Having spent the last thirty years providing effective treatment for those with disabling diseases such as chronic fatigue syndrome, fibromyalgia, and chronic pain, I know how devastating severe anxiety can be. Unfortunately, all that most doctors have to offer are medications such as Valium and antidepressants. These are not just often ineffective, but they are also rife with side effects. Fortunately, herbal remedies can be helpful, and I have found these to be dramatically effective in treating anxiety in my practice. Patients are amazed at how highly effective these remedies are at restoring a naturally calm and peaceful state of mind. What is even more remarkable is that patients find that these herbs actually increase their energy and mental clarity. Let’s look at a few of the more helpful ones.
L-THEANINE
L-THEANINE is an herbal remedy that helps insomnia and calms anxiety, while keeping one energized and clear-minded. It does so by increasing the calming neurotransmitter gamma-aminobutyric acid (GABA) while stimulating the production of alpha brain waves, which are associated with a meditative, awake yet relaxed state of mind.1 L-theanine also naturally stimulates the release of the “happiness molecules” serotonin and dopamine. As it balances out the excess stimulation caused by caffeine,2 it’s only a matter of time until you go to your local Starbucks and the barista asks, “Would you like one pump of Suntheanine or two?” For more information on L-theanine, see Chapter 3. Take between 50 and 200 milligrams of the Suntheanine form (by Taiyo International) to produce relaxation within thirty to forty minutes, without inducing drowsiness.
VITAMIN B COMPLEX
VITAMIN B1 (THIAMINE ) is critical for proper brain function, mental clarity, and energy production, as well as for preventing the production of excess lactic acid (lactate). Research has shown that excess sensitivity to high levels of lactic acid is intimately involved in causing anxiety attacks in those who are prone to them. Dr. Janet Travell, who during her lifetime remained the world’s leading expert on pain management, discovered that vitamin B1, in very high doses, decreases anxiety and improves mental clarity by overcoming metabolic blocks and helping your body work more effectively—instead of by numbing you. It takes two to six weeks to see the benefits. Take 500 milligrams of vitamin B1 three times a day for anxiety.
VITAMIN B3(NIACIN) is known as a natural tranquilizer. In a study on rats, niacin had similar effects to Valium on the turnover of serotonin, noradrenaline, dopamine, and GABA in the areas of the brain that are thought to be affected by anxiety—without being addictive. Some experts go so far as to call niacin “nature’s Valium.” Niacin also helps decrease excess lactic acid levels and episodes of low blood sugar/hypoglycemia (from adrenal fatigue). Take 10 to 100 milligrams of the niacinamide form daily.
VITAMIN B6( PYRIDOXINE ) deficiency can contribute to anxiety, as this vitamin is critical for the production of two brain chemicals (neurotransmitters) that prevent anxiety (GABA and serotonin). Take 25 to 100 milligrams daily.
VITAMIN B12 Many individuals require superhigh levels to get adequate levels into the brain, where B12 is needed. Take 500 to 1,000 micrograms a day.
VITAMIN B5(PANTOTHENIC ACID) is another B vitamin that is critical for the treatment of adrenal fatigue. As noted earlier, adrenal fatigue is a common trigger for hypoglycemia-induced anxiety. If you get irritable when you’re hungry, crave sugar, crash with stress, and/or have low blood pressure with dizziness on standing, you probably have adrenal fatigue. Take 50 to 1,000 milligrams daily.
Optimal and often high-dose levels of B vitamins create an important foundation for the treatment of anxiety.
MAGNESIUM
Most Americans are deficient in magnesium, a key mineral critical for more than three hundred chemical reactions in the body. In fact, magnesium has been called the antistress mineral. Magnesium relaxes muscles, helps sleep, and relieves tension. Clinically, we have seen that dropping magnesium levels can trigger hyperventilation/panic attacks (and even seizures, if very severe) and that these are often relieved with magnesium therapy. Take 200 milligrams a day.
