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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Melanie-00 on December 12, 2010, at 22:24:41
I've been taking inositol (currently about 18 g/day) for the past few months with good results. It substantially helps me control my trichotillomania. It MAY also help with panic. But I'm still having HUGE problems with anxiety. I don't have a doctor, so I don't have access to prescription meds. Also, my experience with SSRIs in the past wasn't all that positive (though I was on an SSRI only very briefly), and while I think benzos have a great effect, I know they are not a long-term solution. And I can't get a prescription right now, anyway. After much research, I've decided to try Rhodiola rosea (I have MIND BODY & SPIRIT by Verde Botanica brand on order).
Any thoughts or experiences you would like to share? My current plan is to stick with the inositol + rhodiola regimen for a few weeks to see how I feel, but I'd be happy to know if anyone has tried rhodiola with other medications (in particular, other non-prescription/alternative medications). I will probably add in a b-complex vitamin, too. There was a very recent small-scale placebo-controlled study (Journal of Clinical Psychopharmacology 2009) indicating that chamomile (extract standardized to 1.2 % Apigenin) may help with anxiety. Anyone tried that? I decided to try the rhodiola before trying the chamomile since it sounds a little more promising, but who knows! And I have a list of a bunch more things to try, which while giving me hope, also gets me down, because I am so tired of living with the agony of constant anxiety. I don't want to be fooling around with this for months, let alone, years!
Thanks in advance for your thoughts/feedback/advice.
Posted by jeaner on December 14, 2010, at 14:54:00
In reply to Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 12, 2010, at 22:24:41
Inositol works with b complex. You should take b complex with it. Inositol is usually in the complex but not as much as you are taking. People low in b6 can have anxiety and panic attacks.
Posted by Christ_empowered on December 14, 2010, at 15:19:25
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by jeaner on December 14, 2010, at 14:54:00
B-100, niacinamide, taurine, and vitamin c help me considerably. I know you're not impressed by niacinamide, but maybe you could try the other components?
Posted by bleauberry on December 14, 2010, at 17:06:28
In reply to Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 12, 2010, at 22:24:41
I understand you said you don't want to be messing with this for months or years, and I hope it doesn't take that. But it could. To do it right is sometimes a journey of self discovery. It teaches us patience and perseverance. And hopefully rewards us with a huge win.
In the anxiety realm, you have lots of choices.
Rhodiola isn't a bad choice. It is a tricky one to manage for several reasons. It is more stimulating at low doses, more calming at high doses, and finding the right dose is experimental....maybe some rough times trying to find it. If your anxiety is cortisol related, rhodiola is going to impact that, but exactly how it feels in the short term will be differenct from how it feels in the longterm. So it takes, again, some patience and perseverance.
Plenty of options:
Magnesium Gycinate
Magnesium Taurate
GABA
Niacinimde high dose (not other forms of Niacin)
Glycine
Lemon Balm
Passionflower
Skullcap
St Johns Wort (sometimes stimulating at first)
5htp (low doses, less than the instructions say)Of all the above, I found Lemon Balm to be the fastest most impressive. Total calm without sedation. (tincture, not pills)
Most naturopaths agree that the combo of Lemon Balm and St Johns Wort is far better than either alone. Sort of like, 1 plus 1 equals 3.
The second most effective I ever experienced was a combo of magnesium, glycine, and gaba. It to me was mildly depressing where lemon balm was not.
During my journey through Lyme I discovered that Japanese Knotweed is calming to the nervous system. The brand I use is called Resveratrol by Source Naturals. J*p Knotweed is the most potent source of resveratrol. Most brands use grapes instead. But there is nothing in grape resveratrol much helpful for anxiety or Lyme....it's the J*p Knotweed other constituents that do it.
With supplements and herbs, the name of the game is synergy....two, three, or more is very common. Especially in Eastern medicine where they have practiced this stuff for thousands of years, a pharmacy prescription will involve the mixture of 6 or more plants/roots.
A complicating factor is that sometimes what works is what doesn't seem to make sense. Boosting norepinephrine or dopamine would not make sense in anxiety, but sometimes is exactly what works...they were too low to begin with and the body was overcompensating by making adrenaline instead.
For longterm support, Eleuthero should be in the mix. (Siberian Ginseng...not the other ginsengs). Over months it gradually balances out the thyroid, adrenal glands, and overall helps the body deal with stress and illness.
