I shared these 60+ Nutritional & Biochemical Causes of Anxiety on my closing call of the The Anxiety Summit season 3. Since then I’ve kept this list updated as I find additional research, connections and case studies. In conjunction with my book “The Antianxiety Food Solution”, interviews and other blogs, I hope this list will help you put the puzzle pieces together to resolve your anxiety.
Keep in mind it’s not uncommon to have many root causes so if it feels too overwhelming, addressing low serotonin and/or low GABA first, really does help with the overwhelm, fear, anxiety and negativity.
The Foundational Causes from The Antianxiety Food Solution :
- Food – real whole food, organic (pesticides may be problematic), quality protein (grass-fed, wild, pastured), healthy fats; avoid junk/processed food with additives/colors/trans fats/GMOs
- Sugar – depletes zinc and magnesium and fills us up. We should not feel the need for treats/fruit should satisfy our desire for sweet
- Low blood sugar – breakfast/protein/healthy snacks/no coffee
- Caffeine/Coffee – even decaf coffee may be an issue. Coffee has high-levels of pesticides, affects blood sugar and affects hormones
- Tobacco – depletes key nutrients like zinc, vitamin C
- alcohol – depletes key nutrients like zinc, vitamin C
- Food sensitivities – gluten (plus glyphosates/roundup affect serotonin/zinc etc), dairy, GAPs, grains
- Digestive system – low HCl
- Digestive system – Low good bacteria/probiotics
- Digestive system – other enzymes are low
- Digestive system – candida
- Digestive system – parasites
- Digestive system – leaky gut
- Digestive system – liver/gallbladder issues
- Digestive system – SIBO
- Brain chemicals/neurotransmitters: low GABA (covered in detail in season 4 of the Anxiety Summit)
- Brain chemicals/neurotransmitters: low serotonin
- Brain chemicals/neurotransmitters: low endorphins
- Brain chemicals/neurotransmitters: low catecholamines (need for coffee/sugar) or high catecholamines. Gut health, what you eat, coffee, gluten all affect the brain chemicals
- Pyroluria/social anxiety – zinc, vitamin B6 and EPO (addressing this improves brain chemical imbalances and hormone imbalances)
- A need for zinc
- A need for vitamin B6
- A need for EPO
- Toxins/pesticides/plastics/BPA
- Medication side-effects/withdrawal (benzos are the worst)
- Sex hormones imbalances (especially low progesterone)
- Thyroid problems – hyperthyroid/Hashimoto’s thyroiditis can cause anxiety symptoms; low thyroid symptoms – amino acids are not as effective
- Adrenals issues: cortisol imbalance can affect how you handle stress, digestion, inflammation; high cortisol can have direct impact on anxiety levels
- Low total cholesterol (<150)
- Low levels of vitamin D, magnesium, vitamin C
- Low levels of vitamin B12
- Low levels of folate
- Low levels of iron (test ferritin)
- Not getting exercise
- Not working on stress-reduction (tai chi, meditation, guided imagery, yoga)
- Not getting out in nature
- Not getting at least 8 hours of sleep
Other possible nutritional/biochemical/physical causes of anxiety/depression
- Drug-induced nutrient deficiencies (for example: the birth control pill depletes vitamin B6, folate, magnesium)
- MVP (mitral valve prolapse) – it feel like the “heart is skipping a beat” (magnesium may help)
- Infections – strep can cause OCD/PANDAS/PANS. Also consider: H/Pylori, Lyme disease, clostridia
- Heavy metals like mercury or lead. We covered mercury in season 2 – Your hidden mercury burden: A likely root cause of the other root causes of anxiety and mercury/lead detox in season 4 with Dr. John Dempster
- Anything that increases inflammation in the body (high CRP is a good clue)
- Herbicide/Roundup use in the home/garden
- Genetic polymorphisms – MTHFR, COMT, MAOA, GAD – Dr. Ben Lynch is an excellent resource and has shared his expertise on season 2 – Anxiety: Biochemical and genetic predispositionsand season 3 – How Methylfolate can make you Feel Worse and even Cause Anxiety
- Apolipoprotein E ?4 (ApoE ?4) gene polymorphism
- Other possible hormone issues: high prolactin, low oxytocin
- Histamine reaction to certain foods (Yasmina covers this in her interview in season 3: Histamine-containing Foods: their Role in Anxiety, Depression and Schizophrenia )
- Oxalates reaction (berries, leafy greens, nuts). A good resource is lowoxalateinfo
- SIBO and FODMAPs/fructose malabsorption (affects serotonin levels)
- Too much of some nutrients: fish oil, a B complex, tyrosine, folate
- Low lithium (impacts GABA levels)
- Copper toxicity i.e. high copper and low zinc
- EMFs, air pollution, noise pollution, cell phone use, smart meters
