Has Your Doctor Missed Something? Causes of Debilitating Anxiety

It’s normal to feel anxious or worried at times. Everyone experiences a certain amount of nervousness and apprehension when faced with a stressful situation.

However, when anxiety becomes excessive or prolonged and begins to interfere with your ability to perform your daily activities, that’s when you can say one has crossed the road from simple worry to a full force illness.

Imagine you are walking down a dimly lit road and out between two parked cars a man with a gun confronts you and demands that you give him all your money or he will kill you. As you can imagine, your heart quickly begins to thump, your legs feel like rubber, you want to run but you are paralyzed with fear. By shear luck, out of the corner of your right eye, you see a police car and without a moment hesitation, you scream and gain the attention of your hero. You are saved!

As the criminal is whisked away in handcuffs, you begin to gain a sense of calm. Still nervous but all in all an inner contentment that you just for the first time in your life you looked death right in the eye.

Now what would you say if I told you that a full blown anxiety or a major panic attack have all the same characteristics as the above scenario.

Yes, you will get that same pounding heart, you will be paralyzed with an intense terrifying fear, you will get nauseous, get lightheaded and a bunch more symptoms soon to be explained.

Unfortunately, unlike the victim who was lucky to be saved by the police officer, anxiety suffers continue to experience these terrible symptoms day in and day out. The anxiety victim soon becomes a prisoner within their own body not knowing if they will ever see the sunshine or the birds sing again.

Anxiety Overview

You see, there are more than 19 million Americans suffering from all anxiety disorders combined. It’s normal to feel anxious or worried at times. Everyone experiences a certain amount of nervousness and apprehension when faced with a stressful situation. However, when anxiety becomes excessive or prolonged and begins to interfere with your ability to perform your daily activities, that’s when you can say one has crossed the road from simple worry to a full force illness.

Most people are convinced they are minutes from dying and experience something commonly called “impending doom”. They are frequent visitors of the local emergency room. Test after test continues to show that nothing life threatening is wrong.

Unfortunately, the anxiety sufferer is still not satisfied. Something has obviously been overlooked. So more tests are run only to once again find nothing wrong. Soon their family and friends begin to label you a hypochondriac. It must be all in your mind they say.

Signs & Symptoms

The signs and symptoms of anxiety can vary in combination or severity. They may include:

  • Restlessness
  • Feeling of being keyed up or on edge
  • Feeling a lump in your throat
  • Difficulty concentrating
  • Fatigue
  • Irritability
  • Impatient
  • Being easily distracted
  • Muscle tension
  • Trouble falling or staying asleep (insomnia)
  • Excessive sweating
  • Shortness of breath
  • Stomachache
  • Diarrhea
  • Headache

If you have anxiety you may feel on edge about many or all aspects of your life. For example, you may feel intense worry about your safety or that of your loved ones, or you may feel that something bad is about to happen, even when there’s no immediate danger. When you feel anxious, your body releases hormones that prepare you to react to a threat. This is called the fight-or-flight response. When anxiety gets out of control, this response can occur almost continuously, even at times when you seem calm.

Clinical Lab Assessments

Some of the following laboratory testing can provide information necessary for diagnosis and treatment. In addition, the tests listed may also give insight to functional metabolism and functional nutrient status in the body.

Adrenal Stress/Cortisol Testing/Neurotransmitter Testing

Adrenal insufficiency can lead to a host of problems, including a weakened immune response, anxiety and panic attacks. Imbalance in the Hypothalamic-Pituitary-Adrenal axis (HPA) is involved in anxiety related disorders. In this complex, adrenal functional abnormalities are relatively simple to identify and address. Plasma or salivary cortisol measurements can be used as a marker in the evaluation of stress syndromes that may relate to anxiety disorders. Some study has suggested that altered cortisol response to stress in panic disorders may complicate successful lifestyle intervention.

Thyroid Profile

Elevation of thyroid antibodies has commonly been found in individuals with anxiety disorder. Correlations have been observed between thyroid laboratory values and anxiety. Assessment of thyroid hormone production, peripheral hormone conversion, cellular sensitivity response, thyroid hormone antibody activity can provide critical information for intervention with a goal of optimal function.

Allergy and Food Sensitivity Response Assessment

Allergic responses to foods, inhalants and environmental chemicals, and other substances can cause a variety of responses that induce or aggravate anxiety. Screening can enable an individual to eliminate or minimize exposure to unfriendly allergens.

Organic Acids

Organic acids analysis is a useful method for measurement of biochemical intermediates in urine. These intermediates can offer information about key enzyme functions and nutrient competence (amino acids, nutrient cofactors, minerals, and fatty acids). Elevation of vanilmandelate reflects elevations in epinephrine and homovanillate indicates norepinephrine elevation. High levels of these neurotransmitters are associated with physiologic inability to manage stress.

