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S-Adenosylmethionine (SAMe) is a naturally occurring compound that is
involved in many biochemical processes in the body. SAMe plays a role in the
immune system, maintains cell membranes, and helps produce and break down brain
chemicals such as serotonin, melatonin, and dopamine as well as
vitamin B12. SAMe also participates in the making of genetic material, known as DNA, and
cartilage. Low amounts of folate (vitamin B9) in the body may lead to reduced
levels of SAMe.
Numerous scientific studies indicate that SAMe may be useful in the treatment
of depression, osteoarthritis, fibromyalgia, and liver disorders. Although it
has been available in Europe by prescription for a number of years, SAMe was
only recently introduced as a dietary supplement in the United States.
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SAMe offers a variety of potential therapeutic uses, primarily in the
treatment of the health conditions listed below. It is important to note that
SAMe has not been tested carefully over long periods of time. For this reason,
it is not yet known whether using SAMe for an extended length of time (months or
years) is safe.
SAM-e for depression
Preliminary research suggests that SAMe is more effective than placebo in
treating mild to moderate depression and is just as effective as anti-depressant
medications without the side affects frequently associated with the medications
(headaches, sleeplessness and sexual dysfunction). Plus, antidepressants tend to
take six to eight weeks to begin working, while SAMe seems to begin much more
quickly than that.
More research regarding the safety and effectiveness of SAMe, especially for
longer periods of time, is needed. It is not clear exactly how SAMe works to
relieve depression, so it is best to avoid using SAMe together with other
antidepressants. In addition, given the serious nature of this mood disorder,
professional help should be sought for symptoms of depression before taking SAMe
or any substance.
Osteoarthritis
Laboratory and animal studies suggest that SAMe may reduce pain and inflammation
in the joints as well as promote cartilage repair, but researchers are not clear
about how or why this works. Clinical trials with people (although generally
small in size and of short duration) have also shown favorable results for SAMe
when used to relieve osteoarthritis symptoms. In several short-term studies
(ranging from 4 to 12 weeks), SAMe supplements were as effective as NSAIDs (nonsteroidal
anti-inflammatory drugs) in adults with knee, hip, or spine osteoarthritis. SAMe
was equivalent to the medications in diminishing morning stiffness, decreasing
pain, reducing swelling, improving range of motion, and increasing walking pace.
Several of the studies also suggest that SAMe has fewer side effects than NSAIDs.
Fibromyalgia
From studies comparing SAMe to placebo, this supplement seems to improve pain,
fatigue, morning stiffness, and mood in those with fibromyalgia.
Liver Disease
Results of several animal studies suggest that SAMe may be beneficial in
treating various liver disorders, particularly liver damage caused by excessive
alcohol consumption. Animal studies also suggest that SAMe may protect the liver
from damage after acetaminophen overdose (a pain-relieving medication purchased
without a prescription). A study of 123 men and women with alcoholic liver
cirrhosis (liver failure) found that SAMe treatment for 2 years may improve
survival rates and delay the need for liver transplants more effectively than
placebo. Although the results of this study are encouraging, more clinical
trials are needed to determine whether SAMe is safe and effective for the
prevention and/or treatment of liver disease.
SAM-e for Alzheimer's
Disease
Studies suggest that people with
Alzheimer's Disease (AD) have low levels of SAMe in the brain and that supplementation can actually increase those levels.
While it has been reported that some individuals with AD have improved cognitive
function from SAMe supplementation, well-designed research studies are needed to
determine whether this supplement is truly safe and effective for people with
the disease.
Other
Although it is premature to tell if these are safe or appropriate uses for SAMe,
some early research has looked at the relationship between SAMe and Parkinson's
disease, migraine headaches, Sjogrens disorder (which causes pain in connective
tissue),
attention deficit/hyperactivity disorder (ADHD) in adults, and vascular
disorders such as heart disease.
SAMe levels may be low in people with Parkinson's and heart disease. However,
experiments in rats have indicated that SAMe supplements may actually cause
Parkinson's disease in these animals.
Given SAMe's structure, some have raised concern about the potential for SAMe
to increase homocysteine levels. (Homocysteine has been shown to contribute to
the development of plaques in the blood vessels). However, early information
suggests that SAMe may actually lower homocysteine. Research is needed to know
whether taking SAMe supplements may reduce homocysteine and reduce one's chances
of getting heart disease.
