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15 Unexpected Things That Are Majorly Triggering Your Anxiety

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As someone who's gone through anxiety myself, I'm here to agree with you that it really, really sucks. There are a lot of reasons people struggle with anxiety and panic attacks, and my job as a functional medicine practitioner is to find out what they are so we can work together to reverse, improve, or manage them.

This comprehensive (if I do say so myself) list is a mixture of the most common physiological anxiety triggers and aggravators. Mental health issues—any health issue, for that matter—are often times multifactorial; each piece of the anxiety puzzle is unique. And because your body is brilliantly interconnected, so are the factors on this list.

1. Caffeine:

Say hello to your caffeine gene CYP1A2. This guy determines how you handle coffee, tea, or anything else with caffeine in it. If you have the fast metabolizer version of this gene, you get all the cool health benefits of tea and coffee, but slow metabolizers of caffeine are often fueling their anxiety with each cup of coffee.

2. Sugar:

Sugar acts as fuel for the anxiety fire, and multiple studies have shown that the more sugar you eat (especially the refined kind), the more likely you are to have anxiety. The underlying mechanism? Inflammation.

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3. 5HT2A receptor activation:

Our brain, specifically the hypothalamus, brain stem, and prefrontal regions, have what's called 5HT2A receptor sites. When these little guys are activated, it can be linked to a number of bad things like anxiety, depression, and chronic fatigue. What can trigger 5HT2A? Stress and some of the other factors on this list.

4. Menstrual cycle imbalances:

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I often find underlying hormonal imbalances in my anxiety patients during different times of their cycle, but especially before menstruation, imbalances between estrogen metabolites, progesterone, and cortisol—which can all fuel anxiety during this time.

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5. HPA-axis dysfunction:

Your brain-adrenal communication line—something called the hypothalamic-pituitary-adrenal (HPA) axis—is one of the top factors playing a role in anxiety. What is commonly known as "adrenal fatigue" is actually a brain-based issue. Balancing HPA-axis function takes time, but it is essential for many people to overcome their anxiety.

6. Thyroid problems:

Every cell of your body has a thyroid receptor site, so if your thyroid isn't working, nothing is. There are many underlying thyroid pathway problems like thyroid conversion issues or autoimmune thyroid (Hashimoto's or Graves' disease) that are common factors to anxiety.

7. Alcohol:

People often turn to alcohol to curb their anxiety, but that is not a good idea. Studies have shown that consuming alcohol is associated with a worsening of anxiety disorders over time. Other studies have shown that drinking alcohol in general can rewire the brain, making us more susceptible to anxiety.

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8. High LPS:

Your gut is often referred to as the "second brain." Formed from the same fetal tissue, your gut and brain are inextricably linked for the rest of your life through what's called the gut-brain axis. Gut problems like intestinal hyper-permeability or "leaky gut syndrome" are associated with brain problems like anxiety. This often occurs through increased levels of lipopolysaccharides (LPS), which are bacterial endotoxins found on gram-negative bacteria in the microbiome. When these bacteria are able to pass through the gut's protective lining in the bloodstream, it can trigger inflammation and a whole host of health issues, one of them being anxiety.

9. Inflammation:

Just like LPS, there is another inflammatory bad guy, called NFkB, that is associated with anxiety. Lower levels of NFkB usually means lower rates of anxiety. We're finding more and more that inflammation is a hugely important factor in anxiety, depression, fatigue, and brain fog research. In fact, there's a whole field referred to as the cytokine model of cognitive function. (Translation: How inflammation messes with our brain.)

10. Food sensitivities:

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The foods you eat instruct your biochemistry, simple as that. Clinically, I have found when we remove a patient's specific food sensitivity, such as gluten or dairy, this significantly reduces or eliminates their anxiety.

11. Viral infections:

Multiple studies have found a link between mental health issues (anxiety and depression) and cytomegalovirus (CMV) and Epstein-Barr virus (EBV). For more information on chronic viral infections, check out my article.

12. Lyme disease:

Lyme disease is sadly spreading to epidemic proportions. One of the most common symptoms that I see in people struggling with chronic Lyme disease are neurological symptoms like anxiety.

13. Methylation impairments:

Methylation is a big, fancy biochemical superhighway in the body that helps make our brain, hormones, and gut super healthy. People with specific methylation impairments such as MTHFR gene mutations are at higher risk for an imbalance of GABA/glutamate, lower lithium levels, and higher homocysteine inflammation—which is a recipe for anxiety. The good news? There's a lot you can do to mitigate risk factors.

The foods you eat determine how well your body works on a biochemical level—simple as that. Clinically, I have found that when we remove a patient's specific food sensitivity, such as gluten or dairy, it significantly reduces or eliminates their anxiety.

14. Blood sugar problems:

The balance of our blood glucose is paramount for brain health. If you have dips and spikes in your blood sugar, it's akin to a roller coaster that is anything but fun. The good news? There's a lot you can do to balance your blood sugar naturally.

15. Nutrient deficiencies:

We can't underestimate how much our body needs each specific vitamin and mineral. That's why one piece of my anxiety work-up for patients is to look for low levels of lithium, vitamin D, and magnesium, which are all associated with anxiety.

It could be any one of these factors (or combination of factors) that are responsible for your anxiety. Luckily, taking the time to get accurate testing and working with a functional medicine expert can help you get to the root cause of your anxiety. It's my hope that you'll find some relief in no time!

Is strengthening this nerve the secret to taming anxiety?

William Cole, D.C.

Functional Medicine Practitioner
Dr. Will Cole, leading functional medicine expert, graduated from Southern California University of Health Sciences as a doctor of chiropractic. His extensive postdoctorate education and training is in functional medicine and clinical nutrition. Dr. Cole consults people around the world via webcam and locally in Pittsburgh. He specializes in clinically investigating underlying factors and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders and brain problems. Visit www.drwillcole.com for free e-books, recipes, and webcam evaluation.
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William Cole, D.C.

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