Reducing stress is an important part of good health, but can taking supplements really make you feel more at ease? Find out which ones may help and which you should avoid.
Feeling frazzled on a regular basis? Your health may take a hit. Elevated stress hormones, especially cortisol, can increase inflammation, reduce immunity, and raise the risk of high blood pressure, stroke, and heart attack. According to the National Institute of Mental Health, chronic stress can negatively impact every aspect of your health and contribute to a wide range of problems from headaches to type 2 diabetes and even anxiety.
Strategies like a healthy diet, plenty of exercise and sleep, and mental health help are proven for relieving stress, but another tool to consider in your arsenal is dietary supplements.
While no supplement is a magic pill, some people say certain types can help lower anxiety levels, tame sleep troubles, ease depression symptoms, and more. Although these claims are often overhyped, there is some evidence that dietary supplements can be part of a holistic approach to reducing stress, along with a healthy diet and other lifestyle changes.
Notably the U.S. Food and Drug Administration (FDA) doesn’t regulate supplements in the same way that it does medications, so talk to your doctor before taking any product.
You can also look up ingredients used in supplements in the FDA’s new Dietary Supplement Ingredient Directory. Launched in March 2023, the directory is intended to help the public stay informed about the ingredients used in dietary supplements, and find out what the FDA has said about certain ingredients and whether the agency has taken any action regarding specific ingredients.
Robust research on herbal supplements and stress is lacking. Some studies have had promising findings, but the sample sizes were too small to make any definitive conclusions. Other studies have looked at larger groups of people but left out populations that face a higher risk of stress symptoms like anxiety — for example, women and young adults. Ultimately, more large, long-term studies that include a variety of populations are needed before health experts can recommend herbal supplements for stress.
That said, here is the scientific evidence currently available on seven products with the potential to help curb stress (and one you’ll probably want to pass up) as you start your journey toward a more relaxed (and healthier) you.
1. May Help: Ashwagandha
What It Is: Also called winter cherry and Indian ginseng, this plant has been an integral part of Ayurvedic medicine for centuries. Ashwagandha is what’s known as an adaptogen, which means it’s believed to resist disease and regulate the effects of stress on the body, according to the MedlinePlus.
Potential Benefits:There is some evidence linking ashwagandha with reduced stress and anxiety, and some research also suggests that it might be useful for improving sleep. In a small study published in September 2019 in Medicine (Baltimore), 30 stressed but healthy adults were given 240 milligrams (mg) of the extract per day, and 30 were given a placebo. After two months, those who’d taken the ashwagandha reported feeling less anxious, depressed, or stressed over time, although this change was not statistically significant compared with the placebo. A slightly larger study, published in December 2019 in Cureus, followed 60 stressed but healthy adults for eight weeks. Each day, one-third of the group received 250 mg of ashwagandha, one-third received 600 mg of the supplement, and one-third received a placebo. The result: The participants who were given ashwagandha reported sleeping better and feeling less stressed, compared with those who took a placebo. Because both studies were so small, however, the researchers were not able to draw any significant conclusions about ashwagandha.
How You Use It: You can take ashwagandha as a pill or capsule, or add the powdered extract to smoothies, yogurt, and other foods. Be warned, though, that it tastes pretty bad; if you add the root or powder to food, you may want to add a sweetener like fruit or honey to help mask its bitterness.
Precautions: Ashwagandha may lower blood sugar and blood pressure levels, which means it shouldn’t be combined with medications for diabetes or high blood pressure, according to MedlinePlus. It might also increase how much thyroid hormone the body produces, which means it could cause problems if you take thyroid medication. Ashwagandha may also cause sleepiness and slowed breathing. Taking the supplement with sedatives may magnify those effects.
2. May Help: L-Theanine
What It Is: L-theanine is an amino acid found in green tea. It’s believed to have a relaxing effect, among other health boons.
Potential Benefits: L-theanine’s anti-stress effects have been explored in research, and studies suggest it may be helpful for lowering stress, improving focus, memory, and verbal ability. In a small study published in October 2019 in Nutrients, 30 healthy adults were given 200 mg of L-theanine or a placebo every night for four weeks, after which researchers saw improvement in three stress-related categories — sleep problems, depression, and anxiety — in the group that received the supplement. And a review of nine studies published in November 2019 in Plant Foods for Human Nutrition found that getting 200 to 400 mg of L-theanine a day may help reduce stress and anxiety in people exposed to stressful conditions.
