Anxiety supplements

  • Kava beverages, made from dried roots of the shrub Piper methysticum , have been used ceremonially and socially in the South Pacific for hundreds of years and in Europe since the 1700s. Several well-conducted human studies have demonstrated kava's efficacy in the treatment of anxiety with effects observed after as few as one to two doses and progressive improvements over one to four weeks. Preliminary evidence suggests possible equivalence to benzodiazepines. Many experts believe that kava is neither sedating nor tolerance-forming in recommended doses. Some trials report occasional mild sedation, although preliminary data from small studies suggest lack of neurological-psychological impairment. There is growing concern regarding the potential for liver toxicity from kava. Multiple cases of liver damage have been reported in Europe, including hepatitis, cirrhosis, and liver failure. Kava has been removed from shelves in several countries due to these safety concerns. The U.S. Food and Drug Administration (FDA) has issued warnings to consumers and physicians. It is not clear what dose or duration of use is correlated with the risk of liver damage. The quality of these case reports has been variable; several are vague, describe use of products that do not actually list kava as an ingredient, or include patients who also ingest large quantities of alcohol. Nonetheless, caution is warranted. Chronic or heavy use of kava has also been associated with cases of neurotoxicity, pulmonary hypertension, and dermatologic changes. Most human trials have been shorter than two months, with the longest study being six months in duration.
  • Lavender is native to the Mediterranean, the Arabian Peninsula, Russia, and Africa. It has been used cosmetically and medicinally throughout history. In modern times, lavender is cultivated around the world and the fragrant oils of its flowers are used in aromatherapy, baked goods, candles, cosmetics, detergents, jellies, massage oils, perfumes, powders, shampoo, soaps, and tea. English lavender ( Lavandula angustifolia ) is the most common species of lavender used, although other species are in use, including Lavandula burnamii , Lavandula dentate , Lavandula dhofarensis , Lavandula latifolia , and Lavandula stoechas . Many people find lavender aromatherapy to be relaxing and it has been reported to have anxiolytic (anti-anxiety) effects. Overall, the evidence suggests a small positive effect, although additional data from well-designed studies are required before the evidence can be considered strong. Lavender aromatherapy is also used as a hypnotic, although there is insufficient evidence in support of this use. Small phase I human trials of the lavender constituent perillyl alcohol (POH) for cancer have suggested safety and tolerability, although efficacy has not been demonstrated.
  • Rosemary ( Rosmarinus officinalis Linn.) is a common dense, evergreen, aromatic shrub grown in many parts of the world. Historically, rosemary has been used as a medicinal agent to treat renal colic and dysmenorrhea (painful menstruation). It has also been used to relieve symptoms caused by respiratory disorders and to stimulate the growth of hair. Traditionally, rosemary has been used for improving memory, and has been a symbol of remembrance and friendship for centuries. In Morocco, rosemary has been used to treat diabetes and hypertension (high blood pressure). The most researched constituents of rosemary are caffeic acid and its derivative rosmarinic acid. These compounds are thought to have antioxidant effects and are being studied as potential therapies for cancer, hepatotoxicity (liver toxicity), and inflammatory conditions. Currently, available studies show some promise for rosemary in the treatment of anxiety/stress (aromatherapy) and alopecia (hair loss). Current cosmetic uses of rosemary include treating cellulite and wrinkles, and normalizing excessive oil secretion of the skin. Germany's Commission E has approved rosemary leaf for treatment of dyspepsia and rosemary oil (used externally) for joint pain and poor circulation.
  • Endemic in Indonesia, Australia, and the Indian peninsula, the Santalum album tree is the primary source of sandalwood and sandalwood oil. Both are used in Hindu religious ceremonies. In Ayurvedic medicine, East Indian sandalwood is an important remedy for both physical and mental disorders. Sandalwood is also a popular fragrance for incense and perfumes. There is insufficient evidence in humans to support the use of sandalwood for any indication. However, preliminary aromatherapy studies with sandalwood have indicated that it may have anxiolytic (reducing anxiety) and stimulating properties.
  • Bacopa ( Bacopa monnieri ) leaf extract is called brahmi in Ayurvedic medicine and is widely used in India, especially for enhancing memory, analgesia (pain relief), and epilepsy. Bacopa has traditionally been used to treat asthma, hoarseness, and mental disorders, to help improve mental performance, epilepsy, and as a nerve tonic, cardiotonic (heart tonic), and diuretic (increases urine flow). Bacopa was prominently mentioned in Indian texts as early as the 6th Century. Most research on bacopa has concentrated on its effects on learning. Bacopa may also be helpful in managing pediatric attention deficit hyperactivity disorder (ADHD), but clinical evidence is lacking.
  • The dried aerial parts of passion flower ( Passiflora incarnata ) have historically been used as a sedative and hypnotic (for insomnia) and for "nervous" gastrointestinal complaints. However, clinical evidence supporting any therapeutic use in humans is lacking. Early evidence suggests that passion flower may have a benzodiazepine-like calming action. Evidence for significant side effects is also unclear, and is complicated by the variety of poorly classified, potentially active constituents in different Passiflora species. Passion fruit ( Passiflora edulis Sims), a related species, is used to flavor food.
