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Thyroid UK
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How can I rebuild neural pathways to regain speech and improve cognitive skills?

Hi All,

I have ME/ CFS and Fibromyalgia as well as Hypothyroidism. Basically, in terms of cognitive function I’m under fire from all sides!

I’ve struggled with all of these for over 20 years. I’m now 41. I’ve been on Levothyroxine for 15 years with increasing inefficiency, so started T3 a few months back. I wish I’d started sooner: without exaggeration it’s been an absolute life-saver!

When my brainfog was at its worst, I couldn’t figure out how a teabag, kettle, milk and mug went together, even though I *felt* they were connected. That was 15 years ago now, and although I have my moments they’re nowhere near as bad so consistently (continuous days, weeks, months, etc).

A very low dose of Sertraline (an SSRI anti-depressant) helped add a little clarity, as have all the relevant ‘brain function’ Vitamin and mineral supplements.

Similarly, a SAD light in the winter months helps me feel less foggy - literally brighter of mind - and using sinus flushes and antihistamines to fight my allergies also adds a bit of clarity. I also had an initial day or two when starting to take T3 a few months back where my brain actually felt fresh and new. Amazing!

However, I am still slurring my words at times and have little or no deliberate mental connection between what goes in one ear and goes out the other, and what actually stays put and is memorised. I now listen to audio books instead of reading.

I do however regularly try to read out loud to the kids, and am absolutely worn out by the end of the first page. I recorded myself reading to them, and at times I sound like someone who’s just had a stroke (I’m pretty sure I haven’t). I actually do sound as bad as I think I do!

Essentially, after years of being undermedicated and suffering from terrible-to-middling brain fog, I think some neural pathways have been lost or worn away.

My question is (and I’m sure this issue will pertain to many of us); what exercises can I do to improve my brain circuitry?

For example;

Should I seek speech and language therapy?

Are there any good apps or classes online to help with speech or other mental faculties?

Should I try doing crosswords? It’s a bit like climbing Everest at my stage of brainfog!

Does anyone know if there are any physical exercises that can help the brain work better? I’m training to be a remedial yoga teacher so I am aware of the yogic side of things, but how about other disciplines or therapies?

Any practical (and especially medically proven!) tips gratefully received.

Thanks All,


29 Replies

I am sorry you have been diagnosed with all of the above conditions. However, they are most probably all interconnected, i.e. to the thyroid gland.

I am not medically qualified but have read quite a lot over the years and many doctors who trained before the 60's knew all clinical symptoms and we were given a trial of NDT (natural dessicated thyrid hormones) and it was all that was prescribed as levothyroxine was being introduced along with the blood tests. However, over the years doctors have lost their skill in diagnosing people with hypothyroidism and due to the reliance on blood tests and probably TSH and T4 only being tested. If TSH doesn't 'fit the bill' we are diagnosed as having some other condition, i.e. as you have above.



The first and most important is to get a blood test for your thyroid hormones. It has to be a fasting one and allow a gap of 24 hours between your dose and the test and take it afterwards.

Levothyroxine should always be taken first thing with one full glass of water and wait about an hour before eating, or at bedtime as long as you've last eaten about 3 hours before.

Tell your GP you've taken advice from the NHS Choices for information and Advice on Thyroid Hormones, Thyroiduk.org.uk. You would like a Full Thyroid Blood test, TSH, T4, T3, Free T4, Fee T3 and antibodies. B12, Vit D, iron, ferritin and folate.

It has been suggested that you may be very low in the hormone T3 due to 'brain fog' and therefore both FT4 and FT3 are necessary. She/he may not or lab may not. You probably may not be able to afford your own private test but you can show the GP copies of the following two links. Tell her you don't want an answer immediately as it will take time to reach your links.

Tick off your symptoms on the first link:



Also inform her that your TSH has to be 1 or below as stated by Dr Toft, who was President of the British Thyroid Association at one time:

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

Get a print-out of your results and post for comments.

