Blackmores Institute

Clinical evidence indicates that supplementation with high-dose B group vitamins significantly reduces symptoms of stress, levels of perceived stress and anxiety, improves mood and may increase resilience.1-6 The B vitamins comprise eight water-soluble vitamins that perform essential, closely interrelated roles in cellular functioning. Collectively, their effects are particularly important for numerous aspects of brain function, including energy production, synthesis and repair of genetic material, genomic and non-genomic methylation, and the synthesis of numerous neurochemicals and signalling molecules. Dietary deficiencies in B group vitamins have been implicated in altered mood states, including work stress and psychiatric symptoms, in otherwise healthy individuals.7 Conversely, supplementation to address deficiency states has been shown to improve perceived stress, mild psychiatric symptoms and some aspects of everyday mood, as reported in two meta-analyses.5,6 Although it is well established that B group vitamins support many important physiological functions, including the nervous system, our understanding of their roles in brain function, stress and mood remains to be fully elucidated. To better understand the role of high-B complex vitamins on various aspects of brain activity and psychological outcomes, an RCT involving 108 healthy participants was conducted at Swinburne University in Melbourne.4 Researchers found that after six months of daily use, vitamin B supplementation increased connectivity in the brain between the caudate and posterior cingulate cortex (PCC). These areas of the brain are involved in reward processing, pleasure and motivation, and are suspected of being linked to resilience. These results help better explain why stressed individuals report feeling better when taking a B complex vitamin supplement. Supplementation with a multivitamin and mineral formula, particularly those with high-dose B vitamins, has a beneficial effect on perceived stress, mood and mild psychiatric symptoms in healthy individuals according to a 2013 meta-analysis of eight RCTs.5 These studies that investigated the influence of supplementation on aspects of stress, mild psychiatric symptoms or mood in the general population showed that treatment reduced the levels of perceived stress, mild psychiatric symptoms and anxiety, but not depression. Fatigue and confusion were also found to be reduced. Positive results were also reported in a more recent systematic review and meta-analysis of 18 articles (16 trials with 2015 participants, of which 12 trials met the criteria for meta-analysis).6 The review concluded that B vitamin supplementation benefits stress in healthy and at-risk populations and may particularly benefit populations at risk due to poor nutrient status or poor mood status. In particular, it found that B vitamin supplementation significantly benefited stress but not depressive symptoms and there was no effect on anxiety.6 All of the included studies in the reviewed trials used supplements containing B6 and B12, with all but one study including folic acid. Vitamins B1, B2, B3 and B5 were included in 16 of the 18 studies. Biotin was the least included micronutrient and was only included in 10 studies. Compared with the recommended daily intakes set by the Australian National Health and Medical Research Council (NHMRC), most supplements contained double the recommended daily intake (RDI) of B vitamins, with some exceeding the daily intake by 10-300 times.6 Some studies indicate that effects may be seen within four weeks. For example, a study of 300 healthy adults reported that subjective stress ratings were significantly improved following four weeks of supplementation with a vitamin B complex.1 Similar findings were reported in a small RCT of 80 healthy males, which showed that perceived stress ratings were significantly reduced following four weeks of supplementation with B vitamins compared to placebo.2 <h3>Studies on stress in a workplace setting have also shown efficacy for high-dose B group vitamins to alleviate chronic stress after three months of use. This study involving 60 participants confirmed that those receiving the supplement reported significantly lower ratings of personal strain.3</h3><h3> </h3><h3>Practice Points</h3><ul><li>B vitamins can be used therapeutically to address a range of stress states </li><li>Select a high-dose vitamin B complex or a multivitamin and mineral supplement </li><li>Evidence suggests that doses beyond the RDI may be required for therapeutic benefit in stress </li><li>The general approach is to use B vitamins in combination for stress rather an a single B vitamin supplement </li><li>Effects become apparent within one month of use</li></ul> <h3>With a high proportion of Australians experiencing mental health and mood imbalances, understanding the benefits of natural medicines for the prevention and improvement of these imbalances is key in supporting people to move from stress to strength.</h3> <h3>References</h3> <ol><li>Schlebusch L et al. (2000). A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J, 90:1216 –1223.</li></ol>2. Carroll D et al. (2000). The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind placebo-controlled trial. Psychopharmacology, 150:220–225.3. Stough C et al. (2011). The effect of 90 day administration of a high dose vitamin B-complex on work stress. Hum. Psychopharmacol, 26:470 –476.4. Downey LA et al. (2019). Increased Posterior Cingulate Functional Connectivity Following 6-Month High-Dose B-Vitamin Multivitamin Supplementation: A Randomized, Double-Blind, Placebo-Controlled Trial. Front Nutr, 6:156.5. Long SJ, Benton D. (2013). Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Psychosom Med, 2013;75(2):144-153.6. Young LM et al. (2019). A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients, 11(9):2232.7. Benton D. (2013). To establish the parameters of optimal nutrition do we need to consider psychological in addition to physiological parameters? Mol Nutr Food Res, Jan; 57(1):6-19.

Professor Lesley Braun's authoritative work in her book 'Mental Wellbeing: The Essential Guide to Using Herbs and Nutritional Supplements' offers evidence-based, clinically relevant advice for the practitioner on how to support patients in the prevention and treatment of mental health and mood imbalances. Here, we focus on an excerpt from this book looking at the important role of the B group vitamins and their role in stress and anxiety.

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