Figure 2.

Mechanisms of herbal supplements for stress. Cancer and cancer treatment affect a patient's quality of life resulting in various symptoms of stress, such as anxiety, depression, sleep disturbance, and fatigue [155]. The human body's response to such stressors involves many different mechanistic pathways. This diagram outlines the mechanisms by which herbal supplements reduce stress-related symptoms in cancer patients. The majority of herbal supplements have anti-inflammatory properties, but their primary target of action is different. Lavender acts as vascular smooth muscle relaxant through nitric oxide/cGMP phosphorylation and myosin light chain dephosphorylation [156]. Lemon balm is an immune stimulating agent with potent free radical scavenging properties [157–159]. Kava and St. Johns's wort function reduce norepinephrine (NE) and increase serotonin levels, similar to antianxiety drugs such as benzodiazepines [116, 122, 160]. Valerian and passionflower are GABA_A receptor agonists that produce a sedative effect [161, 162]. Ginseng and mistletoe are potent anti-inflammatory agents that inhibit NFkB and/or COX2 [127, 163].