  • The thymus is a lobular gland located under the breastbone near the thyroid gland. It reaches its maximum size during early childhood and plays a large role in immune function. The thymus is responsible for the production of T-lymphocytes, as well as the production of various hormones including thymosin, thymopoeitin, thymulin, thymic humoral factor, and serum thymic factor. These hormones may be involved in the increase in lymphokines (interleukin 2, interferon, colony stimulating factor), increase of interleukin 2 receptors, and regulation of weight. With age, the thymus is replaced by fat and connective tissue. According to legend, glandular or organotherapy, which refers to the use of animal tissues or cell preparations to improve physiologic functioning and support the natural healing process, first gained popularity in the early to mid 1900s. The idea of homeopathic glandular therapy was first introduced almost 200 years ago. Thymus extracts for nutritional supplements are usually derived from young calves (bovine). Bovine thymus extracts are found in capsules and tablets as a dietary supplement. Thymus extract is commonly used to treat primary immunodeficient states, bone marrow failure, autoimmune disorders, chronic skin diseases, recurrent viral and bacterial infections, hepatitis, allergies, chemotherapy side effects, and cancer. Most basic and clinical research involving oral and injectable thymus extract has been conducted in Europe. Clinical trials in humans suggest promising results in terms of allergies, asthma, cancer, chemotherapeutic side effects, cardiomyopathy, chronic obstructive pulmonary disease, HIV/AIDS, immunostimulation, liver disease, respiratory tract infections, systemic lupus erythematosus, and tuberculosis. However, not all study results agree, and properly randomized, double-blind clinical trials are still needed in many fields. Future areas of research include (but are not limited to) rheumatoid arthritis, warts, urinary tract in...
  • Gotu kola is from the perennial creeping plant, Centella asiatica (formerly known as Hydrocotyle asiatica ) , which is a member of the parsley family. It is native to India, Madagascar, Sri Lanka, Africa, Australia, China, and Indonesia. Gotu kola has a long history of use, dating back to ancient Chinese and Ayurvedic medicine. Gotu kola is mentioned in the Shennong Herbal , compiled in China roughly 2,000 years ago, and has been widely used medicinally since 1700 AD. It has been used to treat leprosy in Mauritius since 1852; to treat wounds and gonorrhea in the Philippines; and to treat fever and respiratory infections in China. The most popular use of gotu kola in the United States is the treatment for varicose veins or cellulitis. Preliminary evidence suggests short-term efficacy (6-12 months) of the total triterpenic fraction of Centella asiatica (TTFCA) in the treatment of "chronic venous insufficiency" (a syndrome characterized by lower extremity swelling, varicosities, pain, itching, atrophic skin changes, and ulcerations, possibly due to venous valvular incompetence or a post-thrombotic syndrome). While quality human evidence on the efficacy of gotu kola is still lacking, gotu kola can now be found worldwide as a component of skin creams, lotions, hair conditioners, shampoos, tablets, drops, ointments, powders, and injections. Gotu kola is not related to the kola nut ( Cola nitida , Cola acuminata ). Gotu kola is not a stimulant and does not contain caffeine.
  • Melatonin is a hormone produced in the brain by the pineal gland from the amino acid tryptophan. The synthesis and release of melatonin are stimulated by darkness and suppressed by light, suggesting the involvement of melatonin in circadian rhythm and regulation of diverse body functions. Levels of melatonin in the blood are highest prior to bedtime. Synthetic melatonin supplements have been used for a variety of medical conditions, most notably for disorders related to sleep. Melatonin possesses antioxidant activity, and many of its proposed therapeutic or preventive uses are based on this property. New drugs that block the effects of melatonin are in development, such as BMS-214778 or luzindole, and may have uses in various disorders.
  • Chamomile has been used medicinally for thousands of years and is widely used in Europe. It is a popular treatment for numerous ailments, including sleep disorders, anxiety, digestion/intestinal conditions, skin infections/inflammation (including eczema), wound healing, infantile colic, teething pains, and diaper rash. In the United States, chamomile is best known as an ingredient in herbal tea preparations advertised for mild sedating effects. German chamomile ( Matricaria recutita ) and Roman chamomile ( Chamaemelum nobile ) are the two major types of chamomile used for health conditions. They are believed to have similar effects on the body, although German chamomile may be slightly stronger. Most research has used German chamomile, which is more commonly used everywhere except for England, where Roman chamomile is more common. Although chamomile is widely used, there is not enough reliable research in humans to support its use for any condition. Despite its reputation as a gentle medicinal plant, there are many reports of allergic reactions in people after eating or coming into contact with chamomile preparations, including life-threatening anaphylaxis.
  • 5-HTP is the precursor of the neurotransmitter serotonin. It is obtained commercially from the seeds of the plant Griffonia simplicifolia . 5-HTP has been suggested as a treatment for many conditions. There is some research to support the use of 5-HTP in treating cerebellar ataxia, headache, depression, psychiatric disorders, fibromyalgia, and as an appetite suppressant or weight-loss agent. There is not enough scientific evidence to support the use of 5-HTP for any other medical condition. 5-HTP may cause gastrointestinal disturbances, mood disturbances, seizure, or abnormal blood counts. Some reported side effects might result from contaminants in 5-HTP products.
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