“Vitamins, minerals, and supplements can certainly play a role in helping to manage anxiety (if deemed safe under the advisement of a doctor), but it is important to keep in mind that they alone will not ‘cure’ anxiety,” says Emily Steinberg, MD, PC, assistant professor of psychiatry at Icahn School of Medicine at Mount Sinai. When considering a supplement, it’s important to understand that some supplements—especially herbal supplements—don’t address the root cause of the anxiety, may interact with certain medications, and, in some cases, should not be taken regularly. If you have anxiety, work with a healthcare provider to develop the best treatment for you, which may or may not include supplements. If you choose to take a supplement, understand the potential benefits and drawbacks of each supplement type and look for products that are quality tested, safe, and appropriately dosed.
Is a Supplement Beneficial for Anxiety?
Occasional mild anxiety isn’t always a problem and may not require treatment, but if it’s disturbing your life, we recommend seeking help. “Some common symptoms of anxiety that might indicate a need for treatment include racing, disturbing, and repetitive thoughts; insomnia; and distractibility. Physical symptoms that can go along with panic such as heart racing, shortness of breath, GI upset, muscle tension, and tingling sensations are also signs,” Steinberg says. Gauri Khurana, MD, MPH, clinical instructor at the Yale School of Medicine, adds that self-medicating with alcohol, marijuana, food, or other numbing behaviors like binge-watching TV are indications that treatment would be helpful. Pharmacotherapy, or prescription medications such as antidepressants, SSRIs, and benzodiazepines, as well as therapy techniques such as cognitive behavioral therapy (CBT), are proven treatments for anxiety. CBT is a fantastic long-term option, and medications can work well for some but may come with unwanted side effects for others. Complementary and alternative medicines (CAM) can also be a useful avenue to explore for treating anxiety. These include tools such as yoga, meditation, acupuncture, hypnosis, dietary changes, and supplements. Supplements may be especially helpful for the following people:
People with a known nutrient deficiency. Studies have shown that low magnesium and vitamin D is linked to anxiety, and supplements may both improve nutrient status and anxiety symptoms.People who don’t respond to more traditional therapies. “Those who are not getting an adequate response from more standardized treatments of anxiety using psychotherapy and psychopharmacological approaches or who may not have had good results from medications may opt to try supplements as an alternative or adjunctive treatment for anxiety,” Steinberg says.People resistant to taking medication. Anxiety medications can have unwanted side effects, making them difficult for some people to take consistently. Supplements may be helpful in reducing some symptoms, especially those that are more mild. “Vitamin, mineral, and herbal supplements are often used by patients who are reluctant to try prescription medications and these are often a good first step toward providing some level of relief. For my patients that do not want to continue with prescription medications, I often help them transition to herbal supplements after we have achieved a period of remission,” says Khurana. People with occasional and mild symptoms. Supplements like ashwagandha have been shown to reduce stress-related anxiety in otherwise healthy people. However, supplements may not be effective for those with more severe anxiety. “In my clinical experience, the best treatment for panic attacks and debilitating anxiety is prescription medication,” says Khurana.
The effectiveness of various supplements is still being explored and is highly individualized, so it’s essential you work closely with a healthcare provider to determine if a supplement is appropriate for you. “Not everyone responds the same to the same supplements. While one person may get a relaxing effect from a particular adaptogen or from CBD, for a segment of the population the same supplement can have an undesirable stimulating effect instead,” says Sharon Puello, MA, RD, CDN, CDCES. It’s also important to note that long-term use of many herbal supplements is not recommended. Most studies testing the effectiveness of herbal supplements are short duration (around eight weeks) and we don’t know much about the safety of long-term use.
Who May Not Benefit From Supplements for Anxiety
Supplements may seem benign because they are “natural,” but they can be potent and come with negative or even dangerous side effects for some people.