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Thank you so much for taking the time to reply; I’ve just edited my post to include the fact I’ve been taking T4 for 15 years and reiterated that I’ve been on T3 for a few months now. Hope it’s clearer!

And yes, absolutely agree with you: the more I learn the more I can see that so much of it is thyroid related.

So since I’m now on the way to healing it, what else can I do for my brain?


You need a blood tests for both FT4 and FT3 so that you can tell if you need more T3.


Thanks Shaws :-)

I recently went Hyper from self-medicating T3, so am aware of the feeling of ‘too much’ T3 and feel I am currently a dose below that.

That said, am going to go for an updated blood test once my levels have settled some more.

Thanks again!


This is a post I put up yesterday.


Levothyroxine is T4 only. T4 is inactive and has to convert to T3. T3 is the active thyroid hormone required in all of our receptor cells and if we don't have sufficient levothyroxine or cannot convert it properly, our Free T3 will be low.

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I notice in one of your previous posts you mention taking T3. I assume this is a fairly new thing for you.

I had/have serious brain fog, vocabulary and speech problems. I used to be able to talk to my husband and I would get his jokes, even when his comment and the joke were 2 or 3 steps apart. But now? I have to have jokes explained to me in laborious, and totally unfunny, detail.

Worst of all is that feeling that when speaking to some people it's as if people are suddenly talking a foreign language. It hasn't affected the parts of my brain which deal with written English nearly as much as spoken English.

The things I've found that help (but I no longer expect to return to full functioning sadly) :

1) Make sure vitamins and minerals are up to optimal and keep them there.

2) I gave up smoking and alcohol years ago which I'm sure has helped me retain mental function.

3) I very recently gave up simple sugars completely - no more sweets, chocolate, ice cream, cakes, biscuits and puddings. I resent it enormously, but it has made a huge difference to my mental clarity - once I got over the cracking withdrawal headaches! I haven't cut out fruit, but I may still do this. I'm still eating carbs, but I may tackle reducing these a bit when I've adapted to lack of chocolate...

4) I recently, for the first time ever, had a test showing I had too high a level of T3. When I lowered my dose of T3 I reduced my brain fog. So - lesson learned for me - you can get brain fog from too little T3 and too much.

5) Don't get excessively dehydrated.

6) Your cortisol could be too high or too low. Mine was high, but lowering it has helped me think more easily. This can be tested with a 4-part saliva test.

7) Don't skip meals - something I find difficult. I rarely eat breakfast, but I feel a lot better when I eat more regularly. The brain needs energy.

8) Bear in mind you may have been getting more and more ill for many years. Recovery could take a long time, but don't give up hope. Some people report improvements still happening a couple of years after they really start working on getting better.

Sorry, this is all personal anecdote. I have no medical evidence that anything I've done was a good idea - it just happened to help me.


Oh - more anecdotal stuff :

I've read that high dose thiamine helps some people :



And me! Also keep reading that. So have it in hand already :-)

Thank you.

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Absolutely; I love everything you’ve said. Really useful.

Thanks so much for your list. I am already on board with most of it, bar having too high T3. I always assumed this would make one a brainbox, not increase the brainfog!

Cortisol yes, definitely need to check. Keeps coming up in conversation and I know that my levels were buggered many, many years back due to work stress when I first had ME. So much better now but still so far to go!

And yes to 8): You’re so right. I’ve already come so far in just a few months thanks to T3, that it’s easy to forget that the decades of lost years will take years more to heal.

Thank you for your input!


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Hi Abi, have a look at Patrick Holfords site, he is a nutritionist who has researched this subject and sells a brain food supplement! I have worked with him in the past and found him to be very good , Like you I have only recently discovered the magical T3 and am just emerging from brain fog, memory lapses and missing words! I am going to give the brain food a go-I have already tried Brain Bright from an American company and it definitely made me feel brighter! 🤓


Ooh, good plan. Will do.

Hopefully some day we’ll be so bright that this will be us 😎 !



