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The Anxiety of Stress

Stress & Relaxation
DaVinci Laboratories

Stress doesn’t exist in a bubble—but managing it also reduces anxiety, and boosts better sleep. Here’s how to help de-stress your clients/patients.

“I have anxiety,” is such a commonly uttered statement today—even from kids! If neurochemical disorders are ruled out—at the root of this is mismanaged stress.

The National Institute of Mental Health (NIMH) describes anxiety as a wide range of disorders, which differ by inducements (eg, genetics, neurochemical disorders, life events, etc.). The range includes panic disorder, generalized anxiety disorder and phobias (from agoraphobia to zeusophobia, which is fear of God or gods). The website, Livingwithanxiety.com, asserts that “anxiety occurs when you develop chronic stress that lasts for six months or longer. The physical symptoms of anxiety are often similar to that in stress.”

Further, according to the Anxiety and Depression Association of America:

• Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults 18 and older, or 18.1 percent of the population every year.

• Anxiety disorders are highly treatable, yet only 37 percent of those seek treatment.

• People with an anxiety disorder are three to five times more likely to go to the doctor than those who do not suffer from anxiety disorders.

Stress and its BFF anxiety are not new in the digital age, but are certainly more widespread. Even back as far as the mid-1990s, up to 75 to 90 percent of all visits to primary care physicians were for stress-related problems.

And supplement companies have been addressing stress and anxiety for a long time, with continued improvements in their offerings as science and technology have advanced. For example, “The stress and mood category has been a focus for BioCeuticals since our company’s founding in 1993 with products included in our earliest product launches, as well as upgrades and new products, as research and development continues to advance,” said Arina Pogossian, head of marketing for Australia-based BioCeuticals. “Stress and anxiety are among some of the biggest concerns for practitioners and their patients.”

Stress also is responsible for creating other symptoms that may encourage visits to your office.

As one example, pointed out Kristin Chadwick, president and CEO of Omax Health (Santa Monica, CA), more than 70 percent of Americans are sleep deprived. There’s a vicious cycle going on—poor and inadequate sleep leads to increased stress, which stimulates the increase of hormones like cortisol, which further disrupts sleep quality. “This, compounded with blue light from cell phones and devices, plus dependency on coffee and energy drinks, continue to wreak havoc on our sleep cycles,” she said.

In agreement is Hannah Braye, RNP, senior technical advisor, Florida-based ADM Protexin, who added that disrupted sleep patterns are thought to negatively affect the gut flora balance, and emerging research is showing that the composition of the gut flora may also potentially be impacting our sleep patterns. For example, she offered, a 2014 study revealed that probiotic supplements could modulate circadian and sleep rhythms in mice. A human trial in 2015 also suggested that multi-strain probiotic supplements may help to regulate melatonin production, which naturally increases during the evening and encourages relaxation and sleep. “Various bacterial metabolites made in the gut also appear to be inducers of REM sleep and may impact on our transition into deeper sleep. Studies have also suggested that live bacteria supplements could help to reduce stress levels and anxiety, which may therefore help to restore sleep patterns in individuals who suffer with stress,” she reported.

“Healthy sleep represents a fundamental pillar in health,” emphasized Jorge Angel, MD, medical advisor for Equisalud Laboratories in Pamplona, Spain. “Melatonin is a substance that secretes the epiphysis in dark conditions and requires its metabolic precursors such as tryptophan and serotonin, as well as cofactors of group B vitamins and some trace minerals for its production,” he explained. “The contribution of these nutrients through nutritional supplements can facilitate their adequate production.”

Stress is also known to affect digestion and bowel habits. “Nervous stomach” is mostly caused by stress and anxiety. Explained Braye, the association between stress and digestive conditions (eg, irritable bowel syndrome [IBS] and reflux) is commonly understood in the health care arena. And consumers are understanding the association as well. “Many people report a worsening of their digestive symptoms during times of stress,” she commented. “Further, stress is also known to trigger and/or exacerbate many other non-digestive conditions, for example migraine, skin conditions, such as atopic dermatitis and autoimmune conditions. Emerging research is indicating that many of those who suffer with these stress-related conditions may have dysbiosis.”

Braye further explained that the importance of the microbiota-gut–brain axis in regulating stress-related responses is becoming increasingly understood and validated via scientific investigations, opening up new avenues of potential treatment. The routes of communication between the gut microbiota and brain are understood to involve the vagus nerve, gut hormone signaling, the immune system, tryptophan metabolism and the production of microbial metabolites. “This has led to increasing research into ‘psychobiotics,’ the name given to supplemental probiotic bacteria thought to have a positive effect on brain function, mood and stress response.”

If a disruption in the microbiota-gut-brain axis may be suspected, she noted, culprits can include poor diet low in fiber and high in sugars, use of antibiotics and other medications, environmental pollutants, situational stress, excessive alcohol consumption (sometimes these two are in tandem), and lack of sufficient exercise.

