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Herbs for anxiety - the myths & the research by Clinical Naturopath Monica



As a naturopath with a keen eye for all things mental health, here are my top prescribed herbs for anxiety and some of the research behind them.



Ashwaganda (Withania somnifera)


This is quite a commonly used and well-known herb in the West, but ashwaganda is a traditional Ayurvedia Rasayana (tonic) specifically used for the nervous system. Ashwaganda is a well-researched herb with studies demonstrating it increases stamina by preventing the adrenal glands from changing ascorbic acid (Vitamin C) bioavailability. It has also been found useful for a long list of conditions including memory in children and adults, neurodegenerative diseases, and for rheumatoid and osteoarthritis.


Considering it is most commonly being used in Australia by women aged 20-50 to support anxiety and stress, where does the research hold up in this area?


Studies clearly show that any dose and any strength of Withania is still more useful at managing anxiety symptoms than placebo (or simply put not taking anything) (1). However, like with any good thing, caution is still warranted.


While Ashwaganda definitely exhibits anti-stress and anti-anxiety activity through the hypothalamic-pituaitary-adrenal (HPA) and sympathetic-adrenal-medullary axis in over 28 clinical trials (2), there is caution needed in thyroid conditions particularly hyperthyroidism and autoimmune thyroiditis. There are cases of thyrotoxicosis from Ashwaganda in some cases.


This is where it gets tricky because stress can negatively affect thyroid function and thyroid issues can cause anxiety-like symptoms. This is a good reminder to work with a professional rather than self-diagnose or self-prescribe even when research and traditional knowledge are present for it’s benefit, we’re all individually built.


However, just because you have thyroid issues might not mean that Ashwaganda isn’t for you, it may be that a lower dose is more relevant, especially because Ashwaganda is traditionally a low-dose herb meaning only a small amount is needed to be effective.


But other herbs are also effective at reducing anxiety symptoms as well, so let’s take a look at them !





Kava (Piper methysticum)

Ah Fiji, anyone who has visited the Fijian islands is most likely familiar with this herb. It has been drunk for many years in Fiji and is native to Polynesian islands where it’s consumed to help people relax and is widely enjoyed by grinding up the root and serving as a drink. In Western herbal medicine, it is widely used as a tablet or tincture to support anxiety brought on by acute stress. For example, moving house, exams, temporary increase in workload situations. Even though we know these events will pass, it puts an enormous amount of pressure on us.


With Kava withdrawn in Europe and Canada due to concerns over liver toxic effects but still available in Australia and widely used by naturopaths, is Kava a herb that can be used for anxiety?


A randomized, placebo-controlled crossover trial using 250mg of Kava, 5 times a day (a very high dose!) over a 3 week period found all participants lowered their scores in elevated generalized anxiety (4). It really is safe to say it’s effective but the caution is, it is only for short term use that is not more than 3 months and in individuals with liver function within normal range.

If you’re not sure if your liver is functioning optimally, then be cautious and don’t take it.


Are you otherwise healthy and experiencing heavy stress? Then chat with a health professional: it could be extremely helpful in helping you get through a challenging period.



Lemon Balm (Melissa officinalis)

Is anxiety affecting your gut?



Lemon balm is the anxious gut herb, when children with anxiety complain of a sore tummy, or adults notice IBS-type symptoms when stressed, this is the herb.

The research is exciting because not only does Lemon Balm have anti-viral properties resulting in it being used in many commercial cold sore formulas. It also has a positive effect on the nerves in the bowel, hence making it useful for the gut-brain axis and IBS. It is useful in both anxiety and depression as seen in a variety of trials, making it useful for when stress and anxiety are so elevated it gets you a bit down as well (5). Remembering that long-term stress is the number one risk factor for developing depression, it really does make sense that Lemon Balm could be a useful herb when stress is making you teary and apathetic.





Passionflower (Passiflora incarnata)

In terms of research available for herbal medicine and anxiety, Passionflower has the most successful trials.

One study was a double-blind randomized controlled trial that compared Passionflower to Oxazepam and found it was just as successful as the medication however, Oxazepam had negative side effects that impaired people’s job performance whereas Passionflower didn’t (6). It is important to keep in mind too, that pharmaceuticals such as Oxazepam have a quicker onset, whereas herbs take longer but ultimately have fewer to no side effects. Of course, this would require working with a health professional and always taking appropriate medical advice.



Remember in Traditional Chinese Medicine one of the key focuses is preventative health called Yang Sheng. This is not as prevalent in the West but in terms of mental health, prevention is just as important as treatment. So don’t ignore your high-stress levels, nature has some science-backed help for you.



Book a consultation with Monica here







References


1. Pratte, M. A., Nanavati, K. B., Young, V., & Morley, C. P. (2014). An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha ( Withania somnifera ). The Journal of Alternative and Complementary Medicine, 20(12), 901–908. https://doi.org/10.1089/acm.2014.0177 2. Speers, A. B., Cabey, K. A., Soumyanath, A., & Wright, K. M. (2021). Effects of Withania somnifera (Ashwagandha) on Stress and the Stress- Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia. Current Neuropharmacology, 19(9), 1468–1495. https://doi.org/10.2174/1570159X19666210712151556 3. Singh, N., Bhalla, M., de Jager, P., & Gilca, M. (2011). An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines, 8(5S). https://doi.org/10.4314/ajtcam.v8i5S.9 4. Sarris, J., Kavanagh, D. J., Byrne, G., Bone, K. M., Adams, J., & Deed, G. (2009). The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo- controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology, 205(3), 399–407. https://doi.org/10.1007/s00213-009-1549-9 5. Ghazizadeh, J., Sadigh‐Eteghad, S., Marx, W., Fakhari, A., Hamedeyazdan, S., Torbati, M., Taheri‐Tarighi, S., Araj‐khodaei, M., & Mirghafourvand, M. (2021). The effects of lemon balm ( Melissa officinalis L.) on depression and anxiety in clinical trials: A systematic review and meta‐analysis. Phytotherapy Research, 35(12), 6690– 6705. https://doi.org/10.1002/ptr.7252 6. Akhondzadeh, S., Naghavi, H. R., Vazirian, M., Shayeganpour, A., Rashidi, H., & Khani, M. (2001). Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. Journal of Clinical Pharmacy and Therapeutics, 26(5), 363–367. https://doi.org/10.1046/j.1365- 2710.2001.00367.x



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