Hey Hip, I got interested in brain fog after noticing that a large number of people on the forums where I posted were struggling with it. I've read thousands of studies over the years in an attempt to enhance my own brain so I thought I might be able to apply some of that knowledge to helping others who were dealing with brain fog.Ah, OK.
Because your fascinating blog has a couple of articles on treating brain fog, and also on the possible links between brain inflammation and brain fog, I thought you might be an ME/CFS patient (as ME/CFS patients often assume their cognitive dysfunction could be underpinned by neuroinflammation).
May I ask, what created this particular angle of interest, of brain fog and the possibility that neuroinflammation may disrupt cognition? I see from your blog that you have a huge interest in nootropics (smart drugs) and brain optimization. I also used to be pretty interested in nootropics before I developed ME/CFS.
But for healthy people experimenting with cognitive enhancement and nootropic drugs, theories of brain fog and neuroinflammation are not the usual way of approaching and understanding this subject (by the way, your blog on the anti-neuroinflammation combo of ibudilast + galantamine as a means to cognitive boosting is really interesting). So I am just curious to know what got you thinking in terms of anti-brain fog and anti-neuroinflammation as a route to cognitive enhancement.
It could of course be the case that even healthy people with sub-optimal cognition are suffering some minor levels of neuroinflammation, so your anti-neuroinflammation approach might be hitting the nail on the head.
As an aside, before developing ME/CFS, my favorite nootropics were:
deprenyl 2 mg (I found it provided a great mood boost, libido boost, and increased creativity and lateral thinking, via it's dopaminergic effects), Q10 300 mg (I found this further boosted the dopaminergic effects),
piracetam 12000 mg (I found it hugely increased task focus, concentration, short-term memory and working memory, via its effects on the acetylcholine system), Lucidril (a good add-on to stack with piracetam, to further boost piracetam's cholinergic effects, but works well on its own too), choline bitartrate 500 mg (another good add-on for piracetam for increased cholinergic effects, but also works well on its own),
acetyl-L-carnitine 1000 mg (excellent for increasing your active vocabulary when writing or speaking; you can find the word you are looking for much easier when you take ALC, and there was study I read once that showed this), Bacopa monnieri (noticeably increases your enthusiasm and curiosity, so you find yourself getting engaged and interested in many activities; higher doses of Bacopa, say 10 to 20 grams, can have an MDMA/ecstasy-like boost to loving feelings towards other — although I don't have any direct experience of taking MDMA; I was always too wary and cowardly about trying psychedelic drugs).
I'd often take all the above nootropics together, to super-charge all my mental abilities; as I found these nootropics had a very good synergy.
The cholinergic-boosting nootropics like piracetam, Lucidril and choline bitartrate I found would make your mind razor sharp in terms of information processing and logical thinking; but on their own, these cholinergic boosters made you become a bit mentally dry and dull, like dry and logical engineer or nerd. However, I found once you added the dopaminergic-boosting nootropics like deprenyl, your thinking would would become more intuitive, creative and inspired, which then nicely balanced out the dry logical side that the cholinergic boosters produced.
In other words, in terms of the left-brain logic and linear information processing, I found the cholinergic boosters would ramp up the left-brain abilities; and in terms of the right-brain intuition and creativity, I found the dopaminergic boosters would ramp up these right-brain abilities. That why I liked to mix the cholinergic and dopaminergic boosters together, because it felt like I was optimizing both the left and right sides of my brain. I found you become very productive in this state. You become more precise yet creative.
(This notion of left-brain logic / right-brain intuition is a bit out of date and inaccurate these days, but I am wheeling out this out this old paradigm just to help illustrate this logic vs intuition idea).
Unfortunately since developing ME/CFS, because ME/CFS patients tend to start with such a low baseline of cognitive function, although many of the above nootropics still work for me, they no longer propel me into an optimized productive mental state that I used to achieve when healthy, but rather just help pull me up out of the "cognitive blur" or the "cognitive gutter" of ME/CFS, and towards a state of cognitive normality.
Anyway, I am very interested to see what intranasal insulin might do for the ME/CFS brain fog.
Interesting to see your blog post on the types of insulin used in these studies on intranasal insulin and cognitive enhancement.
As you probably know, insulin medications fall into different classes:
Rapid-acting insulins — take effect within 15 minutes, and last for around 4 hours. Examples: aspart (Novolog, NovoRapid), lispro (Humalog), glulisine (Apidra).
Short-acting insulins — take effect after around 45 minutes, and last for around 6 hours. Examples: regular insulin, aka: neutral insulin (Actrapid, Humulin R, Novolin R).
Intermediate-acting insulins — take effect after around 3 hours, and last for up to 14 hours. Examples: NPH insulin, aka: isophane insulin (Novolin N, Humulin N).
Long-acting insulins — take effect after around 2 to 6 hours, and last for up to 24 hours. Examples: glargine (Lantus), detemir (Levemir).
Source: Insulin Comparison Chart
My understand is that the short-acting regular insulin (brand names: Actrapid, Humulin R, Novolin R) is the same insulin as you find in the human body; whereas the other types of insulin products are in fact analogues of regular insulin, with a slightly different chemical structure that gives them a different onset of action and duration of action.
From your blog article, it looks like most studies opted for regular insulin products such as Actrapid, Humulin R, Novolin R, which are chemically identical to normal human insulin.
Though one study used the rapid-acting aspart (Novolog), one used the rapid-acting lispro (Humalog), a couple of studies used the intermediate-acting NPH insulin (Humulin N), and one used the long-acting detemir (Levemir). These are all chemical analogs of normal human insulin.
Sounds like you had quite the stack for cognitive enhancement!
Thanks for the great discussion on the various types of insulin. Regular insulins (Actrapid, Novolin R, Humulin R, etc.) are the most tested types intranasally but there is some evidence for others (aspart was especially effective in one study). Let me know how the Actrapid goes. I'm really interested in hearing how it works for you.