Oestrogen Dominance Panel
A targeted five-marker panel assessing oestradiol, progesterone, the oestradiol-to-progesterone ratio, SHBG, and testosterone.
£89.00
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Overview
What Is Anxiety?
Anxiety is characterised by persistent worry, physiological arousal, and a sense of threat that feels disproportionate or uncontrollable. Symptoms range from racing thoughts and restlessness to physical manifestations including heart palpitations, muscle tension, sweating, and gastrointestinal disturbance. While anxiety has well-established psychological dimensions, a significant proportion of people presenting with anxiety symptoms have an identifiable physical cause that has been missed — most commonly involving the thyroid, adrenal system, or sex hormones.
The most clinically important physical mimic of anxiety is hyperthyroidism. An overactive thyroid floods the body with excess thyroid hormone, producing a near-identical symptom picture: racing heart, tremors, heat intolerance, restlessness, and psychological agitation. A suppressed TSH with elevated free T4 confirms the diagnosis. Equally important is the role of cortisol — the adrenal stress hormone. Chronically elevated cortisol, whether from psychological stress or adrenal dysfunction, sustains physiological arousal, impairs the prefrontal cortex’s ability to regulate fear responses, and disrupts sleep — all of which intensify anxiety.
At a nutritional level, magnesium is essential for GABA receptor function — the brain’s primary inhibitory neurotransmitter system. Magnesium deficiency, extremely common in Western diets, lowers the threshold for nervous system excitability and worsens anxiety symptoms. Blood sugar instability from insulin resistance causes reactive hypoglycaemia — episodes of low glucose that trigger adrenaline release, producing panic-like symptoms. Identifying these physical contributors does not diminish the psychological reality of anxiety; it simply ensures the full picture is addressed.
Anxiety vs. Hyperactive Thyroid
Hyperthyroidism produces symptoms that are virtually identical to a panic or anxiety disorder: racing heart, tremors, restlessness, heat intolerance, and psychological agitation. It is frequently misattributed to anxiety for months or years before a thyroid blood test is performed. If your anxiety is accompanied by weight loss, increased sweating, or palpitations, a TSH and free T4 test should be your first step.
Related experience
Common Symptoms Associated With Anxiety
Anxiety commonly co-occurs with other symptoms that collectively suggest an underlying hormonal or physiological imbalance.
Palpitations
Racing or irregular heartbeat often accompanying anxiety episodes
Poor Sleep
Hyperarousal makes it difficult to fall or stay asleep
Low Mood
Anxiety and low mood frequently coexist, sharing hormonal drivers
Brain Fog
Cortisol-driven anxiety impairs working memory and concentration
Muscle Weakness
Chronic stress and magnesium depletion reduce muscular function
Night Sweats
Cortisol surges and hormonal fluctuations trigger nocturnal sweating
The big picture
What Causes Anxiety?
Anxiety has multiple physiological pathways — identifying which is driving your symptoms enables targeted, effective intervention.
What to measure
Biomarkers Associated With Anxiety
These biomarkers are the most clinically relevant when investigating the physical drivers of anxiety.
Cortisol
Elevated or dysrhythmic cortisol is the primary biological marker of chronic stress and adrenal-driven anxiety
Magnesium
Essential for GABA inhibitory neurotransmission; deficiency lowers the threshold for nervous system excitability
TSH
Suppressed TSH is the primary indicator of hyperthyroidism, the most common physical mimic of anxiety
Free T4
Elevated free T4 alongside suppressed TSH confirms thyroid overactivity
Testosterone (Total)
Low testosterone in men is associated with anxiety, irritability, and emotional dysregulation
Oestradiol
Falling oestradiol during perimenopause destabilises the autonomic nervous system and worsens anxiety
Vitamin B12
Deficiency causes neurological symptoms including anxiety, paraesthesia, and cognitive disturbance
HbA1c
Reflects average blood sugar control; insulin resistance drives reactive hypoglycaemia and adrenaline surges
Underlying causes
Conditions Associated With Anxiety
Several underlying health conditions present with anxiety as their primary or prominent symptom — all are identifiable through targeted blood tests.
Hyperthyroidism
Excess thyroid hormone produces physiological arousal indistinguishable from anxiety disorder
Adrenal Dysfunction
Dysregulated cortisol production maintains chronic physiological stress and hypervigilance
Menopause
Oestradiol decline destabilises the autonomic nervous system, causing anxiety, palpitations, and sleep disruption
Insulin Resistance
Blood sugar swings trigger adrenaline release, producing episodes that closely resemble panic attacks
Low Testosterone
Testosterone deficiency in men is associated with heightened anxiety, irritability, and reduced stress tolerance
Getting answers
How Anxiety Is Investigated
A systematic blood test approach can distinguish physical from purely psychological anxiety and identify specific, treatable causes.
1
Rule out thyroid overactivity first
TSH and free T4 should be tested as a priority. A suppressed TSH — typically below 0.4 mU/L — indicates excess thyroid hormone and explains symptoms including palpitations, tremors, heat intolerance, and agitation that are frequently misattributed to anxiety disorder.
2
Assess cortisol and adrenal function
A morning cortisol blood test captures peak output and can identify both excess cortisol (associated with chronic stress and adrenal overactivity) and insufficient cortisol (associated with adrenal fatigue and poor stress resilience). Results should be interpreted in context with symptoms.
