Are you a regular pro-biotic user? A review of studies published in General Psychiatry suggests that regulating probiotic and other supplements to balance your gut bacteria may help those with anxiety.

Roughly 18% of the US population suffers from anxiety symptoms, and while anxiety is treatable, only 39% get any help for it. Whether it’s due to access to healthcare or stigma, the new review is promising for those who might want to take steps in finding relief for their symptoms.

The gut regulates brain function though a thing called the “gut-brain axis.” All those microorganisms living in the gut aren’t just there to process food. They affect the immune system and the metabolism by acting as the referees for nutrients, vitamins and inflammatories. This has a direct impact on brain function.

Researches from the Shanghai Mental Health Center at Shanghai Jiao Tong University School of Medicine reviewed 21 studies encompassing 1,503 people to find evidence that might show anxiety symptoms improve by regulating the microorganisms in the intestines. 14 of those studies used probiotics to regulate the bacteria and the rest simply adjusted their diets and daily routines for wellness.

What are probiotics? They’re essentially “good” bacteria that prevents bad bacteria from hijacking your gut.

The conclusion from the studies? 52% of the studies showed improvement in anxiety symptoms by regulating the gut bacteria.

Of those studies, the ones that proved most effective in encouraging good bacteria growth and relieving anxiety symptoms? The methods using a dietary change rather than a direct probiotic supplement. The researchers cited that the efficacy of a diet change had a significantly better effect on relieving anxiety because diverse energy sources introduce many more ways for gut bacteria to grow.

Another reason for this? The studies that used probiotics introduced different strains at once which might have been competing with each other instead of growing in the gut.

The researchers conclude: “We find that more than half of the studies included showed it was positive to treat anxiety symptoms by regulation of intestinal microbiota.”

“There are two kinds of interventions (probiotic and non-probiotic interventions) to regulate intestinal microbiota, and it should be highlighted that the non-probiotic interventions were more effective than the probiotic interventions. More studies are needed to clarify this conclusion since we still cannot run meta-analysis so far.”

They also suggest that, in addition to the use of psychiatric drugs for treatment, “we can also consider regulating intestinal flora to alleviate anxiety symptoms.”