Show Notes In Today's Episode In this episode of the Table Talk Podcast, Melody Hartzler sits down with Everest Goldstein, a board-certified psychiatric nurse practitioner and functional psychiatry practitioner, to explore anxiety through a functional medicine lens. They discuss the potential connections between anxiety and gut health, blood sugar, thyroid function, nutrient deficiencies, hormones, stress, and medication, while highlighting the importance of looking beyond symptoms to understand individual root causes. Key Take Aways Anxiety can be a symptom, not just a diagnosis. Functional psychiatry looks beyond the diagnosis itself to explore potential contributors such as hormones, gut health, nutrient deficiencies, trauma, stress, and other factors. Gut health and mental health are closely connected. Comprehensive stool testing can provide insight into the microbiome, digestion, pathogens, inflammation, and other gut-related factors that may contribute to mental health symptoms. Blood sugar stability may influence anxiety. Meals that combine carbohydrates with protein, healthy fats, and fiber can support more stable blood sugar, while long periods without eating or significant blood sugar fluctuations may contribute to physical feelings of anxiety. Hormonal changes can affect anxiety throughout a woman's life. The conversation explores PMS, PMDD, perimenopause, progesterone, estrogen, and the relationship between hormonal fluctuations and neurotransmitters involved in mood, anxiety, and sleep. Treatment should be individualized. Medication can be an important tool alongside functional and lifestyle approaches. Everest emphasizes shared decision-making, patient preferences, symptom severity, and understanding how medications may interact with factors such as gut health and genetics. Topics Discussed 00:00 – Welcome to Table Talk: Anxiety & Women’s Health Melody introduces Everest Goldstein and sets the stage for a conversation about anxiety, functional psychiatry, and women’s health. 01:00 – Understanding Anxiety Through Functional Psychiatry Exploring the difference between diagnosing anxiety and looking for the underlying factors contributing to anxiety symptoms. 03:00 – Anxiety, Gut Health, and the Microbiome How gut health, digestion, the microbiome, and neurotransmitters may be connected to anxiety and mental health. 04:00 – Comprehensive Stool Testing A look at what comprehensive stool testing can reveal about bacteria, pathogens, digestion, immune function, and gut health. 06:00 – Choosing the Right Gut Test Exploring different testing technologies and the challenges of navigating the growing number of available gut tests. 08:00 – Blood Sugar and Anxiety How blood sugar spikes and drops can contribute to physical symptoms of anxiety, shakiness, irritability, and feeling overwhelmed. 10:00 – Eating Patterns and Blood Sugar Stability Why pairing carbohydrates with protein, healthy fats, and fiber—and avoiding long gaps between meals—may help support blood sugar stability. 11:00 – Using CGMs to Track Blood Sugar How continuous glucose monitors can help identify patterns between food, blood sugar changes, and mental health symptoms. 13:00 – CGM Options and Beyond Diabetes A discussion of Stelo, Dexcom, FreeStyle Libre, insurance coverage, and potential uses for CGMs outside traditional diabetes care. 15:00 – Thyroid Function and Anxiety Exploring the connection between thyroid function and anxiety and why a broader thyroid assessment may provide additional insight. 18:00 – Thyroid, Stress, and Nutrient Deficiencies How chronic stress, thyroid function, and nutrients such as selenium, vitamin D, iron, and ferritin can intersect with anxiety. 20:00 – Iron, Ferritin, and Mental Health Discussing how low iron and ferritin may contribute to anxiety and other mental health symptoms while also prompting questions about gut health. 21:00 – Inflammation and Anxiety Exploring the relationship between inflammation, brain health, depression, brain fog, and anxiety. 23:00 – Finding the Root Cause of Anxiety How a thorough evaluation can help determine where to begin, including nutrients, gut health, environmental factors, and lifestyle. 24:00 – Hormones and Women's Mental Health How hormonal changes throughout the female lifespan can contribute to anxiety, depression, irritability, and changes in sleep. 25:00 – PMS, PMDD, and Progesterone Understanding how changing estrogen and progesterone levels—and their relationship with GABA—may influence anxiety and sleep. 27:00 – Tracking Hormones With Mira Exploring at-home hormone tracking and how cycle data can help identify connections between hormonal changes and symptoms. 30:00 – When Medication Becomes Part of the Conversation How Everest approaches SSRIs, SNRIs, and other medications while considering symptom severity, patient preferences, and functional approaches. 33:00 – Pharmacogenomic Testing and GeneSight How genetic testing can provide additional information about medication metabolism and potential medication response. 36:00 – Understanding Genetic Medication Reports Why GeneSight results do not simply determine whether a medication will or will not work and how metabolism can influence dosing. 37:00 – Becoming Your Own Healthcare Advocate Why tracking symptoms, asking questions, and advocating for yourself can be important parts of navigating mental health care. 38:00 – Why Stress Is More Than “Just Stress” Exploring the physiological effects of chronic stress and how the nervous system responds when the body remains in a heightened state. 40:00 – Nervous System Regulation and Wellness Tools Discussing tools and practices that may support nervous system regulation, including Apollo Neuro, Pulsetto, PEMF, and neurofeedback. 41:00 – Supporting the Vagus Nerve at Home Simple practices such as humming, singing, gargling, and safe cold-water exposure are discussed as accessible ways to support vagal activity. 42:00 – Closing: Finding Everest Functional Psychiatry & Wellness Everest shares where listeners can learn more about her practice, while Melody highlights PharmToTable’s women's health resources. Resources Mentioned Gut health and microbiome testing: Gut Performance Test Blood sugar and metabolic support: Glucose Support bundle Continuous glucose monitors (CGMs): Stelo by Dexcom FreeStyle Libre Lingo by Libre Hormone tracking and women's health: Mira Hormone Monitor Mental health and medication resources: GeneSight Pharmacogenomic Testing Everest Functional Psychiatry & Wellness Nervous system regulation and wellness tools: Apollo Neuro Pulsetto PEMF Therapy