The reason many dietary supplement/natural remedies brands focus on developing a natural product for stress and also for anxiety is “because the need is so great,” asserted Cheryl Myers, chief of scientific affairs and education for Wisconsin-based EuroMedica. “Patients and practitioners alike may feel frustrated in finding something that effectively addresses the symptoms of acute or ongoing anxiety without causing side effects or taking a long time to work.”

Supplementation can help your clients/patients to begin to manage stress, which will serve as a stronger foundation to manage anxiety.

Products to Recommend

Omax Sleep & Stress Relief CBD soft gels, said Chadwick, are formulated for adults for whom stress prohibits the ease of falling asleep and staying asleep, and who do not want to take OTC (over-the-counter) medicine and prescriptions that may foster habitual need. “It is helpful for anyone who is dealing with a lot of stress, has racing thoughts or cannot shut off their brain and relax at the end of the day. The natural formula helps them fall asleep easier, stay asleep longer and awake refreshed without the grogginess of typical sleep aids,” she described.

The companion Omax Sleep & Stress Remedy CBD provides a three-part therapeutic solution: Patented ProResolv Omega-3 formula with polyunsaturated fatty acids to support optimal inflammatory and mood response, full-spectrum hemp CBD to support stress-relieving endocannabinoids, and AlphaWave L-theanine to support relaxation and reduced stress. “This patent-pending, multi-mode formula promotes a sense of calm and deep relaxation unmatched by CBD alone,” she commented. Suggested dosage is two soft gels two to three hours before bed with a light snack. “Patients should see results within three to seven days of regular use,” Chadwick added.

Equisalud Labs’ HoloRam products are also developed to support sleep and bioregulate stress that can also affect the sleep quality, according to Dr. Angel.

HoloRam Dormisol provides a specific multisystemic approach to induce the balance of neurotransmission systems involved in sleep, he explained. “It provides information on activated nutrients, amino acids, trace elements and vitamins, to favor the balance of the biological reactions involved in physiological sleep. It modulates the normal adaptive response of the organism to stress. Dormisol activates the relaxing and anxiolytic systems of the nervous system, while providing a neurotonic effect, which enhances naturally healthy sleep-and wake process. It provides the modulating information of the balance of neuropeptides and neurotransmitters that control adaptive responses, favoring the physiological control of anxiety, agitation, nervousness and irritability.

Dormisol contains gamma-aminobutyric acid, and dried extracts of California poppy, valerian, chamomile and passionflower. It also offers L-tryptophan, L-arginine, L-glutamine, L-ornithine, and niacin, folic acid, vitamins B6 and B8, magnesium and zinc gluconate.

To support stress, HoloRam Equilibrium “contributes to the bio-regulation of the adaptive response to different types of stress. It blends adaptogens and energy regulators of the neurovegetative system, the central nervous system and the natural stress response systems, which have been energetically activated to promote harmonious adaptation to the changing demands of the physical and emotional environment,” Dr. Angel described. “HoloRam Equilibrium has soft sedative actions that are harmonized with the tonic stimulant effects of phytotherapeutics of recognized adaptogen potential.”

ADM Protexin’s Bio-Kult Migréa is a unique triple action, multi-strain probiotic supplement that reduces stress-induced GI (gastrointestinal) dysfunction and migraines, according to Braye. It contains 14 different strains that she said were recently used in the “largest ever double-blind randomized controlled trial of probiotics in IBS-diarrhea type patients ever conducted.”

The study in 400 people found that the Bio-Kult strains significantly improved overall symptom severity in IBS patients and was well tolerated. Abdominal pain and frequency reduced by an average of 69 percent, and 34 percent of participants were completely symptom free at the end of the five-month trial. Additionally, she noted, the Bio-Kult strains were also shown to markedly improve all aspects of quality of life. This includes psychological issues such as anxiety about health, depression, lack of enjoyment of life and feelings of having to avoid stressful situations.

“A further recent randomized, double-blind, placebo-controlled trial found that the 14 strains of live probiotic bacteria in Bio-Kult Migréa significantly decreased migraine frequency and intensity in both episodic and chronic migraine compared to placebo,” Braye reported. In addition, the use of abortive medication and Migraine Disability Assessment Score (MIDAS) were significantly reduced.

Bio-Kult Migréa also features vitamin B6 and magnesium, important to those who have high stress and suffer migraines. “There is a strong body of evidence demonstrating a relationship between magnesium status and migraine. Stress is the most commonly reported trigger for migraine attacks, and research shows an association between stress reactions and magnesium levels, with increased elimination of magnesium from the body in times of stress,” Braye explained. In those with severe stress, she added, magnesium and vitamin B6 used in combination appears to elicit greater stress-reducing benefit. Bonus—both magnesium and vitamin B6 are beneficial nutrients for sleep regulation, as these nutrients are essential co-factors for melatonin production.

According to Myers, AnxioCalm is one of EuroMedica’s primary natural remedies for calming anxiety; this clinically studied echinacea extract is said to work along the endocannabinoid pathway, but in a different way compared to hemp.