Rule out Pyroluria

Pyroluria is a known biochemical marker for life long anxiety symptoms. According to one alcoholism treatment center, one-third to one-half of alcoholics treated have this marker. High levels of pyrrolles systematically bind to B6 and zinc, preventing the use of these nutrients in the body and brain. The result is a myriad of symptoms, including severe inner tension, ongoing anxiety, poor stress control, fearfulness, and sometimes episodic anger.

Amino Acids

Deficiencies or imbalances in amino acids can indicate fundamental reasons for numerous disorders. Amino acid malabsorption syndrome or imbalanced amino patterns reflect abnormal organ and glandular processes that have critical bearing on optimal function. Phenylalanine and tyrosine are precursors to the catecholamines and affect the capability to manage stress in anxiety disorders.

Other Potential Culprits
  • Melatonin levels
  • Rule of Progesterone deficiency or Estrogen dominance
  • Rule of Lyme disease
  • Rule out mycotoxins (mold)
  • Rule of mercury toxicity
  • Determine magnesium levels (RBC assessment, not serum)
Treatment Options

Treatment should be determined from the results of testing as decided by your physician. There are always several options available which should be discussed at length with your Doctor.

Stress Reduction

Stress reduction can take form in a variety of ways. Some of the more structured forms of anxiety relief include; counseling, tai chi, yoga, meditation, deep breathing. These tips may help reduce your anxiety:
Take action. Determine what’s making you anxious and address it. For example, if finances are your concern, draw up a budget.

  • Let it go. Don’t dwell on past concerns. Change what you can and let the rest take its course.
  • Break the cycle. When you feel anxious, take a brisk walk or delve into a hobby to refocus.
  • Take care of yourself. Get enough rest, eat a balanced diet, exercise, and take time to relax.
  • Talk to someone. Share your problems with a friend or professional counselor who can help you gain perspective. Clinical Notes
Prescription Medications

The standard medical approach includes either anti-anxiety drugs such as lorazepam (Ativan),alprazolam (Xanax), and buspirone (Buspar). Antidepressants, such as fluoxetine (Prozac), paroxetine (Paxil), and venlafaxine (Effexor), are often prescribed to treat generalized anxiety and panic attacks.

Nutritional Medicine

Magnesium – may provide benefit for people with anxiety. Symptoms of magnesium deficiency include anxiety, nervousness, insomnia, muscle fatigue, and tachycardia. Clinical studies have supported the theory that anxiety is one of the symptoms that can occur in individuals with magnesium depletion.

Vitamin B6 – In a study of individuals suffering from frequent anxiety attacks, patients were given vitamin B6 (125mg, 3 times daily) and tryptophan (2 grams daily). This regime enabled in 70 percent of patients (9 of 13) to become free of anxiety attacks within three weeks. Vitamin B6 is required for the conversion of tryptophan to serotonin. Therefore, a deficiency of vitamin B6 may result in symptoms of anxiety and depression due to inhibition of serotonin synthesis. In a study of individuals suffering from frequent anxiety attacks, patients were given vitamin B6 (125mg, 3 times daily) and tryptophan (2 grams daily). This regime enabled in 70 percent of patients (9 of 13) to become free of anxiety attacks within three weeks.

Inositol – Clinical studies have found that inositol may be a valuable natural aid for patients suffering with Panic Attacks and may provide benefit for anxiety suffers. Biochemically, inositol is precursor for the phosphatidyl-inositol system and as such should be considered for its impact on elevated cortisol levels.
A double-blind, controlled study comparing the effect of inositol against fluvoxamine in panic disorder. Twenty patients completed 1 month of inositol up to 18 g/day and 1 month of fluvoxamine (Luvox) up to 150 mg/day. Improvements on Hamilton Rating Scale for Anxiety scores were similar for both treatments. In the first month, inositol reduced the number of panic attacks per week by 4.0 compared with a reduction of 2.4 (2) with fluvoxamine.

5-Hydroxytryptophan (5- HTP) – Studies that induce low levels of tryptophan result in low serotonin levels, which can cause anxiety. Tryptophan and 5-hydroxytryptophan (5-HTP) are the precursors for serotonin. Tryptophan is an essential amino acid that the body cannot manufacturer. Tryptophan is converted into 5-HTP, which in turn is converted into serotonin. There is ample evidence that tryptophan depletion causes reduced synthesis of serotonin, which can result in anxiety and other mood disorders.
Patients taking anti-anxiety drugs or other antidepressants should not take tryptophan or 5-HTP without the supervision of a health care professional because it can increase the effects of other antidepressants.

Tyrosine – Tyrosine is the precursor to the neurotransmitters dopamine, norepinephrine, and epinephrine, which all influence and regulate mental and emotional states. In a clinical study reduced brain tyrosine levels caused a reduction in catecholamine synthesis. This caused decreased calmness, increased tension and anger. The authors of this study state that brain catecholaminergic dysregulation is involved in pathological anxiety states.

Phosphorylated Serine – should be considered with elevated cortisol levels

In summary, there are a variety of options to address anxiety and the underlying mechanisms. For help on finding these speak to your doctor or find a functional medicine practitioner. If you prefer to speak directly to one of our physicians, please contact our office at 305.448.2600.

References
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