- Marijuana use – used recreationally or as medical marijuana (Dr. Hyla Cass covers this in season 4 of the Anxiety Summit – cognitive issues, anxiety, psychosis, schizophrenia, social anxiety)
- Toxic mold exposure (Dr. Jill Carnahan covers this in season 3)
- Fluoride exposure
- Poor mouth health
- Toxoplasma gondii
- Metals/chemicals/drugs in the tap water
- Low leptin (signals satiety/fullness) and high ghrelin
- Over-the counter drugs, inner ear issues/cochlear damage, light sensitivity (Sharon Heller shared Hidden Causes of Anxiety on season 2)
- Physical pain (from an injury)
- Gas leaks
- Plastics/BPA
- Accutane, the acne drug can lead to psychiatric disorders in some people
May 14, 2016 updates after Season 4 of the Anxiety Summit:
66. Leptin resistance, obesity, skinny-fat and high body fat % (Mike Mutzel covers this in season 4 – anxiety, inflammation, microbiome, PTSD, cortisol and HPA axis)
67. Fluoroquinolone antibiotics (Lisa Bloomquist covers this in season 4 – anxiety, psychosis, connective tissue damage, mitochondrial impacts)
68. Low histamine/histapenia/overmethylation or high histamine/histadelia/undermethylation – read more here and the season 4 interview with Dr. William Walsh
69. Lack of community and social connection (James Maskell covers this in season 4)
Note: these causes do not include psychological or physical trauma or abuse (both past and current).
If the idea of 60+ causes feels too overwhelming and scary for you start with the basic food changes and look at the Amino Acids Mood Questionnaire from The Antianxiety Food Solution. GABA and serotonin support benefits most of my clients. You can see how to do a trial here and find the products I use with my clients here – such as tryptophan and GABA.
Missed this interview or can’t listen live? Or want this and the other great interviews for your learning library? Purchase the MP3s or MP3s + transcripts and listen when it suits you.
You can find your purchasing options here: Anxiety Summit Season 1, Anxiety Summit Season 2, and Anxiety Summit Season 3.
My total cholesterol is 159. Is this good?
Rebekah – total cholesterol below 150 is cause for concern
Ty!!
Hi! I was reading this page and came across this reply about low cholesterol. Mine is 84. It has always been well under 100. It runs in the family as well (my mom, sister, and mom’s father). What does that mean since you said that below 150 is a cause for concern? Thanks
Thank you, Trudy for such comprehensive list. It can help to navigate anxiety issues and some other too.
I would like to ask you: did you ever heard that amino acids cause bloating and pain? And it may cause bacteria overgrow? I mean such sweet amino acids like Alanine, Glycine and L-Glutamine? It is possible that bacteria ( Candida or SIBO bags) can start to eat them if starving on special diet?
Lisa
Anything is possible but I’d look at fillers too in case they are causing the bloating and pain
I’m not familiar with aminos making candida worse but if symptoms did get worse I’d stop
Hi Trudy..
Can Tyrosine help with adrenal fatigue..I am in a complete exhaustive state..cant sleep at night..I need your help..have my apt. in June.
Eileen
I’m so sorry you can’t sleep
I’d avoid tyrosine for someone who is not sleeping and would use tryptophan and GABA if they score high in those sections on the amino acid questionnaire (https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/)
Other causes of insomnia: food sensitivities, parasites, high night time cortisol and many of what is listed above. All of these need to be ruled out or addressed
Dear Judy,
I enjoy listening to you. Can you please tell me if a test called T3 can determine if the thyroid is the culprit of anxiety and depression. She can’t gain weight and has been diagnosed with severe depression. She is only 15. She is unable to attend her school. Any help would be appreciated.
Kind regards,
Joanne
Joanne
I think you are referring to free T3 and yes thyroid issues can be related to anxiety and depression.
I would suggest having your doctor measure free T3 and Free T4, TSH and the 2 antibodies: antithyroglobulin and antithyroperoxidase.
Hi!! I would also be interested in any information you have on children with anxiety. My child has anxiety that comes from life threatening food allergies, but it has taken over daily life. When you are scared to eat, it’s hard to get these nutrients into your body. The only thing that has really helped is the AlphaStim machine. Have you heard of that? It brought him out of the constant state of panic he was in. It might help people who are in dire need. Would be great to find a professional to speak about it on the summit. The person who recommended it to us was Heather Goodwin (Holistic Behavior Specialist) at Heights of Health in Houston, TX.
