June 30, 2025 • 23 mins
Feeling anxious? Your body might be sending you an SOS signal that goes far beyond a simple "chemical imbalance" in your brain. This deep dive into anxiety reveals why conventional approaches often fall short and how functional medicine offers a more comprehensive solution.
Anxiety affects over 40 million American adults yearly, yet conventional medicine typically rushes to label and medicate without asking the crucial question: why is this happening in the first place? As we discover in this episode, anxiety isn't just in your head—it's in your gut (where 70% of serotonin is produced), your hormones, your mitochondria, and even your mineral levels. It's not simply a mental disorder but a whole-body signal crying out for attention.
We explore the fascinating anatomy of anxiety, from your amygdala's alarm system to your HPA axis stress response and the delicate balance of neurotransmitters like GABA, glutamate, and serotonin. Most importantly, we uncover seven key root causes of anxiety that conventional medicine often misses: blood sugar dysregulation, gut-brain axis dysfunction, micronutrient deficiencies, hormonal imbalances, mitochondrial dysfunction, environmental toxins, and genetic polymorphisms. Each of these pathways offers opportunities for targeted intervention that addresses causes rather than just symptoms.
While medications can serve as helpful bridges during crisis, functional medicine aims to build resilience by addressing inflammation, trauma, and nutrient imbalances that fuel anxiety. Through comprehensive testing and personalized treatment protocols, we can decode your body's distress signals and create sustainable calm from the inside out. Ready to transform anxious energy into genuine wellbeing? Your journey to understanding the true roots of anxiety starts here.
Book a functional medicine consultation at Harmony Hub Health to discover your personalized path to healing anxiety at its source. Available online or in-person at our Manchester, Maryland location.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Harmony Hub Health, where my mission is
to provide comprehensive,affordable, integrative care
that addresses the root cause ofhealth issues.
At the Hub, the focus is onindividual patient journeys.
I strive to optimize health,vitality and longevity,
fostering a community where eachperson can thrive in body, mind
and spirit.
(00:21):
So today I want to talk about asymptom that I hear in I don't
know almost every single newpatient that I meet.
(00:42):
This is anxiety.
And anxiety isn't just in yourhead, it's in your gut, your
hormones, your mitochondria andmaybe even your mineral levels.
So while conventional medicineoften rushes to label and
medicate anxiety, functionalmedicine asks a deeper question
Like why is this happening inthe first place?
It is simply not a mentaldisorder, it's a whole body
(01:05):
signal.
In functional medicine, I don'task you know what drug matches
the diagnosis.
I ask why is this person havinganxiety in the first place?
Functional medicine recognizesthat anxiety is a symptom, not a
diagnosis, and the goal isn'tjust symptom suppression but
root cause resolution.
And this is a spoiler alert theanswer is not just a serotonin
(01:29):
imbalance.
Okay, let's look at somenumbers for anxiety.
So anxiety disorders affectsover 40 million adults in the
United States each year, butthey find that only 36.9%
receive treatment.
According to the NIH, women aretwice as likely to experience
generalized anxiety as men.
There was a 2021 studypublished in Frontiers in
(01:52):
Psychiatry that identifiedsystemic inflammation and
oxidative stress as centralplayers in the pathophysiology
of anxiety.
So why isn't that talked aboutmore?
And here we are in 2025.
So over 70% of your immunesystem does reside in your gut
and that links anxiety and guthealth more closely than ever
(02:16):
before.
You know, 70% of your serotoninis made in your gut, not in
your brain, like people think.
So it's not just worry, it'syour nervous system throwing
what I call a biochemicaltantrum.
Anxiety is a multi-systemresponse to a perceived threat,
whether it's real or if you'reimagining it because you're
(02:36):
thinking.
It's driven by your limbicsystem in the brain, especially
the amygdala that's yourbuilt-in danger detector,
especially the amygdala.
That's your built-in dangerdetector.
And it's modulated byneurotransmitters, hormones and
your nervous systems wiring.
So it's not just in your head,it's in your hpa axis, your
neurotransmitter balance, yourgut and your cellular metabolism
(02:58):
.
So now I want to give kind of anerdy breakdown of the anatomy
of anxiety because most peopledon't even think about what's
going on and your brain's alarmsystem.
So the amygdala this sounds thepanic alarm.
It processes threat andtriggers a stress response,
(03:18):
whether you're being chased by abear or just checking your
email inbox.
Then your hippocampus this iswhere you store emotional
memories.
So your brain overreacts ifit's seen it before.
Then we have our prefrontalcortex, and that should help
calm things down with logic.
But in chronic stress it getshijacked and shuts down.
(03:39):
So this brings on thoseirrational spirals.
The hypothalamic pituitaryadrenal axis, the HPA axis, is
the core of your stress responseand here's a play-by-play of
how it works.
So first the amygdala perceivesdanger.
It sends a signal to yourhypothalamus.
Your hypothalamus then releasescorticotropin-releasing hormone
(04:03):
known as CRH.
That CRH then tells yourpituitary to release ACTH.
