|Natural Product Number|
Anxiety can be an acute response to a temporary situation or circumstance, or it can involve a chronic anxiety disorder. Anxiety disorders involve a “state of distressing chronic but fluctuating nervousness that is inappropriately severe for the person’s circumstances.” Anxiety is associated with physical symptoms including sweating, shortness of breath or dizziness, palpitations or rapid heartbeat, trembling, and avoidance of certain situations. Anxiety can also contribute to insomnia and depression. Anxiety disorders are usually diagnosed using prespecified, established criteria.
Anxiety disorders are the most common mental health disorder, and are believed to affect about 15% of adults in the United States. Anxiety disorders are often not recognized by patients or health-care providers, however, and as such are often undertreated.
Conventionally, treatment of anxiety disorders consists of psychotherapy or counseling, and medications. Drugs used usually include benzodiazepines (same class as most sleeping pills) and antidepressants (norepinephrine/serotonin reuptake inhibitors). This is problematic because these drugs alter brain chemistry in such a way that discontinuing the drug is very difficult, and must be done very gradually under the supervision of a physician. In addition, antidepressant drugs have a long list of side effects, including other mood changes, blunting of the person’s emotions, drowsiness, fatigue, weight gain, and loss of libido.
Natural treatment options offer a more gentle alternative to these drugs. Calm can be helpful for management of chronic anxiety, or simply as a temporary help during a particularly stressful period.
Key Herbs and Nutrients
ʟ‑Theanine is an amino-acid derivative found in black tea. It is known to counteract the stimulating effects of caffeine in the body, exerting calming effects and improving concentration and mental performance.
In a study of young healthy adults, ʟ‑theanine was shown to improve ability to perform study tests: it improved accuracy during task switching and self-reported alertness (both p < 0.01) and reduced self-reported tiredness (p < 0.05).
ʟ‑Theanine was shown to reduce anxiety (p = 0.015) and symptoms compared to placebo, among patients with schizophrenia and schizoaffective disorders, and this was associated with improvements in the cortisol:DHEA ratio.
Rhodiola rosea is an adaptogenic herb with mild anxiolytic and antidepressant effects. Rhodiola works in part by normalizing cortisol, which is often elevated in and contributes to anxiety. Rhodiola is known for its antifatigue effects and has been shown to increase mental performance (improving concentration), as well as reduce burnout in patients with chronic fatigue syndrome.
One study examined the effect of Rhodiola in combination with two other adaptogens on cognitive function, and found that there was a significant improvement (p < 0.05) in attention, speed, and accuracy during stressful cognitive tasks.
Another study examined whether rhodiola (567 mg/d) could improve stress-related fatigue compared to placebo. After 28 days, investigators found that Rhodiola reduced symptoms of fatigue as rated by the Pines’ burnout scale as well as ratings of attention. Rhodiola also decreased the cortisol response to awakening stress.
Passionflower calms the mind by acting on the (inhibitory) GABA receptors in the brain. Passionflower has compared favorably to the benzodiazepine oxazepam. In 36 patients with generalized anxiety disorder (GAD), passiflora (45 drops per day for four weeks) was found to be equal to the drug for management of anxiety symptoms. Importantly, passionflower was also better tolerated, with fewer issues related to impaired job performance.
A study in patients with mild insomnia also found that passionflower tea consumption (one cup before bed for seven days) significantly improved sleep quality compared to placebo (p < 0.01).
Finally, passionflower has also been shown to be effective for controlling symptoms of opiate withdrawal, with effectiveness demonstrated alone in comparison to clonidine, as well as superior effectiveness when used alongside clonidine.
Ashwagandha (Withania somnifera) is an important Ayurvedic herb known as “Indian ginseng.” It is known for its adaptogenic effects; however, it is not stimulating like ginseng—rather, it has mild sedative effects that make it ideal for individuals who are “overactive but debilitated.”