Hi Gina
I’m sorry to hear about your child but pleased to hear the AlphaStim has helped so much. This is an FDA approved device that can help many people.
I would suggest going thru this list and resolving or ruling out potential causes of anxiety many of which may also be factor in food allergies.
Trudy
Hi Trudy
What is the relationship between an EPO requirement & anxiety. I realise that it is useful in PD but do you know the biochemical basis for this? Is it also useful in the absence of PD or is its use specific to anxiety related to PD?
Thanks
Please let me know what PD is and then maybe I can answer
Hi Trudy,
Can you comment to my question regarding the Thyroid and it’s function as it relates to depression and anxiety?
Thank you kindly,
Joanne
done – please see above
Hi Trudy,
I have a 6 year old girl who recently developed a dislike of having a bath (or shower). To the point of refusing unless I force her in. She is embarrassed to the point of getting so worked up about the whole issue and cries if I even mention she needs a bath. Rewards make no difference. She tends to have some other anxiety issues occasionally e.g. shyness, falling asleep difficulties occasionally. I will be going through this list and plan to have a stool test done as I suspect dysbiosis. I’m also looking into pyroluria. Otherwise she’s always been brought up on whole foods since age 2 and seems healthy otherwise. Do you think this excessive embarrassment issue can be cured. Is it part of anxiety do you think? I hate the stress it causes us. It’s been an ongoing issue for months now.
Claire
It’s hard to know if this fear/anxiety around bathing is due to some physical or nutritional cause but I’d review the 60+ causes and rule out each one and address those that seem to be issues. The fact that you say “She tends to have some other anxiety issues occasionally” makes me think possibly not – typically you’d see a cluster of anxiety/shyness/sleep/fear symptoms that are there all the time
Trudy
Hi Trudy,
I have been interested in this topic because of myself but learning more about the amino acids and cravings my husband gets I believe he may have an issue. He can’t seem to cope without having a sweet snack after dinner or before bed. I try to provide “healthy” alternatives but he often ends up buying his own bad quality ones (chocolates, desserts, biscuits, burgers…). He knows it may be bad for his health but says his body obviously needs it as he’s craving it. I’m not sure what to do. I so want him to change but he is not fully willing. Do you think an amino acid may be worth a try? I suspect fungal/yeast issues as he does have other signs of those.
Bernadette
If it’s brain chemicals and you try the aminos they will work right away. But he needs to be willing to try them. I’d have him do the questionnaire and try what ever seems to be needed. Often evening cravings are low serotonin (so tryptophan or 5-HTP), possibly low blood sugar (so glutamine and a good breakfast with protein).
If these don’t work then it may be yeast and that would be the next thing to address.
I realised from your summit that I have pyroluria. I had a viral infection last October and started having anxiety attacks. I was prescribed Xanax and is having difficulties withdrawing. I have down so and had to return because of the severity of the symptoms. Do you have any suggestions in addition to the B6, zinc & Evening Primrose oil for getting off the xanax safely?
Veronica
Benzo withdrawal is a big thing and must be done very slowly. I suggest you check out prior interviews from previous summits (https://www.everywomanover29.com/blog/anxiety-summit-tapering-psychiatric-drugs-dont-ruin-life/ and https://www.everywomanover29.com/blog/anxiety-summit-benzodiazepines-risks-vs-benefits/) and also connect with folks on benzobuddies.org
Here is another blog that may help https://www.everywomanover29.com/blog/nutrients-for-dementia-benzodiazepine-withdrawal/
I would really recommend working with someone to help you
Thanks Trudy. I’ll let you know how it works out. On my Island home it is difficult to find a health care personnel who understands how addictive these drugs are and how to effectively come off of it. I am really frustrated at this point but not losing hope.
Veronica – you may then need to work long distance with someone who is familiar with all this
Hi, Trudy. There’s a huge wave of secondary-college aged people who are experiencing anxiety via the ‘Which Came First” vicious cycle of: poor nutrition, poor sleep habits, caffeine, pot smoking (nevermind the other drugs), alcohol, Rx meds…This obvious issue, poses a daunting education-to-action challenge. It’s inadequately addressed by schools, et al. Parents, students, friends are left to navigate a rabbit hole search for The Way to Recovery, hows & whys notwithstanding! It puts a sad and often tragic spin to the phrase “higher learning” as the anxiety elicits suicidal tendencies. Many thanks for your work and cheers!
Christine
Thanks for sharing – and I agree, it’s a big problem! Sound like you are in education and are hopefully sharing some of what you know?
