Anxiety is the number one mental health issue in America, with 18-30% of adults experiencing anxiety or panic disorders, according to the National Institute of Mental Health. (

Though medications are a common treatment approach, many people don’t want to rely on medications, or aren’t comfortable with the side effects, which can include weight gain, digestive symptoms, and long-term medication dependency.

Dr. Kelly Brogan, MD, board certified Psychiatrist, and author of A Mind of Your Own, ( claims that anti-anxiety medications are some of the most addictive known substances. She notes withdrawal symptoms while titrating her patients’ medication doses by amounts as small as 1/1000th of a gram.

So if medication has challenging and unwanted side effects, or if people don’t want to use them, what else can be done to help manage anxiety?

The truth is that we need a meaningful complementary approach to help people who either don’t want medication, who haven’t been helped by medication, or even as an adjunct to those who wish to continue with medication. Successfully helping people shift symptoms of frustrating, frightening, and sometimes debilitating anxiety requires a broad, holistic, and patient-empowered approach.

The functional medicine and nutrition approach looks for root causes of health complaints. Here are 5 things that may contribute to anxiety, and that are readily actionable by either patients or providers to help relieve symptoms:

1.Food sensitivities and blood sugar issues 

Many people are suffering from sensitivities to common foods that can contribute to anxiety symptoms, but aren’t yet aware of this.

The top six food allergens are gluten, dairy, sugar, soy, corn, and eggs, but any food could be a culprit. An elimination and reintroduction diet can help illuminate which foods are a challenge.

Of course, caffeine is a big elephant in the room. Too much coffee or other caffeine foods or beverages can easily contribute to anxiety symptoms, and should be a first-line recommendation to help shift anxiety.

Finally, blood sugar swings can also create a feeling of anxiety. Tracking blood sugar with a simple at-home glucometer can be a helpful and low-cost tool to see if blood sugar swings are contributing to anxiety symptoms. Minimizing blood sugar swings by eating a low-glycemic plan and eating smaller, more frequent meals, can significantly reduce anxiety.

2.Nutrient deficiencies

People with anxiety symptoms often have certain nutrient deficiencies. They are more likely to need extra B vitamins, magnesium and other minerals, essential fatty acids, as well as certain amino acids. (

Fortunately, clues in standard blood chemistry and a medical history can help identify specific deficiencies. Increasing foods rich in deficient nutrients and adding targeted supplements can shift anxiety symptoms significantly while other root causes are investigated. (Bralley, J. Alexander and Richard S. Lord. Laboratory Evaluations for Integrative and Functional Medicine. Metametrix Institute, 2012.)

3. Stress 

It’s no mystery that stress can exacerbate feelings of anxiety. Exploring what is stressful can illuminate sources of the anxiety, and provide a route to resolution.

And whether or not the situation is resolvable, stress management techniques such as mindfulness, meditation, self-hypnosis, time in nature, connecting with community, exercise, and making space for things one enjoys can make a profound difference in stress and anxiety levels. Adequate sleep is also vitally important.

There are many low cost or free apps that provide easy access to these key mood-affecting practices, which patients and clients can use at home with meaningful benefit.

4. Hidden stressors 

In functional medicine and nutrition, sometimes we need to help our patients and clients dig deeper to uncover the root causes of their complaints. If the body is harboring hidden infections, or has certain genetic weak links, appropriately addressing these situations can help reduce symptoms.

A quick scholarly article search for “anxiety” and “gut infections” turned up 59,000 results. According to the National Center for Complementary and Integrative Health, changes in the gut microbiome may affect moods. ( The wrong kind of changes can lead to mental health symptoms.

Clearing parasite, bacterial, and yeast and fungal infections, as well as rebalancing the gut microbiome are a key part of helping people overcome anxiety at the root cause level. It’s important to work with a qualified functional medicine or nutrition provider to get the appropriate help.

Genetics are another possible hidden stressor. According to Dr. Amy Yasko, PhD, (, certain copies of specific genes can cause a person to have a less-efficient ability to perform the invisible biochemical processes that maintain their health, including production of our feel-good mood chemicals, like serotonin, melatonin, dopamine, and endorphins.

Being aware of these possible weak links allows one to investigate whether to follow up with real-time blood chemistry testing, which can suggest a need for key nutrients to support your unique genetic make up.

5. Thyroid

One of the most overlooked causes of anxiety is thyroid dysfunction, which can cause anxiety and heart palpitations, as well as depression.

According to Izabella Wentz, Pharmacist and author of Hashimoto’s Protocol, ( the unfortunate thing for anxiety patients is that the interpretation of thyroid function is woefully misunderstood by a vast majority of primary care providers.

It’s important to work with a provider who can correctly evaluate thyroid function if anxiety symptoms are present.

Anxiety patients need willing practitioners to help
them look at all the reasons why symptoms are present, and to help provide a
meaningful plan to shift this terrain, while anxiety patients can work make the
effective diet and lifestyle changes that will help themselves feel better.