Chapter 8: Dietary Supplements for Stress Adaptation

You'll notice that supplements are the fourth part of the overall SENSE program—coming after stress management, exercise, and nutrition. I firmly believe, and the research strongly supports, that adding a targeted supplement regimen to your overall program will enhance your benefits in terms of stress reduction, cortisol control, and well-being.

Keep in mind that my supplements recommendations are not, and never have been, anything along the "take a pill and you'll be fine" line of thinking that you'll undoubtedly encounter among the many miracle weight-loss products that are on the market. Again, the role of a supplement is just that—to supplement a healthy diet and exercise regimen.

Supplements Versus Prescription Drugs

Are supplements safe? For the most part, yes. I say, "for the most part" to emphasize the importance of taking supplements only as they are recommended to be used. The vast majority of problems associated with dietary supplements result from improper use—such as taking too much in an attempt to get a "faster" or "greater" effect. It is not uncommon to find people taking a double or triple dose of a particular supplement because they want to lose weight faster. DO NOT fall for the myth of "more is better" when it comes to supplements, because more often than not, more is worse in terms of safety and effectiveness. Instead, follow the dosage guidelines listed on every supplement you are taking—and discontinue immediately if you experience any adverse side effects.

When we compare the safety profiles of natural supplements to those of synthetic drugs, the differences are striking. There are currently over three million adverse event reports (AERs) in the FDA's MedWatch database for drugs, but there are very few for dietary supplements. In the last ten years, during which several billion supplement doses have been consumed in this country, we're talking about possibly a few hundred AERs for supplements—almost all of which were due to improper use of the supplement, such as taking more than the label recommends. As far as safety profiles go, it is hard to beat the safety record for dietary supplements.

One of the reasons for the superior safety profile of supplements compared to drugs is that supplements are less potent—and a lower potency generally means fewer side effects. Even at this reduced potency, supplements may actually be just as effective as a more potent drug for producing certain positive outcomes. Because natural supplements often have dozens or even hundreds of different constituents, they can work on several aspects of metabolism simultaneously. For example, an antidepressant like Prozac may have a very potent effect on a single neurotransmitter in the brain (serotonin), while a natural supplement such as St. John's wort may help to modulate and balance several different neurotransmitters at the same time. This "multifunction" effect of natural supplements, versus the "single-effect" of synthetic drugs, has the potential to both increase effectiveness and decrease side effects.

How many drugs do we have for treating stress and the "metabolism of stress"? None! Instead, doctors will often prescribe antidepressants for stress-related mood problems and appetite suppressants for stress-induced eating—but none of these drugs addresses the root problem (and, thus, they are only marginally effective for most people). Consider the most popular drugs for "treating" obesity: Rimonabant/Acomplia, which causes side effects such as depression and anxiety; Sibutramine/Meridia, which causes side effects such as high blood pressure and anxiety; and Orlistat/Xenical, which causes side effects such as gastrointestinal problems. Each of these drugs delivers only an additional five to ten extra pounds of weight loss per year (when added to a diet/exercise regimen)—and they only work for about 50 percent of the people who try them! If that weren't a poor cost/benefit relationship, consider the fact that these drugs cost $100–$150 per month (or about $200 per pound of weight that you might lose)! The various side effects come with no extra charge.

Given the huge profit potential for drugs to treat stress-related conditions such as obesity, depression, diabetes, and fatigue, the "off-label" use of many drugs is growing—especially among those trying to lose weight. Drugs approved for treating diabetes, depression, and epilepsy are increasingly used by dieters because of their weight-loss side effects. None of these drugs has been studied or approved for safe weight loss, but because weight loss is a side effect of their main effect, some patients are asking their doctors (and the doctors are agreeing) to prescribe these drugs for weight loss. Among the growing list are drugs meant to treat attention-deficit hyperactivity disorder (Adderall and Ritalin), depression (Wellbutrin), epilepsy (Topamax and Zonegran), diabetes (Glucophage and Byetta), sleep disorders (Provigil), and smoking (Zyban).

Often, these drugs are used alone, but sometimes they're used in combinations that were never intended, or certainly not recommended, when they were allowed on the market. For example, Adderall is a stimulant that was originally marketed as a diet drug in the 1970s and has now become the weight-loss agent of choice among folks ranging from Hollywood starlets to soccer moms (most of whom take it without a prescription for the ADHD it is intended to treat).

Aside from the annoying side effects that many of these drugs carry, such as abdominal cramps, anxiety, insomnia, and memory problems, some of the drugs (such as Wellbutrin) carry the FDA's harshest "black box" warning, informing consumers about an increased risk of suicide. Adderall also carries a black box warning because it can cause sudden death, serious cardiovascular events, and addiction. Topamax causes confusion and mental disturbances, and Provigil leads to dizziness and insomnia in many people.

Used alone or in combination, monthly costs for most of these drugs easily run close to $200. Typical drug cocktails might consist of Phentermine (a stimulant) plus the antidepressant Prozac, anti-seizure drugs like Topamax, or diabetes drugs such as Byetta. Often, patients are told that because obesity is a chronic disease, they will need to take these drugs for life—or until the side effects are no longer tolerable.

As clear evidence that these drugs are being used "off label" for weight loss, sales of Adderall XR (a stimulant) increased more than 3,000 percent between 2001 and 2005, while sales of Provigil (also a stimulant) increased more than 360 percent. Last year, sales of Wellbutrin XL (a once-daily depression drug) were up more than 1,000 percent, to $1.4 billion in sales. At the same time, sales of the only two FDA-approved obesity drugs (Orlistat and Meridia) were down more than 40 percent, because they don't work very well for weight loss.

Given the high cost of drugs, in terms of both money and side effects, it is logical to look to natural options to control stress, manage cortisol exposure, and modulate the biochemical stress response. The sections that follow outline some of the most effective natural supplements for adapting to stress, including:

  • "Stress-formula" vitamin/mineral supplements
  • Cortisol-control supplements
  • HSD-balancing supplements
  • Testosterone-control supplements
  • Adaptogens
  • Relaxation and calming supplements

But first, let's review which supplements to steer clear of.

 

Shawn Talbott

Supplement Watch

Wisdom of Balance