There are probably a dozen other things I could mention. The ones listed here are the ones I feel have the most immediate potential.
Also keep in mind, lithium is usually calming and is a natural salt of the earth. Without a prescription it can be bought in the form lithium orotate. Tiny doses is all it takes.
Posted by Hombre on December 14, 2010, at 20:04:15
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by bleauberry on December 14, 2010, at 17:06:28
I forget, was there a reason why you did not try niacin instead of niacinamide?
What about all the other herbs that have been suggested?
The bottom line will be just trying various things. Psyching yourself out by reading too much will only limit possible options, no?
Posted by Melanie-00 on December 14, 2010, at 21:35:12
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by Hombre on December 14, 2010, at 20:04:15
Thanks for all the recent posts and detailed suggestions. I'll post back soon, but it's late where I am, so I won't write more tonight. But just wanted to let you all know I've been reading your suggestions and very much appreciate them!
Posted by morgan miller on December 14, 2010, at 22:54:19
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by bleauberry on December 14, 2010, at 17:06:28
More suggestions,
Picamillon
Holy Basil-New Chapter is the best brand IMO
L Theanine
Ashwaganda-Any brand using Sensoril, Himalaya or Avesta brands are all good
Bacopa monnieriIt's definitely a trial and error thing. Go with the cheapest and easiest to get first then move on to the more expensive and less accessible. Many natural remedies can be taken together without any issues and may help you even more when combined. I believe Bleauberry mentioned something about synergy, it's true.
Posted by morgan miller on December 14, 2010, at 22:58:53
In reply to Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 12, 2010, at 22:24:41
Oh yeah, Exercise! Moderate to intense exercise followed by a long meditative and thorough stretch. There is some evidence that the brain actually goes through changes after a month or so of exercise that better equip it to function better in a way that reduces anxiety and stress.
Posted by Melanie-00 on December 15, 2010, at 15:51:38
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by morgan miller on December 14, 2010, at 22:58:53
Definitely yes on exercise!
But I need more help than what I get from just exercise.As I mentioned in my original post, I am taking inositol 18g/day. I just started taking rhodiola rosea and am playing around with dose.
When my order arrives in a few days, I will also try taking a chelated calcium &magnesium glycinate supplement and a b-complex supplement.
Others near the top of my list to maybe try are:
(in no particular order)Brahmi
Gotu kola
Lemon balm
Chamomile
Theanine/L-theanine
Passionflower
Skullcap/scullcapHas anyone tried a chamomile & lemon balm combo?
Beauberry: I'd love to hear more about your experience with lemon balm, including brand, dosage, preparation, etc.
Any experiences with passionflower?
I'm not so interested in herbs/supplements that help with sleep. I have insomnia, but I also suffer from anxiety all day. I want to be awake during the day, not in a sleepy stupor! I can always take an ambien for sleep. I think my sleep will improve when my anxiety improves.
Thanks for everyone's suggestions!
Posted by Melanie-00 on December 15, 2010, at 20:09:16
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 15, 2010, at 15:51:38
I've crossed passionflower off of my list for now. Not comfortable with the level of research backing this herb. (See my other thread on this board - titled "High-quality, Standardized Passionflower in the US".) But in the course of looking more into passionflower, I came across this abstract, which would seem to give quite a bit of support to the experience of bleauberry, as discussed in an earlier post on this thread.
From: http://www.ncbi.nlm.nih.gov/pubmed/18066140/
Can J Physiol Pharmacol. 2007 Sep;85(9):933-42.
Effects of traditionally used anxiolytic botanicals on enzymes of the gamma-aminobutyric acid (GABA) system.
Awad R, Levac D, Cybulska P, Merali Z, Trudeau VL, Arnason JT.Ottawa-Carleton Institute of Biology, University of Ottawa, Ottawa, ON K1N6N5, Canada.