Acth then tells your adrenalsto pump out cortisol and
adrenaline.
So this is one of the reasonswhy I like the Dutch test when I
talk to my hormone patientsthat are having these types of
responses, patients that arehaving these types of responses.
(04:24):
So when you pump out cortisoland adrenaline, these increase
your blood sugar, it makes yourheart rate go up, it dilates
your pupils and it gets youready to fight or flee.
All right.
Chronic cortisol release canshrink your hippocampus and it
makes emotional regulation worseover time.
(04:44):
So that's how long-term anxietydoesn't just feel bad, it
literally remodels your brain.
Think of neurotransmitters asyour brain's messaging system,
and when you have anxiety, thebalance is very off.
You have GABA.
This is your main calmingneurotransmitter.
Think of it as your brake pedal.
(05:05):
When you have low GABA, yourmind can race, your chest gets a
little tight, you get veryrestless.
Then we have glutamate.
This is the excitatorycounterpart.
If you have too much, you'reoverstimulated and you get these
anxious thoughts, maybeintrusive thoughts.
Then we have serotonin, whichis the 5-HT.
It regulates your mood, yoursleep and emotional resilience,
(05:29):
and it's made in the gut.
70% of it is made in your gut.
Then we have dopamine.
This governs your motivation,your attention and your fear
processing.
Then we have norepinephrine,and this triggers alertness and
hypervigilance.
It's also known as why did Ijust spiral about a text message
(05:52):
?
Neurotransmitter.
So chronic inflammation causesactivated microglia in the brain
, which then causes increasedcytokines like that IL-6,
tnf-alpha, and they mess withyour tryptophan metabolism.
It diverts it away fromserotonin and toward quinolinic
acid, which is a neurotoxiccompound.
It messes with neuroplasticityand the brain-derived
(06:16):
neurotrophic factor whichsupports mood stability.
So did that just sound likeGreek to you.
All it means is thatinflammation makes you feel
anxious, foggy and emotionallyunstable.
So your gut microbesmanufacture short-chain fatty
acids, neurotransmitters andanti-inflammatory compounds.
If your gut is leaky ordysbiotic, which we talk about a
(06:39):
lot here, gaba and serotoninsynthesis goes down.
Here GABA and serotoninsynthesis goes down.
Endotoxins like LPS orlipopolysaccharides they enter
your circulation and they causesystemic inflammation and your
vagus nerve gets disrupted.
So this reduces parasympathetictone, or I call your chill mode
.
The result of all of that is ananxious brain riding on a
(07:03):
dysregulated gut.
Some people are just morebiologically wired for anxiety
because maybe they have MTHFRpolymorphisms.
This reduces your ability toconvert folate to its active
form and causes poorneurotransmitter production.
I love helping MTHFR patientsbecause it's a missing link that
(07:24):
they've had their entire life.
I was one of them.
Comt slow variants.
So this impairs dopaminebreakdown, leading to overwhelm
or panic under stress.
And then the MAOA.
This impacts serotonin andnorepinephrine levels with high
low activity influencing moodregulation.
So anxiety equals your brainplus your body, plus your
(07:45):
biochemistry being in overdrive.
It's a hyperactive limbicsystem.
It's a cortisol drenched HPAaxis.
It's neurotransmitters that areout of balance.
It's gut bugs gone rogue.
I say that a lot of my consultsand people just love to hear
that because they never evenknew about it.
Sometimes it's as easy as lowmagnesium and B vitamins and a
(08:10):
little inflammation andsometimes a lot of unprocessed
emotion.
If your anxiety feels physical,it's because it is, and
functional medicine is designedto decode the why and build a
strategy that works at the rootcause level.
If you want to transformanxious energy into calm clarity
(08:31):
, we have to look under the hoodthe brain, the gut, the
hormones, all of them together.
Okay, so we'll talk about someroot causes of anxiety that we
see in functional medicine,because anxiety is a downstream
effect.
But what are the upstreamcauses?
Let's unpack this a little bitwith some examples.
The first one that I see isblood sugar dysregulation.
(08:54):
If your brain is fueled byunstable glucose, you'll ride
the anxiety train all day long.
So what happens is a rapid dropin blood sugar triggers
cortisol and adrenaline spikes.
Your brain thinks you're indanger.
That racing heart and thatsense of doom, that's just your
pancreas poor planning.
If you ever feel hangry or likeyou're losing your mind when
(09:18):
it's time for lunch, that's poorglucose control and that leads
to cortisol and adrenalinespikes that can mimic panic.
An example would be becausethis was me, I would skip
breakfast and I would grab asugary coffee by 10.30 in the
morning.
I can get a little dizzy, alittle sweaty, a little
irrationally panicked in a Zoommeeting, and it doesn't mean
(09:42):
that I need Xanax, it just meansI needed protein and fiber.
A 2020 study in nutrients didconfirm that unstable glucose
metabolism is associated withincreased risk of mood disorders
, especially anxiety.
