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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Lao Tzu on August 9, 2010, at 10:10:04
I have suffered from social anxiety for many years, which may be related to my bipolar depression. I have had success with kava kava for anxiety, but it isn't enough for social anxiety. Other nutrients are needed in most cases. A possible social anxiety formula could consist of the following:
1-- 100mg of B62-- 200mg of Natrol kava kava
3-- 50mcg maximum of selenium-yeast
4-- 300mg of cinnamon
5--Optional: 5-10mg of manganese
6--Optional: 30mg of Niacinamide or 250mg of sustained-release Niacin
7--Optional: 200mg of Magnesium Citrate
8--Optional: 20mg of zinc picolinate (best form)
The point to finding a combination that works is to combine enough of the nutrients/herbs that are synergistic with each other and do not cause excessive drowsiness. You don't want to be driving a vehicle or operating machinery if you are too drowsy. I really do think that at the very least, the B6, selenium, and kava kava would work, but other nutrients could be added.
Posted by morgan miller on August 9, 2010, at 23:59:21
In reply to Social Anxiety supplement formula, posted by Lao Tzu on August 9, 2010, at 10:10:04
I say add 30mg regular Niacin(nicotinic acid). The sustained release formula may be hard on the liver and I don't believe Niacinamide works as well as regular old Niacin.
Maybe add a little GABA to the mix?
Posted by morgan miller on August 10, 2010, at 0:00:44
In reply to Social Anxiety supplement formula, posted by Lao Tzu on August 9, 2010, at 10:10:04
I think Magnesium and Niacin should definitely be in there, and maybe 100 to 300 mg GABA.
Posted by morgan miller on August 10, 2010, at 10:22:55
In reply to Social Anxiety supplement formula, posted by Lao Tzu on August 9, 2010, at 10:10:04
I think P-5-P would be the best form of B6. I also think that maybe 50 mg of B6 would be enough. I may be wrong. You've done more research than I have on this. Where did you get 100 mg from?
Posted by Lao Tzu on August 10, 2010, at 15:22:44
In reply to Re: Social Anxiety supplement formula, posted by morgan miller on August 10, 2010, at 10:22:55
50mg of B6 may be okay, I agree. In my experience, however, 100mg is best for depression for some people. I've found that higher doses of B6 are more beneficial for anxiety, but I guess if you are just starting off taking B6, a lower dosage might be good to start with and then raise it later, so I get your point.
GABA supplements, in my experience, never really helped all that well with social anxiety. Maybe it was just me. Actually, I found that either pure glycine or magnesium glycinate can probably be more beneficial than GABA supplements. Maybe even taurine would be better than GABA. I've never really had a great experience with GABA. It always left me wanting a little more punch.
I agree. The magnesium and niacin could really help those with severe anxiety. In my experience, I think the niacin would have more of an impact than magnesium as far as social anxiety, but both may be needed since everybody needs a little magnesium in their diet. Don't really believe, however, that magnesium is a link in social anxiety. Niacin would be very beneficial, however.
I think the ones that really helped me with the anxiety are first, adequate B6 intake, kava kava, niacin, selenium-yeast, and manganese. Vitamins C and E help with anxiety to a certain extent, but I don't think I'd put these in the social anxiety formula, but rather a depression formula.
I like your comments, Morgan. I think what I'd have to learn is that what works for me won't necessarily work for everyone, and like I said, it would be a daunting task to come up with a formula that would help everyone with social anxiety.
I am wondering also whether the addition of 5htp or tryptophan would also be beneficial. I think so, but I have limited experience with either of these, and I don't think either one would be a quick fix. They may help over time, but personally, I like the SSRIs. The only thing is, if you're going to take antidepressants, it might not be a good idea to take kava kava. When I started on Effexor XR, I tried kava again, and it just didn't work the same. In fact, it was rather irritating, so there might be an interaction between the meds and kava kava. If you don't take meds, kava kava really helps in modest dosages.
Thanks again for your comments, Morgan, and I would welcome anyone else's input in this thread. What has helped you the most with social anxiety, be it medications, vitamins, herbs, etc? I need to get a general consensus as to what are the most effective supplements for this disorder.