Abstract
In Canada, the use of botanical natural health products (NHPs) for anxiety disorders is on the rise, and a critical evaluation of their safety and efficacy is required. The purpose of this study was to determine whether commercially available botanicals directly affect the primary brain enzymes responsible for gamma-aminobutyric acid (GABA) metabolism. Anxiolytic plants may interact with either glutamic acid decarboxylase (GAD) or GABA transaminase (GABA-T) and ultimately influence brain GABA levels and neurotransmission. Two in vitro rat brain homogenate assays were developed to determine the inhibitory concentrations (IC50) of aqueous and ethanolic plant extracts. Approximately 70% of all extracts that were tested showed little or no inhibitory effect (IC50 values greater than 1 mg/mL) and are therefore unlikely to affect GABA metabolism as tested. The aqueous extract of Melissa officinalis (lemon balm) exhibited the greatest inhibition of GABA-T activity (IC50 = 0.35 mg/mL). Extracts from Centella asiatica (gotu kola) and Valeriana officinalis (valerian) stimulated GAD activity by over 40% at a dose of 1 mg/mL. On the other hand, both Matricaria recutita (German chamomile) and Humulus lupulus (hops) showed significant inhibition of GAD activity (0.11-0.65 mg/mL). Several of these species may therefore warrant further pharmacological investigation. The relation between enzyme activity and possible in vivo mode of action is discussed.
Posted by Hombre on December 16, 2010, at 22:31:21
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 15, 2010, at 20:09:16
This looks interesting:
It's a blend of herbs and vitamins. There are several products in this line. Might be worth a shot.
Posted by Melanie-00 on December 17, 2010, at 9:12:24
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by Hombre on December 16, 2010, at 22:31:21
Interesting ... I like looking at blends like this just to see what's in them. But when it actually comes to trying things, I prefer to try the individual ingredients by themselves, or add them in slowly one at a time. Otherwise, how will I know what's working? I mean a blend might work great, but that might just be because of one or two ingredients in the blend. Or by adjusting the proportions of the ingredients that work, I might find something that works even better. That's just the way I approach these things, though. Thanks for the recommendation. I noticed that one of the ingredients in this blend is rhodiola rosea. I started taking that a few days ago and am not yet ready to say whether it's helping me at all or not. I'll try to give an update when I know more.
All the best.
Posted by Lao Tzu on December 20, 2010, at 16:02:31
In reply to Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 12, 2010, at 22:24:41
There are some key vitamins that can help with anxiety. In my opinion, the best ones for me have been high dose B6, B12, Niacin (for some people), zinc picolinate, manganese (for some people), adequate magnesium intake, Kava Kava (if you're not on medication), and GABA (750mg per day) and for some people, Taurine may be helpful as well as Glycine for some people. There may be others. Some people say fish oil can help somewhat with anxiety. I think it can help somewhat.
Lao
Posted by bleauberry on December 21, 2010, at 17:53:34
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 15, 2010, at 20:09:16
> I've crossed passionflower off of my list for now. Not comfortable with the level of research backing this herb. (See my other thread on this board - titled "High-quality, Standardized Passionflower in the US".) But in the course of looking more into passionflower, I came across this abstract, which would seem to give quite a bit of support to the experience of bleauberry, as discussed in an earlier post on this thread.
>
> From: http://www.ncbi.nlm.nih.gov/pubmed/18066140/
>
> Can J Physiol Pharmacol. 2007 Sep;85(9):933-42.
>
> Effects of traditionally used anxiolytic botanicals on enzymes of the gamma-aminobutyric acid (GABA) system.
> Awad R, Levac D, Cybulska P, Merali Z, Trudeau VL, Arnason JT.
>
> Ottawa-Carleton Institute of Biology, University of Ottawa, Ottawa, ON K1N6N5, Canada.
>
> Abstract
> In Canada, the use of botanical natural health products (NHPs) for anxiety disorders is on the rise, and a critical evaluation of their safety and efficacy is required. The purpose of this study was to determine whether commercially available botanicals directly affect the primary brain enzymes responsible for gamma-aminobutyric acid (GABA) metabolism. Anxiolytic plants may interact with either glutamic acid decarboxylase (GAD) or GABA transaminase (GABA-T) and ultimately influence brain GABA levels and neurotransmission. Two in vitro rat brain homogenate assays were developed to determine the inhibitory concentrations (IC50) of aqueous and ethanolic plant extracts. Approximately 70% of all extracts that were tested showed little or no inhibitory effect (IC50 values greater than 1 mg/mL) and are therefore unlikely to affect GABA metabolism as tested. The aqueous extract of Melissa officinalis (lemon balm) exhibited the greatest inhibition of GABA-T activity (IC50 = 0.35 mg/mL). Extracts from Centella asiatica (gotu kola) and Valeriana officinalis (valerian) stimulated GAD activity by over 40% at a dose of 1 mg/mL. On the other hand, both Matricaria recutita (German chamomile) and Humulus lupulus (hops) showed significant inhibition of GAD activity (0.11-0.65 mg/mL). Several of these species may therefore warrant further pharmacological investigation. The relation between enzyme activity and possible in vivo mode of action is discussed.
