It is one of the distinctive symptoms of my RA. I had brain fog before I had joint issues. I remember I was taking a French vocabulary course, and I could not remember a single word, despite a semester of study. I kept writing out the words, and nothing stuck. I was only days from the final exam, and looking at a complete fail. I used to be a top student, because of my ability to memorize. I had a GPA of 4.0

So I got sick with a lung infection and asthma only days before that French exam. I was put on 40 mg daily of prednisone. I took another look at the 500 French words, and in two days, I had them all memorized! I was kind of shocked. Why did prednisone help me go from not a clue, to acing that test in only a few days? I think it dealt with the brain fog. Although it took a while for me to figure out the problem.

And when I did my Mdiv, my RA was really under control, except one semester when I was studying first year Greek. I was taking lots of prednisone during that time, and a few times I took Diclofenac, and what I learned that day was so crystal clear.

So now, when the joints get bad, I am always aware that the brain is going to be foggy. Not remembering daily details, let alone important things. I took Intermediate New Testament Greek this year. It had an vocabulary quiz weekly, and a midterm and final. My RA wasn't totally under control, so sometimes, when the mind was thick, I upped the prednisone I was taking, and did quite well. I debated if that was cheating, but I figure getting your mind back to where it should be, isn't any different than taking meds to stop the joint flares and anything else that RA hits.

I've had severe brain fog since the beginning along with severe fatigue. I will have been on Humira for 4 years next month and have seen an improvement of ~50%. I feel the fog and fatigue are related. I do have to take 2-3 45 minute naps a day. These aren't naps because I want to - my eyes will just close on me and I am out.

So for me this is just another aspect of my RA. I have to plan my days around these mandatory naps and have to write absolutely everything down due to the brain fog. When I go to get something in another room I have to keep telling myself why I am going somewhere so I don't forget.

I have also changed the day I take my Methotrexate which is now on a Friday. Saturday and Sunday I am down and out staying primarily in my chair. It just knocks me down.

It is what it is.

That's sad....the saddest part is that you felt ashamed.......it wasn't your fault. [But I understand why you felt that way. I re-built my business based on less risky projects...only because I couldn't handle the stress of the earlier work. And I hated that people thought I was not as good as I used to be. Still hate it.]

I have it to a high degree this summer. It began when my RA began a couple years ago. It does improve some when I get adequate sleep for several nights in a row but that is a challenge in itself. Like Linzey I believe it is the main reason I left my job as well. My superintendent noticed that I had trouble at times gathering my thoughts and expressing myself at the same level I had in the past. She is a sharp woman to notice because not everyone did as I became good at hiding the fog and decline in cognition. There is no hiding it this summer. It's simply too dense. When I Google it I found an lot of articles tying brain fog to corticosteroid use. I don't know where I fit into this so I asked my doctors. My rheumy feels brain fog will increase as we lower prednisone dosage. My mental health doctor feels that prednisone in a low, stable dose is probably fine but using high doses during a taper could contribute to fog though I never asked him why. My thoughts are simpler: prednisone causes me to be hypomanic and hurts my sleep. Less sleep for me equals greater fog. I also think that a portion of the fog can certainly be attributed to the increased inflammation in the body. My neurologist believes that the inflammation of RA can definitely affect the brain.
I do know one thing and that the fog I've had since May has been as difficult to deal with than any of the other complications I have faced. It makes me feel like I'm no longer me. It's as though I lost myself and it is a major priority for me to finish the prednisone taper that I'm on and work on my sleep habits and anything else I can do to improve from this fog.

I find that strange. Prednisone helps my brain fog every time, including doing intermediate Greek! And that is all about memorization, recognition and language decoding. I know I am not nearly as good in translating as when I took the introductory course, and I was taking large amounts of prednisone. That was only short term - 4 months. I've been on prednisone for 19 months now, and the only time the brain fog left was when I increased the prednisone.

I'd like to know why your doctor feels this. Prednisone has saved my life in remembering stuff. Not that I want to stay on it - I would much rather have the disease under control, but I have my doubts that will happen any more.

And yes, prednisone definitely makes you hypomanic. I have worked on my sleep hygiene, and I take 150 mg of Trazadone 2 hours before bed. The psych meds really played havoc with my mind, but getting the RA under control, helped me get off of them. Sleep is always a big issue, for sure! But there are ways to counter that. A pain management doc helped me with that. You might want to look into it.

Neither doctor who I discussed long term prednisone use with was opposed to prednisone treatment. I think my rheumy feels it will help with the fog particularly if we are in a transition period and trying to taper off the med. My other doctor, who happens to be a psychiatrist, feels that prednisone can cause mania and he tries to offset it by prescribing a tiny dose of Seroquel, which is a major tranquilizer. He went on to state that he believes that the increased then decreased doses of prednisone during a taper would cause brain fog. He used the words "mental confusion:" He feels my brain fog will improve with more sleep and a lower, stable, prednisone dose. I can certainly pick their brain and ask for more details.

The "fog" is there with MTX but it started for me with meloxicam (generic mobic).