A study conducted by naturopathic doctors examined the effects of ashwagandha (300 mg twice daily) in addition to deep-breathing techniques and a multivitamin, compared to standard psychotherapy. Results showed that the combination intervention including ashwagandha reduced scores on the Beck Anxiety Inventory (BAI) by final BAI scores decreased by 56.5%, compared to 30.5% in the control group (p = 0.003). The treatment group also had significantly better scores for mental health, concentration, fatigue, social functioning, vitality, and overall quality of life.
B vitamins are important as cofactors in the synthesis and metabolism of the neurotransmitters that regulate mood. B vitamins are also important for the production of adenosine triphosphate (ATP) (energy) in the body. A study found that administration of B vitamins for three months significantly lowered patient-reported ratings of personal strain and reduced ratings of confusion and depressed/dejected mood in response to a stressful work environment.
Adults: Take 2 capsules daily with food or as directed by your health-care practitioner. Not to be taken immediately before bedtime. If you are taking other medications, take this product a few hours before or after them.
Duration of use: Consult a health-care practitioner for use beyond 4 weeks.
Cautions and warnings:
Cautions and warnings: For adult use only. Consult a health care practitioner if symptoms persist or worsen. Consumption with alcohol, other medications or natural health products with sedative properties is not recommended. Consult a health care practitioner prior to use if you are taking sulfonamides, antidepressants, heart or blood pressure medication, hormone replacement therapy (HRT), or birth control pills; or if you have diabetes or an autoimmune disorder.
Contraindications: Do not use if you are pregnant or breast-feeding, or if you or your partner are attempting to conceive; if you are taking cyclosporine; if you have bipolar or bipolar spectrum disorder; or if you have a history of asthma or allergies.
Known adverse reactions: Some people may experience stomach upset, dizziness, dry mouth, and/or constipation. Some people may experience drowsiness; exercise caution if operating heavy machinery, driving a motor vehicle, or involved in activities requiring mental alertness. Hypersensitivity (e.g. allergy) has been known to occur; in which case, discontinue use. May cause irritability and/or insomnia; in which case, discontinue use immediately.
|Each vegetable capsule contains:|
|Astragalus (Astragalus membranaceus) root extract, 3% astragalosides||26.5 mg|
|Oat (Avena sativa) extract 10:1||52.5 mg|
|Choline bitartrate||25 mg|
|Folate (from calcium ʟ‑5‑methyltetrahydrofolate)||500 mcg|
|Magnolia (Magnolia officinalis) bark extract 50:1, 80% magnolol + honokiol||7.5 mg|
|Inositol hexanicotinate, flush-free||18 mg|
|Holy basil (Ocimum tenuiflorum) leaf extract, 10% ursolic acid||52.5 mg|
|para-Aminobenzoic acid (PABA)||26.5 mg|
|Vitamin B₅ (calcium ᴅ‑pantothenate)||26.5 mg|
|Passionflower (Passiflora incarnata) extract, 4% flavonoids||52.5 mg|
|Phellodendron (Phellodendron amurense) bark extract, 0.1% berberine||15 mg|
|Roseroot (Rhodiola rosea) root extract, 5.0% rosavins||52.5 mg|
|Vitamin B₂ (riboflavin, riboflavin-5′‑phosphate sodium)||29 mg|
|Vitamin B₁ (thiamine hydrochloride)||26.5 mg|
|Vitamin B₁₂ (methylcobalamin)||75 mcg|
|Vitamin B₆ (pyridoxine hydrochloride / pyridoxal-5′‑phosphate)||29 mg|
|Ashwagandha (Withania somnifera) root extract, 2.5% withanoloides 78.5 mg|
|Chinese jujube (Ziziphus jujuba) fruit||13.5 mg|
|Other ingredients: Vegetable magnesium stearate, silicon dioxide, and microcrystalline cellulose in a non‑GMO vegetable capsule composed of vegetable carbohydrate gum and purified water.|