Where anxiety comes from
Dr. Martin opened this episode with a report he had just read: anxiety has now overtaken depression as the most common mental health condition, and by the numbers he quoted, an estimated 40 million Americans live with it every day. He called it an epidemic.
His explanation for it starts in two small glands that sit on top of your kidneys.
Dr. Martin, The Doctor Is In, Episode 1174Cortisol is that that kind of hormone that's released from the adrenal glands, okay? So anxiety comes from cortisol.
Your nervous system runs in two modes. One is rest and digest. The other is fight or flight, and cortisol is the hormone that drives it. In his view the balance between the two has tipped, and it has tipped for almost everyone.
Dr. Martin, The Doctor Is In, Episode 1174What's happened in the world is that we've gone from mostly resting and digesting to fight or flight, and that's taken over the world.
For a woman over 60 that matters, because the years of carrying everyone else's stress do not disappear at retirement. Caring for a spouse, worrying over grown children, health scares and broken sleep all keep the same system running.
The switch that stays on
Cortisol is not the enemy. He is clear that fight or flight can save your life, and the adrenal glands are built for exactly that.
Dr. Martin, The Doctor Is In, Episode 1174The problem with cortisol is when cortisol doesn't get turned off.
That is the heart of his answer. A short burst of cortisol is normal. Cortisol that stays high month after month is the state he links to anxiety, and to the long list of symptoms that travel with it. More on how that shows up in the body is in high cortisol symptoms in women over 60.
"So anxiety comes from cortisol."
Dr. Martin, The Doctor Is In, Episode 1174Why the adrenals get missed
His interest in cortisol goes back to the late 1980s, when he was seeing large numbers of women with chronic fatigue syndrome. He tested their adrenal hormones at a time when, as he tells it, almost nobody else was, and he concluded that what he was seeing was adrenal exhaustion.
He says he was rarely the first doctor these women saw. They had already been told their thyroid and their blood work came back within normal limits, and nobody had checked their cortisol. His point is about training: medicine tends to think of the adrenal glands only when there is a named adrenal disease, such as Addison's or Cushing's. Outside of that, he says, the adrenals get no respect, and he used to call them the Rodney Dangerfield of the body.
So if you are over 60, anxious, worn out, and your tests keep coming back normal, his advice is to ask whether anyone has looked at your cortisol.
Sleep: the chicken or the egg
The first thing he goes after is what he calls the low hanging fruit, and it is sleep.
Dr. Martin, The Doctor Is In, Episode 1174If you don't sleep, your cortisol goes up. If your cortisol goes up, you don't sleep.
Poor sleep raises cortisol, and high cortisol wrecks sleep, so it hardly matters which came first. He also points to what happens in the brain overnight. The brain has what he likes to call a self cleaning oven, and it only runs when you sleep.
His instruction is simple even if it is hard to do: everything you can to get the body through all five stages of sleep. If sleep is where it falls apart for you, he covers it in more detail in why can't I sleep after 60.
Sugar, insulin and cortisol
The second thing is diet, and he says he found this out early. Back in the late 1980s and early 1990s, part of his protocol for patients with anxiety and chronic fatigue symptoms was a low sugar or no sugar diet, and he says it was always amazing what happened when people got off the sugars. In later years that became his 30 day metabolic reset of eggs, meat and cheese.
Dr. Martin, The Doctor Is In, Episode 1174Too many carbs, your insulin goes up, insulin goes up, your cortisol goes up. It's part of the package.
Insulin and cortisol often travel together, which is why he wrote a whole book about the pair. Cleaning up the diet, he says, lowered insulin and had a major effect on lowering cortisol as well.
The deficiencies he looks for
The third thing is nutrients. He describes himself as a doctor who always went looking for what was missing.
Dr. Martin, The Doctor Is In, Episode 1174Whenever I saw anxiety, whenever I saw a case of anxiety, I was always looking for deficiencies.
Four came up again and again in his anxious patients.
- Vitamin B12. His number one. He says a blood result can come back within normal limits and still be too low, and that he wants B12 up around 800 to 1200 to be optimized. Those are his targets, not the lab's.
- Vitamin D. He says the brain and the adrenals do not work properly without it, and that deficiency is very common.
- Magnesium. He notes that a blood test says little, because most magnesium sits in your tissue rather than your blood.
- Omega 3. Often low as well.
Magnesium gets special attention in this episode because of what it does.
Dr. Martin, The Doctor Is In, Episode 1174Remember, magnesium is the mineral that helps you to relax.
He goes through the list: it relaxes your muscles, your nerves, your blood vessels, your brain and your bowel. There is more on that in magnesium for women over 60.
The gut and the brain
The fourth thing is the gut. He says he was one of the first to talk about the connection between the gut and the brain, and that in patients with chronic fatigue syndrome, and now in patients with anxiety, he found a leaky gut almost every time.
He does not pretend the physical side is the whole story. Relationships, family and psychological issues are always part of it, he says. His point is that it is the combination. Sleep, diet, deficiencies and the gut are all connected, and fixing them together is what changed things for his patients.
He also lists what tends to come with anxiety when the adrenals are involved: insomnia, brain fog, hair loss, belly fat, exhaustion, and cravings for sugar and salt. If several of those sound familiar, the steps he uses to bring cortisol down are set out in how to lower cortisol after 60.
Common questions
What causes anxiety in women over 60?
Dr. Martin traces it to cortisol, the stress hormone from the adrenal glands, staying switched on instead of turning off. Poor sleep, too much sugar, nutrient deficiencies and a leaky gut all keep it running, alongside the life stresses that come with this age.
Can poor sleep cause anxiety?
In his view the two feed each other. Without sleep, cortisol goes up, and with high cortisol you do not sleep. He treats sleep as one of the first things to fix.
Which deficiencies does Dr. Martin link to anxiety?
Vitamin B12, vitamin D, magnesium and omega 3. He says B12 was low almost consistently in his anxious patients, even when a blood test read within normal limits.
Does sugar make anxiety worse?
He says too many carbohydrates raise insulin and that cortisol rises with insulin. Taking his patients off sugar was part of his anxiety protocol from the late 1980s on.
Help the switch turn off at night
His whole case is that anxiety comes from cortisol that does not get turned off, and that sleep is the first place to start. Martin Clinic's Cortisol Control PM is built for the evening side of that.
60-day money-back guarantee. Formulated in clinic.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
