When Anxiety Has a Physical Root
Your heart races without warning. A sense of dread washes over you for no clear reason. You lie awake at night with a mind that will not stop spinning. You feel on edge, tense, and exhausted by the constant state of alertness. Anxiety is debilitating – and while psychological factors certainly play a role, the physical contributors are often overlooked.
At our practice in Zürich Seefeld, I take a comprehensive approach to anxiety. Before assuming it is purely a mental health issue, I investigate the medical and metabolic causes that can trigger or amplify anxious feelings. You might be surprised how often we find something treatable.
Physical Causes of Anxiety
Hyperthyroidism: An overactive thyroid is a classic and frequently missed cause of anxiety. The excess thyroid hormones directly increase sympathetic nervous system activity, causing palpitations, tremor, restlessness, and a persistent sense of internal unease.
Blood sugar instability: Reactive hypoglycaemia – where blood sugar drops rapidly after a carbohydrate-rich meal – triggers adrenaline release, causing symptoms identical to a panic attack: racing heart, sweating, shaking, and acute anxiety.
Magnesium deficiency: Magnesium is the body’s natural relaxant, essential for GABA receptor function (your calming neurotransmitter). Deficiency is extremely common and directly correlates with anxiety symptoms.
Iron deficiency: Low iron, even without anaemia, impairs dopamine signalling and is associated with increased anxiety, restlessness, and panic symptoms.
Histamine intolerance: Excess histamine acts as an excitatory neurotransmitter and can cause anxiety, racing thoughts, insomnia, and panic-like episodes. Many patients notice their anxiety worsens after histamine-rich foods.
Gut-brain axis dysfunction: The vagus nerve carries signals from the gut to the brain. Gut inflammation, dysbiosis, and intestinal permeability can generate anxiety-promoting signals. GABA and serotonin production in the gut directly influences brain chemistry.
HPA axis dysregulation: Chronic stress alters cortisol patterns, and both high and dysregulated cortisol contribute to anxiety. The relationship between stress hormones and anxiety is bidirectional – each worsens the other.
Hormonal changes: Progesterone has anxiolytic (calming) effects via GABA receptors. Drops in progesterone during PMS, perimenopause, or anovulatory cycles can trigger significant anxiety.
Caffeine and stimulant sensitivity: Some individuals metabolise caffeine slowly (CYP1A2 gene variants), leading to prolonged stimulation that manifests as chronic anxiety.
When to Seek Medical Evaluation
If anxiety appeared suddenly without an obvious trigger, if it is accompanied by physical symptoms like palpitations or weight loss, if it fluctuates with your menstrual cycle or meals, or if standard psychological treatments have not been fully effective, a medical workup is warranted.
Our Diagnostic Approach
I assess thyroid function (full panel), blood sugar dynamics (fasting glucose, insulin, sometimes a glucose tolerance test), magnesium (red blood cell magnesium, not just serum), iron and ferritin, vitamin D, B vitamins, hormonal status, cortisol rhythm, and inflammatory markers. If histamine intolerance is suspected, I check DAO levels and a trial elimination diet may be indicated.
What We Do: Calming the Body to Calm the Mind
Treat identified physical causes: Thyroid optimisation, blood sugar stabilisation, magnesium repletion, iron correction – addressing these often dramatically reduces anxiety.
Nervous system support: Magnesium, L-theanine, GABA support, and adaptogenic herbs like ashwagandha can help regulate the overactive stress response.
Vagus nerve activation: Specific breathing techniques, cold exposure, and other vagal toning exercises help shift the autonomic nervous system toward calm.
Gut-brain axis restoration: Targeted probiotics (particularly Lactobacillus and Bifidobacterium strains with evidence for anxiety), gut barrier support, and anti-inflammatory dietary strategies.
Integrated psychological support: When indicated, referral for CBT or other evidence-based psychotherapy alongside medical treatment for the best outcomes.
Conclusion
Anxiety is not always “just anxiety.” Physical causes are common, identifiable, and treatable. If you have been struggling with anxiety and want to understand whether your body is contributing to your symptoms, book a consultation at our practice in Zürich Seefeld. A thorough medical evaluation could change everything.