3
Check magnesium and key vitamins
Serum magnesium, vitamin B12, and ferritin are often low in people with anxiety. Magnesium deficiency impairs GABA function — the brain's brake system. B12 deficiency causes neurological symptoms including anxiety, pins and needles, and cognitive disturbance.
4
Add hormone and metabolic markers
For women aged 35 and over, oestradiol, LH, and FSH identify perimenopausal hormonal fluctuation. For men, total testosterone and SHBG reveal androgen deficiency. HbA1c screens for insulin resistance as a driver of blood sugar instability and adrenaline surges.
Recommended testing
Recommended Blood Tests
Private blood tests analysed by UK-accredited laboratories.
Comprehensive Hormone and Wellbeing Panel
A 20-marker comprehensive hormone and wellbeing panel covering sex hormones, adrenal markers, thyroid function, metabolic indicators.
£249.00
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Vitamin D Test
Measure your 25-OH vitamin D level with a simple home fingerstick kit. Results reviewed by a GMC-registered physician and returned in 3 to 5 working days.
£29.00
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Advanced Health and Wellness Panel
A 28-biomarker advanced panel covering full blood count, thyroid (TSH, FT4), extended liver and kidney function, full cholesterol, HbA1c, iron status, and CRP.
£139.00
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Female Hormone Profile
A six-marker hormone panel measuring oestradiol, progesterone, LH, FSH, testosterone, and SHBG.
£79.00
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PCOS Hormone Panel
A targeted nine-marker hormonal and metabolic screen designed to assess the key features of polycystic ovary syndrome — including androgens.
£109.00
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Everyday contributors
Lifestyle Factors That Can Contribute
Alongside investigating physical causes, evidence-based lifestyle adjustments can substantially reduce anxiety through biological mechanisms.
Diaphragmatic Breathing
Slow, deep breathing activates the vagus nerve and parasympathetic nervous system within minutes, countering the physiological stress response
Regular Aerobic Exercise
30 minutes of moderate cardio reduces cortisol acutely and improves HPA axis regulation over time
Magnesium-Rich Foods
Dark leafy greens, pumpkin seeds, and dark chocolate are among the richest dietary sources of magnesium
Sleep Hygiene
Consistent sleep and wake times regulate the cortisol awakening response, reducing baseline physiological arousal
Caffeine Reduction
Caffeine inhibits adenosine receptors and elevates cortisol — reducing intake often produces rapid anxiety improvement
Balanced Blood Sugar
Eating protein and fat with each meal reduces blood sugar spikes and troughs that trigger adrenaline-like anxiety episodes
Safety first
When To Seek Medical Advice
While anxiety with a physical basis is usually manageable, certain presentations require urgent medical assessment.
Red flags — speak to a doctor
These can point to a more serious underlying cause and should not be ignored.
- Panic attacks accompanied by chest pain, pressure, or left arm discomfort — seek emergency care immediately
- Sudden severe shortness of breath, especially at rest
- Visible hand tremors or significant unintentional weight loss alongside anxiety symptoms
- Anxiety onset that is abrupt and severe with no prior history or identifiable trigger
Common questions
Frequently Asked Questions
Yes — hyperthyroidism (an overactive thyroid) is one of the most common and most frequently missed physical causes of anxiety. Excess thyroid hormone stimulates the sympathetic nervous system, producing racing heart, tremors, restlessness, sweating, and psychological agitation that are clinically indistinguishable from anxiety disorder. A simple TSH blood test is the first-line screen and should be performed in all patients presenting with new anxiety symptoms.
Yes — cortisol, the body’s primary stress hormone, drives physiological arousal and hypervigilance. When cortisol remains chronically elevated — due to persistent psychological stress, adrenal dysfunction, or poor sleep — the brain’s threat-detection systems become hypersensitive, amplifying anxiety. Morning cortisol testing and a full adrenal function assessment can reveal whether cortisol dysregulation is contributing to your symptoms.
Yes — magnesium is an essential cofactor for GABA receptors, the brain’s primary inhibitory neurotransmitter system. When magnesium is deficient, the threshold for neuronal excitability is lowered, making the nervous system more reactive and anxiety more easily triggered. Magnesium deficiency is extremely common in Western diets and is under-tested in routine health checks. It is measurable by a simple blood test.
Yes — the hormonal changes of perimenopause and menopause are a common and often unrecognised cause of new or worsening anxiety in women over 40. Falling oestradiol destabilises the autonomic nervous system and reduces the brain’s sensitivity to GABA — the same calming neurotransmitter affected by magnesium deficiency. Testing FSH and oestradiol can confirm whether perimenopausal hormonal shifts are contributing to your anxiety.
A comprehensive physical investigation of anxiety should include TSH and free T4 to exclude thyroid overactivity; cortisol to assess adrenal function; magnesium and vitamin B12 to identify nutritional gaps; and oestradiol, LH, and FSH in women over 35, or testosterone in men. HbA1c is also valuable to screen for blood sugar instability as an anxiety driver.
Keep exploring
Related Symptoms
Related Biomarkers
Related Conditions
Sources
References
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Anxiety and Depression Association of America — View source
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De Groot LJ et al. — View source
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Boyle NB et al. — View source
This page is for general information only and does not replace personalised medical advice. If you are worried about your health, please speak to a qualified healthcare professional. Trupoint Health blood tests are analysed by UK-accredited laboratories.