by Dr. Will Cole

I’ve dealt with anxiety in the past, so I will be the first to agree with you that it really sucks. As a functional medicine practitioner I see many people who struggle with anxiety and panic attacks. My job is to figure out the underlying cause in order to work toward reversing, improving, or managing these symptoms.

This comprehensive (if I do say so myself) list is a combination of some of the most common physiological anxiety triggers and aggravators. All health issues – mental health included – are most of the time multifactorial. Every piece of the anxiety puzzle is unique. The factors on this list are interconnected because your body is brilliantly interconnected as well.

1. Caffeine

Let me introduce you to your caffeine gene, CYP1A2. This little guy has the final say on how you handle tea, coffee, or any other form of caffeine. People with the fast metabolizer version of this gene get tons of cool health benefits from coffee and tea, but people who have the slow metabolizer gene can be feeding anxiety with each sip of coffee.

2. Sugar

The sweet stuff is fuel for the anxiety fire. In fact, many studies have shown that the more sugar you eat (specifically the refined kind), the worse your anxiety can be. The underlying mechanism? Inflammation.

3. 5HT2A receptor activation

The brain stem hypothalamus, and prefrontal regions of the brain have what is called 5HT2A receptor sites. Activation of these sites can be linked to depression, anxiety, and chronic fatigue. Stress and other items on this list, can trigger 5HT2A activation.

4. Irregular menstrual cycles

In my anxiety patients, I often see underlying hormonal imbalances during different times of their cycle, especially before menstruation when there is an imbalance between progesterone, estrogen metabolites, and cortisol – all of which can fuel anxiety.

5. HPA-axis dysfunction

Your brain-adrenal communication line is what is known as the hypothalamic-pituitary-adrenal axis, or HPA-axis for short. This is often one of the top contributing factors to anxiety. What is commonly known as “adrenal fatigue” is actually a brain-based issue. Bringing balance back to HPA-axis function can take time but is crucial in order to overcome anxiety.

6. Thyroid problems

Each cell in your body has a thyroid receptor site – meaning, if your thyroid isn’t working well, than nothing is. Underlying thyroid pathway problems like autoimmune thyroid (Grave’s or Hashimoto’s disease) or thyroid conversion issues can be contributing to anxiety.

7. Alcohol

Alcohol can often be used as a way to curb anxiety but that is far from a good idea. Research has shown that alcohol consumption is associated with a worsening of anxiety disorders over time. Studies have also shown that drinking alcohol can rewire the brain and contribute to feelings of anxiety.

8. High LPS

Research often refers to your gut as your “second brain.” Your gut and brain were formed from the same fetal tissue while in the womb and are inextricably linked for the rest of your life by the gut-brain axis. Gut problems like “leaky gut syndrome” are associated with anxiety and other brain problems. This can happen because of increased levels of lipopolysaccharides (LPS) – bacterial endotoxins located on gram-negative bacteria in the microbiome. When your gut lining is compromised they are able to pass into the bloodstream and contribute to anxiety and other health problems.

9. Inflammation

NFkB is another inflammatory bad guy that is associated with anxiety. People with lower levels of NFkB often have lower rates of anxiety as well. We are continuing to find more and more research that inflammation is a huge factor in depression, anxiety, fatigue, and brain fog. There is actually a whole field of research known as the cytokine model of cognitive function on how inflammation messes with our brains.

10. Viral infections

Multiple studies have found links between mental health issues like anxiety with Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Check out my article for more information on chronic viral infections.

11. Lyme disease

Sadly, Lyme disease is reaching epidemic proportions. Neurological symptoms, like anxiety, are one of the most chronic symptoms that I see in people dealing with chronic Lyme disease.

12. Methylation impairments

Methylation is your body’s biochemical superhighway that makes our brain, gut, and hormones run optimally. People with methylation impairments such as the MTHFR gene mutation, have a higher risk for GABA/glutamine imbalance, low lithium levels, and high homocysteine inflammation which is a recipe for anxiety. But there is good news! You can do a lot to mitigate risk factors.

13. Food intolerances

It all comes down to the food that you eat – or don’t eat. Clinically, I have found that just by removing a patient’s particular food sensitivity like gluten or dairy, it reduces or even eliminates their anxiety.

14. Blood sugar problems

Blood glucose balance is essential for brain health. If your blood sugar goes up and down, it is anything but fun. Thankfully, you can do a lot to naturally balance your blood sugar.

15. Nutrient deficiencies

Your body needs each vitamin and mineral for a specific purpose. When I run labs for patients dealing with anxiety I look for low levels of vitamin D, magnesium, and lithium which are all linked to anxiety.

Any of these factors, or a combination of some of these, can be responsible for your anxiety. Luckily, it can be beneficial to take the time to get accurate testing and work with a functional medicine practitioner to get to the root cause of your anxiety. My hope is that you’ll find some relief in no time!

If you want to learn more about your own health case please check out our free health evaluation. We offer in person as well as phone and webcam consultations for people across the country and around the world.

Photo: Stocksy


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