Lao
Posted by morgan miller on August 10, 2010, at 18:48:33
In reply to Re: Social Anxiety supplement formula, posted by Lao Tzu on August 10, 2010, at 15:22:44
I wonder if some of the things that help boost libido would also be beneficial for social anxiety. Just a thought.
Posted by Lao Tzu on August 11, 2010, at 12:27:48
In reply to Re: Social Anxiety supplement formula, posted by morgan miller on August 10, 2010, at 18:48:33
Interesting thought. B12 and folate might be good if your histamine levels are low. People with higher histamine levels tend to be more sexual. I have found that B12 does help with social anxiety if you are deficient. I don't know why I didn't think of that one. I'm not sure about herbs. Which ones help libido?
Posted by morgan miller on August 11, 2010, at 23:47:20
In reply to Re: Social Anxiety supplement formula, posted by Lao Tzu on August 11, 2010, at 12:27:48
For libido,
Maca
Ashwaganda
Tongkat Ali
Horny Goat Weed
Muira PuamaI know Ashwagandha can reduce anxiety and could be good for social anxiety.
Posted by Hombre on August 12, 2010, at 19:01:45
In reply to Re: Social Anxiety supplement formula, posted by morgan miller on August 11, 2010, at 23:47:20
Which ones have you tried, Morgan? Any notes to share in terms of dosage, effects, etc?
Thanks.
Posted by morgan miller on August 12, 2010, at 22:26:23
In reply to Re: Social Anxiety supplement formula » morgan miller, posted by Hombre on August 12, 2010, at 19:01:45
I tried Maca, Horny Goat Weed, and Aswhagandha. I think I noticed the most effect on libbido from horny goat weed. Maca gives me energy and ashwagandha tends to mellow me.
Something you probably wouldn't mess with that can have a profound effect on libido is D-Aspartic-Acid. I've been taking it lately and definitely feel a libido boost.
Posted by proudfoot on August 28, 2010, at 9:58:21
In reply to Social Anxiety supplement formula, posted by Lao Tzu on August 9, 2010, at 10:10:04
> I have suffered from social anxiety for many years, which may be related to my bipolar depression. I have had success with kava kava for anxiety, but it isn't enough for social anxiety. Other nutrients are needed in most cases. A possible social anxiety formula could consist of the following:
>
>
> 1-- 100mg of B6
>
> 2-- 200mg of Natrol kava kava
>
> 3-- 50mcg maximum of selenium-yeast
>
> 4-- 300mg of cinnamon
>
> 5--Optional: 5-10mg of manganese
>
> 6--Optional: 30mg of Niacinamide or 250mg of sustained-release Niacin
>
> 7--Optional: 200mg of Magnesium Citrate
>
> 8--Optional: 20mg of zinc picolinate (best form)
>
> The point to finding a combination that works is to combine enough of the nutrients/herbs that are synergistic with each other and do not cause excessive drowsiness. You don't want to be driving a vehicle or operating machinery if you are too drowsy. I really do think that at the very least, the B6, selenium, and kava kava would work, but other nutrients could be added.Looks like a very interesting "recipe," if you will. Am new to this board, so pardon my ignorance. I come from a medical background professionally, so not a lot of experience with supplements, but am very open-minded to alternative treatments. I'm on Nardil 60 mg and Neurontin 4,800 mg every day, which are agreeing with me very well right now.
I'm trying to get a firm recommendation on B6 (pyridoxine) supplementation while taking Nardil (both the dosage amount and timing of the B6), and would like to learn more about what other supplements might be helpful for me without sending me to the ER about to stroke out because of them. Is pyridoxine by itself adequate, or should I take a B-complex? Is a plain multi-vitamin a good choice?
I'm intrigued by the use of fish oils I've seen on here too. Are they helpful with atypical depression/social anxiety? I've either got that or Bipolar II, depending on which of my providers you believe.
Are there other supplements I should consider taking? If so, why are they indicated and how much of each is usually beneficial?
I know I'm just full of questions, but doesn't hurt to ask. Look forward to your feedback.