A preliminary study of 124 migraine sufferers suggests that SAMe may decrease
the frequency, intensity, and duration of headaches as well as lead to an
improved sense of well being and use of fewer pain killers.
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SAMe is not found in food. It is produced by the body from ATP and the amino
acid methionine. (ATP serves as the cell's major energy source and drives a
number of biological processes including muscle contraction and the production
of protein).
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- S-adenosylmethionine butanedisulfonate
- S-adenosylmethionine disulfate ditosylate
- S-adenosylmethionine disulfate tosylate
- S-adenosylmethionine tosylate
It is important to purchase enteric-coated tablets packaged in foil or foil
blister packs. SAMe should be stored in a cool, dry place, but not refrigerated.
Tablets should be kept in the blister pack until the time of ingestion.
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Starting with a low dose (for example 200 mg per day) and increasing slowly
helps avoid upset to the digestive system.
It is important to note that many of the studies evaluating SAMe for the
conditions mentioned have tested injectable, not oral, forms of SAMe. Therefore,
the reliability and effectiveness of oral SAMe is not entirely clear. Look for
enteric-coated tablets as these are more stable and may be more dependable in
terms of the amount of SAMe in the pill.
Pediatric
There are no known scientific reports on the pediatric use of SAMe.
Therefore, it is not currently recommended for children.
Adult
Recommended doses of SAMe vary depending on the health condition being
treated. The following list provides guidelines for the most common uses:
- depression: The majority of studies have used between 800 and 1,600 mg
of SAMe per day for depression. The daily dosage is typically split between
morning and afternoon.
- Osteoarthritis: A dosage of 600 mg (200 mg three times per day) for the
first two weeks and then 400 mg (200 mg twice per day) for another 22 weeks
has shown improvement in symptoms of osteoarthritis. Another study
demonstrated improvement using 1,200 mg (400 mg three times per day) for 30
days.
- Fibromyalgia: A dosage of 800 mg per day for six weeks was shown to
improve symptoms.
- Alcoholic liver disease: 800-1,200 mg per day orally in divided doses
for six months enhances liver function. For liver disease, SAMe should be
administered with the supervision of a qualified health care provider. This
is because SAMe is administered intravenously.
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Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
The safety of SAMe has not been fully assessed in children or women who are
pregnant or nursing. For this reason, these groups of people should avoid SAMe.
Side effects may include dry mouth, nausea, flatulence, diarrhea, headache,
anxiety, a feeling of elation, restlessness, and insomnia. For this reason, SAMe
should not be taken at night.
People with bipolar disorder (manic-depression) should not take SAMe since it
may worsen manic episodes. SAMe should not be combined with different
antidepressants without first consulting a health care provider.
People taking SAMe should supplement its use with a multivitamin that
contains folic acid and vitamins B12 and B6.
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If you are currently being treated with any of the following medications, you
should not use SAMe without first talking to your healthcare provider.
SAM-e and antidepressant medications
There have been reports of SAMe interacting with antidepressant medications and
increasing the potential for side effects including headache, irregular or
accelerated heart rate, anxiety, and restlessness. On the other hand, because it
often takes up to six or eight weeks for antidepressant medications to start
working, SAMe has been used with certain drugs to relieve symptoms more quickly.
Consult your healthcare provider before using SAMe if you are taking any
medications for depression.
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The publisher does not accept any responsibility for the
accuracy of the information or the consequences arising from the application,
use, or misuse of any of the information contained herein, including any injury
and/or damage to any person or property as a matter of product liability,
negligence, or otherwise. No warranty, expressed or implied, is made in regard
to the contents of this material. No claims or endorsements are made for any
drugs or compounds currently marketed or in investigative use. This material is
not intended as a guide to self-medication. The reader is advised to discuss the
information provided here with a doctor, pharmacist, nurse, or other authorized
healthcare practitioner and to check product information (including package
inserts) regarding dosage, precautions, warnings, interactions, and
contraindications before administering any drug, herb, or supplement discussed
herein.
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list of all supplements, vitamins
Reviewed: 02/2006
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