>
>These kinds of studies are basically useless to you and me. They do not predict what will happen in your body or mine. They usually say what happened in rats or mice or lab dishes, which are very different than humans brains, and more especially very different from diseased human brains.
Here is an example. There are a handful of botanicals proving very effective in Lyme disease. However, there are ZERO studies on any of them in Lyme. There are a lot of studies and centuries of proof in real practice that they are effective against similar shaped bacteria. We're talking spirochetes. Wormlike bacteria with a tail basically. Since these herbs are effective against Leprosy and Syphillis, both caused by spirochetes, the assumption was that maybe they would be effective against Lyme spirochetes too. But zero proof. Anyone who said NO to those herbs because there wasn't enough scientific evidence would still be sick and getting worse by the year.
In our basic rudimentary limited knowledge of the brain, we tend to associate anxiety with GABA. In my view, that is grossly in error. That assumes we know more than we do. Anxiety comes from multiple avenues. Certainly the GABA avenues can calm some of it down, but to assume it is the heart of the machine is wrong I think.
The studies on chamomile, yeah, it is indeed a calming herb. But also to many who have tried it, it aggravates depression. That is the reason I did not include it in my list. I included herbs that I know for a fact work without worsening or causing depression. I don't know how they work and I don't care.
The Chinese use medicines they've used for thousands of years and they don't know how they work, only that they do work. That's the difference between Eastern medicine and Western medicine. In Western medicine, we are not comfortable with a treatment unless we can explain it. The Chinese explain it only symbolically, not scientificially, such as "clears heat" or "relieves dampness". They see psychiatric disorders originating in the kidney, liver, spleen, and gut, not the brain. In contrast, we totally ignore the entire body as if it were somehow unattached to the brain and can't possibly have any impact on it.
I'm just saying. Don't base your decisions on whatever science you can find. Just try stuff. You'll find something that works really well and agrees with you. You will likely never know how it works, why it works, or what it is doing. And quite frankly, it doesn't matter.
Passionflower may not be a great one for you. Or it could be a miracle. No study is going to tell you that. A personal trial will.
Posted by Melanie-00 on December 21, 2010, at 22:34:44
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by bleauberry on December 21, 2010, at 17:53:34
Hi Bleauberry,
Only problem with just trying stuff is that this could get really expensive really fast. I don't have much of a budget for this stuff. So I'm trying to hedge my bets by looking at the research, as I make my choices about what to try and in what order. Anyway, this is the kind of person I am. Sort of scientific-minded, though not a scientist myself. But I agree that rat studies are not going to tell us anything very useful, but sometimes they are an indicator. Usually rat studies preceed any clinical trials on humans. The clinical trials on humans may turn out totally differently from the rat studies, but that's the starting point.Again, I wanted to say thanks again for all your many suggestions posts/suggestions. It's really great to get your ideas, and as time goes by, I'll probably experiment with more of them. I've been taking a calcium glycinate chelate/magnesium glycinate chelate supplement and rhodiola rosea supplement for a week+ or so now (along with inositol and NAC), and I think it's helping a bit. I broke my own rule by adding in supplements faster than one at a time, so I don't know for sure which one is helping the most. (It's not the inositol, since I was on that one for 2 months before I started the others.)
My anxiety may be linked to trichotillomania (I've suffered from that for decades), which is why I've focused on the inositol and NAC in addition to the more "traditional" alternative/complementary treatments for anxiety.I wish there were more research on botanicals, I think this would be extremely useful to so many people. But most medical researchers just aren't interested. What a shame! So, yes, to a large degree, we do have to go it alone because even if we are research-oriented (as I am), the research just doesn't exist. But when it does exist, it can be a useful guide (not definitive in any way, but a guide, anyway).