'Nutty on Nardil'
Posted by Lao Tzu on August 31, 2010, at 15:35:38
In reply to Re: Social Anxiety supplement formula » Lao Tzu, posted by proudfoot on August 28, 2010, at 9:58:21
Thanks for your post. The first thing I have to say that it can be a little tricky incorporating nutrients into your medicine regimen. In my case, which is Bipolar psychosis, I've never stayed satisfied with my regimen for long. However, I can say some good things about the supplements. In my case, I never was completely happy with my medication, but of course, I'm an extreme case. If your meds alone are working well, stick with it. That's great!! I wasn't always a believer in medication, but it has literally saved my life and improved my prognosis significantly. Still, being bipolar, I always had issues with low energy, which is why I take the vitamins now. If used properly and continuously, you will notice improvements in mood and energy. If your diet is exquisite, you actually may not need more than a good multivitamin and maybe some fish oil, if you prefer. Most doctors will say that medication, a good balanced diet, and exercise are all you need, and that might ring true for most people with depression. However, I always felt I needed the supplements to stay healthy. Again, I am an extreme case. So I can give some examples as to what has helped me, but if you're doing fine with the meds and you eat properly and you exercise then you're a long way to getting better. However, there are some good vitamins you can take that may help improve mood and energy.
For instance, fish oil is good for mood, and I always say to start off with a low dosage because most people don't need much of it to see a difference in mood. Fish oil is also good for lowering triglycerides, which has worked beautifully for me. It will take daily use of fish oil for a while to see any real improvement, but what I like about fish oil is that anyone can take it even if you're on meds, and it is beneficial to health and mind.
I have found that I seem to be lacking in omega-6 fatty acids, but many people actually are not. Therefore, I take one capsule of borage oil (300mg GLA) a couple hours after I take my fish oil. I seem to need both omega-3s and omega-6s, though I think most people do just fine on fish oil alone.Next, antioxidant vitamins and B vitamins are very important for staving off depression. The ones that help me the most are vitamins E, C, selenium, B1, B2, B6 and in the past, B12 and B3 were helpful.
I choose to take the vitamins individually instead of a multi or a B complex because I find that I need to tailor the dosages to myself and you can't do this with a multivitamin. But like I said, I am an extreme case. I have psychosis.Next, adequate zinc is important. The dosage depends on your individual needs. I find that zinc picolinate is a very effective form. I think the average person would need no more than 20mg per day. I take 40mg per day. In some rare cases, a higher dosage of zinc is required, but that probably doesn't fit most people.
Next, for some people, balancing your magnesium and calcium levels is important for depression and improved sleep. I take all of my magnesium and calcium at bedtime, not during the day. I sleep better and I have less depression during the day. I prefer chelated forms of magnesium and calcium because supposedly they are absorbed better by the body. Don't know how true this is, however. I prefer using Magnesium Citrate, NOT magnesium oxide. I get a good response from the citrate form. My suggestion is to not use magnesium oxide at all. I also think that calcium chelated with an amino acid is better than plain old calcium carbonate, but some would disagree. I just feel the chelated forms are more agreeable to me. You be the judge.
I find that these few supplements are the most helpful to me and probably to others. If you take them individually, you might have to adjust dosages, and this can be a little tricky. I always say try a multivitamin and a B-complex first, and see if that makes you feel any better. If it doesn't work you might try taking individual vitamins that I listed here. B6 alone is a very important vitamin that many people supplement with for depression and anxiety. My suggestion is 50-100mg per day. Another good form of B6 is called P5P. It is the activated form of B6 and in many cases, may actually be more effective that pyridoxine hcl. A good dose of P5P is 50mg per day. Some people find that taking a combination of both forms is even more helpful to them. I've always liked both of these forms.
If you are anemic, you might benefit from B12 injections and/or possible supplementation with folic acid. Personally, I do like B12, but for some reason, I can't tolerate any folic acid supplements. Believe it or not, the folic acid actually makes me feel more depressed. However, some people do well on folic acid. It may have something to do with your reaction to histamine, as histamine can act a neurotransmitter in the brain, and may be affected by your folate status.
