Mental Health

Natural supplements for anxiety that were proven to work

As I have previously mentioned, I am not a big fan of “natural” anxiety supplements. The reason for it is quite simple: I don’t believe they work as well as medications that are prescribed by a therapist or a physician. They are also not as safe, as many people think they are and have its own side effects. However, I believe some of them can be helpful in relieving our symptoms.

It’s a pet peeve of mine, when people on social media claim something that worked for them in the past to be a panacea for someone else’s mental health. We all have hopes that there is a magic supplement or a medication that can cure our mental illness, and we are often ready to try anything that has even a slight potential to make us feel better. However, there is no such treatment that would work for everyone, that’s why there are so many different supplements on the market.

I understand that not everyone can see a doctor, and more and more people like the idea of “natural remedies”. I personally have tried many of them. I can see how they can be viewed as safe. If you don’t take them on a regular basis, they may be safe, but there is no scientific evidence to think that they are completely harmless if used daily.

Having said that, I wanted to do my little research and find out more information about the supplements that are often recommended (mostly on Internet) for helping with anxiety. I hope this post will be helpful to those of you who are looking for natural supplements for anxiety and don't know where to begin. 

Vitamins, minerals, and amino acids

Magnesium

Magnesium is a very important mineral in our body. It participates in protein synthesis, muscle, and nerve function as well as blood glucose control and blood pressure regulation1.

Hypomagnesemia (low levels of magnesium) has been associated with stressful conditions such as photosensitive headache, fibromyalgia, chronic fatigue syndrome, audiogenic stress, cold stress, and physical stress. Even though correlation doesn’t mean causation, it may be something to consider, if you are experiencing any of these issues.

Supplementing magnesium in mice has been demonstrated to reduce the expression of anxiety-related behavior. In humans magnesium has been shown to influence anxiety states via the moderation of the stress response2

I like magnesium as it’s a natural muscle relaxant. It does sometimes help with my chronic back pain and headache as well. As for anxiety, I personally didn't notice any difference in my symptoms while taking it, but I heard people claim it to be helpful, so I think it's very individual.

Vitamin D

Vitamin D is a vitamin that regulates absorption of calcium and phosphorus in the body. It is also known to help normal immune system function3. Our body produces vitamin D as a result to sun exposure. Some foods contain this vitamin or are fortified with it. So, if you don't get enough sun and don't eat many foods fortified with vitamin D, you may be deficient.

Low levels of vitamin D are associated with anxiety, depression, and schizophrenia. It appears to play a neuroprotective role in the brain. One study shows that significantly lower levels of calciferol (scientific name for vitamin D) were found in men and women with depression and anxiety disorders4. Even though correlation doesn’t mean causation (again), if you are dealing with anxiety or depression, it most likely won't hurt to supplement.

I take at least 2000 UI of vitamin D a day, it is a widely recommended daily dose.

B-complex

There are 8 vitamins that play an extremely important role in our body. B-vitamins help the process of releasing energy from carbs and fat, as well as breaking down amino acids and transporting energy around the body.

However, there is still not enough evidence, that supplementing with B-vitamins can help anxiety symptoms, and further research is needed.

Baseline micronutrient status and dietary status may influence the effects of supplementation. Perhaps, if you are deficient at the baseline, you can benefit from supplementation5

L-Theanine

L-Theanine is an amino acid that isn’t produced in our body and is not essential. L-Theanine is naturally found in black and green tea and can often be found in supplements for anxiety. According to research it improves sleep quality, cognitive function and may help with anxiety and depression associated with stress6

According to one study, 50 mg of L-Theanine was enough to improve mental alertness. A typical 200 ml cup of brewed black tea contains about 24 mg of L-Theanine. However, since tea contains caffeine, it's better not to drink it in the evening. Supplements containing L-Theanine may be a good option for those who would like to try it. 

What L-Theanine is known for is that it helps achieve "relaxed but alert mental state via a direct influence on the central nervous system"7. However, we are talking about relaxation during stressful events here, not necessarily anxiety disorder. I think, that's why L-Theanine is one of multiple components of stress supplements. It's not like it would be effective for stress or anxiety on its own. I drink a lot of tea but see no relaxing effect from it. 

GABA

Gamma-aminobutyric acid (GABA) is a naturally occurring amino acid that works as a neurotransmitter in our brain. It produces a calming effect by attaching to a protein in the brain known as a GABA receptor. Many medications (including benzodiazepines) interact with GABA receptors to produce anxiolytic effect. 

GABA supplements have become very popular, and many people claim that they do help, however it’s still unknown whether it’s just a placebo effect, since GABA is unable to cross the blood-brain barrier (BBB)8

In one study treatment with GABA (300 mg daily) improved sleep in participants9. But more research is needed. Here I am talking about foods that contain GABA, however as well as with supplements, the question is how much of those foods' GABA if any at all can be used by the brain.

L-lysine and L-arginine

L-lysine is an essential amino acid that we obtain from food. Besides being an important building block of protein, it promotes immune health, collagen production and calcium absorption. It may also reduce anxiety by blocking stress response receptors. 

L-arginine is another amino acid. It is known for promoting wound healing, maintaining immune and hormone function, helping the kidneys do their work of removing waste products from the body. One of potential benefits of L-arginine is alleviating anxiety, but more research is required.

Together L-lysine and L-arginine (2.64 g per day each) have been shown to reduce anxiety and cortisol levels in healthy humans10

Herbs

Ashwagandha

Ashwagandha (Withania somnifera) is an herb in Ayurveda, a form of alternative medicine based on Indian principles of natural healing.

