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Balancing Gut Microbiota Could Improve and Treat Anxiety

Probiotics and nutritional changes can reduce anxiety symptoms.

Key points

  • Research suggests that nutritional changes can restore the gut microbiome and help treat anxiety. 
  • Adding probiotics to one’s daily routine can help restore gut balance.
  • A low FODMAP diet can help reduce anxiety symptoms.
Karley Saagi / Pexels
Source: Karley Saagi / Pexels

A recent review of 3,334 articles and 21 studies found that interventions such as probiotics and nutritional changes can restore the gut microbiome and help treat anxiety. About half of the studies found that regulating intestinal microbiota through probiotics or diet changes could improve anxiety symptoms.

Gut microbiota refers to the trillions of microorganisms that live in the gastrointestinal tract, including bacteria, fungi, protests, and viruses. These microorganisms are vital for a healthy immune system and metabolism and can impact inflammation, absorption of nutrition, and vitamin levels. The gut-brain connection describes the impact that gut microorganisms have on the nervous system, immune system, and hormonal system.

Dysbiosis is an imbalance of intestinal microbiota, which can result from antibiotics, infections like Covid-19, or an imbalanced diet. A diet high in sugars or food additives like artificial sweeteners can cause worsening intestinal inflammation and overgrowth of certain types of bacteria, leading to both negative physical and mental side effects. Gut imbalance and overgrowth of microbiota have been linked to worsened anxiety and mood.

The most typical form of dysbiosis is a decrease in the diversity of gut microbiota. There are different ways to restore the gut microbiota such as probiotics, dietary changes, and lifestyle changes. A review of research studies found 11 of the 21 studies showed that changing intestinal microbiota could improve anxiety symptoms. Five of these studies used probiotics to change gut health, and six studies used non-probiotic treatments such as a low FODMAP diet.

Non-probiotic dietary interventions were significantly better (80% of studies) and more effective than the probiotic intervention (45% of studies) at improving anxiety symptoms. One hypothesis is that food directly provides energy to the gut microbiota, so changing diet directly alters the ecosystem living in the gut.

In particular, a low FODMAP diet could be helpful to reduce anxiety symptoms. A low FODMAP diet means foods low in a class of carbohydrates called "fermentable oligosaccharides, disaccharides, and monosaccharides and polyols."

Foods to avoid are "high FODMAP foods" such as:

  • green peas, cauliflower, mushrooms, onions
  • apples, apple juice, mango, watermelon
  • milk, dairy, yogurt
  • biscuits, wheat bread
  • cashews, pistachios
  • high fructose corn syrup.

Instead, anxiety could be improved by shifting your diet to low FODMAP foods including:

  • carrots, cucumber, lettuce, potato, tomato, bell pepper
  • cantaloupe, grapes, kiwi fruit, orange, pineapple, strawberries
  • almond milk, eggs, tofu
  • oats, spelt bread
  • dark chocolate, maple syrup
  • peanuts, walnuts, and pumpkin seeds.

Adding probiotics to your daily routine can help restore gut balance. Changing what you eat has an even greater chance to reduce your anxiety symptoms.

Marlynn Wei, MD, PLLC © 2023


Hrncir T. Gut Microbiota Dysbiosis: Triggers, Consequences, Diagnostic and Therapeutic Options. Microorganisms. 2022 Mar 7;10(3):578. doi: 10.3390/microorganisms10030578. PMID: 35336153; PMCID: PMC8954387.

Yang B, Wei J, Ju P, Chen J. Effects of regulating intestinal microbiota on anxiety symptoms: A systematic review. Gen Psychiatr. 2019 May 17;32(2):e100056. doi: 10.1136/gpsych-2019-100056. PMID: 31179435; PMCID: PMC6551444.

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