Harmony Hub Health
Functional Medicine, Hormone Health and Weight Loss with Michele Postol, CRNP
Harmony Hub Health
Your Anxiety Is Valid—But So Is the Science Behind It
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.
Welcome to Harmony Hub Health, where my mission is to provide comprehensive, affordable, integrative care that addresses the root cause of health issues. At the Hub, the focus is on individual patient journeys. I strive to optimize health, vitality and longevity, fostering a community where each person can thrive in body, mind and spirit. So today I want to talk about a symptom that I hear in I don't know almost every single new patient that I meet. This is anxiety. And anxiety isn't just in your head, it's in your gut, your hormones, your mitochondria and maybe even your mineral levels. So while conventional medicine often rushes to label and medicate anxiety, functional medicine asks a deeper question Like why is this happening in the first place? It is simply not a mental disorder, it's a whole body signal. In functional medicine, I don't ask you know what drug matches the diagnosis. I ask why is this person having anxiety in the first place? Functional medicine recognizes that anxiety is a symptom, not a diagnosis, and the goal isn't just symptom suppression but root cause resolution. And this is a spoiler alert the answer is not just a serotonin imbalance. Okay, let's look at some numbers for anxiety. So anxiety disorders affects over 40 million adults in the United States each year, but they find that only 36.9% receive treatment. According to the NIH, women are twice as likely to experience generalized anxiety as men. There was a 2021 study published in Frontiers in Psychiatry that identified systemic inflammation and oxidative stress as central players in the pathophysiology of anxiety. So why isn't that talked about more? And here we are in 2025.
Speaker 1:So over 70% of your immune system does reside in your gut and that links anxiety and gut health more closely than ever before. You know, 70% of your serotonin is made in your gut, not in your brain, like people think. So it's not just worry, it's your nervous system throwing what I call a biochemical tantrum. Anxiety is a multi-system response to a perceived threat, whether it's real or if you're imagining it because you're thinking. It's driven by your limbic system in the brain, especially the amygdala that's your built-in danger detector, especially the amygdala. That's your built-in danger detector. And it's modulated by neurotransmitters, hormones and your nervous systems wiring. So it's not just in your head, it's in your hpa axis, your neurotransmitter balance, your gut and your cellular metabolism. So now I want to give kind of a nerdy breakdown of the anatomy of anxiety because most people don't even think about what's going on and your brain's alarm system. So the amygdala this sounds the panic alarm. It processes threat and triggers a stress response, whether you're being chased by a bear or just checking your email inbox. Then your hippocampus this is where you store emotional memories. So your brain overreacts if it's seen it before. Then we have our prefrontal cortex, and that should help calm things down with logic. But in chronic stress it gets hijacked and shuts down. So this brings on those irrational spirals.
Speaker 1:The hypothalamic pituitary adrenal axis, the HPA axis, is the core of your stress response and here's a play-by-play of how it works. So first the amygdala perceives danger. It sends a signal to your hypothalamus. Your hypothalamus then releases corticotropin-releasing hormone known as CRH. That CRH then tells your pituitary to release ACTH. Acth then tells your adrenals to pump out cortisol and adrenaline. So this is one of the reasons why I like the Dutch test when I talk to my hormone patients that are having these types of responses, patients that are having these types of responses. So when you pump out cortisol and adrenaline, these increase your blood sugar, it makes your heart rate go up, it dilates your pupils and it gets you ready to fight or flee. All right. Chronic cortisol release can shrink your hippocampus and it makes emotional regulation worse over time. So that's how long-term anxiety doesn't just feel bad, it literally remodels your brain.
Speaker 1:Think of neurotransmitters as your brain's messaging system, and when you have anxiety, the balance is very off. You have GABA. This is your main calming neurotransmitter. Think of it as your brake pedal. When you have low GABA, your mind can race, your chest gets a little tight, you get very restless. Then we have glutamate. This is the excitatory counterpart. If you have too much, you're overstimulated and you get these anxious thoughts, maybe intrusive thoughts. Then we have serotonin, which is the 5-HT. It regulates your mood, your sleep and emotional resilience, 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 I just spiral about a text message? Neurotransmitter.
