Can Certain Supplements Actually Help With Anxiety?

Anxiety is skyrocketing right now, especially among women.

A quarter of all women report severe anxiety with physical symptoms like a racing heartbeat, compared to only 11 percent of men, and more than half also report sleep issues, according to a LeanIn.org survey.

What's more, women have a higher risk of experiencing depression, anxiety and post-traumatic stress syndrome, a May 2020 study in the journal ‌Brain, Behavior and Immunity‌ found.

Given all this, the idea of popping an over-the-counter supplement to ease your jitters may sound very appealing. But you still need to be careful.

"Herbal supplements aren't monitored by the FDA the same way medications are," says Brent Bauer, MD, director of the Mayo Clinic Complementary and Integrative Medicine Program. "Natural doesn't always mean safe."

That's why if you're feeling anxious, you should always talk to your primary care provider first. They can refer you to a behavioral health specialist, and help you understand possible risks and benefits if you choose to try a natural remedy or herbal supplement.

But while there's no pill that will poof away your anxiety instantly, there are certain supplements that research suggests do work — and are safe, to boot.

Here's a guide to help you sort through some of the supplements used for anxiety to help you determine which may be worth trying, which ones need more data to confirm they work (or don't) and which to steer clear of.

Fish oil is rich in the omega-3 fatty acids EPA and DHA, which have been shown to improve symptoms in moderate and major depression and also to significantly reduce anxiety, says Tod Cooperman, MD, president and founder of ConsumerLab.com, an independent evaluator of dietary supplements.

A September 2018 review of 19 clinical trials in ‌JAMA Psychiatry‌ found, for example, that people who took over 2,000 grams of fish oil a day reported improvements in their anxiety symptoms.

Brands that have passed Consumer Lab's testing include Kirkland Signature Fish Oil, Life Extension Omega Foundations Super Omega-3 EPA/DHA, Minami Garden of Life Platinum Omega-3 Fish Oil and OmegaBrite.

A January 2017 review in the journal ‌Nutrients‌ looked at 18 studies and concluded this mineral is linked to reducing symptoms of mild anxiety.

"Magnesium plays many different roles in relaxing muscles and nerves, which calms you down," explains Arielle Levitan, MD, board-certified internal medicine physician, co-founder of Vous Vitamin LLC and co-author of ‌The Vitamin Solution‌.

The recommended dose varies depending on your individual magnesium levels, but most people can take anywhere from 100 to 350 milligrams daily.

Another option: An Epsom salt bath before bed, suggests Ivy Branin, ND, a naturopath in New York City. A small 2015 study by the Epsom Salt Council found that people who soaked in an Epsom salt bath two to three times a week saw increases in their blood magnesium levels.

Some evidence suggests that oral lavender or aromatherapy with lavender can reduce anxiety, Dr. Bauer says.

A March 2013 review in ‌Evidence Based Complimentary and Alternative Medicine‌ suggests it may be helpful for mild anxiety and can improve sleep. In fact, one study suggests lavender effectively ameliorates generalized anxiety comparable to a 0.5-milligram daily dose of lorazepam, an anti-anxiety medication. However, the evidence is preliminary and limited.

But oral lavender can cause side effects such as constipation, headaches and even low blood pressure, he warns. You're better off using it in your bath (you can combine it with an Epsom salt bath, says Branin) or as part of aromatherapy.

A December 2016 randomized controlled study in the journal ‌Phytomedicine‌ found that taking 500 milligrams of chamomile three times a day for 12 weeks significantly reduced anxiety.

But you should avoid chamomile if you are on a blood-thinning drugs like warfarin, or if you're allergic to plants in the same family such as ragweed, marigolds, daisies and chrysanthemums, Dr. Bauer stresses.

This brightly colored plant is thought to increase levels of gamma-aminobutyric acid (GABA), a brain chemical that helps boost mood. Several studies have shown passionflower has anxiety-lowering effects, including a October 2010 review in ‌Nutrition Journal‌.

While it's generally considered safe, passionflower can cause drowsiness, dizziness and confusion, Dr. Bauer says. You're best off taking it in tea form, sipping one to two cups a day.

If you do buy it as a supplement, check the label: Passionflower is often combined with other herbs, so you want to make sure you're not getting more than what you bargained for.

This lemon-scented herb contains chemicals called terpenes, which are thought to play a role in its relaxing effects. In small studies, lemon balm has been shown to reduce anxiety symptoms.