The second one I would say isgut-brain axis dysfunction,
because your gut is your secondbrain and when it's inflamed,
(10:03):
your neurotransmitters really dosuffer.
When you have leaky gut or gutdysbiosis, it causes endotoxins
to enter your circulation and itprovokes neuroinflammation.
It also disrupts production ofcalming neurotransmitters like
your serotonin and your GABA.
An example of that would be Isee a man.
(10:24):
He has chronic bloating andfood sensitivities and he
started to get some panicattacks.
Well, his stool test revealed areally low lactobacillus
species and a high clostridia,both associated with GABA
suppression and increasedcatecholamines.
Even a Cell Reports 2019 studyrevealed that gut microbiota
(10:47):
directly influenced GABA levelsand anxiety-like behavior in
mice.
So human correlation studiesare mounting and the third root
cause I see, which I probablyshould have put number one is
your micronutrient deficiencies.
Your brain cannot run on fumes.
Many with anxiety are deficientin key nutrients needed for
(11:11):
neurotransmitter production.
The main players I see aremagnesium.
This is your calming mineral.
It helps regulate your HPA axisand your NMDA receptor activity
.
Then your B6 and your B12, youneed both of these for serotonin
and dopamine synthesis, so youcan try to increase your
dopamine, but you need the B6and the B12.
(11:32):
And then zinc is a cofactor inover 300 enzymatic reactions,
including your GABA regulation.
Omega-3 fatty acids reduceinflammation and helps to
modulate serotonin receptors.
An example of this I wouldthink of as a college student
that is having panic attacks.
They usually test low on serum.
(11:52):
Magnesium and omega-3s andsupplementation combined with
dietary changes can reduceanxiety symptoms within six
weeks.
All right, can reduce anxietysymptoms within six weeks, all
right.
Even a meta-analysis ofnutrients, the one I did find
was in 2017, but it found thatomega-3 supplementation
significantly reduces anxiety inboth clinical and non-clinical
(12:15):
populations.
And then a 2020 PLOS ONE studyconfirmed that magnesium
deficiency contributes todepressive and anxious behavior
in rodents, and that correlatesa lot with human data.
The fourth root cause ishormonal imbalance, because
hormones are mood messengers.
When they're out of sync, youfeel out of sync.
Also, when you have lowprogesterone, whether it's in
(12:37):
perimenopause or a luteal phasedeficiency whether it's in
perimenopause or a luteal phasedeficiency, it increases your
GABA receptor sensitivity, whichcauses more anxiety.
And when you have estrogendominance, this fuels your
histamine and glutamate and thatcauses overstimulation.
When you have adrenaldysfunction, whether it be low
(13:03):
cortisol or HPA axis dysfunction, it leaves you unable to cope
with stress.
So a good example would be a42-year-old woman.
This might be somebody I seenow.
They notice anxiety andinsomnia increase during the
second half of her menstrualcycle.
We did a Dutch test and it didreveal low progesterone and
elevated cortisol at night.
So we balanced her hormones andreduced her symptoms.
(13:24):
And there's that 2018 menopausejournal review that showed
hormone replacement, especiallyestradiol and progesterone,
helped reduce perimenopausalanxiety symptoms significantly.
I did not need a study to tellme that.
The fifth root cause, I wouldsay, is your mitochondrial
dysfunction and oxidative stress.
Your brain is energy hungrywhen your mitochondria aren't
(13:48):
working.
Neither is your mood regulationsystem.
So what happens is thatoxidative stress damages neurons
and your glial cells and itcreates brain fog, fatigue and
anxiety.
I saw a man that was recoveringfrom long COVID and he just
felt anxiety, a lot andexhaustion.
We did an OATS test and thatrevealed elevated oxidative
(14:10):
markers, mitochondrialdysfunction.
I treated him with NAD,antioxidants and CoQ10 and he
has had complete reversal.
That was a big win for me andfor functional medicine.
There is a 2021 Journal ofAffective Disorders review that
noted that mitochondrialdysfunction and oxidative stress
(14:31):
markers are elevated inpatients with anxiety and
depression.
Again, probably not somethingyou need a research study to
tell you, but it's nice to seeit in black and white, okay.
So number six, I would sayenvironmental toxins and mold
Toxic exposures can dysregulateyour immune and nervous system.
I did have a patient withunexplained panic attacks.
(14:53):
I mean, even through therapy,through just looking at these
other root causes, nothingseemed to fit.
Turns out, she lived in a homewith mold.
Mycotoxin testing did confirmthe exposure.
After remediation and binders,her anxiety symptoms have
(15:13):
improved dramatically.
So you never really know untilwe kind of go through our full
consultation to figure out whatthe root cause might be.
And then those geneticpolymorphisms this would be the
MTHFR, the COMT, the MAOA.
I think I can make my wholepractice just about genetic
polymorphisms and it would makemy life worthwhile.
(15:36):
So if your methylation pathwayis sluggish, not that it's not
worthwhile now, I didn't mean itto sound that way.
What was I trying to say?
Mission accomplished, I guess,is what I would say.