Speaker 1:So chronic inflammation causes activated microglia in the brain, which then causes increased cytokines like that IL-6, tnf-alpha, and they mess with your tryptophan metabolism. It diverts it away from serotonin and toward quinolinic acid, which is a neurotoxic compound. It messes with neuroplasticity and the brain-derived neurotrophic factor which supports mood stability. So did that just sound like Greek to you. All it means is that inflammation makes you feel anxious, foggy and emotionally unstable. So your gut microbes manufacture short-chain fatty acids, neurotransmitters and anti-inflammatory compounds.
Speaker 1:If your gut is leaky or dysbiotic, which we talk about a lot here, gaba and serotonin synthesis goes down. Here GABA and serotonin synthesis goes down. Endotoxins like LPS or lipopolysaccharides they enter your circulation and they cause systemic inflammation and your vagus nerve gets disrupted. So this reduces parasympathetic tone, or I call your chill mode. The result of all of that is an anxious brain riding on a dysregulated gut.
Speaker 1:Some people are just more biologically wired for anxiety because maybe they have MTHFR polymorphisms. This reduces your ability to convert folate to its active form and causes poor neurotransmitter production. I love helping MTHFR patients because it's a missing link that they've had their entire life. I was one of them. Comt slow variants. So this impairs dopamine breakdown, leading to overwhelm or panic under stress. And then the MAOA. This impacts serotonin and norepinephrine levels with high low activity influencing mood regulation. So anxiety equals your brain plus your body, plus your biochemistry being in overdrive. It's a hyperactive limbic system. It's a cortisol drenched HPA axis. It's neurotransmitters that are out of balance. It's gut bugs gone rogue.
Speaker 1:I say that a lot of my consults and people just love to hear that because they never even knew about it. Sometimes it's as easy as low magnesium and B vitamins and a little inflammation and sometimes a lot of unprocessed emotion. If your anxiety feels physical, it's because it is, and functional medicine is designed to decode the why and build a strategy that works at the root cause level. If you want to transform anxious energy into calm clarity, we have to look under the hood the brain, the gut, the hormones, all of them together. Okay, so we'll talk about some root causes of anxiety that we see in functional medicine, because anxiety is a downstream effect. But what are the upstream causes?
Speaker 1:Let's unpack this a little bit with some examples. The first one that I see is blood sugar dysregulation. If your brain is fueled by unstable glucose, you'll ride the anxiety train all day long. So what happens is a rapid drop in blood sugar triggers cortisol and adrenaline spikes. Your brain thinks you're in danger. That racing heart and that sense of doom, that's just your pancreas poor planning. If you ever feel hangry or like you're losing your mind when it's time for lunch, that's poor glucose control and that leads to cortisol and adrenaline spikes that can mimic panic. An example would be because this was me, I would skip breakfast and I would grab a sugary coffee by 10.30 in the morning. I can get a little dizzy, a little sweaty, a little irrationally panicked in a Zoom meeting, and it doesn't mean that I need Xanax, it just means I needed protein and fiber. A 2020 study in nutrients did confirm that unstable glucose metabolism is associated with increased risk of mood disorders, especially anxiety.
Speaker 1:The second one I would say is gut-brain axis dysfunction, because your gut is your second brain and when it's inflamed, your neurotransmitters really do suffer. When you have leaky gut or gut dysbiosis, it causes endotoxins to enter your circulation and it provokes neuroinflammation. It also disrupts production of calming neurotransmitters like your serotonin and your GABA. An example of that would be I see a man. He has chronic bloating and food sensitivities and he started to get some panic attacks. Well, his stool test revealed a really low lactobacillus species and a high clostridia, both associated with GABA suppression and increased catecholamines. Even a Cell Reports 2019 study revealed that gut microbiota directly influenced GABA levels and anxiety-like behavior in mice. So human correlation studies are mounting and the third root cause I see, which I probably should have put number one is your micronutrient deficiencies.
Speaker 1:Your brain cannot run on fumes. Many with anxiety are deficient in key nutrients needed for neurotransmitter production. The main players I see are magnesium. This is your calming mineral. It helps regulate your HPA axis and your NMDA receptor activity. Then your B6 and your B12, you need both of these for serotonin and dopamine synthesis, so you can try to increase your dopamine, but you need the B6 and the B12. And then zinc is a cofactor in over 300 enzymatic reactions, including your GABA regulation.
