John Kernick

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The multibillion-dollar market for dietary supplements is filled with products that claim to boost mood or improve depression. Some products are even billed as an alternative to prescription antidepressants.

Don’t believe everything you read on a label. Often the claims made by supplement manufacturers aren’t backed up by solid scientific evidence, and the potency and contents of supplements can vary widely. (Some are anything but “natural.”) Serious depression generally requires professional help, whether or not that includes antidepressant medication.

That said, some supplements—such as St. John’s wort and SAMe (pronounced “sammy”)—have been tested fairly extensively and may improve your symptoms if you experience mild depression or related conditions such as seasonal affective disorder.

Below, we break down the evidence (or lack thereof) supporting the most popular supplements used to treat depression and mood.

Folic acid

What it is: The synthetic form of folate, a B vitamin (B9) found in fruits, leafy vegetables, and other foods, that affects the neurotransmitters known as monoamines. Folic acid is sold in stores as a capsule or tablet.

The evidence: Folate deficiency is common among depressed people, especially those who don’t respond to antidepressants. Folic acid has never been tested as a stand-alone treatment for depression, but it has been compared with placebo as an addition to Prozac. In one study, patients who received folic acid responded better than those who received placebo—but only the female patients. Nearly 95% of the women who received folic acid responded to the combo treatment, compared to about 60% of the women who received the placebo.

Other forms of folate that are more chemically complex have been tested on their own. In one early ‘90s study involving elderly depressed patients, a type of folate known as 5-methyltetrahydrofolate (5-MTHF) was found to be roughly as effective as the antidepressant trazodone.

The bottom line: The evidence for the use of folic acid in depression is limited and inconclusive. (The Natural Standard Research Collaboration, an independent research group, has given the evidence a “C” grade.) 5-MTHF and a related form of folate called L-methylfolate—which is available as the “prescription medical food” Deplin—may be helpful as an addition to antidepressants, but you should be wary of nonprescription products that list 5-MTHF, L-methylfolate, or “optimized folate” as the main ingredient.

GABA

What it is: Gamma-aminobutyric acid (GABA), a neurotransmitter involved in inhibition and stress relief. GABA is sold as a capsule, pill, or powder.

The evidence: Low GABA levels have been linked to depression and anxiety. Although supplement makers claim on their labels that GABA provides “Positive Mood Support” and “Supports a Calm Mood,” there is no evidence that GABA supplements have an effect on depressive symptoms; no studies have been conducted in humans to date.

The evidence for its use in anxiety isn’t much stronger. A pair of small studies conducted by a maker of GABA supplements in Japan reported that GABA did have an anti-anxiety effect. In the first study, the researchers found that taking GABA had a relaxing effect on brain waves. In the second, people afraid of heights were asked to walk across a narrow pedestrian bridge after taking GABA or a placebo. The participants who took GABA had lower levels of anxiety (as measured by a stress marker in saliva samples).

The bottom line: A connection between naturally occurring GABA and depression and anxiety has been established. Although prescription medications such as Depakote (an anticonvulsant used to treat bipolar disorder) and benzodiazepines (used to treat anxiety) affect GABA levels, there is very little evidence that commercial GABA supplements impact mood in the same manner.

Next page: Inositol, Omega-3s, and Saffron

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Green tea is rich in immunity-boosting antioxidants, but your body doesn’t absorb them well.

Solution: Add an ounce of lemon juice (or any citrus juice) to your tea, and you’ll increase absorption by up to 80%, according to researchers at Purdue University.

You don’t like hot tea? Try Tazo Lemon Green Iced Tea, made with concentrated lemon juice.

 
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Ted Morrison

Maybe you take some echinacea when you feel a cold coming on or sip a little chamomile tea to soothe an upset tummy. Smart moves. But which natural health boosters should you take regularly—and when?

The answers are extra important during tough financial times, when more and more Americans are buying vitamins and supplements as they struggle to afford traditional health care.

And because women are the biggest users of supplements, it’s critical that they know which ones really work. To make safe and effective buys, try this age-targeted advice from leading women’s-health experts.

Your 30s

Calcium You may not realize that your bone health starts waning in your late 30s. That means it’s never too early to maximize bone density with calcium, says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at the Yale School of Medicine.