I could quit tomorrow and knowthat I did a really good thing,
but I'm still on my journey.
Okay, um, if your methylationpathway is sluggish or you clear
dopamine way slow, um, becauseof your calm tea, you're prone
(16:00):
to more anxiety.
So testing this helpspersonalize supplementation,
especially those B vitamins.
And I want to be clear now thatI've said these things I am not
anti-medication SSRIs.
You know benzos, anti-anxietymedicines they can be
life-saving bridges when someoneis drowning.
(16:21):
But what I'm against isband-aid therapy slapping a
label and a pill on a problemthat's rooted in inflammation,
trauma or nutrient imbalances,and just calling it a day.
One of my greatest joys this ismore so at Circle Medical,
where I also do primary care andADHD care.
(16:41):
Watching patients safely andgradually wean off of their
medications when their bodysystems are healing, their
hormones are balancing and theirnervous system regulated Like
that's real healing to me andthat is one of my greatest joys.
Ssris can be a great bridge,but they don't fix the
(17:03):
underlying biochemistry Plus.
Long-term use of these SSRIs orother medications can lead to
sexual dysfunction, weight gain,emotional blunting and
withdrawal symptoms.
So functional medicine aims tobuild resilience so that you can
taper, if appropriate, underthe proper supervision.
And talking about emotionalresilience, anxiety can be your
(17:26):
body's response to unprocessedemotion or trauma.
I'm still working on my traumacertification.
I just have 30,000 other thingsthat are causing me anxiety and
keeping me from finishing mytrauma class or course.
But functional medicine doesn'tignore that emotional terrain,
(17:47):
we just like to integrate it.
I don't need a certification init, I just want it because I
want to understand at a deeperlevel of how I can incorporate
that into my practice.
Anxiety definitely can be thebody's response to unprocessed
emotion or trauma and we don'twant to ignore that.
(18:09):
It's the inner conflict betweenwhat we feel and what we allow
ourselves to feel.
Suppressed anger, shame or fearbecomes somatic.
Tension becomes somatic tension.
Tight chest, shallow breathing,racing thoughts.
You know there was a patientthat I had.
(18:29):
This was before I startedHarmony Hub Health.
She was having thisfree-floating anxiety every
Sunday night.
Her labs looked good.
Through somatic therapy sherealized that the anxiety is
grief masked as productivity andaddressing emotional
suppression through nervoussystem work.
She was doing vagus nervetoning.
(18:50):
I think she even went and didsome EMDR and finally got relief
.
The adverse childhoodexperiences study that is what
proved that there's a strongcorrelation between early trauma
and adult anxiety.
And then there's a polyvagaltheory by Dr Stephen Porges and
he explained how unresolvedemotional states trap us in
(19:14):
sympathetic overdrive and whenwe have emotional resistance,
you know we have to kind of zoomout.
Not every anxious brain needssupplements, some just need
space to feel.
Emotional resistance happenswhen we avoid, we suppress or
(19:35):
intellectualize our feelingsinstead of processing them.
So anxiety builds in our bodywhen emotion has nowhere to go.
So just like the lady that hadthe free-floating anxiety every
Sunday somatic therapy sheuncovered unresolved grief
around a miscarriage and theanxiety finally lifted.
Research shows that trauma, evenmicrotrauma, can dysregulate
(19:56):
the autonomic nervous system fordecades if you don't address it
.
And that's where therapy comesin.
Functional medicine shines whenyou pair it with psychotherapy,
somatic therapy,trauma-informed coaching.
You can't supplement your wayout of a nervous system stuck in
fight or flight.
Therapy helps you untangle thewhy behind the what.
It's where you learn toregulate, release and rewrite
(20:19):
your internal narrative.
And that's just one of thethings in my functional medicine
toolbox to treat anxiety.
There's therapy.
Then I like to talk about theGI map or the OAT test to look
at the gut and neurotransmitters.
There's the Dutch hormone panelto look at the HPA axis.
My favorite is the HTMA or hairtissue mineral analysis.
(20:42):
It's a great micronutrientanalysis.
There's the genetic testing formethylation and detox pathways.
I am a certified provider withthe 3x4 genetics.
Then there's the mycotoxintesting, if that's appropriate.
A lot of my treatment protocolsI've put together I mean, I
have a lot of them but it looksat supplementation.
(21:05):
It looks at different therapies.
It looks at lifestyle.
So if you do feel anxious, yourbody is not broken.
It's brilliantly, brilliantlysounding an alarm.
Imagine if you had nothing Infunctional medicine.
I don't want to mute thatsignal.
I like to decode it.
(21:26):
I've always loved puzzles.
I always love finding out howthings work.
So whether it's nutrientdepletion, trauma, toxic burden
or emotional avoidance, you knowanxiety is the result of
systems overload.
Let's find the why.
Let's calm the chaos and buildresilience, body and mind.
(21:46):
Anxiety is not a randomchemical imbalance.
It's your body's SOS signal.
When we stop silencing thesymptom and start listening to
the message, that's when we canreally heal.