Speaker 1:Omega-3 fatty acids reduce inflammation and helps to modulate serotonin receptors. An example of this I would think of as a college student that is having panic attacks. They usually test low on serum. Magnesium and omega-3s and supplementation combined with dietary changes can reduce anxiety symptoms within six weeks. All right, can reduce anxiety symptoms within six weeks, all right. Even a meta-analysis of nutrients, the one I did find was in 2017, but it found that omega-3 supplementation significantly reduces anxiety in both clinical and non-clinical populations. And then a 2020 PLOS ONE study confirmed that magnesium deficiency contributes to depressive and anxious behavior in rodents, and that correlates a lot with human data.
Speaker 1:The fourth root cause is hormonal imbalance, because hormones are mood messengers. When they're out of sync, you feel out of sync. Also, when you have low progesterone, whether it's in perimenopause or a luteal phase deficiency whether it's in perimenopause or a luteal phase deficiency, it increases your GABA receptor sensitivity, which causes more anxiety. And when you have estrogen dominance, this fuels your histamine and glutamate and that causes overstimulation. When you have adrenal dysfunction, whether it be low cortisol or HPA axis dysfunction, it leaves you unable to cope with stress. So a good example would be a 42-year-old woman. This might be somebody I see now. They notice anxiety and insomnia increase during the second half of her menstrual cycle. We did a Dutch test and it did reveal low progesterone and elevated cortisol at night. So we balanced her hormones and reduced her symptoms. And there's that 2018 menopause journal review that showed hormone replacement, especially estradiol and progesterone, helped reduce perimenopausal anxiety symptoms significantly. I did not need a study to tell me that.
Speaker 1:The fifth root cause, I would say, is your mitochondrial dysfunction and oxidative stress. Your brain is energy hungry when your mitochondria aren't working. Neither is your mood regulation system. So what happens is that oxidative stress damages neurons and your glial cells and it creates brain fog, fatigue and anxiety. I saw a man that was recovering from long COVID and he just felt anxiety, a lot and exhaustion. We did an OATS test and that revealed elevated oxidative markers, mitochondrial dysfunction. I treated him with NAD, antioxidants and CoQ10 and he has had complete reversal. That was a big win for me and for functional medicine. There is a 2021 Journal of Affective Disorders review that noted that mitochondrial dysfunction and oxidative stress markers are elevated in patients with anxiety and depression. Again, probably not something you need a research study to tell you, but it's nice to see it in black and white, okay.
Speaker 1:So number six, I would say environmental toxins and mold Toxic exposures can dysregulate your immune and nervous system. I did have a patient with unexplained panic attacks. I mean, even through therapy, through just looking at these other root causes, nothing seemed to fit. Turns out, she lived in a home with mold. Mycotoxin testing did confirm the exposure. After remediation and binders, her anxiety symptoms have improved dramatically. So you never really know until we kind of go through our full consultation to figure out what the root cause might be.
Speaker 1:And then those genetic polymorphisms this would be the MTHFR, the COMT, the MAOA. I think I can make my whole practice just about genetic polymorphisms and it would make my life worthwhile. So if your methylation pathway is sluggish, not that it's not worthwhile now, I didn't mean it to sound that way. What was I trying to say? Mission accomplished, I guess, is what I would say. I could quit tomorrow and know that I did a really good thing, but I'm still on my journey. Okay, um, if your methylation pathway is sluggish or you clear dopamine way slow, um, because of your calm tea, you're prone to more anxiety. So testing this helps personalize supplementation, especially those B vitamins.
Speaker 1:And I want to be clear now that I've said these things I am not anti-medication SSRIs. You know benzos, anti-anxiety medicines they can be life-saving bridges when someone is drowning. But what I'm against is band-aid therapy slapping a label and a pill on a problem that's rooted in inflammation, trauma or nutrient imbalances, and just calling it a day. One of my greatest joys this is more so at Circle Medical, where I also do primary care and ADHD care. Watching patients safely and gradually wean off of their medications when their body systems are healing, their hormones are balancing and their nervous system regulated Like that's real healing to me and that is one of my greatest joys. Ssris can be a great bridge, but they don't fix the underlying biochemistry Plus.