It sounds like you are very interested in Chinese medicine, and that is another wonderful medical tradition that certainly deserves attention. I don't in any way discount it, but, frankly, I know almost next to nothing about it, and I don't have a Chinese medical doctor to advise me. It would take me a while to get to the point where I was proficient enough in it to be able to comfortably use it in my own medical decision making process. But having been a patient in the Western biomedical system all my life, and having some basic background in biology, I do feel that I can read a medical journal article and take away something from it that might be useful to me. So that's why I usually go in that direction (versus thinking about herbs from a Chinese medical perspective or some other perspective). Nothing beats out personal experience, though. Except that personal experience may miss out on some of the risks/hazards. For example, an herb may work great for anxiety but be harming your liver without you even knowing it. That's the one area where personal experience alone may not be quite enough to protect you ... Although I think most of these herbs/botanicals are probably extremely low risk at low doses.
Best wishes.
Posted by mrtook on January 10, 2011, at 9:50:20
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas? » bleauberry, posted by Melanie-00 on December 21, 2010, at 22:34:44
Melanie,
I am curious to how you are doing? Have your trials in alternative therapies been successful? I hope they have! I would love to hear more about what works for you.
Posted by psychobot5000 on January 10, 2011, at 12:24:53
In reply to Non-prescription therapy for anxiety (GAD): ideas?, posted by Melanie-00 on December 12, 2010, at 22:24:41
Saw this thread, thought I'd share recent experiences:
Have been taken Passiflora recently, but now have stopped. It was not, overall, a good experience; taking several capsules of the herb was briefly anxiolytic, but was followed by a 'come down' about twelve hours later--making for a very unpleasant afternoon, if one took it the night before. This happened on four occasions, so it seems to be a consistent effect for me. Do not intend to take it again.
Have also been taking chamomile, which herb's effect I do not fully understand at this point. When taken in sufficient doses, i.e. 3-4 350 mg capsules nature's way chamomile, it is mildly anxiolytic, but the effect seems to last longer than I'd prefer--at least eight hours. It also seems to have an interaction of some sort with my sleeping med, zaleplon (similar to ambien or benzodiazepines), possibly blocking its action in some way. (my hypothesis is that something in the chamomile competes with the zaleplon to bind at GABA receptors, but who knows) I'd like to understand more about this, to know whether the chamomile can be useful in the medium term. Right now, it's hard to say.
Hope that's helpful, in some way. The chamomile definitely has some action, and might be worth trying, at least (the Nature's Way stuff is fairly cheap).
Psychbot
Posted by Melanie-00 on January 10, 2011, at 14:53:00
In reply to Re: Non-prescription therapy for anxiety (GAD): ideas?, posted by mrtook on January 10, 2011, at 9:50:20
Hi All,
Thanks for your continued interest in this thread.
I didn't want to experiment with too many supplements at once because it would get too confusing and expensive. I decided to try NAC (N-acetyl-cysteine) and Rhodiola rosea (RR).Currently, I am taking 2400 mg of NAC per day (1200 mg bid). And 600 mg per day of RR (300 mg bid) (a very high dose). I worked my way up to these doses slowly over a matter of weeks and will give more details on that later. However, I plan to stay at these doses for now, and I doubt I will go any higher.
If there is an effect from these supplements so far on my anxiety, it has been subtle. My anxiety is still pretty bad. But I also am in a stressful situation.
I plan to report back to you all once I've been on both supplements long enough to know whether there is an effect or not. At the very least, maybe my experience can be useful to someone else. For the NAC, I have heard it usually takes about 9-10 weeks to start seeing results, and for the RR, I've heard one should wait at least a month or two (though usually it kicks in quickly ..or so I've heard).
I should note that NAC is not an ordinary choice for anxiety. The reason I decided to try it is because recent research suggests it may help with trichotillomania, which I also suffer from. I'm hoping that if it helps with trichotillomania (and related disorders like OCD), then it will also help with my generalized anxiety, if my anxiety issues happen to be related at all to my trich. I also control my trichotillomania with inositol (6 g tid), but the inositol doesn't seem to help my mental state beyond helping me to not pull my hair out. Plus the inositol powder is expensive compared to the NAC. So if the NAC can help with my trich, then at the very least I hope to reduce my inositol dosage.
Anyway, I hope to have a better sense of the efficacy of these supplements in a few more weeks ...
Thanks again for your comments and suggestions.
This is the end of the thread.
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