You mentioned speech training-if you can get your GP to send you I would think it definitely worth doing! The more experts you see the more help seems to become available! I'm currently doing a mindfulness course run by the NHS I've already done an ACT course(acception theory not drama lol) and a Patient Self Management course, the last was reccomended by my OCT(again worth getting a referral if you have any mobility problems) the other courses my daughter found on local NHS website!


My poor GP will never hear the end of me, I swear! You’re right though, I should ask.

I do have huge mobility issues but don’t see an OCT. Good to know there are things out there. And yes, will look at our local NHS website. Top tip!

Are you starting to get your speech back, then?


Lumosity is a website with brain training - I sometimes do the freebies but have not joined 😊

Did you have the tests suggested on the PAS Forum ? Homocysteine and MMA - if results are high it can suggest B12 deficiency at a cellular level ......


Luminosity sounds useful!

And unfortunately, we’re too skint for any private blood tests at the mo. So I have added those above to the list for when we’re finally able to pay for some.

Thanks Marz :-)


Lumosity is the name of the website for brain training games - not Luminosity :-) I know I find it confusing too !

Yes I appreciate Private Testing costs - but what price health ? I am a pensioner living in Crete and do not have Private Insurance. I so wish the UK system was like the Greek one - I go to the GP and he ticks the boxes of the tests that I am covered for under the NHS - TSH and FT4. I take the paper along the road to Draculas Den and add the tests I would like :-) Job done ! I save for these tests as I feel they are so important to track my own health.

Should a batch of tests cost a 100 pounds - that is only 27p a day :-) Perhaps get everyone in the family to put their loose change in a Piggy Bank - collectors items now no doubt !!


You’re quite right and I agree wholeheartedly.

But having 4 people on one wage (my husband’s) and living in the South East of England means sometimes things have to wait!

Glad Greece is the treating you well :-)

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And what does one do when B12 Deficiency at a cellular level is found?


Click onto my name above and read in a couple of minutes - it has been quite a journey :-)

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Treat the symptoms .... :-)


Can’t quite see which post you’re referring to. Is it your dog’s B12 injections?

There’s so much info there (and I’m so glad you’re feeling so much better: sounds like you had a rough ride)!


No - just the Profile blurb at the top of the page. Just wanted you to know you can get better 😊


Well aren’t you just the sweetest!

Message received and understood.

Thanks Marz 🤗

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Learning another language helps with the brain function. Also plenty of good nutrional support i.e. a good healthy organic diet. Any type of exercise is good for the brain but it has to be done everyday. Plenty of oxygen is good.

Have you had your vitamins and mineral tested?

MCT oil is good too and can be used on salads.

There are various herbs that when taken together can do much to improve the brain function.


Haha, I speak 4 languages and a smattering of words of another couple, but all that does is make it so that I can get the word in my head in French or Spanish, say, but can’t get past that to find the English!

Yoga everyday. Diet is great. Vits and minerals are also being consumed ;-)

Herbs may well be the next thing! And MCT oil looks great. Does it actually work?!


MCT oil is an essential fatty oil which goes straight to the liver. The other great source is 200mg to 400mg of Centrophenoxine for aging brains.

I use Vit D Vit C K2 Q10 and Rhiola and H. Ginseng the last two taken together.

Other tests need to be taken to find and rule out any other things going on.

When my mother died she was 99 years old and had a very sharp brain.

I was adopted so I have not inherited her good genes I only have the bad ones.


Thanks to your recommendation I already bought some MCT oil on Amazon UK yesterday morning! Did my research and plumped for the LLS C8 oil. The reviews are great, so I’m intrigued.

I already take the supplements you mentioned. Thank you for the suggestion 😃


You mentioned neural pathways and I know that we are capable of forging these at any age. However it gets increasingly difficult as we age. Almost all of our neural pathways are made by the age of 3. They are made by experience and then by repetition so any training that is repeated positively should get results.


Quite right; just need to know if there are particularly useful exercises to do repeatedly! :-)


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