I met with a gentleman yesterday – he’s battled with pyroluria and social anxiety for 40 years and spent a fortune on therapy and meds – to no avail. He read my book, got on the pyroluria protocol and is now doing so much better. He has a ways to go but he is blown away by this dramatic change he’s experiencing. It just warms my heart. But the added bonus is that he is a teacher and sees all these problems in the kids he teaches and is sharing the nutritional/biochemistry component with the social workers who are working with the troubled kids!
Hi Trudy –
Can you explain why cholesterol below 150 is a concern? Mine is at 130. I do have low thyroid and adrenal issues, along with high estrogen and very low progesterone. I am guessing cholesterol is a possible pre-cursor to hormone production or proper brain function? Any suggestions in raising my cholesterol safely? Thanks so much –
Laura
Absolutely – cholesterol is a one of the raw materials for hormone production and proper brain function. Egg consumption may help but I like to look at fat malabsorption issues like low lipase, leaky gut, food sensitivities etc.
Sonic Cholesterol is a supplement that raises cholesterol too
Trudy mentions mercury in #41 and promises to discuss it in greater depth. This is a growing issue of severity. Mercury is in our silver fillings which was always a lie of being silver. Mercury is the vaccines. It has multiplier effect when added to aluminum and floride.I encourag every- one to stop using floride toothpastes and use either Tom’s or Jason natural brand or use himalayan salt solutions to brush teeth. Mercury in mothers mouth is passed to first born baby at very high rate. Encourage everyone to find Susie Cohens book on Drug Muggers which reaffirms Trudy’s info. Encourage everyone to investigate dental care immediately so whn an issue arises you have a patient/doctor relationship and it is one with a Holistic Integrative certified IAMODT dentist. Please write your senators about labeling our foods so we know which one are the gmo laden ones. In 2013, we knew that 1 dose of glycophate caused tumors and infertility in the second generation..so what does that mean for us in 2015 when the crops receive 4 doses of glycophate. Talk this up and wake people up. Can you tell I was a Home Ec teacher?
Bev
Thanks for sharing all this great information. There is so much that can affect us and awareness is key
Hi.
Can you please tell me what EPO stands for?
Thanks
Rebecca
Evening Primrose oil
Trudy,
I’m taking zinc and b6 for pyroluria, having severe stomach issues. I have had irritable bowel off and on for years, but I’ve noticed lately that my food is not being digested. Some vegetables and berries are actually coming out whole in my stools or alone. This is making me nervous. Why am I not digesting my food? Thanks Michele
Trudy,
I have struggled with social anxiety since childhood, pyroluria sounds a possible cause. In teen years had Hormone imbalance with low progesterone.
Painful periods until menopause, severe low esteem, and high anxiety. I am on cymbalta and Paxil because of depression. My short term memory is low because of stress
What do you suggest
For pyroluria: B6, zinc and evening primrose
For major depression?
Trudy,
I am a HUGE fan of yours. It was coming across your blog and staying up-to-date on your FB page that has introduced me to this whole world of nutrition links to psychiatry. Thank you, thank you!
I was wondering about adding another possible cause to the list: Salicylate intolerance. See the following sources (both out of Aussie land):
http://www.failsafediet.com/about-food-chemical-intolerance/what-is-the-failsafe-diet/
http://www.slhd.nsw.gov.au/rpa/allergy/resources/foodintol/ffintro.html
Salicylate intolerance is a big factor we are looking at right now as we try to solve the psychiatric puzzles that exist in my family.
Thanks Trudy–and thank you for ALL that you do!!
Cheryl
Cheryl
Thanks for sharing – and so glad to hear from someone who is new and excited about “this whole world of nutrition links to psychiatry”
I’m familiar with salicylates and will gladly add it as another possible underlying factor. Would you mind sharing how salicylates are contributing to anxiety and other mood issues in your family? which foods? what effects? and how quickly you notice effects? and anything else that may be useful to me and other readers? Thanks!
Is vegan doomed? How can vegan get the necessary protein and minerals and vitamin?
