Supplements That Need More Research

There are supplements recommended for treating anxiety that need to be researched more extensively.

• 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.

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 integrative medicines 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.

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.

Experts we interviewed for more insights on the supplements for anxiety include:

• Emily Steinberg, MD, PC, assistant professor of psychiatry at Icahn School of Medicine at Mount Sinai.
• Gauri Khurana, MD, MPH, clinical instructor at the Yale School of Medicine
• Sharon Puello, MA, RD, CDN, CDCES, registered dietitian and certified diabetes educator
• Samantha Gambino, PsyD, psychologist and mental health consultant

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:

1. Third-party testing does not test to see if a product is effective or safe for everyone, and it does not ensure the supplement will not interact with other supplements or medications.
2. Not all third-party testing is created equal. It is not uncommon for supplement companies to pay labs for certificates after conducting minimal to no testing.
3. The third-party certifications we can trust are: ConsumerLab, NSF, and USP. However, these certifications are difficult to obtain and/or expensive for manufacturers, so many companies choose not to get their products tested by one of these three organizations.
4. Sometimes products tested by these three companies are more expensive to try to offset the cost they pay for certification.
5. Just because a supplement is not tested by one of these three companies, it does not mean it’s a bad product. We recommend doing some research on the reputability of the manufacturer, and calling up the manufacturer and their testing lab to determine their protocols and decide if you feel comfortable consuming the supplement.

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.