People taking certain medications. Many supplements, especially herbal supplements like ashwagandha, L-theanine, and valerian root, interact with common medications like thyroid, diabetes, cholesterol, and blood pressure medications, making them less effective or more potent, which can be problematic. Review any supplements you’re considering with a healthcare provider to understand if they are safe and effective to take with other medications.People with other psychiatric illnesses. “When there are comorbid psychiatric conditions, especially bipolar disorder, some supplements or ingredients in them may precipitate a psychosis or mania. In addition, some psychiatric medications (such as SSRIs like Prozac, Zoloft, Paxil, Lexapro, and Celexa) combined with certain supplements can be dangerous,” says Khurana. Pregnant or breastfeeding people. Most supplements are not studied in pregnant or breastfeeding people and the safety of supplementing to treat anxiety during this time is not known or understood. People with moderate to severe anxiety. Supplements have varying levels of success in treating anxiety symptoms, but in general, they are not enough for more significant debilitating anxiety. “For those with more severe levels of anxiety, supplements can be used as needed, but their level of illness would not be adequately treated with only supplements,” says Khurana.
It’s also important to understand that, unless you are addressing a nutrient deficiency, supplements (like many other therapies) don’t address the root cause of the anxiety. “It’s essential to distinguish between treating anxiety symptoms versus the cause,” says Samantha Gambino, PsyD. Because supplements may not be safe to take long-term, it’s important to determine and ultimately address the underlying reason for anxiety, while developing tools to manage it. However, it’s not a magic bullet, and studies have yet to determine the best dose and frequency as well as the safety of long-term use. In addition, some studies have shown it to be ineffective in treating anxiety. It’s also important to note that ashwagandha may interact with diabetes medications, thyroid medications, immunosuppressants, sedatives, and blood pressure lowering medications, so it may not be safe if you take any of these medications. There have also been a small number of case reports of liver damage after two to 12 weeks of taking ashwagandha. If a healthcare professional has deemed it safe for you to supplement with ashwagandha, we recommend Organic India’s Ashwagandha, which includes the root and herb of the ashwagandha plant. It’s processed into a powder and then neatly packaged into vegetarian capsules for ease of consumption. It’s ConsumerLab approved, non-GMO, and halal. Organic India is also a certified B-corporation. The specified dose is two tablets, which provides 800 milligrams of ashwagandha. Although some research looking into this supplement for anxiety shows benefits at lower doses, the beneficial effect will likely differ from person to person. Work closely with your healthcare provider to determine the best dose for you. Price at time of publication: $21 for 90 Count ($0.23/count) Thorne is a leading supplement brand known for quality and safety, and ConsumerLab confirmed that their L-theanine contains what it says on the label with no harmful contaminants. Thorne’s L-theanine features Suntheanine®, the patented name for the pure form of L-theanine produced by the Japanese company Taiyo, which is the form that is used in many studies. Thorne’s product contains 200 milligrams of L-theanine, is derived from natural flavors and colors, and is gluten-, soy-, and dairy-free, but it does come at a higher price point than some others on the market. Anyone taking sedatives (for example, the drug Midazolam) should avoid L-theanine, and it may not be safe for pregnant or breastfeeding people. Price at time of publication: $59.60 for 90 Count ($0.60/count) While some studies show significant decreases in anxiety with valerian root supplementation, other studies are inconclusive. Of note, one study did find that a high dose of 1,800 milligrams actually worsened anxiety. The herb is usually tolerated well, but possible side effects include headaches, nausea, and heart palpitations. In their testing, ConsumerLab found that some of the products they reviewed didn’t contain the amount of valerenic acids that were on the label, did not contain a clinically effective dose, or were contaminated with lead at a higher amount than may be safe. Therefore, if a healthcare provider recommends you take valerian root, we suggest GNC’s Herbal Plus Valerian Root Extract because ConsumerLab has confirmed that this supplement contains what the label says. GNC Herbal Plus Valerian Root Extract contains 500 milligrams of valerian root extract, which equals 4 milligrams of valerenic acid. Because it promotes sleep, it’s recommended you take it before bed. The product is made without any of the common allergens, but note that the capsule size is described as “large” and might be difficult for