Severe cognitive decline; Any thoughts?
I'm a 22 year old male and for the past 4.5 years, I have been dealing with a significant cognitive functioning issue. It has made it difficult for understanding anything with the slightest bit of complexity. As someone who's strong point was by far math, science, critical/logical thinking, and problem solving, it was quite the dramatic transition. When it happened, I had to drop out of high school and saw many doctors to no avail. It was a sudden decline that occurred around a few nights where I drank a normal amount with my friend 3 or so nights in a row. I had drank many times before so I don't think it correlates. Otherwise, no drugs and nothing out of the blue. I apologize if this gets lengthy. Please bear with me!
I'll start with what I think is the root issue. Basically, any time I hear or think of any word (or anything else, not just words), I don't get a flash of meaning or understanding for that word based on previous experience with it. I don't get mental visualization of things I'm thinking of. I don't know what process it is I'm missing because I've been so long without it, but I believe it's like I said, having that inner self-created meaning/visualization automatically pop up in relation to their corresponding words. I also apologize if certain things get repetitive. I just don't know what might come across as making sense and what won't depending on how I phrase it.
EXAMPLES - To better understand exactly how it effects my constantly. If you really are curious, feel free to read them all but to gather the cliff notes, just 2-3 of these paragraphs will probably explain the gist then skip to "My over-all Health and Things I've tried". Or just ignore all this and tell me I'm crazy! They're all a little different so I threw a bunch in:
-A basic example that'll make a good starter would be when my buddy mentioned he was going to hyperventilate to stay underwater longer. I can't for the life of me understand what hyperventilation means. I knew what it was and what it meant most of my life but since my cognitive decline, I don't get visual meaning that shows what hyperventilation is when I hear the word. This goes for any word, hyperventilation is just the word I decided to make an example out of. I can recite what hyperventilating is with words and explain it but I won't understand what I'm explaining. It's very strange to me that I can often explain certain things that I can't even understand myself. To think of what it means to me, rather than it just popping in my head from memory or getting a flash visual of the way I've understood it before, I have to keep pondering over the word and think through the process of it. I may eventually be able to faintly visualize the act of breathing heavily. This isn't a visual I'll be able to remember, I'll just have it while in deep thought trying to figure out what hyperventilating is. I may even have to have to start breathing heavily to make myself understand it. If I do take my time and visualize what hyperventilating is so I understand it, I can't just re-have that visual I created so I can understand it on the dime again in the future. If I use the word again 20 seconds later, I don't have a visual that pops up simultaneously that shows what the word means.
-I was out bowling. For my 2nd roll, the pins were set up a certain way from my first roll where I took out most of the right pins and 1 or 2 in the back middle left. I thought through how I should hit it and figured out what I thought was a good roll because of the domino effect it would have but once I stopped thinking of that and tried to think it again before the roll or when I had the same set up a couple turns later, I had to go through the same task of looking at the set up the pins are in and go through the same process of listing the steps of why the way I thought would be the most efficient way to roll. I have to go through the same process I had to go through the first time when figuring out why rolling the ball this way would be my best chance. Any time in the future, I'll just have to repeat this same rethinking process or I can just roll using the strategy but completely not understand it or why I'm using it. I should be able to visualize what I visualized when I first came up with the plan/idea of how I need to roll it and automatically recall the understanding I made. Also, I should be able to visualize this plan/idea without looking at the pins but I can't. I have to look at them to think about them like that because I can't create the mental picture of them in my head.
Maybe the issue is that I'm not creating these visuals, not just that I cannot memorize or recall them. That's why I have to be looking at the pins to come up with a simple strategy of how I'll roll or why I have to be looking at a traffic light to understand a simple strategy I might use every day when pulling up to one. I can hardly think about them without looking at them.
-At work I was going through invoices and organizing them. I was putting certain numbers in a certain stack for a certain reason and I understood it when I first thought of it. When I try to rethink of it each time I put another paper in the pile, I have to stop and try to re-understand what that stack is for and why I'm putting papers there. Shouldn't I be able to just get a visual that makes me automatically remember/understand it like I did when I first made the process?
-Another example: Things like using a comma in the right place. When I used to think of where to use a comma, when it came to a place where it was needed I would get a flash visual memory that reminds me where/what a comma is used for. That flash visual memory would take me back to previous understanding I've made on commas and their purpose. Now it 100% automatic for me and I've noticed I've gotten worse and worse at fuguring out where/when to use them.
-At one of my jobs, I sell lotto and have been doing it for over 2 years. If someone made money off a ticket it'll show a -$(amount) meaning I owe them that amount, if they owe for tickets they purchased, it will show the $(amount) without the minus sign. To this day, any time I see the amount, I have to think through and figure out what each one means so I know whether they owe me or I owe them because I don't make automatic understandings over time anymore. I can't look at it and automatically fully understand based on previous experience. When I stop to think “okay Evan, minus means I owe them”, just thinking that doesn't make it make sense because it lacks meaning when I say it. The statement doesn't carry inner visuals or whatever that shows me what it actually means so I have to carry out actions automatically based on experience from my younger days.
