Hidden Causes of Anxiety in Perimenopause and Menopause
06 Nov 2019

Hidden Causes of Anxiety in Perimenopause and Menopause

In last week’s post, I focused on common causes of anxiety in perimenopause and menopause; like, low progesterone and stress. These causes are familiar in perimenopause and menopause. But what about hidden reasons that increase the likelihood of anxiety?  

What you may not realize is that nutritional excesses and deficiencies, as well as, genetics can have a significant impact on anxiety. 

Symptoms of anxiety include:

  • A rapid heart beat.
  • A sense of dread.
  • Feeling dizzy or light-headed.
  • Grinding your teeth, especially at night when you’re sleeping.
  • Headaches.
  • Pins and needles feeling. 
  • Changes in your sex drive.
  • Feeling restless or unable to sit still.
  • Hot flashes.

If you are experiencing anxiety and can’t figure out why, consider these possibilities:

  • A deficiency of essential fatty acids (omega-3). Brain membranes contain a high proportion of these fats, and human studies suggest that a lack of omega-3s in the brain may induce various behavioral and psychiatric disorders.
  • Insufficient dietary protein or fat. This affects levels of neurotransmitters and taurine, which is a precursor to GABA.
  • B6 deficiency or excess. Stress, anxiety, and alcohol use burn through vitamin B6 and deficiencies are common. B6 is used in a number of cellular processes, so low levels can result in lower methylation, and lower levels of taurine, glutathione, and serotonin.  An optimal level is important, however, this is a case where too much of a good thing is a problem. Excess B6 interferes with sulfation, which is required to process and get rid of cortisol. Slowing sulfation will further increase anxiety. If you’re supplementing B6, you only need a small amount in the pyridoxal-5-phosphate (P-5-P) form, which is activated. Avoid pyridoxine as a solo product.
  • Excitotoxicity. Excitotoxicity is the pathological process by which nerve cells are damaged and killed by the over-activation of receptors for glutamate (a neurotransmitter). Today, more than 70 excitotoxins lurk in most packaged and processed foods, including soups, sauces, gravy mixes, frozen dinners, diet foods, beverages, chips, and fast foods. The main culprits are MSG, aspartame (NutraSweet), cysteine, hydrolyzed protein, free glutamate, and aspartic acid. There are also genetic variants (GAD-1) that causes glutamic acid to build up in the brain which is excitatory.
  • Medications. Excessive thyroid supplementation, corticosteroids, asthma medications, and over-the-counter products like pseudoephedrine can increase anxiety.
  • Thyroid dysfunction. Hashimoto’s thyroiditis is an autoimmune condition that is characterized by phases of hypo and hyperthyroidism. Hyperthyroidism can cause anxiety.
  • Food sensitivities. If you are feeling more anxious, angry, or irritable right after mealtimes, then you may have a food sensitivity. Here is a list of the most common trigger foods:
    • Gluten
    • Dairy
    • Grains (including corn)
    • Beans
    • Soy
    • Eggs
    • Sugar
    • Alcoholic beverages

In addition, some people may have sensitivities to nightshade vegetables (potatoes, tomatoes, peppers, tomatillos, and eggplant) and nuts. You can test for sensitivities by eliminating these foods for 4 weeks, then adding one back every 3 days to see how your body reacts. Or you can complete a food sensitivity test. Contact me at info@drannagarrett.com if you’d like to know more about that.

What About Genetics?

Another hidden source of anxiety may lie in your genetics. These 3 gene SNPs play an important role in breaking down neurotransmitters. Any slowing in these processes can result in an increase in anxiety.

  • COMT AA variant. This variant is nicknamed “the worrier.” Women with this genetic SNP breakdown dopamine slowly. High estrogen levels further slow this process, and this can lead to an inability to relax and calm down. You can read more about the COMT gene here.  
  • MTHFR variants. Methylenetetrahydrofolate reductase (MTHFR) converts folic acid (which is synthetic) to methylfolate (also known as 5MTHF or active folate). Methylfolate then goes on to power the methylation cycle, leading to methionine and the metabolic processes that create and break down our neurotransmitters; such as, serotonin, dopamine, and norepinephrine. If you have variants in this SNP, it means you MAY be more likely to have an imbalance of neurotransmitter levels, which can affect mood, especially when you are stressed.
  • MAO variants. MAOA is an enzyme that breaks down the neurotransmitters serotonin, dopamine, and norepinephrine. Certain types of variants in the MAOA gene give rise to a sluggish MAOA enzyme, slowing down the metabolism of the neurotransmitters, resulting in higher levels of serotonin, dopamine, and norepinephrine, and lower levels of their respective metabolites.

If you’d like to take a deep dive into your own genetics and anxiety, contact me at info@drannagarrett.com or go to www.drannagarrett.com/genetic-mastery

Next week, I’ll focus on solutions for managing anxiety in perimenopause and menopause.

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.

Dr. Anna is available for 1-1 consultations. Find out more at www.drannagarrett.com/lets-talk

Dr. Anna Garrett


  1. Andrea Smith-Wilson Says: December 23, 2019 at 5:34 pm

    Hi Dr. Anna, I am 55years, and still take low dose birth control pills. I do experience steady weight gain (not from eating! I exercise 6xper week) and especially anxiety. My mood and libido are down, down. I am afraid to get off the pill because I don’t want to experience all the other symptoms and fall into the “aging hole” where hair falls out, skin gets crepy, etc. So I am not sure if you could even help me. I am already afraid to get off the pill but having to “doctor” afterwards to regulate my hormones until I find the right combination. I read your book ,but cannot find myself in it….is there any hope for me? I am very sad…

    • Hi Andrea…the Pill is not necessarily keeping you out of the “aging hole”. You have no way of knowing what you will experience until you stop. Some women do just fine. And there’s a lot more to it than estrogen and progesterone. I am wondering if you are experiencing weight gain due to undereating and overexercising, both of which raise cortisol. The birth control pills are not without risk. They deplete nutrients and the synthetic progestins increase breast cancer risk. There is definitely hope for you!

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