Anxiety is heightened in many right now due to the global pandemic. Many are offered a prescription medication before ever investigating other treatable causes for the anxiety. Below are 5 of the most common causes of anxiety I come across in my practice.
- Thyroid issues
The thyroid sets the metabolic rate of the body. It is an important organ making important hormones. But if those hormones are out of balance anxiety can be a common symptom. Most often only one parameter of thyroid is tested – TSH (thyroid stimulating hormone). Then only if this value is too high (hypothyroidism) or too low (hyperthyroidism) are any other parameters looked at. Often patients have normal TSH values but I find their T3 (active thyroid hormone) or T4 (storage form of thyroid hormone, gets converted to T3) is too high or low or that there may be an autoimmune component (by testing thyroid antibodies) contributing to the symptoms. Doing a complete thyroid panel is very important when assessing underlying contributors to anxiety.
- Low iron
Iron is crucial for carrying oxygen around the body and to all the organs and it is crucial for making some neurotransmitters and hormones too. When iron is low it is common to feel tired, easily winded, bruise easily or feel dizzy or lightheaded. I would say most of these symptoms are fairly common knowledge, but anxiety can be another common symptom and not many know about it. Iron is desperately needed for the nerves and brain and low iron levels can cause a higher than normal heart rate. These two things combined are a perfect storm for feelings of anxiousness.
- Low blood sugar
When blood sugar falls, usually from not eating enough or not eating often enough it can cause anxiety. This happens because low blood sugar causes cortisol (the stress hormone) to be released, which also causes an increase in epinephrine. This increase in epinephrine or adrenaline is typically what causes symptoms like shakiness, sweating, heart palpitations and even anxiety. If you are getting low blood sugar symptoms but eating regularly it may be indicated to test your fasting insulin levels. Insulin is a hormone that helps modulate blood sugar. If it isn’t working properly it can cause blood sugar highs an lows, but there are way to improve its function.
- Too much or too little cortisol
Cortisol is the stress hormone and is released during acute stress. But it also has its own daily curve. It is suppose to be highest in the morning just before you wake up to make you feel energetic and motivated, then it slowly decreases through the day until it is lowest at night so you can sleep. If you are waking in the morning not rested, lack motivation, have low appetite in the morning, energy crashes through the day or trouble falling or staying asleep at night then chances are your normal cortisol rhythm is off and it could be the source of your anxiety.
- Low progesterone
Progesterone is a sex hormone involved in the menstrual cycle, pregnancy and the formation and development of an embryo. It is suppose to be low in the first part of the menstrual cycle (from the first day of a period until ovulation), and then it increases from ovulation until the next period, where it drops suddenly to trigger bleeding. If progesterone is too low you may experience midcycle (around ovulation) spotting, PMS symptoms, heavy bleeding, breast tenderness, insomnia before your period or breast tenderness. It can also be the cause of anxiety – especially if you notice your anxiety gets worse during certain times in your cycle or if you have some of the above listed symptoms.
In some cases it can be a mixture of any of the above plus other factors! That is why it is so important to be worked up by a licensed Naturopathic Doctor. We know what to test for and what to look for and what specific factors may be contributing to your overall health. As well, we can come up with a protocol that best addresses the underlying causes. In some cases the anxiety may be so severe that you may want or need a prescription anti-anxiety medication while we work on the underlying causes as well. The good news is that Naturopathic Physicians in BC have prescribing rights and can prescribe most medications when indicated.
Dr. Alyssa Fruson, ND
Integrated Health Clinic
Clinic number: 604-888-8325