PASSIONFLOWER EXTRACT
This is one of the best-known herbs for the treatment of anxiety. Passionflower was first cultivated by Native Americans. Spanish conquerors first learned of passionflower from the Aztecs of Mexico, who used it as a sedative to treat insomnia and nervousness. The plant was taken back to Europe, where it became widely cultivated and introduced into European medicine. In fact, in South America when people are anxious, their friends often tell them to “go get a passionflower drink.” Take 100 to 200 milligrams one to four times a day, as needed.
MAGNOLIA
Magnolia bark has a long history of use in traditional Chinese formulas that relieve anxiety without leaving you feeling like you’ve been drugged. Magnolia extract is rich in two phytochemicals—honokiol, which exerts an antianxiety effect, and magnolol, which acts as an antidepressant—and can also alleviate stress without sedating you. Dozens of animal studies have shown that it is a nonaddictive, nonsedating stress buster, even at low doses.
The good news is that you can now be calm and energized, and have a clear mind—naturally. The components above can be taken individually or more easily found in combination in several products such as Calming Balance from Health Freedom Nutrition, or Tranquility from Ultraceuticals (see Appendix E: Resources). For severe anxiety, begin with two to three capsules of either three times a day. Although some effect is seen within a half hour (so it can also be used on an as-needed basis) the effects continue to powerfully increase over two weeks with continued use. Once your anxiety is under control, the dose can then be lowered, or it can be taken when needed. People find it helpful to have effective natural anxiety relief without side effects including brain fog.
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The Kava Kava Controversy
Kava kava (or simply kava), a member of the peppercorn family, has been one of the South Pacific’s most revered herbs and intoxicants. In several of that region’s cultures, it was central to many social celebrations and was often used as a remedy for a number of physical ailments. Uses included soothing the nerves, counteracting fatigue, inducing relaxation, aiding in weight loss, and treating cystitis, urinary tract congestion, and rheumatism. Hawaiian kahunas (medicine men) used it extensively for ailments such as “general debility (especially in children), weary muscles (a great restorer of strength), chills and head colds, difficulty in passing urine, and sharp blinding headaches.” Overall, kava was “found to reduce fatigue, allay anxiety, and to produce a generally pleasant, cheerful, and sociable attitude…[sometimes] bordering on intoxication.”3 Kava was traditionally prepared as a drink from the chewed or ground-up herb. When used ceremonially, kava was usually taken on an empty stomach in the evening.
In the United States, it is usually taken in capsule form. A single dose containing 150 to 210 milligrams of kava pyrones is the usual recommended dose to induce sleep. Most capsules contain 30 percent kava pyrones, so a 250-milligram capsule has 75 milligrams of kava. Thus, to get 150 to 210 milligrams of the pyrones, you would take 500 to 700 milligrams of the extract at night for sleep. At this dose, many people find that it relieves insomnia and induces a deep, restful sleep with clear, epic-length dreams. Upon waking, they report feeling rested.3
When used for anxiety, the usual dose is one 100-milligram capsule three times a day. The effect begins in about one week and increases over the next eight weeks. Interestingly, while several placebo-controlled studies have shown kava to be as effective for anxiety as prescription medications like amitriptyline (Elavil) and diazepam (Valium), unlike the sedating prescription medications, it was not found to cause any significant side effects. Surprisingly, it actually improved mental functioning and clarity. Research also shows kava to be an excellent muscle relaxant. It seems to work by a mechanism similar to that of lidocaine (Novocain), which has been shown to be beneficial for CFS/FMS.3–4
Although most people do not get any side effects when using kava alone for short periods, there
are several cautions. Kava may increase the effect of other sedative medications. If you do combine kava with other sedatives, you should do so only if it does not severely impair functioning. The German Commission E monograph on kava suggests it not be used in pregnancy or non-situational depression (that is, depression for no apparent reason).4
A second concern with kava is that taking prolonged high doses may cause a dry, scaly rash that begins on the face and moves downward. Visual sensitivity to bright light may also occur. Taking the B vitamins may decrease this, as can staying in the dose range discussed above. If you take kava kava and a rash occurs, stop taking the kava or lower the dose immediately.
