Dr. Sara Szal’s 5-Step Roadmap to Reverse Brain Fog

We’ve all had those moments when we walk into a room and wonder why we’re there, or stare at our laptop like it’s written in another language. That’s brain fog—and if you’ve ever whispered to yourself, “Is this early Alzheimer’s?” you can dial it back just a little.

On Treated with Dr. Sara, host Dr. Sara Szal gets real about what’s actually happening inside your head and, more importantly, how to clear the haze.

“The good news is that brain fog is reversible. The brain is plastic. Your energy systems can reboot, but you have to treat the root cause,” she says. “Mental clarity is not optional. It is a marker of systemic health.”

What brain fog really means

Before breaking down the fix, Szal sets the record straight. “Brain fog isn’t a diagnosis. It’s a constellation of symptoms,” she explains. That can include forgetting why you entered a room, struggling to find the right words, or having trouble concentrating on tasks.

What’s especially important is that while brain fog is common, it’s not “normal.” Szal points out that it can signal dysfunction in hormones, energy metabolism, or even inflammation. The takeaway? Feeling foggy isn’t just a nuisance—it’s information.

Dr. Szal’s 5 steps to reverse brain fog

1. Track your biomarkers

Step one is getting the data, says Szal: “That includes hormones, heart rate variability, sleep architecture, fasting glucose, and cognition test. Don’t guess.” It’s a reminder that the more you know about what’s going on in your body, the better you can respond.

2. Replace what’s missing

Sometimes, brain fog isn’t just in your head. It’s your hormones or nutrient levels asking for backup. In her practice, Szal addresses these symptoms by filling in the gaps: “That includes estradiol, generally transdermal and bioidentical. That also includes progesterone. I like to give thyroid medication if I’ve got a patient who’s got a problem with hypothyroidism. And I like to replace micronutrients often with B complex, magnesium, omega-3s.”

3. Heal your mitochondria

This step is about supporting your body’s energy factories—the mitochondria. “That includes Zone 2 training, CoQ10, alpha-lipoic acid, creatine, sometimes cyclic ketosis—like I talk about in Women, Food, and Hormones—or a fasting-mimicking diet,” she says.

4. Calm the neuroinflammation

Your brain can’t run smoothly if it’s inflamed. “This is where gut repair is so important,” says Szal. “Taking polyphenols, getting five to seven different colors of the rainbow with your food each day, and deep restorative sleep.”

5. Rewire your stress response

Finally, there’s stress. It may not be the root cause of all brain fog, but it can make everything worse. “That includes HRV biofeedback, somatic practices, and therapy that targets limbic looping—like EMDR,” Szal says.

Why this matters now

Brain fog can creep up in different life stages—from postpartum exhaustion to perimenopause chaos to the fuel shortages of menopause. Each stage has its own challenges, but they all tie back to the same theme: your brain needs support. Szal emphasizes, “If you’re foggy, fatigued, or feel like your brain betrayed you, you’re not broken. Your mitochondria are probably underpowered, and that’s fixable,” Szal emphasizes.

Whether you’re juggling work, caregiving, or the hormonal rollercoaster of midlife, this is your cue to check in with yourself. And as always, remember to consult with a trusted and licensed health care professional before beginning any regimen. 

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