Speaker 1:Long-term use of these SSRIs or other medications can lead to sexual dysfunction, weight gain, emotional blunting and withdrawal symptoms. So functional medicine aims to build resilience so that you can taper, if appropriate, under the proper supervision. And talking about emotional resilience, anxiety can be your body's response to unprocessed emotion or trauma. I'm still working on my trauma certification. I just have 30,000 other things that are causing me anxiety and keeping me from finishing my trauma class or course. But functional medicine doesn't ignore that emotional terrain, we just like to integrate it. I don't need a certification in it, I just want it because I want to understand at a deeper level of how I can incorporate that into my practice.
Speaker 1:Anxiety definitely can be the body's response to unprocessed emotion or trauma and we don't want to ignore that. It's the inner conflict between what we feel and what we allow ourselves to feel. Suppressed anger, shame or fear becomes somatic. Tension becomes somatic tension. Tight chest, shallow breathing, racing thoughts.
Speaker 1:You know there was a patient that I had. This was before I started Harmony Hub Health. She was having this free-floating anxiety every Sunday night. Her labs looked good. Through somatic therapy she realized that the anxiety is grief masked as productivity and addressing emotional suppression through nervous system work. She was doing vagus nerve toning. I think she even went and did some EMDR and finally got relief.
Speaker 1:The adverse childhood experiences study that is what proved that there's a strong correlation between early trauma and adult anxiety. And then there's a polyvagal theory by Dr Stephen Porges and he explained how unresolved emotional states trap us in sympathetic overdrive and when we have emotional resistance, you know we have to kind of zoom out. Not every anxious brain needs supplements, some just need space to feel. Emotional resistance happens when we avoid, we suppress or intellectualize our feelings instead of processing them. So anxiety builds in our body when emotion has nowhere to go. So just like the lady that had the free-floating anxiety every Sunday somatic therapy she uncovered unresolved grief around a miscarriage and the anxiety finally lifted.
Speaker 1:Research shows that trauma, even microtrauma, can dysregulate the autonomic nervous system for decades if you don't address it. And that's where therapy comes in. Functional medicine shines when you pair it with psychotherapy, somatic therapy, trauma-informed coaching. You can't supplement your way out of a nervous system stuck in fight or flight. Therapy helps you untangle the why behind the what. It's where you learn to regulate, release and rewrite your internal narrative. And that's just one of the things in my functional medicine toolbox to treat anxiety.
Speaker 1:There's therapy. Then I like to talk about the GI map or the OAT test to look at the gut and neurotransmitters. There's the Dutch hormone panel to look at the HPA axis. My favorite is the HTMA or hair tissue mineral analysis. It's a great micronutrient analysis. There's the genetic testing for methylation and detox pathways. I am a certified provider with the 3x4 genetics. Then there's the mycotoxin testing, if that's appropriate. A lot of my treatment protocols I've put together I mean, I have a lot of them but it looks at supplementation. It looks at different therapies. It looks at lifestyle.
Speaker 1:So if you do feel anxious, your body is not broken. It's brilliantly, brilliantly sounding an alarm. Imagine if you had nothing In functional medicine. I don't want to mute that signal. I like to decode it. I've always loved puzzles. I always love finding out how things work. So whether it's nutrient depletion, trauma, toxic burden or emotional avoidance, you know anxiety is the result of systems overload. Let's find the why. Let's calm the chaos and build resilience, body and mind. Anxiety is not a random chemical imbalance. It's your body's SOS signal. When we stop silencing the symptom and start listening to the message, that's when we can really heal. Functional medicine gives you the why and the how, so you can calm your body by treating your body.
Speaker 1:If you're curious about your own root causes for anxiety, come and see me, book a functional medicine consultation and start your personalized path to calm, testing treatment and true healing all in one place, online or in person, at Harmony Hub Health. So you can come and find me at wwwharmonyhubhealthcom. You can see me in person at Monarch Beauty and Spa in Manchester, maryland, and I would love to get to your root cause. You can even reach out to me and send me an email at michelle. That's M-I-C-H-E-L-E at harmonyhubhealthcom. This podcast is for educational purposes only. It's not a substitute for clinical care, therapy or prescription advice. Always work with a qualified provider, ideally one who listens to more than your symptoms. I would love to be that person. I hope to see you soon.