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  • Writer's pictureAdam O'Neill

Supplements for Mental Health.

Updated: Aug 3, 2023


Supplements for Mental Health.
 

Article Summary:

  • Fish oil has been shown to be protective against depression, improve anxiety, and mood stabilization.

  • Magnesium is one of the most common nutrient deficiencies in the United States.

  • The Mediterranean Diet has solid evidence for mental and physical health.

  • Not all research is created equal.

  • Supplements are not created equal and must be evaluated for purity and potency.

 

Many of my patients are on supplements that are backed by science and good for mental health. It seems, however, that every time I walk through the supermarket, I see magazine headlines with the latest supplement or superfood craze. It can be difficult to wade through the mass pop culture literature on supplement trends. My distaste for this advertising style is mixed with a dose of humility in that before there were traditional pharmacies and medications, providers had been crushing herbs and making tinctures for millennia.


This article aims to first describe a few supplements which may be beneficial for mental health and then provides a framework for finding and evaluating research regarding supplements so that you can be well informed as you make decisions about your health.

It should be noted that specific supplement and medication recommendations should come from your mental health or medical provider. There is no one-size-fits-all model for health.


Fish Oil (Omega-3 Fatty Acids)


For many years, fish oil has been recommended to patients to reduce the amount of bad cholesterol present in their blood. More recently, this common OTC supplement has been recommended for mental health concerns ranging from mood stabilization, depression prevention and even anxiety.


What is important in supplementing for mental health disorders is the amount of Omega-3 fatty acids present in a fish oil supplement. Where lower doses seemed to positively impact physical health, mental health conditions generally used higher doses (around 1-2g total of EPA/DHA, which are reported on the back of the bottle).

The main side effects of fish oil supplementation include upset stomach and fishy burps. These can be mitigated, however, by taking fish oil with a meal and not before bed.


Magnesium.


Magnesium deficiency is one of the most common nutrient deficiencies in the United States. It isn’t hard to see why when we know what foods are highest in this important micronutrient: whole grains, dark-green vegetables, and beans.

A magnesium supplement has been used to improve depression, reduce anxiety, and improve sleep.


Magnesium comes in different forms. Magnesium citrate is used to correct deficiencies but has a laxative effect at higher levels. Magnesium oxide seems more difficult for the body to absorb, so it is not frequently used to correct a deficiency. Magnesium glycinate has good evidence for improving sleep, depression and anxiety.

Average supplement doses are generally 320mg daily for women and 420mg for men.


Overall Diet.


This article was originally written and published in January, a month marked by advertisements for the newest diet trends. I am often asked which is the best for mental health. In my opinion, our view about food is more crucial than any particular diet. All food is fuel, and we want the highest quality, cleanest fuel available. By the same token, less nutritious food does not cease to be fuel and doesn’t need to be eliminated entirely, but it certainly may produce less “mileage” than higher-quality fuel.


In terms of densest nutrition, the Mediterranean diet has one of the highest concentrations of green leafy vegetables, high-quality oils, lean meats and fish, fruits, beans/legumes. In addition, it seems to include higher antioxidant foods than other diets, which help the body fight against free radicals and prevent cancer. Studies have confirmed the Mediterranean diet’s efficacy in improving mental and physical health.


One of the goals of modern medicine is to encourage patients to be active participants in their health and be key decision-makers regarding healthy choices. More important than supplements or diet recommendations is equipping you, the reader, to evaluate evidence independently.


How do we find good literature?


There’s a lot of information available today. From print media like magazines, books, and newspapers to electronic articles, blogs (like this one), and social media, it can be difficult to find trustworthy and succinct literature. Providers often rely on databases to quickly search and refine articles, and while these are also available to patients, they can be difficult to navigate. Other organizations have made it a goal to make these studies available to patients in a readable and understandable way. I like Examine.com for their ability to summarize articles, evaluate evidence (discussed more next), and make recommendations.


How do we evaluate research studies?


Not all research studies are created equal. Some don’t have enough participants; good studies should have at least 30 subjects but ideally many more. Some can only look back in time by studying databases or events that have already happened. Others conduct experiments and record the findings, but neither the participants nor the researchers are aware of which is the treatment or placebo. Some don’t contain a placebo at all.

When looking at research, it is best to look at Randomized Controlled Trials (RCTs) that were double-blinded (neither the participants nor researchers were aware which was the actual drug/supplement and what was placebo until the end). When enough RCTs have been conducted, researchers can conduct reviews of all these studies and publish Meta-Analyses which can summarize thousands and even hundreds of thousands of trials.


Lower on the list of good studies would be things like an expert opinion, personal testimony (such as from a celebrity), or controlled trials that weren’t blinded.


How do we find good supplements?


In 2015 an investigation by the New York Attorney General’s office concluded that supplements from 4 major retailers (GNC, Target, Walgreens, and Walmart) didn’t contain any of the herbs/ingredients listed on the label. This revelation brought to light the lack of oversight and regulation in the supplement and vitamin industry.

Because the FDA does not regulate supplement companies, it is up to each individual company to show consumers that their brand can be trusted. Some have in-house labs that sample their products and report results. However, it is better when companies hire outside laboratories to test their products for purity and potency.

This is what we are looking for when we want a good supplement:

  • Independent lab tested.

  • Tested for purity (free from contaminants and harmful materials).

  • Tested for potency (that what is reported on the label is, in fact, in the bottle).

As a general rule, I would avoid supplement “stacks,” which contain several (or even a dozen) ingredients. Though convenient, stacks make it difficult to verify amounts of individual ingredients and can lead to interactions with other supplements/medications.


For more specific recommendations, we invite you to schedule a free phone consultation to see if meeting with one of our providers would be helpful to you.



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