Although there have been a few rare reports of liver inflammation with chronic use, these are so unusual relative to most medications (e. g., acetaminophen) that I still consider it acceptable to use. Nonetheless, this rare side effect has made the use of kava controversial. Like a number of natural treatments, you should take kava kava only under the care of a holistic physician.
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For Depression
Happiness has its own biochemistry, which can be powerfully balanced and enhanced naturally. Using the SHIN protocol will help achieve that balance, through a good night’s sleep (Chapter 3), hormonal supplementation (Chapter 4), and overall nutritional support (Chapter 6). Research has also shown that walking briskly each day is as effective as Prozac for depression.
It is also critical that your body has the building blocks to make the three key “happiness” neurotransmitters that your body needs: serotonin, dopamine, and norepinephrine. Many natural products are helpful for depression, and as is often the case, it is critical to begin with proper nutrition. Let’s review these, beginning with the basics.
B12 and folate/folic acid seem to be especially important. These two nutrients together contribute strongly to the production of both serotonin and a powerful depression-fighting nutrient called SAMe. Approximately one-third of patients with depression have been found to be deficient in folic acid, and this by itself can cause depression, as can B12 deficiency. In fact, studies of high-dose folic acid have shown this nutrient to be effective as an antidepressant. Take 500 to 2,000 micrograms of vitamin B12 and 400 to 1,200 micrograms of folic acid a day to be sure that optimal levels are getting into the brain where they are needed.
The B vitamins riboflavin and niacinamide are critical for energy production. Depression is a common symptom of riboflavin and niacin deficiency. Take 25 to 100 milligrams of each daily.
Vitamin B6 levels are often quite low in depressed patients, and this is especially problematic in women taking birth control pills or estrogen—both of which can deplete vitamin B6. Vitamin B6 is critical for the production of serotonin, dopamine, and norepinephrine. Take 25 to 100 milligrams daily.
Magnesium deficiency is the single most important nutritional deficiency in the United States. It contributes to pain, fatigue, and increased risk of heart attacks, in addition to depression, as magnesium is critical in more than three hundred different reactions in the body. Take 200 to 400 milligrams a day.
Serotonin is made from 5-hydroxytryptophan (5-HTP), and dopamine and norepinephrine are made from tyrosine. Studies have shown 5-HTP to be as effective as prescription antidepressants, but much better tolerated. Another placebo-controlled study has shown tyrosine to also be as effective as prescription antidepressants without side effects. In addition, if 5-HTP is given without tyrosine, it often stops working after a few months.
Do not take 5-HTP without your holistic doctor’s okay if you are also on prescription antidepressants, as the combination may raise serotonin too high. Because it can be stimulating, tyrosine is best taken early in the day. Take 200 to 400 milligrams of 5-HTP and 500 to 1,000 milligrams of tyrosine a day.
The effectiveness of Saint John’s wort as an antidepressant has been documented in twenty-five double-blind studies with a total of more than fifteen hundred patients. Those studies showed the herb to be as effective as prescription antidepressants, without the side effects. In addition, it helped improve sleep, lower anxiety, and raise self-esteem in study participants. Take 300 to 500 milligrams three times a day.
Magnolia bark helps depression as well as anxiety.
Although some effect is seen within two to three weeks of starting these natural antidepressants, the effects continue to powerfully increase over six weeks with continued use. Once your depression is under control, the dose can then be lowered, and you can ask your physician about tapering off your antidepressants.
These nutrients and herbs can be tried individually or can be found in combination in Happiness 1–2–3 from Health Freedom Nutrition and in In Harmony by Ultraceuticals (see Appendix E: Resources). Both products contain 5-HTP and Saint John’s wort, so consult with your holistic physician if you are also taking prescription antidepressants, to maintain safe serotonin levels.
