
3. Amino Acids and Co-Factors
The body uses amino acids to make proteins for the body, including neurotransmitters, which are often severely depleted or imbalanced in Lyme disease. I have found certain amino acids to help improve my cognitive function, especially L-tyrosine and 5-HTP, which also regulate mood, energy, sleep,  and other things. In addition, people with Lyme disease battle leaky gut and gastrointestinal dysfunction, which means they are often deficient in protein, despite consuming ample amounts through fish, meat, chicken and other sources. Amino acid supplements can often help to restore healthy protein levels in the body and provide much-needed food for the brain, when the GI tract cannot adequately digest and absorb it from food.
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According to Datis Kharrazian, DHSc, DC, MS and author of Why Isn’t My Brain Working?, this amino acid compound binds and activates acetylcholine receptors. Acetylcholine, as I just mentioned, plays a major role in cognitive function. Studies have also shown L-acetyl-carnitine to delay Alzheimer’s progression which may have important implications for those with Lyme disease since spirochetal infections such as Borrelia have been linked to Alzheimer’s.
Vinpocetine increases oxygen and blood flow to the brain and protects it against the effects of glutamate, a neurotransmitter found in excess in people with chronic Lyme and which damages neurons. Vinpocetine also protects against the cytotoxic effects of glutamate overexposure. Glutamate toxicity leads to the dysregulation of mitochondrial function and neuronal metabolism. In addition, vinpocetine increases brain cell ATP production, and improves glucose utilization. So vinpocetine may be a very helpful nutrient for some people with Lyme disease.
Other nutrients that have been shown in the research to improve cognitive function include the herb Gingko biloba, and phenylalanine, which is an essential amino acid and vital precursor to dopamine, epinephrine and norepinephrine, which are stimulatory neurotransmitters that regulate mood, memory, alertness, and other mental functions.
Beyond supplements, other tools that help to restore cognitive function include:
1. Balancing the hormones, since hormones play a powerful role in mood, cognition and other brain-related functions. Proper thyroid  balance is especially important for cognitive health. I highly recommend seeing an integrative or holistic healthcare practitioner or endocrinologist who understands how to balance the hormones using bio-identical hormones and natural remedies, as part of a complete healing regimen.
2. Oxygenating the brain with exercise or supplemental oxygen. I notice that whenever I go for a 30-minute walk, my brain works faster and better for about 2 hours after that. I often take advantage of the hour or two after I exercise to do my most challenging writing work.
3. Balancing the blood sugar with a fat and protein-rich diet, and by eating at regular intervals. Proper blood sugar balance powerfully affects cognition. Personally, I have found a high-fat, moderate protein and low carb diet to be most beneficial for stabilizing my blood sugar. Supplements such as chromium and cinnamon, when taken with meals, can also help to balance blood sugar.
4. Healing your gut, since much research in recent years has established that the health of the gut  is linked intimately to the health of the brain. Leaky gut syndrome, which is common in people with Lyme disease, causes inflammation in the brain and consequently, brain fog.
It is beyond the scope of this article to describe all of the tools that are needed to heal the gut, but for more information, I highly recommend the book: Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia,  by Dr. Natasha Campbell-McBride.
This article was first published on ProHealth.com on August 12, 2017 and was updated on February 3, 2021.