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Focus, Cognitive Health, and Nootropics

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The ability to both focus for long periods of time and perform cognitive and memory-related tasks is important in everyday life and for many careers. Due to our busy lifestyles and high work demands, aspects like the standard North American diet, stress, physical inactivity, and endocrine imbalances can lower mental performance and cognition. According to the literature, many factors are involved in focusing and cognition, and various natural means can boost these capabilities. For example, the Mediterranean‑DASH (MIND) diet, regular physical activity, and natural supplements like fish oil and B vitamins, along with nootropic herbs, can all enhance cognitive function. Physiological factors can lead to cognitive impairment and can be assessed by a health-care practitioner to determine a therapeutic order and to achieve success.

Focus and Cognitive health

Some of the physiological factors include:

  • Vitamin deficiencies (B12 and B6)
  • Low iron (iron-deficiency anemia)
  • Thyroid disorder (hypothyroidism and hyperthyroidism)
  • Hormonal imbalances (low estrogen)
  • Adrenal fatigue and HPA axis dysfunction (cortisol dysregulation)
  • Mental-health conditions (anxiety, depression, ADHD)
  • Diet and lifestyle
  • Addictions

When some or all the above physiological factors are addressed, cognition and the ability to focus may improve if there is no underlying pathology. Having deficiencies in particular vitamins and minerals (commonly B12, B6, and iron) can affect the ability to focus due to lack of oxygenated blood flow and neurotransmitter cofactors in the brain. Imbalances in the thyroid, an endocrine gland located at the front of the throat, was also shown to lead to both mental and cognitive impairments. 1 These cognitive deficits are largely reversible with thyroid treatment and support. 2 Quite often, however, serum thyroid levels on blood tests appear in the normal range, yet symptoms of hypothyroid are apparent, a condition now termed subclinical hypothyroidism. Research shows that, despite the effects of normal laboratory thyroid levels (with presenting symptoms), small deficits in memory and executive functioning can still occur, although to a much lesser extent than laboratory-confirmed hypothyroidism. 3 A naturopathic doctor can do more extensive thyroid testing to determine imbalances, by revealing T4, T3, rT3, and antiTPO levels in addition to standard TSH testing. On the contrary, hyperthyroidism, where there is too much thyroid hormone available, may also lead to trouble focusing and agitation. Hormonal imbalances and adrenal fatigue also affect cognition. For example, low estrogen states can reduce cognition, as do high or low levels of cortisol associated with negative emotions, referred to as emotion regulation (however, generally, cortisol improves focus). The estrogens not only function as hormones but also play a neurocognitive and antioxidant role, are neuroprotective, and prevent neuronal injury and disease. 4 This can also be seen in the cholinergic effects that estrogens have on the hippocampus, which directly affect memory and cognitive performance. 5 Naturopathic panels can aid in uncovering some physiological causes of trouble focusing and cognitive impairment such as vitamin deficiencies, thyroid disorders, estrogen imbalances, and cortisol dysregulation.

In addition to the above physiological factors, mental-health conditions and difficulty with emotion regulation can also contribute to reduced cognition and focus. Determining an appropriate and well-informed diagnosis can direct treatment and therapy protocols, which in turn can improve memory, focus, and concentration.

Addressing underlying physiological imbalances or seeking help for mental and emotional concerns may be the most effective solution for brain health. However, when these have been exhausted, or when time, age, or circumstances are factors affecting progress, then consider some of the following natural remedies that can be discussed with a naturopathic doctor if you have questions.

Natural Supports for Better Mental Health, Focus, and Cognition

Focus and Cognitive health

Fish Oils—Omega 3 fatty acids in fish-oil supplements have been investigated. Evidence from a meta-analysis shows that omega 3 long-chain polyunsaturated fatty–acid supplementation, high in EPA, is efficient to help treat depression. A small study in young middle-aged adults with diets low in omega 3s found that consuming a fish oil supplement significantly improved working and episodic memory, compared to placebo.6

B12 and Other B Vitamins—Neurotransmitters in the brain requires vitamins like B12, B6, and folate for cell signalling. 7 Vitamin B12 is an important vitamin for insulating the myelin sheath (white matter) of neurons and can slow down brain atrophy in aging. Supplementing with both B12 and B6 can enhance cognitive performance, especially in older adults.8

B12 and Other B Vitamins—Neurotransmitters in the brain requires vitamins like B12, B6, and folate for cell signalling. Vitamin B12 is an important vitamin for insulating the myelin sheath (white matter) of neurons and can slow down brain atrophy in aging. Supplementing with both B12 and B6 can enhance cognitive performance, especially in older adults.