How You Use It: Brew yourself a cup of tea: Green, black, white, and oolong all contain L-theanine, albeit in varying amounts, and none that come close to the amounts used in research. A past study measured the amount of L-theanine in a standard cup of tea (200 milliliters) and found that black contains the most (up to 30 mg), while green tea contains the least (up to 11.7 mg). To get the amount of L-theanine used in stress research, you would have to get the amino acid in supplement form (capsules, liquids, or powders).
Precautions: Research on the safety of L-theanine is lacking, however the Memorial Sloan Kettering Cancer Center states that consuming large amounts of green tea can cause side effects, due to the caffeine content. Therefore, if you choose to get L-theanine through tea, it’s important to watch your intake. According to the FDA, 400 mg a day is generally safe for healthy adults — and an 8-ounce cup of green or black tea has roughly 30 to 50 mg of caffeine. Consuming too much caffeine can make you restless and anxious, which isn’t helpful if your goal is to lower stress. Over-caffeinating can also cause headaches, dizziness, dehydration, insomnia, and a fast heart rate.
3. May Help: Magnesium
What It Is: Magnesium is a mineral that the body uses to regulate dozens of processes, from the functioning of nerves and muscles to the synthesizing of protein and bone.
Potential Benefits:So far, research points to magnesium possibly being helpful for people who have mild anxiety. A review of 18 studies published in May 2017 in Nutrients found that magnesium supplements may improve stress and anxiety levels, but it also noted that the quality of the evidence was poor and more research needs to be done before magnesium can be established as a stress reducer.
How You Use It: Magnesium is found in green leafy vegetables, nuts, seeds, legumes, whole grains, and some breakfast cereals and other fortified foods. Even so, many of us aren’t getting enough of it, according to the National Institutes of Health (NIH). The NIH recommends 310 to 320 mg of magnesium per day for most women and 400 to 420 mg for men, and no more than 350 mg per day in supplement form for adults of either sex. If you opt for a supplement, consider magnesium aspartate, citrate, lactate, or chloride, which are absorbed better than magnesium oxide or sulfate, according to the NIH. And be aware that many laxatives and antacids contain magnesium, so if you take those, make sure to count that amount toward your daily amount from supplements.
Precautions: The NIH warns that several types of medication may interact with magnesium supplements or affect the amount of magnesium in your body, including bisphosphonates (used to treat osteoporosis), antibiotics, diuretics, and proton pump inhibitors. Check with your healthcare provider before using magnesium supplements, if you’re taking any of those medications.
4. May Help: Melatonin
What It Is: Melatonin, a hormone made in the pineal gland, is released when it gets dark, helping to keep your internal clock on track and priming your body for sleep, according to the Sleep Foundation.
Potential Benefits: Melatonin is famous for helping people nod off at night, but it may also help lower anxiety levels in people who are scheduled for surgery. A past review of more than 12 randomized controlled trials including 774 people undergoing surgery found that melatonin may be as effective as midazolam (a sedative) at reducing presurgical anxiety. However, researchers note that most of the studies did not include female subjects, and three of the studies only examined patients older than 60. This is problematic, given that younger age and female gender are independent risk factors for anxiety. Therefore, it’s unclear how melatonin may affect anxiety levels in other surgery patients.
How You Use It: Melatonin supplements are easy to find as tablets, capsules, and drops; most come in doses of 1 mg or 5 mg. Keep in mind that you might not always be getting what it says on the label, though: A study published in February 2017 in the Journal of Clinical Sleep Medicine examined 31 melatonin supplements purchased at pharmacies and grocery stores and found that most didn’t have the amount indicated — and one-quarter also contained serotonin, another hormone.
Precautions: Melatonin is generally safe when taken in appropriate amounts, but it may not be for everyone. According to Mayo Clinic, melatonin interacts with several medications, including anticoagulants, anticonvulsants, blood pressure medications, diabetes medications, contraceptives, immunosuppressants, seizure-threshold-lowering drugs, fluvoxamine (used to treat obsessive-compulsive disorder), central nervous system depressants, and diazepam.
5. May Help: Rhodiola
What It Is: Also known as golden root and arctic root, the Rhodiola rosea plant grows in the frigid mountains of Europe and Asia, as well as in the Arctic, and it has been used as a remedy for stress, according to a study published in December 2017 in Current Pharmacology Reports.
Potential Benefits:A review published in January 2018 in the International Journal of Psychiatry in Clinical Practice concluded that rhodiola extract may be effective in treating stress symptoms and preventing chronic stress and its complications.
One very small past study found that eight people with anxiety who were given rhodiola reported a significant reduction in anxiety, stress, anger, confusion, and depression, as well as a significant improvement in mood, at the end of 14 days. The researchers caution, however, that more research is needed to determine if it was the rhodiola that caused these effects, and the sample size of this study was extremely small. More studies with larger sample sizes are needed to confirm the effects of rhodiola on stress and anxiety.
