More Helpful Supplements for Stress (April 21, 2015)

“Stress” is a big and somewhat vague topic. It refers generally to mental and emotional tension outside of one's comfort zone, but it can also include feelings of anxiety, depression and/or insomnia. In trying to deal with it, the particular form that the stress is taking can be a guide toward what might be most helpful to relieve it. I will explain.

A “sedative” reduces general irritability or excitement by making you feel more relaxed, sleepy or calm. If we are talking about reducing stress in a general way, we are usually looking at something with sedative effects. If you're past the point of simply feeling tension and are distressed, or your mind is uneasy or disturbed, we are talking anxiety and “anxiolytics” are what relieve that. Depression (which in a very tiny nutshell consists of feelings of despondency and sadness) is relieved by antidepressants but depression is a huge subject in itself and if it is the main problem it should be addressed directly. That being said, if the depression is only a minor part of the whole stress thing, it can probably be dealt with as part of general stress relief. Same deal with insomnia.

So today I’m going to list a few supplements, generally from strongest to mildest.

Kava (also known as “kava kava” for some reason I was unable to discover) has been found to "significantly lower anxiety" and to work as well as some prescription medications in that fashion. It also helps when there is some depression associated with the anxiety (which is kind of a rare characteristic among stress-relieving supplements). However, because kava was “implicated in several cases of liver failure” some years ago, most writers are too gutless to recommend it. Not me! It sounds great to me.

Of course whenever you take something with any real punch to it you need to use some intelligent caution. With that said, a typical dosage of kava when used for treatment of anxiety is 300 mg daily of a product standardized to contain 70% kavalactones. (Half that dosage may work too.) For insomnia it’s 210 mg of kavalactones one hour before bedtime. Kava is something you should take regularly for the proper effect, not just gulp down when you come home at the end of a hard day to find the cat leisurely dismembering a bunny on the living room rug.

I hope I don’t really have to say this, but if you’re already taking an OTC or prescription medication for one or more of these reasons, or for any other reason actually, don’t just piggyback supplements on top of it without due consideration. If it's a prescription from your M.D., talk to him/her. If it's something OTC, be cautious and look things up. If it's something you got from your roommate or sister-in-law and are not sure what it is, well, I can't help you there. Adding a supplement to a medication can be very beneficial; you just have to know what you're doing.

Last week I had nice things to say about Formula 303. It is a homeopathic preparation of magnesium, passionflower and valerian. All three of those ingredients individually have some good evidence for them, so if you tried 303 and didn’t like it, don't stop there. 

Magnesium. It’s an essential mineral that is used (among umpteen other functions) in burning sugar for energy and in muscle relaxation, so it gets depleted quickly in chronic stress. There is a lot of it in various foods but despite this the majority of Americans are deficient in it. In fact, about 20% of us don’t get even HALF of the RDA. It works for general stress relief, muscle relaxation for both tension and cramps, and in insomnia (when taken before bedtime). And since deficiency of magnesium is so widespread AND is strongly implicated in heart disease and high blood pressure, 200 mg of magnesium citrate (the recommended dosage) might be worth looking into for more than one reason. (It loosens stools as well, which you may or may not consider a bonus.)

Passionflower (passiflora incarnata) is used mainly to reduce anxiety but it can also be used in general stress relief and/or for insomnia as well. It does not cause any sedation or grogginess and is milder than kava. The best reference I could find was equivocal about the dosage – go by the label on whichever product you choose. 

Valerian (Valeriana officinalis) is mostly used for insomnia (400 to 900 mg shortly before bedtime). If using it for anxiety, you would use that dosage twice a day, but there's less evidence for it in that regard than there is for its use as a sleep aid. It has a very long tradition of use, but the scientific evidence for it is still up in the air. 

I would now speak very highly of lemon balm. One study found 1600 mg of it to promote feelings of calmness and generally support mood for up to six hours. 600 mg can be taken regularly as a daily dose. Besides this use as a general sedative, it can be used in anxiety and insomnia as well. It grows like a weed in the Nashville area and you can make tea with it, or even use the essential oil. Lemon balm is very mild with no evidence of any kinds of problems associated with its use, and I heartily recommend trying it as well if you are looking for something gentle to use regularly and/or just on occasion. 

The hard part is finding something that works for you personally, not just because there are endless combinations of one or more of these substances available, but because supplement manufacturers vary considerably in reliability. This is the problem with supplements of all kinds. If you try something and it doesn’t work, it could be that the product itself was faulty. Unless it’s USP verified or has been tested by another independent third party of some sort, you just don’t know what you’re getting. This is why you should join ConsumerLab.com or at the very least strong-arm the username and password from a friend who has. 

I meant to get into relaxation therapies today as well, but it is too big a subject. Plus they are useful in a lot more than stress reduction, so I will do them justice on some future occasion. In the meantime, I hope you find one or more of these useful. Stress is a genuine killer, and it's a good idea to fight back once in a while.

--dr. diane holmes
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