The Symptoms of “Sugar-Brain” or CARB syndrome
As you have already learned, if you eat the wrong types of food there’s a good chance you will fry your brain and end up with Sugar-Brain. Sugar-brain is like any other chronic disease process because it is associated with certain specific symptoms that tend to surface over time. The medical term for Sugar-Brain is Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Early in the course of the illness a person might have just a few of these symptoms but as time goes on they tend to gradually develop more of them until later stages of the disease where all of them are likely to be present. Because each of us has a different genetic makeup, each person will tend to have his or her own individual pattern of symptoms.
Read through this list of symptoms and see how many apply to you. It’s the best way to find out if you are sufferining from CARB Syndrome
Carbohydrate cravings.
Carbohydrate cravings are the hallmark symptom of CARB syndrome and you really can’t make a diagnosis of the disease without such cravings. These cravings are either for sweet food loaded with sugar or high fructose corn syrup or starchy foods, especially high glycemic starches like white flour, white rice and potatoes. Some people with CARB syndrome crave mainly sweet carbohydrates whereas others crave mainly starchy foods. Many people crave both types of carbohydrates. Whether it’s potato chips or Oreos, it’s still a carb craving.
Whether you are consciously aware of these cravings or not, they will tend to drive your food choices. Look back and see what types of foods you “like”. If you tend to eat a lot of sweet or starchy foods, it’s likely that carbohydrate cravings are behind many of your food choices.
Excessive physical and mental fatigue.
One of the most common symptoms of CARB syndrome and obesity is excessive mental and physical fatigue. Your get up and go, got up and went. You wake up tired and you end the day in a puddle of exhaustion. You don’t seem to have the mental energy to motivate yourself to do the things you need to do and even if you do generate the mental motivation to move, your exhausted body doesn’t seem to want to go along with the plan. Your well-meaning attempts to exercise on a regular basis quickly go by the wayside and the couch becomes your new best friend. With CARB syndrome this physical and mental fatigue is always out of proportion to your age and general health.
Difficulty concentrating and focusing.
One of your brain’s key functions is to concentrate and focus your thoughts in a way that allows you to effectively interact with your environment. When you lose the ability to concentrate and focus, it’ much more difficult to plan and carry out complex tasks. Your mind jumps from one random thought to another without obvious connections between the thoughts. This symptom is identical to the loss of concentration and focus experienced by people with classic ADHD—an identical symptom but a totally different disease
Poor impulse control.
One of your brains most important jobs is to control impulses. As you move through your day many of the things you think about saying or doing stay inside your head for good reason. If you expressed every thought that passes through your mind or acted on emotions without thinking, it’s likely that you would have few friends and your job prospects would be nil.
Although it’s normal for children and teenagers to sometimes have poor impulse control, it’s not normal for adults. CARB syndrome moves you backwards on the developmental scale when it comes to making sound and reasonable decisions and acting like an adult.
Feelings of depression.
People with CARB syndrome tend to have more down feelings than normal people. Adverse everyday events are more likely to put you in a funk and it’s much more difficult to maintain a sunny outlook on life. You tend to see the world through depression-tainted glasses. People with classic major depression will always feel depressed, lose their appetite and lose weight. People with CARB syndrome will sometimes feel depressed, have an increased appetite laced with carbohydrate craving and gain weight
Excessive anxiety.
Normal anxiety is a feeling of unease or discomfort based on some perceived threat in the environment. When you think you see the shadow of a crouching tiger in the bushes, a little anxiety is just what the doctor ordered. When you experience anxiety with minimal or no environment threat, we call it pathological anxiety. This is the kind of anxiety we deal with every day in our medical practices—patients with too much anxiety for no obvious reason. You get anxious when the dog sneezes, when you are placed in certain environments where there are no obvious threats, or for no particular reason at all—what we call free floating anxiety.
The anxiety associated with CARB syndrome isn’t normal because it isn’t a natural response to an environmental threat. The anxiety often appears for no reason, subjected your body to the stressful “fight-or-flight” hormones that can trigger a full panic attack.
Excessive mood swings.
People with normal brain function have some degree of emotional stability. They only get upset when the situation merits it. They somehow know when to feel happy, sad, anxious, or angry. Their moods almost always match the situation. People with CARB syndrome often experience excessive mood swings and they often emotionally overreact to everyday events. In a sense their moods become disconnected from their environment.