-This is an example I had written in my notes from 5 months ago when I got my blood tested and found my T3 and T4 were incredibly low but soon found out that my T3 & T4 Free levels were completely normal therefore I have a protein binding deficiency which while rare, has absolutely no side effects. Anyways:
I haven't been drinking at all lately a lot to do with the fact that it effects thyroid and my thyroid seems to be funky. When people ask me why I'm not drinking, I just say for health but in my head every time, I try to recall why and tell myself “not drinking because of my thyroid” but that's all I get in my head, those simple words with empty meaning. I don't get any visual meaning/understanding of what thyroid is or its correlation to drinking or any understanding of why I'm not drinking because of thyroid. I don't get the original visual had when realizing I should stop drinking because it effects thyroid.
-While watching football, there was a play that was called “forward progress” but there was no forward progress in the play (bullshit call) so when I tried to think of how it was forward progress, I couldn't get the automatic understanding of what forward progress was. Usually I get through these types of situations because I get to see them and that ends up being my definition. For example, usually when forward progress is called, there's actual forward progress so I get to see it and that automatically associates with the words “forward progress” for me. If I don't get to see it, I don't have that inner recollection where I see in my head what it is.
-An example just yesterday at the gym I attend, I was doing my usual swim. I swim typically 5 times a week and was doing some intervals towards the end. I did 2 laps from when the timer read 4:30 to when it read 5:40 (minutes:seconds). I was trying to think if that meant I did 40 seconds per lap or 35. I had a quick visual thought where I thought - just split the extra 10 seconds in half and add to the two 30's so it's 35 seconds per lap. See, this visual that I had I will never be able to have again from memory. When I have this same question during my next 2 lap interval, the only way I can think of this again is to be in the same predicament trying to figure out how long it took me per lap. I don't get the automatic visual memory pop up and have it figured out immediately from the last 250 times I've thought through it in the pool.
MY OVER-ALL HEALTH AND THINGS I'VE TRIED:
I'm quite healthy. I eat some junk but much healthier than the average american. I swim 1-2 miles almost daily (5-6 times a week). I drink lightly maybe once every 2 weeks. No drugs, no meds. I've tried B-complex and fish-oil for months in the past, no help. Tried Frankincense essential oil under tongue for months. Tried pro-biotic, B6, B12, and Magnesium together for months, no help. I've tried zinc and Iodine supps at different times for over a month, no help (seems random but I've shown low on Iodine in blood test).
Here's one little clue that might help along with the examples I spewed. About 2 years ago, I connected with a friend from another state and he sent me marijuana wax (highly concentrated THC). I smoked it 2-4 times daily for 3 months. I wasn't the same as before the cognitive decline but it definitely helped produce mental visuals. I was suddenly imagining/picturing everything I thought of so I could understand it better. I was also memorizing some strategies I was making too. This went away a couple days after I quit. Essentially, I was much smarter and more capable of handling things while using it than I am in my sober pathetic current state. I'd like that to be my final fix if I can't find the issue.
When it started, I saw every kind of doctor. Got MRI, MRA, 40 min EEG, tons of blood tests, everything came up normal. At the time, I had no idea how to explain my issue. Only very recently did I get more clarity of my issue and form the examples/explanations I gave above. Since the recent accurate explanations, I've started setting up doc appt's. I saw a neurologist who ordered an MRI w/o contrast of brain and MRI w/contrast of pituitary (I have history of HGH and testosterone deficiency so he was curious). Both turned up normal. He has me set to do a 40 minute EEG and I'm going to do it just for kicks because I've already met my insurance deductible. I plan to see a neuro-psych next.
I've received a fair amount of blood work recently too. everything was normal. I mentioned above I have a protein binding deficiency. T3 and T4 show super low as does TBG (thyroid binding globulin) but Free T3 & T4 show normal). Vitamin D, iron, cholesterol,cortisol, B12, B6, potassium, etc always show normal. White blood cell count has showed up at 3.3k and 3.7k within last year but seems normal. I don't think I've been sick in 3 years and never clean out my cuts; no issues there.
I also have history of low testosterone (around 300-400, 250ish through puberty till 19) but that was recently figured out by my uro. Taking HCG every other day has increased my T to 700+ since March.
One of my doctors is more holistic and had me do a glucose tolerance test with 75mg Sugar and after 1 hour, I went from 74 (on fast) to (on 30 minute intervals) 131, 82, 62, 62, 42. He felt this was significant but the endocrinologist I see said it was a completely normal reaction and most people would react the same way to that much sugar. I tried ketogenic/paleo diet for 10 days, didn't show any beneficial effects. Tried salad only no Sugar diet for 6 days, no benefit.
When it first started, I remember complaining that the bags under my eyes got darker and deeper. I think I also may have complained about a nauseous feeling in the brain sort of like when you get motion sick minus the sickness, just the feeling of shit going on in the brain where it gets uncomfortable. I'm guessing this was just from the anxiety/emotion of suddenly being not being able to figure out or understand things I understood days before. At this point, I think I'm just throwing wrenches at the case for you guys in case something stands out as a symptom for something. For those that read through this, thank you. If you do recommend something that makes sense and help me find the issue/fix, I swear to god I will come back to connect with you to pay you $1000. I'm not thinking people will only help for $, it's just how important this is to my life. Sorry for the short novel.