The Top 10 Evidence-Based Supplements for Stress and Anxiety

In the past few years, society has experienced a heightened version of stress and anxiety. The American Psychological Association has stated that 8 in 10 adults have conveyed that the COVID-19 pandemic added significant stress to their lives. Stats also conclude that nearly 33% of adults have some feelings of anxiousness. 

With this rising concern, it’s essential to have resources to help you relax, decompress, and address the root causes of these physiological occurrences. Let's explore the top 10 evidence-based supplements for stress and anxiety and provide context for how they can help you. 

[signup]

What is Stress?

Stress is a physiological response to internal and external factors that impact your body’s mental, emotional, and physical homeostasis. There is acute stress, which occurs when our body reacts to brief situational circumstances like running late for an appointment, or there is chronic long-term stress from things like financial hardships or managing a chronic illness. 

Stress can also, in short spurts, be a positive and motivating factor in your life. It’s essential to take regular surveillance of your stress levels, as it can be a detrimental contributor to chronic illness and dysfunction. Some of the most common conditions that stress can impact our mental health digestive complaints, cardiovascular function, sleep, weight, and cognitive function. 

What is Anxiety?

Anxiety is a mental health manifestation of emotions such as fear, worry, and tension that can result in physical symptoms. Some people experiencing anxiety will feel like their heart is racing and may start sweating or have shaky hands. 

Multiple factors can contribute to anxiety, which includes genetics, diet, micronutrient deficiencies, lifestyle factors such as stress, neurotransmitter dysfunction, and conditions like dysbiosis, hyperthyroidism, and IBS. Addressing these underlying root causes is the basis for alleviating signs and symptoms of anxiety and restoring your mental health. 

How Can Supplements Benefit Those Experiencing Stress and Anxiety?

There are many times when the stress and anxiety you are experiencing can take over your life and make your normal activities of daily living daunting. As a naturopathic doctor, my primary goal is to help patients identify and treat the causes of their ailments. When we take a deep dive into their health history and their current presenting issues, we find that lifestyle factors play a key role. Treating things like sleep disturbances, implementing a whole-food anti-inflammatory diet, incorporating an exercise routine, and peeling back layers of complex trauma are often paramount to recovering from stress and anxiety. 

While all of these are the driving force, many people benefit from supplementation with herbal medicine and nutraceuticals that can assist them in modulating their body’s response to incoming stressors and anxiety provocation. With a wide variety of options marketed for these areas, it’s important that you understand what each natural medicine does and how it can support you. 

The Top 10 Evidence-Based Supplements for Stress and Anxiety

Integrative medicine utilizes lifestyle medicine, including vitamins, minerals, nutrients, and herbal medicine, to help address ailments and root causes of dysfunction. Here are the top 10 most utilized evidence-based medicine supplements to treat stress and anxiety.

1. Ashwagandha

This adaptogenic herbal medicine is primarily used for HPA support, which can modulate stress. When you are under work stress, physiological stress, hormonal stress, or your HPA axis is impacted by other conditions such as hypothyroidism, this is an excellent choice for supporting your body’s stress response. 

Chronic Stress Dose: 600mg daily 

Duration: 6 weeks 

2. Omega-3 Fatty Acids

Polyunsaturated fatty acids (PUFAs) in the form of omega-3s are supportive of brain and nervous system function. There are three primary omega-3 fatty acids: alpha-linoleic (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). 

A systemic review of studies showed that supplementation of omega-3 PUFA can reduce the risk of anxiety at doses of 2000 mg per day. Adding these fatty acids to your supplement regimen can decrease inflammation and cortisol levels, which aids in decreasing the body's stress response to aging and mental health conditions like depression. There is a general dosing limitation for DHA/EPA combos. Testing your omega-3 status is an ideal way to decide what dosing is appropriate for you long-term. 

Dose: 2000mg or less per day

Duration: Ongoing or until confirmed balanced omega’s

3. CBD

A natural plant extract known to support the body’s endocannabinoid system is Cannabidiol (CBD). This is a non-psychoactive component of the plant Cannabis sativa, which has been shown to have anxiolytic properties. Numerous studies have also pointed out that CBD is effective in reducing stress response. The brain has cannabinoid receptors type 1 (CB1) and type 2 (CB2). These receptors play a dynamic role in excitatory neurotransmitter release. When active, they can help mitigate stress responses and induce feelings of relaxation, calmness, and happiness. Tinctures, capsules, and gummies are the most common medically recommended CBD products for anxiety disorders in adults. 

Dose: 300 to 600mg per day 

Duration: As needed

4. Magnesium

The mineral magnesium is necessary for hundreds of enzymatic functions in the body. It aids in muscle relaxation, sleep, bowel movements, restless legs, and anxiety. Neurotransmitters also rely on magnesium to help the body modulate stress. While all eight forms of magnesium have a time and place, magnesium glycinate is commonly used for its calming effects.

Adult Dosing (19- 50)

Females: 310-320mg

Males: 400-420 mg

5. B Vitamins

There are eight B vitamins that are essential to health and wellness. A handful of them are significant for the nervous system, brain health, and mental health. Vitamins B6, B12, and Vitamin B9 (folate) are of particular interest in stress modulation and mitigating anxiety. Evidence also suggests that supplementing with these in combo rather than individually can provide a synergistic effect regarding methylation processes. Finding a reputable B vitamin blend that contains at least these three vitamins in their appropriate individualized dosages is key. Here is the standard adult dosage for each vitamin. 

