Picture this: It’s 2 AM before a big presentation. Your mind is racing—and your body is, too. Tight chest, churning stomach, sore muscles. Tests come back “normal,” but you don’t feel normal.

Here’s the bridge: anxiety can signal your immune system to release pro-inflammatory molecules that influence pain sensitivity, gut function, heart rhythm, and more. That’s psychoneuroimmunology in action.

What Your Body Is Actually Doing

During anxiety, brain regions involved in threat detection modulate autonomic output and immune signaling. Circulating cytokines such as IL-6 and TNF-α can rise and interact with neural circuits that regulate mood and interoception.

The Anxiety ↔ Inflammation Cycle

1) Perceived threat → 2) Brain–immune signaling → 3) Cytokine release → 4) Physical symptoms → 5) More anxiety → 6) Continued inflammation.

7 Ways Anxiety Can Amplify Physical Symptoms

1) Heart & Chest Sensations

Stress can transiently affect vascular tone, autonomic balance, and inflammatory signaling—producing tightness, fluttering, or pressure despite normal cardiac tests.

2) Gut–Brain Highway

The vagus nerve and inflammatory mediators shape motility, barrier integrity, and visceral sensation—explaining nausea, cramping, and urgency during acute worry.

3) Muscle & Fascia Tension

Sympathetic arousal + cytokines can heighten nociception and stiffness, creating “flu-ish” aches or heavy limbs when stress runs high.

Breaking the Cycle: Evidence-Informed Strategies

Strategy 1: Target Systemic Inflammation

Omega-3s (EPA/DHA): In an RCT, omega-3 reduced anxiety and lowered IL-6/TNF-α production vs. placebo. Kiecolt-Glaser et al., 2011. :contentReference[oaicite:2]{index=2}

Dietary pattern: Emphasize omega-3 fish, extra-virgin olive oil, colorful plants, legumes, fermented foods; reduce ultra-processed/sugary foods that promote low-grade inflammation.

Strategy 2: Engage the Anti-Inflammatory Reflex

Breathwork & vagal tone: Slow-paced breathing (e.g., 4-7-8) can acutely shift HRV and support autonomic balance; theoretical and empirical work suggests vagal pathways are a mechanism. See Gerritsen & Band, 2018 (model) and Vierra et al., 2022 (physiologic shifts). :contentReference[oaicite:3]{index=3}

Strategy 3: Midlife Hormone Context

Perimenopausal estrogen decline is associated with a more pro-inflammatory milieu, which can sensitize stress responses. See mechanistic and clinical reviews: Zhang et al., 2024; Russell et al., 2019. :contentReference[oaicite:4]{index=4}

When to Seek Medical Care

• Chest pain with radiation to arm/neck/jaw
• Severe breathing difficulty or throat tightness
• Sudden, worst-ever headache
• Palpitations with dizziness, syncope, or neurologic symptoms

Your Symptoms Are Valid—and Modifiable

The psychoneuroimmunology frame validates why anxiety can feel physical—and gives you multiple levers (breath, sleep, nutrition, pacing, therapy) to dial it down.