“Calcium may also ease menstrual cramps because it appears to regulate muscle contractions,” she says. Shoot for a total (through diet and supplements) of 1,000 milligrams a day during your 30s and 40s, and 1,200 to 1,500 in your 50s and beyond. Dr. Minkin recommends taking the cheapest brand that agrees with your stomach—the antacid TUMS E-X 750, whose active ingredient is calcium carbonate, works well and contains 300 milligrams of calcium per tablet ($5.49; Drugstore.com). If you love chocolate, try Viactiv; it contains 500 milligrams of calcium and just 20 calories per piece ($11.49).

Magnesium and Iron If you feel cranky at the end of your cycle, 200 milligrams of magnesium may help relax you, says Roberta Anne Lee, MD, vice chair of the Department of Integrative Medicine at Beth Israel Medical Center in New York City. But you don’t need to take it every day. Daily iron pills might make sense, experts say, because plenty of women are iron-deficient as they age; they either don’t get enough iron from their diets or are low because of blood loss during their periods. Ask your doc to check your iron level with a simple blood test. If it’s low, aim for 18 milligrams of iron a day to keep your energy up.

Next: Omega-3 supplements

Francesco Mosto

It moisturizes, fights frizz, and even stops bad moods. No wonder basil is the new “it” herb. See how you can use the powers of basil to your advantage with these great spa secrets.

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More insurers are covering alternative therapies like acupuncture.

Although it may seem obvious that acupuncture helps relieve, say, your chronic back pain, insurance companies often consider such therapies—from massage to herbal supplements—outside the medical mainstream. They are, after all, still referred to as complementary and alternative medicine (CAM). However, many insurers do cover selected therapies on a case-by-case basis, depending on the way you request reimbursement.

“If you talk to insurance people, they quote you by the book and say massage is not covered. Yet, I would say one-third of our Blue Cross Blue Shield patients are getting some reimbursement,” says Paul Rubin, a chiropractic physician at WholeHealth Chicago, a medical center that integrates traditional and alternative medicine. And even if your insurance company refuses to cover alternative treatments, there are ways you can reduce your out-of-pocket expenses.

Insurance coverage
The best way to get reluctant insurers to cover alternative therapies is by making a good case that your treatment is medically necessary. The simplest way to do this is to get a prescription. Ask your primary care doctor to write one that includes the diagnosis and the frequency and length of treatment. Although they may not advertise the fact, some insurers will rubber-stamp CAM treatments if they are prescribed by a physician. Some of the most frequently covered therapies include chiropractic care, massage therapy, acupuncture, herbal remedies, homeopathy, and mind-body stress management.

One of Rubin’s patients, a woman in her mid-50s, came to his office with fibromyalgia; she had chronic pain and fatigue. She was treated by an internist, who prescribed the pain medication Lyrica, and she also saw an energy healer, an acupuncturist, and a massage therapist on staff. WholeHealth Chicago submitted a detailed claim to the insurer that included a prescription for the CAM treatments and receipts that used standard diagnostic and treatment codes. Her insurance paid for the internist and therapeutic massage, says Rubin, although the acupuncture and energy work were denied.

Another strategy is to convince the insurance company that covering alternative treatments may save them money in the long run. Some conventional treatments for chronic back pain, for instance, cost far more (and in some cases may be less effective) than alternative options such as acupuncture and biofeedback. “To a certain extent, it’s playing the insurance game,” says Rubin. “I would never ask anyone to not tell the truth, but if you can make the case clearly that what is being done is clinically necessary as an alternative to pharmaceuticals or surgical procedures, the insurance company can see, ‘Gee, this treatment is $200, while medication would be $600 and surgery would be $10,000.’”

Next page: Get a receipt

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It’s nothing. Really. Turns out your aching back will feel better after you get acupuncture—and “fake” acupuncture, too!

The Seattle-based Group Health Research Institute found that back-pain sufferers who received simulated acupuncture with toothpicks got just as much relief as those who received traditional needle acupuncture.

And both groups reported feeling better for significantly longer than people who got standard medical care. Find an MD who uses this technique. Get a chart of back-pain pressure points here.

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