5 stress-relieving vitamins and supplements to fight physician burnout

As a physician, you are twice as likely as the average working American to be stressed and experience burnout. According to a recent survey from the American Medical Association (AMA), 43.9% of physician respondents reported at least one symptom of burnout and–compared with other working adults in the United States–were at an increased risk for burnout. The primary causes of physician stress, according to the survey? Administrative burden, lack of time, and long hours.

To fight stress, there are many, many options. But sometimes, exercising regularly, eating right, and getting enough sleep may not be enough to reset you, particularly when you’re faced with these stressors every day. That’s when getting some extra help could come in handy.

Here are five supplements and vitamins that could give your body and your mind that bit of extra resilience to mitigate the stress of life as a physician.

B vitamins. Top on the list of stress relieving vitamins and supplements are the B vitamins. Eight B vitamins make up the B complexes, which are essential for heart and brain health. They include thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), vitamin B6, biotin (vitamin B7), folic acid (folate), and vitamin B12.

The B vitamins are found in a variety of foods, including grains, meats, eggs, dairy products, leafy greens, and legumes. Each B vitamin has its own role in helping the body run smoothly. As a group, they are important for your nervous system, cell metabolism, red blood cell production, and converting food into energy.

Several studies have linked high doses of the B vitamins with reduced symptoms of stress, which may occur because the B vitamins work to lower serum homocysteine levels. High levels of this amino acid are associated with stress and increased risks of heart disease, dementia, and colorectal cancer.

Of particular note is a 12-week study in 60 participants with work-related stress. Researchers found that those who took two forms of a vitamin B complex supplement had fewer work-related stress symptoms such as anger, fatigue, and depression compared with placebo.

Supplementing with B vitamins as part of a multi-vitamin and mineral supplement may improve mood and stress via lowering homocysteine levels, according to several studies and a large review. These vitamins are water soluble and generally safe when taken in the recommended levels, but large amounts can cause side effects such as nerve pain.  

Rhodiola (Rhodiola rosea). Rhodiola is an adaptogenic herb grown in the cold mountains of Russia and Asia. Used for hundreds of years in Chinese and Ayurvedic healing, adaptogenic herbs are non-toxic plants that are purported to help the body resist stressors—both chemical and biological. Rhodiola’s adaptogenic properties are linked to two of its active ingredients: rosavin and salidroside.

Researchers of an 8-week study in 100 participants with symptoms of chronic fatigue found that 400 mg/d of rhodiola extract led to improvements in symptoms—such as poor sleep quality and short-term memory and concentration impairments—in just 1 week, and symptoms continued to improve for the rest of the study.

In another study, symptoms associated with stress-related burnout improved in 118 participants who took 400 mg/d of rhodiola extract for 12 weeks. Symptoms included anxiety, exhaustion, and irritability.

Glycine. Glycine is thought to increase the body’s ability to resist stress by promoting a good night’s sleep. It has calming effects on the brain and can lower the core body temperature, which in turn, promotes sleep. 

Glycine is an amino acid, and as such, is a building block for protein. Glycine also stimulates production of serotonin, the feel-good  hormone, and helps regulate nerve impulses in the CNS, specifically those in the spinal cord, retina, and brainstem. Primary dietary sources for glycine are foods rich in protein, including meat, poultry, fish, dairy, and legumes. Cereals, and pastas are also good sources of this amino acid.

Several studies have been done to assess the stress-relieving properties of glycine. In a small study, researchers found that participants who took 3 g of glycine before bedtime had less fatigue and increased alertness the next day compared with those who took placebo. Results suggested that glycine improved sleep quality, because there were no differences in the time it took subjects to fall asleep or the amount of time they slept. In another study, a bedtime dose of 3 g of glycine improved not only sleep quality, but performance on memory recognition tests.

Ashwagandha. Ashwagandha may reduce stress, anxiety, and depression. Like rhodiola, ashwagandha (Withania somnifera) is an adaptogenic herb. It is also called Indian ginseng, poison gooseberry, and winter cherry. Native to India, ashwagandha has been used in Ayurvedic medicine for centuries. And, like rhodiola, it is thought to bolster the body’s ability to resist both physical and mental stress.

In a recent, randomized, double-blind, placebo-controlled study of 60 participants with mild stress, doses of 240 mg of ashwagandha extract for 60 days were associated with greater reductions in stress, anxiety, and depression compared with placebo. It was also linked to a 23% reduction in morning levels of cortisol, a known stress hormone.

Stress, anxiety, and fatigue levels were improved in participants with anxiety and stress, according to results from one review. Finally, other researchers concluded that ashwagandha, taken at doses of 600 mg/d for 60 days, was safe and well tolerated.

Ashwagandha is traditionally taken as a powder mixed with honey and warm milk.

L-theanine. L-theanine is a natural compound found in tea leaves that has been shown to reduce stress and promote relaxation.  Perhaps the most familiar and studied source of L-theanine is green tea, but it is also found in black tea.

In a large review involving almost 68,000 participants, researchers found that drinking green tea was associated with reduced anxiety and improvements in memory and attention. They attributed these effects to the synergistic effects of the caffeine and L-theanine contained in the tea.

But L-theanine on its own may also relieve stress. Supplementation with 200 mg of this compound reduced measures of stress generated by performing a mentally stressful task, according to one study. In another, researchers found that drinking a beverage containing 200 mg of L-theanine and other nutrients lowered cortisol levels generated in response to a stressful multitasking exercise.

Since the average commercial tea bag contains only 10-20 mg of L-theanine, supplements—which range from 200-600 mg/d in capsule form—are probably the best way to go for noticeable stress relief.