How You Use It: You can take rhodiola as a liquid extract, capsule, or powder.
Precautions: Rhodiola has been used safely in studies lasting 6 to 12 weeks, but little is known beyond that, according to the National Center for Complementary and Integrative Health (NCCIH). It may cause side effects including dizziness, dry mouth, or excessive saliva.
6. May Help: Lemon Balm
What It Is: Lemon balm, or Melissa officinalis, is a lemon-scented herb that was commonly found in Europe in the Middle Ages but is now cultivated around the world. Traditionally, it was used as a mild sedative and calming agent, and it is now being researched for its possible anti-anxiety effects, according to Mount Sinai. Lemon balm is “generally recognized as safe” by the FDA.
Potential Benefits: Lemon balm may help ease anxiety and improve sleep, according to a study published in June 2019 in the European Journal of Integrative Medicine. The researchers followed 80 people who underwent coronary artery bypass surgery and gave half of the group 500 mg of lemon balm three times a day and the other half a placebo. Those who took lemon balm improved their anxiety by 49 percent and sleep quality by 54 percent.
Lemon balm has also been linked to improvements in mood in small groups of healthy but stressed young adults, according to two past studies. The lemon balm was administered as an extract in a yogurt snack in one study and in a beverage in the other study.
The research on lemon balm and anxiety is still very preliminary, however, and more studies using larger sample sizes from various healthy populations are needed to determine if lemon balm can improve sleep and anxiety in people.
How You Use It: The leaves of the plant are commonly made into a tea. As a supplement, lemon balm can also be found in tablet and capsule form, and its extract is available in creams and ointments.
Precautions: Lemon balm may interact with sedatives, thyroid mediations, and HIV medications, according to Mount Sinai. If you take any of these medications, talk to your doctor before trying lemon balm.
7. May Help: Valerian
What It Is: Also commonly referred to as garden heliotrope or all-heal, valerian, or Valeriana officinalis, is an herb that grows in Europe, Asia, and North America. It is known for its calming effects and is commonly used as a dietary supplement for insomnia, anxiety, and other conditions, including depression, according to the NCCIH.
Potential Benefits: While the NCCIH notes that there aren’t enough high-quality studies involving people to draw any conclusions about whether valerian can be effective as a sleep aid or for relieving anxiety, depression, or menopausal symptoms, there is some preliminary research on this topic.
In a review of 100 studies published in May 2018 in Phytotherapy Research, researchers found evidence that valerian root extract may have soothing effects on people with anxiety disorder. The review also found that the herb may be helpful as a sleep aid, and its benefits were found to be comparable to a medication commonly used to treat anxiety and insomnia.
In a past study of 64 women undergoing an x-ray procedure (hysterosalpingography), researchers found those who took valerian capsules saw a reduction in their anxiety levels, compared with women who took a placebo.
The current research is limited by small sample sizes, and no studies to date have tested valerian on healthy populations, or for long-term use, so further research is needed.
How You Use It: Dietary supplement capsules, tablets, teas, and tinctures are made from its roots and stems.
Precautions: Little is known about the safety of valerian, however, and it may have a sleep-inducing effect and should not be taken along with alcohol or sedatives, according to the NCCIH. It may also cause side effects, including headaches, upset stomach, excitability, heart disturbances, uneasiness, and even insomnia.
Finally, a Supplement to Avoid: Kava
What It Is: Kava is a plant that’s native to the South Pacific and is a member of the pepper family.
Purported Benefits: Some research looking at kava for treating anxiety has shown a small positive effect, but more recent research doesn’t back that up. A study published in December 2019 in the Australian and New Zealand Journal of Psychiatry found that when 171 people were given either kava extract or a placebo twice a day for 16 weeks, neither group experienced reduced anxiety. Most of the participants who got the kava tolerated it well, but a few had tremors, and those who got the extract were much more likely to show abnormalities on liver tests.
Of greater concern is its safety: Back in 2002, the FDA issued a warning against kava supplements, citing more than 25 reports of liver damage.
How You Use It: Traditionally, kava is used as a ceremonial beverage, but you can also buy it as an extract, powder, liquid, or capsule.
Precautions: In addition to potential liver damage, kava may cause side effects like upset stomach, headaches, and dizziness. According to the NCCIH, long-term use of high doses may also lead to kava dermopathy, a condition that involves dry, scaly, and discolored skin.
While there are plenty of potentially stress-relieving supplements on the market, not all of them are created equal. Kava is one you may want to pass up.
As always Stay Healthy, Stay Safe and Be Careful Out There
James A Vito, D.M.D.