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DEAR DR. ROACH: I have a sensitive issue I’d like to ask you about. I’m a 79-year-old woman who’s dealing with a lot of stress and anxiety due to the recent suicide of my husband, the trauma of finding him, and all the trauma that followed. I’m in therapy, and I’m healthy and active. I don’t take any prescribed medications.
I recently had my annual physical and asked my doctor about an over-the-counter supplement for stress and anxiety. I won’t take any prescribed medication for anxiety/depression. My husband was taking medication for this, and he committed suicide. My doctor suggested a B-complex supplement.
I bought a good brand, but when I started reading all the amounts of the ingredients, they seemed excessive -- such as 25 mg of niacin, 100 mg of thiamine, and 20 mg of riboflavin. All of these are way over the recommended daily allowance. I also read that too many B vitamins could affect the liver. I’m totally confused now. What would you recommend to a patient in my situation? -- S.L.M.
ANSWER: I’m very sorry about your husband. I don’t think that any supplements are very effective for anxiety, especially the high level that you likely have after the profound trauma of losing a spouse.
Of the supplements that are recommended for anxiety, the one with the best evidence is lavender extract, of which there is one brand (made from English lavender) that has been well-studied at 80 mg. I don’t recommend kava extract, which doesn’t have good evidence and has been associated with liver damage. Chamomile may have some benefit and is very safe, although the evidence isn’t as strong as with lavender.
The doses of the B vitamins you’re taking are in the levels that are generally considered safe. We used to prescribe much-higher doses of niacin for the treatment of high cholesterol, but newer options are safer and more effective. A dose of 35 mg or less is considered safe by the National Academy of Medicine, although our European counterpart says 10 mg.
A dose of 100 mg of thiamine is considered safe. Much-higher doses are sometimes used (although above 100 mg is probably ineffective since the rest is excreted by the kidneys). Similarly, 25 mg of riboflavin is safe, and higher doses, again, just come right out in the urine.
Liver disease with any of the vitamins you mentioned is extremely unlikely at the doses that you’re considering. Water-soluble vitamins are mostly excreted by the kidneys. However, I don’t think that they’re helpful for anxiety.
I do understand your concern about antidepressant drugs (many of which are also used for anxiety and prolonged or severe grief reactions). But the evidence is very strong that especially in older men, the most commonly used SSRI drugs reduce the likelihood of suicide. So, I’m very sorry that he died of suicide in spite of treatment.
There’s a temporary increase in suicide risk for children and adolescents with SSRI drugs, so psychiatrists and other prescribers must carefully consider the risks and benefits for this age group. Unfortunately, depression, like most other diseases, can be so severe that sometimes we can’t treat it effectively, or we may not have brought in our most-effective treatments early enough.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.
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