The Orthomolecular Treatment of Anxiety
In order to be awarded a patent on a pharmaceutical drug, the molecule must be foreign to the natural body chemistry. That is why we will never have a new drug introduced that is as safe as the orthomolecular equivalent. Carl Pfieffer, PhD, the noted biochemist, is quoted as saying that for every pharmaceutical there is at least one naturally occurring substance that can do the same thing. Orthomolecular treatment involves the use of therapeutic agents only occurring naturally in the body. We are about to review the orthomolecular treatments for anxiety disorders that constitute very viable alternatives to the psychiatric drugs.

Please refer to previous articles which have discussed the role of blood alkalinity and neurotransmitter balance in anxiety states. These will not be covered again in this article. Anxiety reactions are predominantly produced by exaggerated emotional response to the abnormally functioning autonomic nervous system (ANS) and certain parts of the brain. It is by stabilizing the ANS and balancing brain neurotransmitter balance that orthomolecular treatments can reduce or eliminate anxiety.

The first nutrient to consider is niacinamide or vitamin B3. It binds to GABA (a relaxation promoting neurotransmitter) channels in the brain in a similar fashion as the first anti-anxiety drugs like Valium and Librium do. The result is that the relaxation effect of GABA is potentiated and anxiety symptoms are dramatically reduced. The usual dose is in the 2000-3000mg range. Dry mouth, nausea, and rarely sleepiness can occur at these higher dose levels. Although temporary liver enzyme elevation was reported in one case at 9000mg per day, the changes were reversible, and such huge doses are not necessary. The niacinamide form does NOT cause the hot, red, and itchy feeling that can occur from taking Niacin, a related vitamin.

The next supplement to discuss is vitamin B12. Over many years of clinical experience I know that B12 injections can reduce symptoms of anxiety, depression and fatigue, and trouble concentrating even when tests for B12 levels appear to be normal. It is possible that brain and cerebrospinal fluid levels of B12 can be low even when blood levels are OK. The ideal form is the hydroxycobalamin, but the other forms also work. The usual dose is 1000micrograms at least twice weekly, usually self administered by the patient at home. Lately I am beginning to prescribe compounded sublingual drops instead of the shots for convenience, and possible equivalent effect. 

Finally, the amino acid glycine can also help anxious patients because of its inhibitory effect on norepinephrine neurotransmission.

This property makes glycine usable for the treatment of acute anxiety or panic attacks. Simply place 2 grams of glycine powder in the mouth, and hold there for a while. This dose may be repeated as needed every few minutes up to a maximum of 10 grams. It usually works very quickly in acute situations, but is not really applicable to every day use like niacinamide.

These three naturally occurring substances have powerful effects against anxiety. They are best used in cooperation with a nutritionally informed physician who is treating the whole person.