Some studies do confirm that ashwagandha produce favorable results in comparison with placebo (1000 mg) when it comes down to anxiety and stress levels, however the primary outcomes were classified as patient-reported measures and results were possibly biased11

One study suggests that ashwagandha (300 mg) effectively improves an individual's resistance to stress, which may explain why it is often called an "adaptogen" (herbs that help our body handle stress) in the modern wellness world. Just like with many other natural supplements, more research is needed to confirm that ashwagandha is indeed effective for anxiety12

Passionflower

Passionflower (Passiflora extract) is a climbing vine that grows in southeastern United States, Central and South America.

You can often find it in the supplements for stress and anxiety. Effectiveness of passionflower in the treatment of generalized anxiety disorder (GAD) was compared to that of oxazepam (belongs to benzodiazepines, a drug class used for treating anxiety) in a pilot double-blind randomized controlled trial. According to results, it is “an effective drug for the management of GAD”.13 The supplement appears to increase the level of GABA in the brain.

Passionflower has also been shown to improve sleep and reduce anxiety in ambulatory surgery patients.14

In my experience, passionflower may have a calming effect, but it mostly makes me sleepy than relaxed (if you have an anxiety disorder, you know there is a difference). However, I believe everyone's experience is different, so it may be worth a try, especially before sleep. I think after this post I am going to try it again.

Valerian root

Valerian is an herb that traditionally grows in Europe and parts of Asia, as well as North America.

There have been many studies conducted with valerian root, however the exact mechanism of working is still not completely understood. Some of its compounds have been shown to interact with GABA in the brain resulting in sedation.15 Aqueous extracts of the roots contain GABA itself, but as I have mentioned earlier, its bioavailability is questionable.16

In my experience supplements with valerian root promote sleepiness and somewhat relaxation, they do not help with severe anxiety attack though. 

What is interesting about herbs is that they contain different compounds that can contribute to their calming effect, which makes it difficult to understand which one works. If you buy a supplement that contain many herbs, you will find that one combination works better than the other, so, it's mostly about finding what works for you. I have previously talked about what supplements help me, if you are interested. 

So, the bottom line is that there are quite a few "natural" options that may help you deal with anxiety. It's worth trying if you are hesitant about taking traditional medicines. However, it's important to remember, that their effects won't necessarily be as noticeable. Many studies were performed on healthy humans. I would personally take them as an addition to traditional treatment (if it’s safe and possible) or in times of stress (when they have proven to be most effective). If you struggle with severe mental illness, don't be afraid to seek help, if supplements don't work, as that's how it often goes. There is nothing wrong about it.

I hope you found this post helpful. Leave the comment below, if you did. I will see you next time, on Pillows&Trees.


References

1 National Institutes of Health. "Magnesium." <https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/>

2 Cuciureanu MD, Vink R. Magnesium and stress. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507250/

3 National Institutes of Health. "Vitamin D." <https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/>

4 M. Bicikova, M. Duskova, J. Vitku, B. Kalvachova, D. Ripova, P. Mohr, L. Starka. Institute of Endocrinology, Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic. "Vitamin D in Anxiety and Affective Disorders", May 2015, article, <http://www.biomed.cas.cz/physiolres/pdf/64%20Suppl%202/64_S101.pdf>

5 Young, L. M., Pipingas, A., White, D. J., Gauci, S., & Scholey, A. (2019). A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals. Nutrients, 11(9), 2232. https://doi.org/10.3390/nu11092232

6 Hidese, S., Ogawa, S., Ota, M., Ishida, I., Yasukawa, Z., Ozeki, M., & Kunugi, H. (2019). Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial. Nutrients, 11(10), 2362. https://doi.org/10.3390/nu11102362

7 Anna C Nobre PhD , Anling Rao PhD and Gail N Owen PhD. L-theanine, a natural constituent in tea, and its effect on mental state, article, <http://apjcn.nhri.org.tw/server/APJCN/17%20Suppl%201/167.pdf>

8 Boonstra, E., de Kleijn, R., Colzato, L. S., Alkemade, A., Forstmann, B. U., & Nieuwenhuis, S. (2015). Neurotransmitters as food supplements: the effects of GABA on brain and behavior. Frontiers in psychology, 6, 1520. https://doi.org/10.3389/fpsyg.2015.01520

9 Byun, J. I., Shin, Y. Y., Chung, S. E., & Shin, W. C. (2018). Safety and Efficacy of Gamma-Aminobutyric Acid from Fermented Rice Germ in Patients with Insomnia Symptoms: A Randomized, Double-Blind Trial. Journal of clinical neurology (Seoul, Korea), 14(3), 291–295. https://doi.org/10.3988/jcn.2018.14.3.291

10 Smriga M, Ando T, Akutsu M, Furukawa Y, Miwa K, Morinaga Y. Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans. Biomed Res. 2007 Apr;28(2):85-90. doi: 10.2220/biomedres.28.85. PMID: 17510493

11 Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). Journal of alternative and complementary medicine (New York, N.Y.), 20(12), 901–908. https://doi.org/10.1089/acm.2014.0177

12 Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577

13 Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001 Oct;26(5):363-7. doi: 10.1046/j.1365-2710.2001.00367.x. PMID: 11679026

14 Movafegh A, Alizadeh R, Hajimohamadi F, Esfehani F, Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth Analg. 2008 Jun;106(6):1728-32. doi: 10.1213/ane.0b013e318172c3f9. PMID: 18499602

15 Murphy K, Kubin ZJ, Shepherd JN, Ettinger RH. Valeriana officinalis root extracts have potent anxiolytic effects in laboratory rats. Phytomedicine. 2010 Jul;17(8-9):674-8. doi: 10.1016/j.phymed.2009.10.020. Epub 2009 Dec 29. PMID: 20042323

16 Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol. 1999 May;51(5):505-12. doi: 10.1211/0022357991772772. PMID: 10411208