Anxiety is a very real and unpleasant physiologic condition, created by over-stimulation of the adrenal glands.  These tiny organs which sit above the kidneys (“ad” above, “renal” kidney) secrete potent hormones including cortisol and adrenaline.  Adrenaline, as you know, is the “fight or flight” hormone, which can cause intense core vaso-constriction as blood is shunted to the major running muscles and to the brain.  This temporary but extreme shift in blood flow dynamics creates many very real symptoms, including sweaty palms, palpitations to the point of chest pain, shortness of breath, a level of vigilance that prohibits relaxation, inability to digest food, inability to defecate.

Adrenaline is useful in an emergency situation: it inhibits bleeding and creates a temporary nearly superhuman ability to run or kick or escape from danger.  That was great in the days of the unexpected encounter with a saber-tooth tiger.  Today, however, our stressors are more likely to be less life-threatening, but more chronic.  A mean boss.  A petty supervisor.  You teen hanging out with the wrong crowd.  Money always tight.  It’s important to identify our stressors and take inventory about what we can change.  Let go of “friends” that cause stress.  Practice some form of slowing down — even 5 nice deep slow breaths — every day.  Exercise every day.  I like to commit weekly to 3 cardio sessions (brisk walking or running or swimming), 2 stretch sessions (yoga or pilates or Tai Chi) and 1-2 strength sessions (free weights or machines at the gym).  Take care of yourself.  Get enough sleep.  Drink water.  Ideally only water.

Anxiety medications are rarely the answer — especially not long term.  Last year a well designed study published in the Canadian Journal of Psychiatry showed that 14,000 people using prescriptions for anxiety had a 36% great risk of mortality.  (http://bit.ly/964PIZ)  This is because many of these medications greatly increased risk of accidents, including falling, and suicide.  The prescription drugs also significantly worsened sleep apnea, which increases risk for heart attack.

Adrenaline is an adrenal hormone, secreted by the adrenal gland, but it’s also an excitatory neuro-transmittor.  That means it stimulates excitement and activity in the brain.  Some neuro-transmittors are inhibitory, which mean they “dial down” the impact of excitatory chemicals.  GABA is an important inhibitory neuro-transmittor and some drugs aim to promote GABA levels.  I have not found giving GABA particularly helpful.  Another very important “feed and breed” neuro-transmittor, the opposite of adrenaline, is called acetylcholine, which is a calming biological molecule which promotes sleep, digestion, feelings of love and nurturing, relaxation.  Sounds good, doesn’t it!  Figuring out ways to naturally increase production of acetylcholine is an important tool for reducing and curing anxiety.

Most everyone knows that B vitamins are called the “anti-stress” vitamins.  A strong over-the-counter “stress B” blend will contain in the range of 50-100 mg of B1, B2, B3, B5 (the most important for adrenal health — also known as pantethenic acid), B6 with 1000-2000 mcg of B12 and usually also 400-1000 mg of folic acid.  Take one or two a day in the morning during periods of high stress.  Don’t take B vitamins at night because they can be mildly stimulating for some.  All these B’s are water soluble — you’ll pee out what your body can’t absorb.  And absorption is a problem for many.  If you have been taking a good B multi for a while and can’t say you notice any improvement, you may not be absorbing them.  The lower part of the small intestine (the ileum) is where B vitamins are absorbed into the bloodstream, and any irritation to the lush “brush-border” of millions of micro-villae in the ileum will compromise absorption.  By far, the most common cause of villae abrasion is gluten.  Dairy, corn, soy, coffee, peanuts, tomatoes and shellfish are other likely culprits.  Work with a naturopathic physician in your area (www.naturopathic.org – use the Find a Doctor tab) to sort out food irritants and “leaky gut.”

There’s another type of B vitamins — the fat soluble ones.  These include lecithin, inositol and phosphatidyl choline.  I mention these because you can add lecithin (unless reactive to soy, which is the source of most OTC lecithin) 1 tablespoon daily to a smoothie or into yogurt or oatmeal.  These fat soluble B vitamins are the building blocks for the calming neuro-transmittor acetylcholine.  Get both fat and water soluble B vitamins into your daily diet.

If you have been anxious for many years and are too tired to feel much enthusiasm for life, then you may have taxed your adrenal glands beyond an ability to respond  normally to the environment.  In this case, building up the glands with tonics may be required.  Some of my favorite adrenal nutrients besides the B vitamins include Licorice, Rhodiola, Siberian ginseng and dessicated adrenal glandulars.  All of these are available over the counter.  Follow the instructions on the label.  Generally double dosing for 5-10 days is not a problem with herbal, glandular or vitamin therapy.  That way you can figure out fairly soon if this supplement will work for you.  Once you sense some improvement in your anxiety, you can reduce the dose to the manufacturer’s daily recommendation.  Keep in mind: most over-the-counter supplements are designed to provide a daily dose to a 175 pound person.  If you weight significantly more, or less, factor that into the daily dosing recommendation.

If you are anxious and also have a “spare tire” of extra fat around your middle, you are likely to be over-producing not only adrenaline, but another major adrenal secretion, cortisol.  Cortisol is also a steroid hormone, and the basis of all the drug steroids such as prednisone and cortisone.  Cortisol, the natural secretion, is the body’s natural anti-inflammatory, but just like when you get the drug version, you risk messing with appetite and blood sugar levels and proper energy conversion.  In other words, steroids make you want to eat sugar, but then stores that sugar as fat, specifically triglycerides, which typically piles up around the heart, lungs, liver and abdomen.  So, if you are anxious, and “apple” shaped, you have been over-producing cortisol and need to use a type of adrenal support which diminishes over-exuberant cortisol release from the adrenal glands every time some little thing threatens to ruin your day.  I like the Ayurvedic herb Ashwaganda (also known as Withania), and also Magnolia.  These two plant medicines combined with phosphatidyl choline are featured in a product called “Cortisol  Manager” I’ve found very helpful for stress, especially for stress that causes poor sleep.

Some anxious people present as tense and jumpy.  They may be wiry and can’t sit still.  Cortisol Manager, as well as “lifestyle” management will help with all cases of anxiety.  Please do your best to accept that fact that changes will keep happening.  That’s the only sure thing in life — it’s important to be able to “roll with the punches.”  There’s a nice saying: smooth sailing doesn’t make for good sailors.