Functional medicine gives youthe why and the how, so you can
calm your body by treating yourbody.
If you're curious about your ownroot causes for anxiety, come
(22:10):
and see me, book a functionalmedicine consultation and start
your personalized path to calm,testing treatment and true
healing all in one place, onlineor in person, at Harmony Hub
Health.
So you can come and find me atwwwharmonyhubhealthcom.
You can see me in person atMonarch Beauty and Spa in
(22:31):
Manchester, maryland, and Iwould love to get to your root
cause.
You can even reach out to meand send me an email at michelle
.
That's M-I-C-H-E-L-E atharmonyhubhealthcom.
This podcast is for educationalpurposes only.
It's not a substitute forclinical care, therapy or
(22:52):
prescription advice.
Always work with a qualifiedprovider, ideally one who
listens to more than yoursymptoms.
I would love to be that person.
I hope to see you soon.
Welcome to Harmony Hub Health, where my mission is
to provide comprehensive,affordable, integrative care
that addresses the root cause ofhealth issues.
At the Hub, the focus is onindividual patient journeys.
I strive to optimize health,vitality and longevity,
fostering a community where eachperson can thrive in body, mind
and spirit.
(00:21):
So today I want to talk about asymptom that I hear in I don't
know almost every single newpatient that I meet.
(00:42):
This is anxiety.
And anxiety isn't just in yourhead, it's in your gut, your
hormones, your mitochondria andmaybe even your mineral levels.
So while conventional medicineoften rushes to label and
medicate anxiety, functionalmedicine asks a deeper question
Like why is this happening inthe first place?
It is simply not a mentaldisorder, it's a whole body
(01:05):
signal.
In functional medicine, I don'task you know what drug matches
the diagnosis.
I ask why is this person havinganxiety in the first place?
Functional medicine recognizesthat anxiety is a symptom, not a
diagnosis, and the goal isn'tjust symptom suppression but
root cause resolution.
And this is a spoiler alert theanswer is not just a serotonin
(01:29):
imbalance.
Okay, let's look at somenumbers for anxiety.
So anxiety disorders affectsover 40 million adults in the
United States each year, butthey find that only 36.9%
receive treatment.
According to the NIH, women aretwice as likely to experience
generalized anxiety as men.
There was a 2021 studypublished in Frontiers in
(01:52):
Psychiatry that identifiedsystemic inflammation and
oxidative stress as centralplayers in the pathophysiology
of anxiety.
So why isn't that talked aboutmore?
And here we are in 2025.
So over 70% of your immunesystem does reside in your gut
and that links anxiety and guthealth more closely than ever
(02:16):
before.
You know, 70% of your serotoninis made in your gut, not in
your brain, like people think.
So it's not just worry, it'syour nervous system throwing
what I call a biochemicaltantrum.
Anxiety is a multi-systemresponse to a perceived threat,
whether it's real or if you'reimagining it because you're
(02:36):
thinking.
It's driven by your limbicsystem in the brain, especially
the amygdala that's yourbuilt-in danger detector,
especially the amygdala.
That's your built-in dangerdetector.
And it's modulated byneurotransmitters, hormones and
your nervous systems wiring.
So it's not just in your head,it's in your hpa axis, your
neurotransmitter balance, yourgut and your cellular metabolism
(02:58):
.
So now I want to give kind of anerdy breakdown of the anatomy
of anxiety because most peopledon't even think about what's
going on and your brain's alarmsystem.
So the amygdala this sounds thepanic alarm.
It processes threat andtriggers a stress response,
(03:18):
whether you're being chased by abear or just checking your
email inbox.
Then your hippocampus this iswhere you store emotional
memories.
So your brain overreacts ifit's seen it before.
Then we have our prefrontalcortex, and that should help
calm things down with logic.
But in chronic stress it getshijacked and shuts down.
(03:39):
So this brings on thoseirrational spirals.
The hypothalamic pituitaryadrenal axis, the HPA axis, is
the core of your stress responseand here's a play-by-play of
how it works.
So first the amygdala perceivesdanger.
It sends a signal to yourhypothalamus.
Your hypothalamus then releasescorticotropin-releasing hormone
(04:03):
known as CRH.
That CRH then tells yourpituitary to release ACTH.
Acth then tells your adrenalsto pump out cortisol and
adrenaline.
So this is one of the reasonswhy I like the Dutch test when I
talk to my hormone patientsthat are having these types of
responses, patients that arehaving these types of responses.
(04:24):
So when you pump out cortisoland adrenaline, these increase
your blood sugar, it makes yourheart rate go up, it dilates
your pupils and it gets youready to fight or flee.
All right.
Chronic cortisol release canshrink your hippocampus and it
makes emotional regulation worseover time.
(04:44):
So that's how long-term anxietydoesn't just feel bad, it
literally remodels your brain.
Think of neurotransmitters asyour brain's messaging system,
and when you have anxiety, thebalance is very off.
You have GABA.
This is your main calmingneurotransmitter.
Think of it as your brake pedal.
(05:05):
When you have low GABA, yourmind can race, your chest gets a
little tight, you get veryrestless.