In women these mood swings tend to occur in the days before your menstrual period because hormonal changes are a strong secondary trigger of CARB syndrome. With effective treatment such PMS symptoms tend to melt away.
Insomnia.
Melatonin is your natural sleep hormone that cycles with the amount of daylight. Because melatonin is derived from serotonin, when you have low levels of serotonin from CARB syndrome you won’t be able to sleep normally. You may have difficulty falling asleep and staying asleep. You don’t spend enough time in critical REM sleep so you wake up in the morning feeling tired. You may also wake up frequently during the night and have trouble falling asleep again.
Lack of proper sensory filtering.
When your brain is working normally, it filters out most signals from your sensory organs. You only see, hear, smell and feel the touch of things that are relevant to your personal wellbeing and the background static is filtered out. If your brain didn’t perform this important task you would be quickly overwhelmed with masses of sensory data, leaving you swimming is a sea of mostly irrelevant information. It would be difficult to effectively function in this situation.
You tend to lose this sensory filtering when you have CARB syndrome, leaving you feeling uncomfortable in highly stimulating environments. You have difficulty concentrating on matters at hand because you are distracted by all this irrelevant incoming data. At the disease progresses you become uncomfortable in your own skin.
Low self-esteem.
It takes a healthy brain to maintain a healthy level of self-esteem or self-worth. If you have normal levels of self-esteem, you tend to have positive feelings about yourself and despite any personal shortcomings and you vow to work on improving them without tearing yourself down. You are an OK person, someone capable of loving and being loved because you find it easy to love yourself. When you develop CARB syndrome, this positive sense of self starts to slowly fade away. You develop negative feelings about yourself even when you have done nothing to deserve such feelings.
When you have low self-esteem it’s much more difficult to interact with others in a positive fashion, leaving you even further socially isolated.
Low self-image.
Self-image is similar to self-esteem but with subtle differences. Your self-image is what you experience when you look in the mirror whereas self-esteem is a more internal sense. Your self-image is how you view your physical self. When your brain is working normally, you like what you see when you look in the mirror regardless of any physical flaws. When you develop CARB syndrome you slowly start to lose this positive self-image and when you look in the mirror you never seem to like or accept what you see because you only see the flaws. Because you don’t like what you see in the mirror, you assume that others see what you are seeing—your flaws. This again pushes you to withdraw from social settings and other people, even those you care about.
Loss of cognitive function.
Your brain’s ability to cognate is its ability to think and perform more complex tasks based on abstract concepts. Using language, mathematics and complex logical reasoning all depend on your brain’s ability to perform higher cognitive functions. In a sense, being able to perform such complex cognitive tasks is what makes us human.
When you develop CARB syndrome, your ability to perform these types of complex tasks becomes somewhat impaired. This change tends to be very subtle and occurs very slowly so it’s not always readily apparent to you or others but over time this change becomes more noticeable. Early in the disease you can compensate by simply working harder. Later as the disease progresses even increased effort leaves you coming up short.
Patients with type II diabetes have been shown to have “reversible cognitive dysfunction”. Because CARB syndrome is the first step down the road to diabetes, patients with this disease will also have some degree of cognitive dysfunction.
Lack of empathy.
To empathize with others you first need to put yourself in their shoes and see the world through their eyes. This process occurs naturally when you brain is functioning normally. People sense your empathy for their situation and this creates a bridge for closer and more meaningful relationships. Without empathy, human interaction tends to be more about differences and conflict rather than shared experiences. Empathy is the glue that binds our social fabric. When you have CARB syndrome your ability to see the world through the eyes of others is diminished. You become more self-centered and less concerning about the feelings and experiences of others.
Chronic pain.
Pain is your body’s way of telling you something is wrong in your immediate environment, something that is an immediate threat to your safety and well being. The pain fibers that feed your brain are constantly sending low-level signals that are filtered out by your brain.
When you develop CARB syndrome your brain slowly loses this filtering function so some of these background pain signals start to get through. In a sense you start feeling things that you aren’t supposed to feel. As the disease progress you may become a candidate for a diagnosis of fibromyalgia. If you have a focus a genuine pain like a a sore knee from an old injury, your brain will begin to magnify these pain signals and you will feel the pain even more intensely. Pain becomes your new best friend.
Short-term memory problems.