Frank
I am a proponent of animal protein in the diet especially when someone has any mood problems or anxiety. I interviewed Lierre Keith on this topic on a prior summit https://www.everywomanover29.com/blog/anxiety-anxiety-depression-vegetarian-diet/
If eating animal protein is not an option I’d make these suggestions: no processed soy, consider adding eggs and dairy and check for low zinc, low D, low iron and low B12 and address if necessary. Also watch for blood sugar swings as many vegan and vegetarian diets can be higher carb – so add in plenty of healthy fats
Trudy,
First of all sorry for my english, second i having anxiety (attacks) since 2014 like especially cold feets and hands with sleepiness that gives me anxiety (strange emotions, low libido, confusion). I checked my blood levels of Vitamin D, Iron, B12 and have kicked them high. I can’t barely even laugh anymore, not enjoying the life because the daily “anxiety” feeling. I tried supplements like GABA (from NOW brand), Holy basil (drowsy, headache), Theanine (making me worser), Tryptophan (worked a little but after long taking nausea), Zinc (from Thorne picolinate, not feeling it well!?) and stopped eating gluten and sugar, caffeine for about for 2 years. What could you advice me? Do i need to try the brand Source Naturals GABA Calm (with taurine), and tried also magnesium glycinate (200-300mg from dr. best) not so effective. I would to chat about this, cause my work and marriage is getting on low fuel. I am 27 years old, and a man.
Thank You!
Belal
I’m sorry to hear this. Right now I have a waiting list https://www.everywomanover29.com/services.html
Thank you Trudy for yet another brilliantly comprehensive and clear cut article. And very timely too. I have a client presenting with acute anxiety, panic attacks and vaginismus and this is a fantastic list to work through to identify and support the root cause. Whilst none of it is new, because Functional Medicine is what I practice, it’s a fantastic list that serves as a great reminder. I truly love your work, thank you.
Kate
I’m so glad this is helpful!
Hi Trudy,
so glad I found this. I have had anxiety since aged about 5 I remember feeling really down and “sensitive” then. I have found in past I could push through social anxiety (I have been an amateur actor and singer in a band) but recently now in mid forties my anxiety through the roof, not helped by perimenopause and long term stressful life events. I do know I have digestive issues, dairy and in last year realised gluten is terrible for me and gives me palpatations. I have trained as a counsellor but have stopped this due to being so “scared”, despite people telling me I am good at working with people. I have even had panic attacks during sessions. Now on HRT but I don’t think that is the solution I was hoping for. I have hated protein but in last year changed diet a lot after reading about feeding yourself properly during perimenopause. It just feels like my diet (due to allergies and impact) and life are so narrow and I don’t feel like the person I once was, I now realise it may be easily remedied by nutrition and I CAN do something about this. I am getting your book and THANK YOU! I feel I have some options .
Claire
So pleased to hear you are connecting the dots and recognize that you have options and there are solutions. To give you more hope …. your description of yourself and your issues is very typical for the majority of clients I see and is just how my health was too!
You’ll find my book (and this blog and my weekly newsletters) very valuable for your healing journey. Please do come back and share how you’re doing.
Apologies for the delay on your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
Hi Trudy,
I have a question about GABA . In the past I used GABA for sleep but it didn’t work for me I seemed
To get the opposite effect . I would like to know why you think that happens to me.
Thanks
Margaret
Margaret
Too much GABA can often do this. I have clients start with 125mg and increase from there as needed.
It can also do this when low GABA is not the issue – in this instance any amount is going to be too much.
Can you share how much has had the opposite effect and which product it was? And which low GABA symptoms you experience?
Oh jeez I stayed away from it when that happened. I was working with a functional
Doctor Awhile back .I don’t remember what brand it was but I do think it was combined with other ingredients. I have the same effect if I take 5htp. I crave chocolate so after reading your article I figured I would ask you. I have sleep issues as well. I’m 60
Is there a test to check gaba levels. The effects that I got from the supplements that I tried made me feel wide awake when taken before bed. I also have extremely low melatonin levels. I have an issue with that as well. I feel hungover the next day . It was a liquid and I took ten drops but I don’t remember the milligrams. I haven’t tried the slow release that can be a possibility.
Margaret
It’s hard to know when you someone doesn’t have details of the product and dose. I recommend tracking all products/doses and responses
There is no GABA test. We uses the symptoms and do a trial and monitor the response.
It’s not uncommon for 5-HTP to affect sleep when cortisol is high – more here https://www.everywomanover29.com/blog/does-5-htp-make-you-wired-tired-and-affect-your-sleep-when-cortisol-is-high-yes-and-not-sure-and-no-5-htp-was-miraculous/
Thanks for highlighting the usefulness of GABA. Just one query. I have read that one can become dependent on it. For that reason, I have avoided using GABA as I have had problems with Benzodiazepines in the past. I would appreciate your input.
Ruth
There is no evidence that one can become dependent on the amino acid GABA. It’s possible you are referring to the prescription drug called gabapentin https://www.everywomanover29.com/blog/gaba-is-not-the-same-as-gabapentin-gaba-gamma-aminobutyric-acid-is-an-amino-acid-supplement-gabapentin-is-a-prescription-medication/