Then we have glutamate.
This is the excitatorycounterpart.
If you have too much, you'reoverstimulated and you get these
anxious thoughts, maybeintrusive thoughts.
Then we have serotonin, whichis the 5-HT.
It regulates your mood, yoursleep and emotional resilience,
(05:29):
and it's made in the gut.
70% of it is made in your gut.
Then we have dopamine.
This governs your motivation,your attention and your fear
processing.
Then we have norepinephrine,and this triggers alertness and
hypervigilance.
It's also known as why did Ijust spiral about a text message
(05:52):
?
Neurotransmitter.
So chronic inflammation causesactivated microglia in the brain
, which then causes increasedcytokines like that IL-6,
tnf-alpha, and they mess withyour tryptophan metabolism.
It diverts it away fromserotonin and toward quinolinic
acid, which is a neurotoxiccompound.
It messes with neuroplasticityand the brain-derived
(06:16):
neurotrophic factor whichsupports mood stability.
So did that just sound likeGreek to you.
All it means is thatinflammation makes you feel
anxious, foggy and emotionallyunstable.
So your gut microbesmanufacture short-chain fatty
acids, neurotransmitters andanti-inflammatory compounds.
If your gut is leaky ordysbiotic, which we talk about a
(06:39):
lot here, gaba and serotoninsynthesis goes down.
Here GABA and serotoninsynthesis goes down.
Endotoxins like LPS orlipopolysaccharides they enter
your circulation and they causesystemic inflammation and your
vagus nerve gets disrupted.
So this reduces parasympathetictone, or I call your chill mode
.
The result of all of that is ananxious brain riding on a
(07:03):
dysregulated gut.
Some people are just morebiologically wired for anxiety
because maybe they have MTHFRpolymorphisms.
This reduces your ability toconvert folate to its active
form and causes poorneurotransmitter production.
I love helping MTHFR patientsbecause it's a missing link that
(07:24):
they've had their entire life.
I was one of them.
Comt slow variants.
So this impairs dopaminebreakdown, leading to overwhelm
or panic under stress.
And then the MAOA.
This impacts serotonin andnorepinephrine levels with high
low activity influencing moodregulation.
So anxiety equals your brainplus your body, plus your
(07:45):
biochemistry being in overdrive.
It's a hyperactive limbicsystem.
It's a cortisol drenched HPAaxis.
It's neurotransmitters that areout of balance.
It's gut bugs gone rogue.
I say that a lot of my consultsand people just love to hear
that because they never evenknew about it.
Sometimes it's as easy as lowmagnesium and B vitamins and a
(08:10):
little inflammation andsometimes a lot of unprocessed
emotion.
If your anxiety feels physical,it's because it is, and
functional medicine is designedto decode the why and build a
strategy that works at the rootcause level.
If you want to transformanxious energy into calm clarity
(08:31):
, we have to look under the hoodthe brain, the gut, the
hormones, all of them together.
Okay, so we'll talk about someroot causes of anxiety that we
see in functional medicine,because anxiety is a downstream
effect.
But what are the upstreamcauses?
Let's unpack this a little bitwith some examples.
The first one that I see isblood sugar dysregulation.
(08:54):
If your brain is fueled byunstable glucose, you'll ride
the anxiety train all day long.
So what happens is a rapid dropin blood sugar triggers
cortisol and adrenaline spikes.
Your brain thinks you're indanger.
That racing heart and thatsense of doom, that's just your
pancreas poor planning.
If you ever feel hangry or likeyou're losing your mind when
(09:18):
it's time for lunch, that's poorglucose control and that leads
to cortisol and adrenalinespikes that can mimic panic.
An example would be becausethis was me, I would skip
breakfast and I would grab asugary coffee by 10.30 in the
morning.
I can get a little dizzy, alittle sweaty, a little
irrationally panicked in a Zoommeeting, and it doesn't mean
(09:42):
that I need Xanax, it just meansI needed protein and fiber.
A 2020 study in nutrients didconfirm that unstable glucose
metabolism is associated withincreased risk of mood disorders
, especially anxiety.
The second one I would say isgut-brain axis dysfunction,
because your gut is your secondbrain and when it's inflamed,
(10:03):
your neurotransmitters really dosuffer.
When you have leaky gut or gutdysbiosis, it causes endotoxins
to enter your circulation and itprovokes neuroinflammation.
It also disrupts production ofcalming neurotransmitters like
your serotonin and your GABA.
An example of that would be Isee a man.
(10:24):
He has chronic bloating andfood sensitivities and he
started to get some panicattacks.
Well, his stool test revealed areally low lactobacillus
species and a high clostridia,both associated with GABA
suppression and increasedcatecholamines.
Even a Cell Reports 2019 studyrevealed that gut microbiota
(10:47):
directly influenced GABA levelsand anxiety-like behavior in
mice.
So human correlation studiesare mounting and the third root
cause I see, which I probablyshould have put number one is
your micronutrient deficiencies.
Your brain cannot run on fumes.