Vitamin B6 Dose: 1-1.7 mg daily

Vitamin B12 Dose: 2.4 mcg daily

Folate Dose: 400 mcg daily

6. Rhodiola

Another adaptogenic herb that is native to Europe and Asia has amazing benefits for both stress and anxiety. This plant is beneficial in those who have fatigue related to mental exhaustion. Rhodiola’s calming and restorative properties can help those in burnout, where cortisol is completely depleted. Sometimes, a titration up to the standard dosing is recommended. Working with a practitioner who is familiar with herbal medicine dosing is always recommended. 

Dose: 400 mg daily

Duration: 4 to 6 weeks

7. L-Theanine

L-Theanine, primarily found in green tea leaves, is an amino acid. It’s a relaxing nutrient that can support neurotransmitter function and, in turn, help reduce stress. In a systematic review study on L-Theanine, it was concluded that daily supplementation of 200-400 mg/day could reduce both anxiety and stress. Another study found that L-theanine at 200mg/day can support mental health in those suffering from health conditions and cognitive deficiencies related to stress. 

Dose: 200-400mg per day

Duration: 4 weeks

8. Valerian Root

This herbal remedy is often noted for it’s sedative properties, but it can also be used to relax the nervous system in times of stress and anxiety. One interesting study looked at the use of valerian root for anxiety during a teeth extract of molars in 20 participants undergoing this procedure. Results revealed that valerian capsules given one hour before surgery at an oral dose of 100 mg provided greater anti-anxiety relief than placebo. For those with generalized anxiety disorder or psychological stress, here is a recommended dosage:

Dose: 50-100 mg three times per day

Duration: 4 weeks

9. Lemon Balm

Melissa Officinalis, also known as lemon balm, is a calming plant that can be beneficial for those dealing with stress, anxiety, or depression. It has been shown to be particularly helpful in pregnancy and with postpartum stress. Another double-blind placebo study revealed that lemon balm extract can improve mood and increase calmness while also still feeling alert. It’s ability to modulate stress without being too sedative makes this a great option for stress in circumstances when you still need to be sharp. 

Dose: 600 mg daily

Duration: 7 days 

10. Lavender

The beautiful flowering plant has been used for centuries for its therapeutic benefits. It’s been studied for its use in a number of ways, including it’s ability as an anxiolytic, mood stabilizer, and relaxation. Lavender in the form of Silexan has been studied both against placebo and the common anti-anxiety medication, lorazepam. In the case of a placebo study, it was superior for 221 patients. Silexan at 80 mg/day tested in a similar cohort was as effective at .5 mg of daily lorazepam. This information provides great context to the potential benefits of lavender for those suffering from anxiety. Consulting with your doctor about this natural option may benefit you.

Dose: 80 mg daily

Duration: 6 weeks 

Functional Medicine Labs to Test For Root Cause of Stress and Anxiety

Triggers for stress and anxiety can stem from many areas of dysfunction going on in the body. From gut health to adrenal stress response to nutritional deficiencies, there are many areas that could be investigated. The root cause of each person's symptoms is very individualized, so it is best to consult with your integrative practitioner to see which of these common tests fits your presentation best. 

Cortisol 

Testing the stress hormone cortisol will provide objective information that is in correlation to your signs and symptoms. Salivary cortisol testing is the best way to get multiple readings and to see how your cortisol fluctuates throughout a day's span. Access Medical Laboratories has a Salivary Cortisol x 4 that will provide insights into your cortisol production. 

Micronutrients 

Vitamins and minerals support many physiological processes in the body that can help manage stress and keep anxiety at bay. The key micronutrients you would want to test are vitamin B6, vitamin B12, folate, and magnesium. There are additional markers that are worth evaluating, like vitamin D and vitamin C, which are both important for inflammation and antioxidation in correlation to stress. The Micronutrient Test by SpectraCell Laboratories measures 31 essential nutrients.

Omega-3 Index

If your diet is low in omega-3 fatty acids or you are concerned that nutrition is contributing to your symptoms, getting a Fatty Acid Omega-3 & 6 Panel could provide insight. This test will assess the types of omega-3- DHA, EPA, and ALA, plus inflammatory omega-6 fatty acids. This will give you a full picture of your fatty acid status, which you can then use to guide the incorporation of dietary or supplementation. 

Neurotransmitters

A urine Neurotransmitter Test can analyze over 30 neurotransmitter molecules and metabolites. This evaluation can provide insight into excess or deficiency of neurotransmitters like 5-HTP that contribute to anxiety and stress-related conditions. 

Comprehensive Stool Test

Gut health is key to neurotransmitter formation, gut-brain connection, and, ultimately, mental health. If you have dysfunction going on in your gastrointestinal tract or you have signs that point to dysbiosis, it would be beneficial to rule out an imbalance of gut flora as part of your root cause. The GI-MAP + Zonulin test by Diagnostic Solutions and the GI Effects® Comprehensive Profile from Genova Diagnostics can asses your microbiome to determine if there are pathogenic microbes, if there are diminished beneficial bacteria, and just what your overall gut microbiome diversity looks like. 

[signup]

Summary

Before using a pharmaceutical option to address your stress and anxiety, I implore you to explore some of these natural medicine options. Functional medicine testing can also help guide this care, as it will pinpoint specific areas that can impact brain and nervous system function. This will allow you to find deeper context as to why you feel stressed or what the triggers to your anxiety are so you can feel well and heal.