Early echinacea research found that of the seven types of echinacea included in a scientific study, only one could compare in strength to the prescription anti-anxiety drug, chlordiazepoxide (also known by the brand name Librium). This particular Echinacea angustifolia extract became the became the basis of AnxioCalm, Myers reported. The Echinacea angustifolia extract in AnxioCalm has an alkamide profile that makes it highly specific for certain CB1 receptors in the brain and targeted for reducing anxiety as a result. AnxioCalm works as effectively for anxiety as prescription drugs, but without causing drowsiness or other side effects.

And, Myers explained, clinical research using AnxioCalm shows that it works quickly. “In one study, after just one day, the participants noticed a reduction in stress and anxiety, with a 25 percent reduction in just seven days,” she said.

In another study, people recorded noticeably reduced stress and anxiety in just three days. The study included 33 men and women who all experienced mild anxiety. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI), to measure anxiety levels. Only individuals meeting the threshold for serious anxiety were included in the study, she noted. Participants used AnxioCalm for one week, and anxiety was evaluated before, during and after using the product. The extract decreased STAI (both state and trait) scores within three days, an effect that remained stable for the duration of the treatment (seven days) and for the two weeks that followed treatment.

“Anecdotally,” said Myers, “we’ve noticed that people can begin feeling a difference the same day, so it is very useful for people who need to feel calm but alert before presentations, business travel or other anxiety-producing situations.”

Another study showed that higher dosages of AnxioCalm can be useful for those with serious anxiety. A multi-center, placebo-controlled, double-blind phase II study of individuals with generalized anxiety disorder (GAD) according to DSM-IV (Diagnostics and Statistical Manual of Mental Disorders) discovered the benefits of increased dosage levels.

In this study, participants received either 40 mg of Echinacea angustifolia twice daily or placebo. Between visits one and six during the treatment period, according to Myers, the number of severely anxious patients (HADS-A scores larger than 11) decreased from 11 to zero in the echinacea group. AnxioCalm significantly reduced anxiety in those with generalized anxiety disorder, with a full effect within about 21 days. Reducing anxiety symptoms, she added, helps promote better sleep—“less ruminating, more relaxing.”

EuroMedica’s Hemp Oil provides a full spectrum of phytocannabinoids, including cannabidiol (CBD)—CBD is proactively sought out by consumers expressly for relaxing and relieving pain/discomfort.

Clinical research of CBD shows that it affects the blood flow in regions of the brain that are associated with anxiety and stress, including social fears and self-consciousness, according to Myers. It may help individuals feel calm and focused, even during highly stressful situations. For example, she pointed out, one study of CBD and stress utilized a stimulated public speaking test—a known high-stress situation. The researchers found that hemp-derived CBD dramatically reduced symptoms.

BioCeuticals Adreno Complex combines herbs used in traditional Chinese medicine such as Siberian and Korean ginsengs, with the ayurvedic herb Withania somnifera (KSM-66 extract), clinically shown to support stress adaptation and to relieve mild anxiety, according to Pogossian. Formulated with added B vitamins and amino acids for healthy adrenal and nervous system support, Adreno Complex may be beneficial during times of increased physical and mental demand. It supports healthy adrenal and nervous system function, which is considerable in relieving stress, nervous tension and mild anxiety. The adaptogen KSM-66 has been shown in studies to support the body’s resistance during stress, thereby improving stress adaptation.

These supplements and remedies discussed here may be a more preferred tool to relieve stress than benzodiazepines, which cause significant side effects—sedation, muscle relaxation and movement coordination problems—and has the potential to be addictive.

Of course, stress and anxiety are often either or both caused and exacerbated by situations. As a natural practitioner, you may assist greatly with lifestyle adjustments and the recommendation of effective supplements and natural remedies. But another key part of care for this type of client/patient is likely talk therapy, so referring to the most suitable therapist will not only help begin to reduce the cause but help effectuate your protocol.

As we know, stress is a part of everyone’s life. It’s how we learn to manage it that makes the difference in daily outlook and quality of life.

Healthy Take Aways

• Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults 18 and older, or 18.1 percent.
• As far back as the mid-1990s, up to 75 to 90 percent of all visits to primary care physicians were for stress-related problems.
• Poor and inadequate sleep leads to increased stress, which stimulates the increase of hormones like cortisol, which further disrupts sleep quality.
• Many people report a worsening of their digestive symptoms during times of stress.
• “Psychobiotics” refers to supplemental probiotic bacteria thought to have a positive effect on brain function, mood and stress response.
• Clinical research of CBD shows that it affects the blood flow in regions of the brain that are associated with anxiety and stress, including social fears and self-consciousness.

For More Information:

ADM Protexin, www.bio-kult.com
Bioceuticals, www.bioceuticals.com.au
Equisalud Laboratories, www.welifenaturals.com
EuroMedica, www.euromedica.com
Omax Health, https://omaxhealth.com