Many with anxiety are deficientin key nutrients needed for
(11:11):
neurotransmitter production.
The main players I see aremagnesium.
This is your calming mineral.
It helps regulate your HPA axisand your NMDA receptor activity
.
Then your B6 and your B12, youneed both of these for serotonin
and dopamine synthesis, so youcan try to increase your
dopamine, but you need the B6and the B12.
(11:32):
And then zinc is a cofactor inover 300 enzymatic reactions,
including your GABA regulation.
Omega-3 fatty acids reduceinflammation and helps to
modulate serotonin receptors.
An example of this I wouldthink of as a college student
that is having panic attacks.
They usually test low on serum.
(11:52):
Magnesium and omega-3s andsupplementation combined with
dietary changes can reduceanxiety symptoms within six
weeks.
All right, can reduce anxietysymptoms within six weeks, all
right.
Even a meta-analysis ofnutrients, the one I did find
was in 2017, but it found thatomega-3 supplementation
significantly reduces anxiety inboth clinical and non-clinical
(12:15):
populations.
And then a 2020 PLOS ONE studyconfirmed that magnesium
deficiency contributes todepressive and anxious behavior
in rodents, and that correlatesa lot with human data.
The fourth root cause ishormonal imbalance, because
hormones are mood messengers.
When they're out of sync, youfeel out of sync.
Also, when you have lowprogesterone, whether it's in
(12:37):
perimenopause or a luteal phasedeficiency whether it's in
perimenopause or a luteal phasedeficiency, it increases your
GABA receptor sensitivity, whichcauses more anxiety.
And when you have estrogendominance, this fuels your
histamine and glutamate and thatcauses overstimulation.
When you have adrenaldysfunction, whether it be low
(13:03):
cortisol or HPA axis dysfunction, it leaves you unable to cope
with stress.
So a good example would be a42-year-old woman.
This might be somebody I seenow.
They notice anxiety andinsomnia increase during the
second half of her menstrualcycle.
We did a Dutch test and it didreveal low progesterone and
elevated cortisol at night.
So we balanced her hormones andreduced her symptoms.
(13:24):
And there's that 2018 menopausejournal review that showed
hormone replacement, especiallyestradiol and progesterone,
helped reduce perimenopausalanxiety symptoms significantly.
I did not need a study to tellme that.
The fifth root cause, I wouldsay, is your mitochondrial
dysfunction and oxidative stress.
Your brain is energy hungrywhen your mitochondria aren't
(13:48):
working.
Neither is your mood regulationsystem.
So what happens is thatoxidative stress damages neurons
and your glial cells and itcreates brain fog, fatigue and
anxiety.
I saw a man that was recoveringfrom long COVID and he just
felt anxiety, a lot andexhaustion.
We did an OATS test and thatrevealed elevated oxidative
(14:10):
markers, mitochondrialdysfunction.
I treated him with NAD,antioxidants and CoQ10 and he
has had complete reversal.
That was a big win for me andfor functional medicine.
There is a 2021 Journal ofAffective Disorders review that
noted that mitochondrialdysfunction and oxidative stress
(14:31):
markers are elevated inpatients with anxiety and
depression.
Again, probably not somethingyou need a research study to
tell you, but it's nice to seeit in black and white, okay.
So number six, I would sayenvironmental toxins and mold
Toxic exposures can dysregulateyour immune and nervous system.
I did have a patient withunexplained panic attacks.
(14:53):
I mean, even through therapy,through just looking at these
other root causes, nothingseemed to fit.
Turns out, she lived in a homewith mold.
Mycotoxin testing did confirmthe exposure.
After remediation and binders,her anxiety symptoms have
(15:13):
improved dramatically.
So you never really know untilwe kind of go through our full
consultation to figure out whatthe root cause might be.
And then those geneticpolymorphisms this would be the
MTHFR, the COMT, the MAOA.
I think I can make my wholepractice just about genetic
polymorphisms and it would makemy life worthwhile.
(15:36):
So if your methylation pathwayis sluggish, not that it's not
worthwhile now, I didn't mean itto sound that way.
What was I trying to say?
Mission accomplished, I guess,is what I would say.
I could quit tomorrow and knowthat I did a really good thing,
but I'm still on my journey.
Okay, um, if your methylationpathway is sluggish or you clear
dopamine way slow, um, becauseof your calm tea, you're prone
(16:00):
to more anxiety.
So testing this helpspersonalize supplementation,
especially those B vitamins.
And I want to be clear now thatI've said these things I am not
anti-medication SSRIs.
You know benzos, anti-anxietymedicines they can be
life-saving bridges when someoneis drowning.
(16:21):
But what I'm against isband-aid therapy slapping a
label and a pill on a problemthat's rooted in inflammation,
trauma or nutrient imbalances,and just calling it a day.
One of my greatest joys this ismore so at Circle Medical,
where I also do primary care andADHD care.
(16:41):
Watching patients safely andgradually wean off of their
medications when their bodysystems are healing, their
hormones are balancing and theirnervous system regulated Like
that's real healing to me andthat is one of my greatest joys.