That's all I can think of right now. Just a word of caution: Most of the supplements out there are garbage. I've learned that the hard way. But there are a few that can help improve mood and energy, if you are still having problems despite medication. Someone on babble swears by Traditional Chinese Medicine and herbal tonics for depression. And he has also been taking medication for his problems. I read somewhere that combining TCM with Western medicine may in some cases, prove more beneficial, but I'm still a skeptic. Take care,
Lao
Posted by proudfoot on August 31, 2010, at 20:26:40
In reply to Re: Social Anxiety supplement formula, posted by Lao Tzu on August 31, 2010, at 15:35:38
Lao,
Wow, what a thoughtful and insightful post. Thanks for taking the time to compose such a thorough response to my questions.
The Nardil is doing a great job so far compared to my pre-MAOI regimen, so no worries about sticking with the drugs. I'm looking to further enhance what they're doing, thus my query on here.
My diet is definitely not "exquisite," as you so charmingly put it. Too much fast food, not enough of the fruits and veggies I know I should eat. Plus, the carb drive from the Nardil isn't helping the weight at this point. And I find the advice about exercise to be great advice, but hard to implement in reality between working full-time and not really enjoying exercise in the first place.
I'm already sold on the idea of fish oil and have ordered some to start taking. I've been thinking of doing this for several years, but the Nardil has been a good impetus for me to follow through with starting it. Plus, if it further enhances the mood beyond what the meds are doing, fantastic! The benefits to the lipid panel from taking fish oil are just the icing on the cake if you will.
I'm going to start with a B-complex for now, that does have both B6 and P5P in it (10 mg of each per pill). I'm hesitant to overdo the B6 for fear of deactivating too much Nardil in the process. Have you ever had any serum testing done for your vitamin levels to use in guiding your choice of dosages, or has it been by trial and error based on your clinical response?
How much vitamin E and C have you personally found helpful? I've always been a bit skeptical of the hype surrounding vitamin C, but have been intrigued by the benefits reported by others taking vitamin E supplementation. And do you take the selenium by itself, or in a combination product? I need to educate myself more about both the selenium and zinc and their role here.
The whole magnesium question leaves me sort of shaking in my boots, as magnesium typically causes the runs for me. I've an element of IBS to start with, and I try to avoid anything that loosens things further. When treating gastric reflux in the past, I've had very good results from good old calcium carbonate in TUMS. And being that I don't consume enough dairy products in my diet, calcium supplementation is just plain a good idea at this stage of my life (pushing 50).
I loved that your discussion ended with a tip of the hat to TCM. Despite my training as a medical professional in Western medicine, I've been a firm believer in the benefits that TCM has to offer many individuals. I've been under the care of an acupuncturist for over ten years when regular medicine failed to address the horrible symptoms of positional central vertigo I developed while taking Wellbutrin. It was only the combination of his healing hands/needles and herbs that brought me back to some level of normalcy, that and a very high dose of Neurontin (gabapentin) recommended by a neurologist. I hadn't seen him in almost a year now, but we have an appointment next week to see where he and his crazy, nasty-tasting herbs might fit in with where we're going with the Nardil.
Anyhow, I can't thank you enough for your kindness in composing such a complete and thoughtful response. It's exactly what I hoped to hear from you. Wishing you the best!
Doug
Posted by morgan miller on August 31, 2010, at 22:21:44
In reply to Re: Social Anxiety supplement formula, posted by proudfoot on August 31, 2010, at 20:26:40
Magnesium glycinate, taurinate, aspartate, and malate may not give you the loose stools that other forms of magnesium like citrate may.
I think fish oil is a must for anyone, those struggling with a mental illness and those that are perfectly healthy mentally. Get a good quality fish oil though, it may make a difference.
Posted by Lao Tzu on September 2, 2010, at 9:54:30
In reply to Re: Social Anxiety supplement formula, posted by proudfoot on August 31, 2010, at 20:26:40
Hi Doug! Thanks for your post and your kind words. I'm not an expert in nutrition, first and foremost. I've just experimented on myself over the past 4 years to see what benefits I could obtain from nutrients. I actually have learned a lot more from the people on psychobabble than I would have from just researching the internet, which you have to be careful about doing because there is so much misinformation out there in cyberspace. I haven't had any tests to detect serum levels of vitamins or minerals, but it may be a good idea to do that first only because if you are not deficient in certain nutrients, your diet probably would be sufficient in that regard or just by taking a multivitamin. Some doctors don't necessarily believe that taking large amounts of magnesium is necessary. They do, however, recommend calcium to women for osteoporosis. I take the magnesium and calcium mainly to help with sleep, and it does a good job at that. Some sources say that some people with schizophrenia require more magnesium and calcium than other people.