MIND Diet—The MIND diet has been researched for its effects and association in preventing cognitive decline. Key components are berries, nuts, and extra-virgin olive oil. A study among 960 participants found that over a 3 year period, the slowing in cognitive decline produced in the highest MIND diet tercile was equivalent to being 7½ years younger than the control group.

Physical Exercise—Exercise proves to be beneficial for many chronic health conditions, and its effects on cognitive function have been investigated. A review found an increase in brain-derived neurotrophic factor (BDNF) as seen in heightened neuroplasticity and cognitive function (memory and learning). Activities like strength training and dance showed the greatest enhancement of both short- and long-term recall, verbal recognition, and attention reaction, compared to other activities.

Organizational and Time Management Strategies—Time-management and organizational skills from an occupational standpoint are also important to succeed. This could involve breaking up larger tasks into smaller tasks, prioritizing which tasks are the most important, and not spending longer than needed on unnecessary tasks.

Nootropics for Further Cognitive Enhancement and Neuroprotective

Nootropic compounds (brain tonics) are gaining popularity for cognitive enhancement and neuroprotection. This group of compounds—containing terpenoids, alkaloids and polyphenols—influences the brain and can be helpful during extended periods of time requiring mental focus and stamina. They have been shown to increase nerve growth, increase the amount of a neurotransmitter available in the brain, and improve nerve-cell signalling. Due to their effects in enhancing memory and executive functioning, nootropics are used commonly by university students and individuals requiring increased levels of cognition for short periods of time. There is a lack of studies on the effectiveness of these compounds in the long-term. Examples are, but not limited to ginsengs, ashwagandha, lion’s mane, bacopa, gingko, gotu kola, and rhodiola. 13 A naturopathic doctor or other health-care practitioner should closely supervise the selection and use of nootropics and other focus-supporting supplements to ensure that no interactions or contraindications are present with medications or health concerns.

Nootropic Herbs for Additional Cognitive and Brain Support

Focus and Cognitive health

AshwagandhaThis ayurvedic herb has been researched for its ability to protect neurons (brain cells) and improve cognition. 14 Ashwagandha also appears to be an herb that may benefit symptoms associated with subclinical (mild) hypothyroidism.15

Lion’s ManeLion’s mane is a medicinal mushroom that has been studied for its effects with key components for brain neuroplasticity, encouraging regrowth of brain myelin (brain white matter). In a randomized, double-blind placebo-controlled study, lion’s mane, taken three times daily, significantly improved the mini-mental exam and activities of daily living scores compared to placebo, in patients with mild Alzheimer’s disease, after 49 weeks. Furthermore, a decline in cognitive abilities was observed in the placebo group. 16

Ginseng—Two of the many varieties of ginseng, Korean (Panax ginseng) and Siberian (Eleutherococcus senticosus), were shown to help the body adapt to important mental and physical demands and improve resilience to stress. 17 These benefits can indirectly improve memory, cognitive, and mental performance. Siberian ginseng is not as stimulating as Panax ginseng. Panax ginseng, because of its stimulating effects, is cautioned with generalized anxiety, in individuals with high blood pressure, and during pregnancy. 18 As always, it is best to consult with a health-care practitioner, such as a naturopathic doctor, to determine efficacy and safety when choosing any therapeutic tool.

Bacopa and Gotu Kola—Bacopa has cognitive-enhancing and neuroprotectant effects. Gotu kola is a nootropic and anxiolytic. There are limited human studies of both despite anecdotal and clinical use. 19

Rhodiola—This adaptogen plant brings anxiolytic, neuroprotectant, and antidepressant effects. A study showed an improvement in mood scores and confusion in young adults using 360–600 mg of standardized Rhodiola rosea extract daily (1% rosavin). Rhodiola should be avoided in individuals with manic-depressive psychosis, in children, and during pregnancy.