Ssris can be a great bridge,but they don't fix the
(17:03):
underlying biochemistry Plus.
Long-term use of these SSRIs orother medications can lead to
sexual dysfunction, weight gain,emotional blunting and
withdrawal symptoms.
So functional medicine aims tobuild resilience so that you can
taper, if appropriate, underthe proper supervision.
And talking about emotionalresilience, anxiety can be your
(17:26):
body's response to unprocessedemotion or trauma.
I'm still working on my traumacertification.
I just have 30,000 other thingsthat are causing me anxiety and
keeping me from finishing mytrauma class or course.
But functional medicine doesn'tignore that emotional terrain,
(17:47):
we just like to integrate it.
I don't need a certification init, I just want it because I
want to understand at a deeperlevel of how I can incorporate
that into my practice.
Anxiety definitely can be thebody's response to unprocessed
emotion or trauma and we don'twant to ignore that.
(18:09):
It's the inner conflict betweenwhat we feel and what we allow
ourselves to feel.
Suppressed anger, shame or fearbecomes somatic.
Tension becomes somatic tension.
Tight chest, shallow breathing,racing thoughts.
You know there was a patientthat I had.
(18:29):
This was before I startedHarmony Hub Health.
She was having thisfree-floating anxiety every
Sunday night.
Her labs looked good.
Through somatic therapy sherealized that the anxiety is
grief masked as productivity andaddressing emotional
suppression through nervoussystem work.
She was doing vagus nervetoning.
(18:50):
I think she even went and didsome EMDR and finally got relief
.
The adverse childhoodexperiences study that is what
proved that there's a strongcorrelation between early trauma
and adult anxiety.
And then there's a polyvagaltheory by Dr Stephen Porges and
he explained how unresolvedemotional states trap us in
(19:14):
sympathetic overdrive and whenwe have emotional resistance,
you know we have to kind of zoomout.
Not every anxious brain needssupplements, some just need
space to feel.
Emotional resistance happenswhen we avoid, we suppress or
(19:35):
intellectualize our feelingsinstead of processing them.
So anxiety builds in our bodywhen emotion has nowhere to go.
So just like the lady that hadthe free-floating anxiety every
Sunday somatic therapy sheuncovered unresolved grief
around a miscarriage and theanxiety finally lifted.
Research shows that trauma, evenmicrotrauma, can dysregulate
(19:56):
the autonomic nervous system fordecades if you don't address it
.
And that's where therapy comesin.
Functional medicine shines whenyou pair it with psychotherapy,
somatic therapy,trauma-informed coaching.
You can't supplement your wayout of a nervous system stuck in
fight or flight.
Therapy helps you untangle thewhy behind the what.
It's where you learn toregulate, release and rewrite
(20:19):
your internal narrative.
And that's just one of thethings in my functional medicine
toolbox to treat anxiety.
There's therapy.
Then I like to talk about theGI map or the OAT test to look
at the gut and neurotransmitters.
There's the Dutch hormone panelto look at the HPA axis.
My favorite is the HTMA or hairtissue mineral analysis.
(20:42):
It's a great micronutrientanalysis.
There's the genetic testing formethylation and detox pathways.
I am a certified provider withthe 3x4 genetics.
Then there's the mycotoxintesting, if that's appropriate.
A lot of my treatment protocolsI've put together I mean, I
have a lot of them but it looksat supplementation.
(21:05):
It looks at different therapies.
It looks at lifestyle.
So if you do feel anxious, yourbody is not broken.
It's brilliantly, brilliantlysounding an alarm.
Imagine if you had nothing Infunctional medicine.
I don't want to mute thatsignal.
I like to decode it.
(21:26):
I've always loved puzzles.
I always love finding out howthings work.
So whether it's nutrientdepletion, trauma, toxic burden
or emotional avoidance, you knowanxiety is the result of
systems overload.
Let's find the why.
Let's calm the chaos and buildresilience, body and mind.
(21:46):
Anxiety is not a randomchemical imbalance.
It's your body's SOS signal.
When we stop silencing thesymptom and start listening to
the message, that's when we canreally heal.
Functional medicine gives youthe why and the how, so you can
calm your body by treating yourbody.
If you're curious about your ownroot causes for anxiety, come
(22:10):
and see me, book a functionalmedicine consultation and start
your personalized path to calm,testing treatment and true
healing all in one place, onlineor in person, at Harmony Hub
Health.
So you can come and find me atwwwharmonyhubhealthcom.
You can see me in person atMonarch Beauty and Spa in
(22:31):
Manchester, maryland, and Iwould love to get to your root
cause.
You can even reach out to meand send me an email at michelle
.
That's M-I-C-H-E-L-E atharmonyhubhealthcom.
This podcast is for educationalpurposes only.
It's not a substitute forclinical care, therapy or
(22:52):
prescription advice.
Always work with a qualifiedprovider, ideally one who
listens to more than yoursymptoms.
I would love to be that person.
I hope to see you soon.
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