As far as vitamin E is concerned, personally, I have worked it into my regimen as follows: 200IU of natural Vitamin E in the morning and an additional 400IU at bedtime. Individual need varies from person to person. I just find that 600IU per day works for me, and I take it everyday. Not saying it is absolutely essential that you supplement with it. Some people may actually get enough from diet or a multivitamin, but I like the extra antioxidant protection because I smoke. Overall, it's a good vitamin to supplement with in certain cases as it may be good for cardiovascular health at lower dosages.
Vitamin C, well, I have tried many different dosages, some high and some low. After 4 years, I have concluded the best dosage that works for me is 500mg per day, that's all. Most people don't need a high dosage of vitamin C, although it is purported that high dose Vitamin C is helpful in some cases of schizophrenia. I never found that higher doses really helped me at all. In fact, I have side effects from too much vitamin C. I take the vitamin C because I smoke cigarettes, and it is said that people who smoke require more vitamin C for antioxidant protection from the tobacco.
Selenium is important in certain people who tend not to get enough from their diet or who have toxins in their system. Personally, I take only 100mcg per day, and find that my mood is slightly improved by supplementation. Some people get enough from their diet. The best source is Brazil nuts.
A good B-complex should be helpful to you. Are you taking a B-50 or a B-100 complex? Some people seem to benefit a little more with a B-100, but may be too much for other people. It depends on what you can tolerate. A B-50 complex would certainly be helpful in most cases to help with energy. There are some people who swear by taking hundreds of milligrams of all the B's, that their depression subsides with supplementation. The only B vitamin I take in a high dosage is vitamin B1. It is purported to be useful for psychosis. I take 200mg per day, and it does make a difference for me. It is an absolute essential for me as I respond very well to it.Zinc is necessary for just about everybody in small amounts. For me, I find that it does make an improvement in my depression and anxiety and it definitely recommended for schizophrenia. However, you may not necessarily need to supplement with real high dosages. Start off at a low dosage and gradually increase to the maximum dosage you can tolerate. I use Solgar's zinc picolinate which comes in a 22mg tablet. I find that two tablets a day works best for my depression.
The fish oil that I supplement with is called Eskimo-3 by Enzymatic Therapy. It is purported to be one of the best fish oils in purity. It comes in 500mg capsules, and I take a maximum of 3 capsules per day. That's all I can tolerate. I'd recommend spending a little more cash for a premium brand, not a generic fish oil product. There are many good ones to choose from. You can get them at your local vitamin shoppe or online. If you shop online which I do sometimes, you're more likely to get a bargain. I shop at House of Nutrition Online. They have a wide variety of fish oil brands. There prices are competitive, and they always get my order correct. I've never had a problem with this company, and I get the same product cheaper than I would at the Vitamin Shoppe. Also, you'd want a brand that states the fish oil is free of mercury and other heavy metals. If it doesn't say this on the package, don't buy it.
Again, I am a proponent of taking medication for severe illness, but the vitamins, minerals, and fatty acids are definitely helpful for those with mood disorders.
I had thought about trying TCM, and I still might. Instead, currently, I am trying individual herbs. Hombre has a very good insight into TCM. You might read some of his posts. A good herb for emotional balance is called Holy Basil. I got the tip from Morgan on babble.
It actually helps with my anxiety disorder. Other herbs he is trying include Schisandra and Cordyceps. Herbs which have not helped me include Licorice, Nettle Leaf, Ginkgo, and Gotu Kola. I can't stand these four herbs. They make me feel worse.Well, that's all I have for now, Doug! If I can answer anymore of your questions, I'll certainly try. Other people on babble have a lot of insight into specific therapies. I've been on babble for quite a while, and I always come back here to read the posts just to see what people have tried and whether it is effective. The people on here are quite serious about alternative therapies and quite knowledgable. Still, medication is a first line treatment for some people, like myself and like yourself, absolutely essential for health, and other therapies are like you said, icing on the cake.
Stay well!!
Lao
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