some to swallow. Due to valerian’s sedative effect, it is not safe to take in combination with sedatives and antihistamines and may interact with statins, some seizure medications, antifungals, and certain antidepressants. Safety has also not been established for pregnancy. Price at time of publication: $25 for 50 Count ($0.50/count) Swanson’s Magnesium Lactate uses the form of this mineral most commonly studied and thought to aid in anxiety reduction. Magnesium lactate is lactose-free, contrary to popular thought, and is known to be gentle on the stomach. Each capsule only contains 84 milligrams of magnesium lactate, which contributes to the recommended 400 milligrams for men and 320 milligrams for women, but may not be enough for some to close nutrient gaps, depending on diet. If you take bisphosphonates (Fosamax), antibiotics (doxycycline or ciprofloxacin), diuretics (Lasix), or proton pump inhibitors (Nexium), speak with a healthcare provider about magnesium supplementation as magnesium may interact with these medications. Price at time of publication: $15 for 120 Count ($0.13/count) While vitamin D is found in some foods, including cod liver oil, sockeye salmon, mushrooms, milk and fortified plant-based milks, and cereals, it is not abundant. Our bodies can synthesize vitamin D through our skin from sunlight. But, with the low sun intensity in northern latitudes, especially during cooler months, and the recommendation to wear sunscreen and limit direct sun exposure, many people are at risk of vitamin D deficiencies and may benefit from supplementation. Nordic Naturals Vitamin D3 gummies provide 1000 international units of vitamin D, which is 125 percent of your daily needs. Those with a diagnosed vitamin D deficiency may need to take a higher dose, so be sure to consult with a healthcare provider. This supplement is NSF certified, making it a trusted choice, and it comes in a tasty gummy form, making it a more enjoyable supplement option. Price at time of publication: $21 for 120 Count ($0.17/count)
Chamomile: Chamomile in tea form is often thought to be a calming drink and may offer some anxiety-reducing benefits. Initial studies suggest some promise for chamomile for general anxiety disorder. However, studies are limited, and findings are inconsistent, so more research is needed to be able to make a product and dose recommendation. Some psychiatrists have found benefit of chamomile in their practice, so it may be that there is use for specific individuals.GABA: “Gamma-aminobutyric acid (GABA) is an amino acid and neurotransmitter located in the brain that is crucial to serotonin production. It decreases anxiety and panic. However, it is unclear if GABA can cross the blood brain barrier, so it is uncertain if this supplement is actually helpful,” says Khurana. A 2020 systematic review showed no benefit in using GABA supplements for anxiety.
How We Select Supplements
Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. We prioritize products that are third-party tested and certified by one of three independent, third-party certifiers: USP, NSF, or ConsumerLab. It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.
What to Look For in Anxiety Supplements
Third-Party Testing
Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:
Ingredients & Potential Interactions
It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included, relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking. As mentioned throughout the article, many supplements marketed for anxiety may interact with certain medications and may potentially lead to dangerous side effects when taken with these medications. Furthermore, be wary of supplement blends marketed for anxiety as they may contain a mix of ingredients. Unless there is research specifically looking at the effects of these combinations of ingredients together, it is unclear what effect their combination will have on the body. Reviewing each ingredient in a blend is also essential to ensure none of them interact with any medications you might be taking. It is important to discuss all current medications and supplements with a healthcare provider.
Anxiety Supplements Dosage
Always speak with a healthcare professional before adding a supplement to your routine to ensure that the supplement is appropriate for your individual needs and to understand which dosage to take. The recommended dose for each supplement is discussed, but the appropriate dose will vary by individual, so it’s important to work closely with your healthcare provider to determine the best dose for you. Upper limits have not been established for herbal supplements, but taking doses higher than the studied amounts is not recommended. Supplements have not been shown to be as effective as medication in most cases, especially for people with more moderate to severe anxiety. However, for those who either don’t respond to traditional medication or aren’t able to tolerate side effects of those medications, supplements may be a good option either in conjunction with or, in some cases, in place of, medication.