Retaining memories is what allows you to learn from your experiences. At first new memories are stored in short-term memory and after a period of time important memories become cataloged in long-term memory. That’s why you still remember your first kiss or where you were when John Kennedy died or when the Twin Towers went down
When you develop CARB syndrome memories don’t stick in short term memory so easily and often they fade away before they make it to long-term memory. You may have trouble remembering the names of people you know fairly well and you start to make more lists to jar your memory. Unlike true dementia the memory problems associated with CARB syndrome tend to be mild and are completely reversible with treatment.
Internal restlessness and racing thoughts.
When your brain is working as intended it’s normal to experience a sense of natural calm when things are going well because you are in tune with your surroundings and your thoughts reflect what is going on around you. In other words, you are fully integrated in your environment. This “in tune with nature” feeling is common and natural with a healthy brain.
When you develop CARB syndrome, this inner calm tends to slowly fade and is replaced with a feeling of internal restlessness where you feel the compulsion to keep moving. It becomes more difficult to sit in one place for any length of time and you often resort to nervous habits like twirling your hair or tapping you leg. These “nervous habits” almost become second nature to you as the disease progresses. When you develop CARB syndrome you race from thought to thought without logical connections between the thoughts leaving you feeling “scatter-brained”.
Poor listening skills.
You need a healthy brain to hear and process what others say to you and then to respond in an appropriate manner. The ability to effectively listen requires a highly functioning brain. When you develop CARB syndrome, your ability to listen starts to disappear and you don’t fully hear or comprehend what others are saying to you, You fail to effectively process communication from others, creating problems in interpersonal relationships. It also makes it more difficult for you to function in school and work environments.
Obsessive-compulsive tendencies.
Obsessions are repetitive thoughts that at some point lose their value when they become to frequent or intrusive. Compulsions are repetitive behaviors that also become counter-productive if they become too frequent or intense.
When you develop CARB syndrome your ability to control obsessions and compulsions becomes impaired to the point where they interfere with your ability to function. You obsessively think about unimportant matters and you repeat meaningless behaviors leaving you little time for productive work.
Intestinal symptoms.
Your second brain called the enteric nervous system controls the movement of food and waste through your stomach and intestines. When you develop CARB syndrome your enteric nervous system starts to malfunction because it is also affected by the adverse effects of magnified glucose spikes. You experience bloating, abdominal cramps, excessive flatus and alternating diarrhea and constipation qualifying you for a diagnosis of irritable bowel syndrome.
Increased communication lag time (CLT).
When somebody says something to you it takes less than a second for you to listen and process this information. When you have processed and understood the message, you acknowledge it with a subtle change in facial expression, a head node or some other form of body language. This period of time it takes to listen to and process a message is called the Communication Lag Time (CLT). You can’t respond to a message unless you understand what is said and this process generally takes less than a second.
When you develop CARB syndrome your ability to listen and process information slows down to the point where it takes you longer to process and respond to information from others. Your CLT starts to slowly increase to several seconds or more. The person speaking to you immediately senses this increase in CLT because it throws a monkey wrench into normal communications. The natural flow of communication is lost along with good part of the content of the message.
Consciously thinking about food and eating.
If you haven’t eaten for six to eight hours it’s perfectly normal to consciously think about food and eating. Up until then hunger drives tend to be subtle and subconscious. If you don’t respond to these subconscious cues to eat, your brain will ratchet things up a notch and push hunger into your conscious thoughts.
When you develop CARB syndrome and obesity your hunger drives become disassociated from your nutritional needs and you start to think about food and eating during or shortly after a meal or at other inappropriate times. These intrusive thoughts about food and eating eventually kidnap your brain, leaving you little time to think about more pressing matters.
Now that you know the 21 symptoms of CARB syndrome, go through the list and see how many apply to you. If you recognize a lot of these symptoms in yourself, there’s a good chance you have CARB syndrome, On the web site there is a lot of information about what you can do to prevent or self-manage this common disease. Be well!
Dr. Bill Wilson







Hi Dr Wilson,
Enjoyed our discussion in Gloucester.
Please keep me updated. I am trying to work with clients to change their eating habits and have found that, like depression, CARB syndrome fuels it’s own fire and can be a difficult cycle to break.
Would like to chat again next time I’m in town.
Katherine Miura, MD
(Weekend rounds on SAU)
Katherine–In my work as a Hospitalist I see patients every day who fit the CARB syndrome model. I have found that it is easier to treat a disease if you understand the pathology of the condition. When it comes to “mental health problems” very few talk about diet. I do so and I appreciate your support.
Dr. Bill Wilson