It should be no surprise that more and more of your health and beauty aids customers are making a beeline for your store?s ?stress? section. More than 19 million Americans are affected by anxiety disorders, according to the National Institute of Mental Health, and the American Psychological Association reports that 75 percent to 90 percent of all physician office visits are for stress-related ailments and complaints.
The typical doctor?s method of reducing the symptoms of stress—anxiety, depression and other emotional disorders—is prescription medications. But many consumers are looking for alternatives to pharmaceutical mood elevators that have harsh side effects.
Although you may be familiar with popular herbs and supplements for stress symptoms such as St. John?s wort and kava, there are also other stress-reduction supplements on the market such as Relora, L-theanine and phosphatidylserine.
Anatomy of stress
Stress and anxiety often go hand in hand. Anxiety involves emotional apprehension and fear, while stress involves a physiological stimulus-response reaction. The symptoms of stress and anxiety run the gamut: irritability, depression, increased heart rate, shallow breathing, muscle tension, headaches, gastrointestinal disturbances, dizziness and chest pain.
Stress triggers what is known as the stress response. Often referred to as the ?fight-or-flight? reaction, the stress response causes the pituitary gland to send out a burst of adrenocorticotropic hormone. The adrenal glands, in turn, release a flood of the stress hormones cortisol and adrenaline into the bloodstream. Shawn Talbott, Ph.D., editor of SupplementWatch.com and author of The Cortisol Connection (Hunter House Publishers, 2002) series of books, explains that short-term activations of the stress response can be a good thing. ?If you?re a zebra and a lion is chasing you, a 60-second, short-term stress response sharpens mental function, burns some calories and temporarily stimulates your immune system.?
Long-term activation of the stress-response system, on the other hand, can disrupt almost all of the body?s processes, increasing risk of obesity, insomnia, digestive complaints, heart disease and depression, according to the Mayo Foundation for Medical Education and Research. The National Institutes of Health reports that chronic stress contributes to immune dysfunction, Alzheimer?s disease, diabetes and age-related disorders.
Many who suffer from chronic stress and anxiety take antidepressants and benzodiazepines. Sales of Zoloft, a popular antidepressant used to treat anxiety, reached $845 million for the first quarter of 2005, according to its manufacturer, Pfizer.
Monoamine oxidase inhibitors, tricyclic antidepressants and selective serotonin reuptake inhibitors are antidepressants that are commonly used to treat anxiety disorders and chronic stress. Grouped according to the specific chemicals in the brain they affect, antidepressants are believed to work by slowing the removal of neurotransmitters or making them more available. Benzodiazepines, which are also used to treat anxiety disorders, are anxiolytics that are believed to work by enhancing the function of the neurotransmitter gamma.
These medications are often accompanied by a host of side effects. Interactions between MAOIs and other substances can cause dangerous elevations in blood pressure or other potentially life-threatening reactions. Tricyclics can cause dizziness, drowsiness, dry mouth and weight gain, whereas SSRIs can cause headache, nausea, sleeplessness and sexual dysfunction. Benzodiazepines can cause drowsiness, loss of coordination, fatigue and dependence. Perhaps most concerning are Food and Drug Administration warnings that antidepressant medications may increase suicidal ideas and behaviors in children and adolescents.
Because of the side effects associated with antidepressants and benzodiazepines, a growing number of health care professionals advocate the use of dietary supplements instead. Relora, L-theanine and phosphatidylserine are among the latest substances that Talbott says HABA retailers should be offering to their stressed-out customers.
Relora is a patent-pending substance that contains extracts of Magnolia officinalis and Phellodendron amurense. Next Pharmaceuticals, based in Irvine, Calif., began marketing Relora in 2001. ?The extracts in Relora contain compounds that act on some of the same benzodiazepine receptors that many of the prescription drugs for anxiety do, but not on the ones that cause sedation,? says Chief Executive Bob Garrison. ?The combination of extracts used in Relora complement each other to make a more complete anti-anxiety agent than either one alone.?
A study published in 2001 in Psychopharmacology found that Relora had nonsedating, anxiolytic activity in eight-day-old chicks following a separation stress procedure. The study concluded that Relora ?may be useful in modulating anxiety states.? Garrison says that additional research is required to determine if Relora?s mechanism of action is balancing cortisol levels, but he says preliminary studies suggest that?s precisely what Relora does.
Relora is currently being used as an ingredient in dozens of supplements brands. Solaray combines Relora with L-theanine in its Total Calm. Other companies market it as a single-entity product. Lifetime Health is using Relora in a functional beverage that Garrison says retailers can expect to see soon.
L-theanine is an amino acid found in green tea. It is believed to be a nonsedating relaxant that works by stimulating the brain?s production of alpha waves and other calming amino acids (dopamine, gamma-aminobutyric acid and tryptophan). Alpha brain waves are associated with a state of relaxed alertness, and studies show that people who produce more alpha brain waves have less anxiety. ?In animal models, theanine is shown to decrease norepinephrine levels, decrease systolic and diastolic blood pressure and suppress the stimulatory effects of caffeine,? according to the Natural Medicines Comprehensive Database (Therapeutic Research Faculty, 2003).
?A cup of green tea might give you 10 or 20 mg of theanine,? says Talbott, ?but as a really effective relaxation agent, you need 50 to 200 mg, so supplemental theanine is your best option.?
Unlike valerian and kava, which depress the central nervous system and have a mildly tranquilizing effect, L-theanine is nonsedating. New York-based physician and nutritionist Fred Pescatore uses L-theanine in his practice. ?It can stop an anxiety attack and can also work on the underlying neurotransmitter issues associated with chronic stress,? he says.
Talbott says both Relora and L-theanine can cause drowsiness in a small percentage of people. ?I also caution people not to use either of these supplements in combination with prescription antidepressants,? he says. ?Because they affect some of the same neurotransmitters in the brain, this could cause a sort of double-dosing situation.?
Phosphatidylserine is a phospholipid found in concentrated amounts in brain cells. PS is believed to play structural and functional roles in muscle metabolism and immune system function. ?PS may have a long-term ability to modulate cortisol levels and overall exposure to stress,? Talbott says, ?but it?s not something that people are going to take and feel immediate effects from.?
Originally, supplemental PS was derived from the brains of cows, but concerns about mad cow disease have prompted manufacturers to use soy sources instead. Results of studies on plant-derived PS indicate the soy lecithin PS, like bovine-derived varieties, has cortisol-blunting abilities (Stress: The International Journal on the Biology of Stress, June 2004). Supplemental PS can be found in tablet, softgel or capsule form and is recommended in two daily doses of 100 mg each.
Next Pharmaceutical?s Garrison says there has been a consumer misperception that dietary supplements are ineffective in treating the symptoms of stress and anxiety. ?Retailers need to know that there are some well-researched products out there that can really help treat the symptoms of anxiety.?
Kristen Lewis is an Arvada, Colo.-based freelance writer.
Natural Foods Merchandiser volume XXVI/number 10/p. 34, 36, 38