For Memory and Circulation
Ginkgo biloba extract has been shown to have multiple benefits. These include:
Improving memory. This effect has been shown in healthy young volunteers and in older adults in several placebo-controlled studies.5–7 Many CFS/FMS patients also find that ginkgo helps their memory. In twelve healthy males, electroencephalogram (EEG) testing showed that taking 120 to 240 milligrams of ginkgo biloba extract improved alpha brain wave activity in a way that supported better cognitive function.
Improving circulation. In general, ginkgo improves circulation in the brain and legs. More than forty controlled studies have shown this. In the process, ginkgo may also decrease tinnitus (ringing in the ears) and headaches, as well as Raynaud’s syndrome, in which spasms in the arteries of the fingers in response to cold cause pain and extreme coldness. This is sometimes seen in people with CFS/FMS. Ginkgo may also lower cholesterol and help angina.
Improving the decreased libido and erections and the delayed orgasm sometimes seen with antidepressant use. Dosages of 60 to 80 milligrams of ginkgo three times a day for six weeks are required for this.
Decreasing the breast tenderness and mood shifts of premenstrual syndrome (PMS).7A
Helping relieve loss of balance and vertigo.8, 9
Helping asthma and bronchitis. In China, ginkgo is made into a tea for this purpose.
Helping depression. Doses of 80 milligrams, taken three times a day, may be effective for this.
The ginkgo you buy should be a 50: 1 extract standardized to contain 24 percent glycosides (it will say this on the label). For most purposes, 40 milligrams three times a day is the standard dose. Treating depression, however, requires 80 milligrams three times a day. It takes six weeks to see the effect of treatment. Serious side effects are uncommon, as are drug interactions. In fact, the side effects seen with ginkgo in studies were often less than those seen with placebo.
For Occasional Energy Boosts
Tyrosine is an amino acid (one of the building blocks of protein) that is used to make the neurotransmitter norepinephrine. This brain chemical is thought to be low in people with CFIDS/FMS. Tyrosine may be considered for occasional use, and acts as a stimulant without significant side effects.10 Take 500 to 4,000 milligrams daily for energy.
For Antiviral Protection
For people with CFIDS/FMS, the main use of lemon balm, also known as melissa, is to improve sleep (see Chapter 3). However, the herb can also be used topically as an antiviral against cold sores if used early in the outbreak.11. Use Loma-hephan cream applied two to four times a day for five to ten days.
For the Flu
Elderberry extract can help ease flu symptoms and shorten the duration of the illness. In one study, 90 percent of patients who took elderberry extract were completely well in two to three days versus six days for the placebo group. Take four tablespoons a day for three days. Children should take no more than two tablespoons a day for three days.
For High Cholesterol
Cholesterol-lowering medications can be very problematic in CFS/FMS patients, depleting coe
nzyme Q10 and triggering or aggravating muscle pain. As an alternative for my patients, I recommend the following herbal combination treatment:
Inositol hexaniacinate, 650 milligrams three times a day
Chromium, 800 to 1,000 micrograms a day
Berberine, 900 to 1,200 milligrams a day
Policosanol, 20 to 40 milligrams a day
Deodorized garlic, 500 to 1,000 milligrams a day, or 1 to 2 cloves of fresh garlic a day
These can be taken individually or found in combination in Chol-less from Ultraceuticals. They can also be taken along with cholesterol-lowering medications. Give these herbals six weeks to work. In addition, add oats, which can also help lower cholesterol, to your diet by eating oatmeal or a cereal such as Life or Cheerios. Your holistic doctor can advise you on how to effectively lower cholesterol without drugs.
For Loss of Libido
This is a common problem, found in 73 percent of CFS/FMS patients.
For women, I recommend the following treatment combination:
Maca root extract, 400 to 800 milligrams a day
Rhodiola rosea extract, 150 to 300 milligrams a day
From Fatigued to Fantastic! Page 27