A December 2010 study in the ‌Mediterranean Journal of Nutrition and Metabolism‌ found that about 70 percent of people who took it for a couple of weeks reported sharp reductions in anxiety.

The recommended dosage is usually 300 to 500 milligrams in capsule form three times a day or as a tea four times daily (to make, steep up to one full teaspoon of dried lemon balm herb in hot water), according to Penn State Hershey. Talk to your doctor about the right dose.

While it's considered safe, it can cause side effects such as nausea or stomach pain, says Dr. Bauer.

This compound is found naturally in your body and helps you produce and regulate hormones important for your mood, such as dopamine and serotonin.

"There is a significant amount of information suggesting that SAMe may be helpful for certain people with depression and, to a lesser degree, anxiety," Dr. Bauer says.

A December 2017 review in the ‌Journal of Clinical Psychiatry‌ looked at over 115 studies and found there was some evidence to show that it helps alleviate depression and anxiety, both alone and with prescription anti-depressants. However, the authors say more research is needed to confirm these findings.

If you do use SAMe, you absolutely should not take it with prescription drugs that raise serotonin (think SSRIs like Zoloft or Prozac), stresses Dr. Bauer.

Talk to your doctor about the right dose — studies suggest it could be anywhere from 400 to 1,600 milligrams a day.

Either a combo of these two spices or curcumin alone are associated with significantly greater improvements in depressive symptoms compared to placebo, a January 2017 study in the ‌Journal of Affective Disorders‌ found.

FYI, curcumin is the active component in turmeric, the golden spice that's ever so popular right now.

It's not clear exactly how these spices affect mood, but since curcumin itself has anti-inflammatory effects, it may help ramp down inflammation in the brain that can contribute to anxiety and depression, explains Dr. Cooperman.

If you decide to try these spices, Dr. Cooperman suggests taking 250 to 500 milligrams of curcumin twice a day. And, if you decide to add in saffron, try 15 milligrams twice daily as well. Always take these with food — curcumin is not well-absorbed on its own, says Dr. Cooperman.

"We are seeing a lot of anecdotal reports of CBD having a positive impact on anxiety, reducing pain and helping with sleep," Dr. Bauer says.

In fact, CBD was effective both in relieving anxiety and improving sleep quality, a January 2019 study in the ‌Permanente Journal‌ found.

Another November 2019 review in the ‌Journal of the American Pharmacists Association‌ found that CBD, along with talk therapy, was helpful in treating anxiety. But since there are also reports of people developing liver test abnormalities when taking CBD, Dr. Bauer recommends skipping it for now — at least until there are larger clinical trials done to gauge its efficacy and safety.

"It's still a 'buyer beware' situation because the market has not done a good job of keeping inferior products off the shelves," he adds.

A November 2017 study in ‌JAMA‌ examined 84 CBD products bought online and found that more than a quarter contained less CBD than what was on the label.

Certain strains of probiotics have been found to reduce symptoms of depression and anxiety in short-term studies, says Dr. Cooperman. A probiotic might be able to reduce anxiety if it contains a specific type of bacteria.

A June 2018 review in ‌PLOS One‌ found that one type of probiotic, Lactobacillus (L.) rhamnosus has the most evidence showing that it could significantly reduce anxiety. But more research needs to be done to pinpoint specific strains.

In the meantime, you can get probiotics through a daily dose of probiotic-rich foods such as Greek yogurt, pickles, sauerkraut and kefir.

An August 2015 study in the journal ‌Psychiatry Research‌ suggests a link between probiotic foods and less social anxiety.

This amino acid is naturally created by your body from tryptophan. It's a precursor to serotonin, a chemical in your body that boosts mood, explains Dr. Branin.

But the research on it is mixed, and a July 2012 review in the journal ‌Neuropsychiatry Disease Treatment‌ concluded more studies need to be done to gauge its efficacy and safety.

There is research to suggest it is effective when it comes to anxiety, per an October 2013 ‌Journal of Clinical Psychpharmacology‌ study.

But reports of serious liver damage — even with short-term use — caused the Food and Drug Administration to issue warnings about its use back in 2002.

This herb is often touted to promote sleep and induce calmness, but research in both areas is weak, says Dr. Cooperman.

A June 2007 review in ‌Sleep Medicine Reviews‌ found it wasn't any more effective than a placebo.

In addition, Consumer Lab's testing has found that many products don't contain the amount of valerian listed on their label, and some even contained high levels of lead.