book review, review

Does being chronically ill make you lose smarts?

I was just reading a bunch of books on chronic illness as you may see from the reviews in some of the more recent posts. In one of the books, The Pain Chronicles by Melanie Thernstrom, I read a disturbing fact about how the grey matter in our brains deteriorates the longer we are in pain.

Um, what the fuck?

I also read, though, about how a person with a bad hip had regenerated grey matter once the hip was replaced and the pain stopped.

Obviously, this is something that has been bugging me. Not only is this especially disturbing for those living with chronic illnesses in general, but I believe it’s especially disturbing for those of us who fell ill as young children. I was starting to really worry about how this wasn’t really a known fact, even in the chronic illness community, until one of my favorite bloggers Andrew Sullivan mentioned some interesting findings about T cells and brain function earlier this week (if you want to read the full study Sullivan refers to, click here, though be warned it’s a lot of terminology or you can click here for an interview with the dude in charge of the study).

Perhaps one of the most intriguing things about the study is that it specifically showed the involvement of IL-4 producing T cells in cognitive abilities – the T cells help improve our cognitive abilities while the absence of those cells protecting the brain allows inflammation which inhibits our thought processes! And all this time we thought brain fog was one of those side effects of chronic illnesses that were just not explainable!

For a lot of people with rheumatic diseases, the causes of their inflammation aren’t known but are treated with medications we probably all know by now – actemra, kineret, ciclosporin, enbrel, humira, etc, etc, etc. Enbrel and humira are in the class of drugs that affect tumor necrosis factor alpha, believing that is the cause of the out of control inflammation. And it works for people.

The first three I mentioned – actemra, kineret, and ciclosporin – work on cytokines (cell signaling proteins that play a result in the inflammatory response in our bodies) that are known as interleukins. Actemra works on IL-6; kineret works on IL-1; and ciclosporin works on IL-2. Interleukins are another believed cause of the over-inflammatory responses in chronic illness and all three work remarkably better in people with Still’s disease, whether they’re young or old.

In the study, interleukin 4 is in high volume in the brain when we are well, attributing to better learning and memory skills. When we are ill, IL-4 levels are low. The thought is that IL-4 is the specific group of cytokines that tells T-cells to protect the brain from any toxins secreted, but after an injury those T-cells have to go off to fight the infection – those of us with chronic illnesses of the autoimmune kind don’t have injuries/infections/etc all the time, but our illnesses fight our own bodies like an infection or an injury. Essentially, this creates issues with our brains where we are literally stupid for periods of time – like a flare up or period of higher disease activity.

Brain fog being something people can’t understand is becoming a thing of the past it seems. Yay!

PS it took me like four days to write this post. Thanks T-cells!

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  1. Thanks for posting this. Maybe it shouldn't matter, but it helps me to be able to say "the proinflammatory cytokines circulating in my body that are causing joint pain are also likely impairing my cognition" versus "my joints hurt and brain fog is making me feel like a big dumb-dumb." Framing is important!

  2. No problem! I think it was a great discovery for me also, as I feel incredibly stupid the majority of the time. I graduated from high school with honors and an international baccalaureate degree, and ended up having to drop out of my master's program because I just couldn't do it anymore and I wasn't learning right. I'm glad to know I'm not a failure, just impaired 🙂

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