|
 |
|
|
|
From Europe, with Love
An antidepressant that also eases arthritis and detoxifies the body? That's what some researchers are saying about SAM-e, a substance which recently gained public attention in the United States because of its use abroad and many positive studies.
SAM-e is perhaps best known for its use as an antidepressant. Studies have shown that it not only works as well as the traditional tricyclic class of antidepressants, [1] but it also works faster and possibly with fewer side effects. [2, 3]
But SAM-e has also proven equally effective in osteoarthritis. Italian researchers have shown that SAM-e may be as effective as the popular anti-inflammatory drugs ibuprofen and naproxen. [4, 5] And because it's a naturally occurring molecule found in virtually all body tissues and fluids, it tends to cause fewer side effects than synthesized drugs. [6, 3]
After years of use in Italy and the rest of Europe, SAM-e has finally caught America's attention. With its unique mechanism of action and minimal adverse effects, SAM-e is an interesting new alternative supplement.
Sources
1 Bressa, GM. "S-adenosyl-l-methionine (SAMe) as antidepressant: meta-analysis of clinical studies." Acta Neurologica Scandinavica Suppl 154 (1994): 7-14.
2 Bell, KM et al. "S-adenosylmethionine treatment of depression: a controlled clinical trial." American Journal of Psychiatry 145 (1988): 110-4.
3 Baldessarini RJ. "Neuropharmacology of S-adenosyl-L-methionine." American Journal of Medicine 83 5A (1987): 95-103.
4 Glorioso, S et al. "Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis." International Journal of Clinical Pharmacology Research 5 (1985): 39-49.
5 Domljan, Z et al. "A double-blind trial of ademetionine vs naproxen in activated gonarthrosis." International Journal Of Clinical Pharmacology, Therapy, And Toxicology 27 7 (1989 Jul): 329-33.
6 Friedel, HA, Goa KL, Benfield, P. "S-adenosyl-L-methionine. A review of its pharmacological properties and therapeutic potential in liver dysfunction and effective disorders in relation to its physiological role in cell metabolism." Drugs 38 3 (1989 Sep): 389-416.
|
|
|
|
|
Supplement with Many Functions
SAM-e's antidepressant effect was first reported in 1973 in Italy, where it is commonly recommended for depression. Since then, dozens of studies have shown that SAM-e may have uses in helping treat a wide range of conditions, including arthritis, liver disease, sleep disorders, and spinal disease.
Existing Medical Research- Numerous controlled studies have shown SAM-e to benefit people with depression. An analysis of several studies showed that SAM-e may work as well as prescription-strength tricyclic antidepressants like Elavil, Norpramin, and Sinequan. [7] SAM-e also had a faster onset of action and reportedly fewer side effects than these traditional depression medications. [8], [9] In all, more than one hundred studies have touted SAM-e's benefits as a natural antidepressant, making it perhaps the most studied non-drug antidepression remedy.
- For osteoarthritis and arthritis, controlled studies have shown that SAM-e might be at least as effective as both ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve). [10, 11] In one study, 71% of the participants taking SAM-e for osteoarthritis described its effect as "very good" or "good." [12] In the same study, 87% of the participants said that SAM-e had few or no side effects.
- Liver disease has also been effectively treated with SAM-e. Taken twice daily by mouth or once daily intravenously, researches have shown that SAM-e improved the symptoms of people with cholestasis, a blockage of the bile duct sometimes occurring with pregnancy. [13, 14, 15]
Latest News- SAM-e is being tested for use in AIDS-related myelopathy (a disease of the spinal cord).
Folic acid and vitamin B-12 are necessary for the production of SAM-e, so people with low levels of these substances may have low levels of SAM-e in the central nervous system. And low levels of SAM-e have been detected in people with liver disease, heart disease, and depression. [16]
Synonyms
- Ademethionine
- S-adenosyl-L-methionine
- Methionyl adenylate
- S-adenosylmethionine
How Does It Work? A Closer Look
A natural molecule produced primarily by the liver, SAM-e is an active form of the amino acid methionine found in most body tissues and fluids. SAM-e has three main actions that occur throughout the body:- Methylation: SAM-e is a "methyl donor" that plays an important role in the building of neurotransmitters (brain chemicals) like serotonin, dopamine, norepinephrine, and epinephrine. [17] A decrease in these neurotransmitters is linked to depression. Production of DNA, RNA, proteins, and cell membranes also require methylation by SAM-e.
- Transsulphuration: SAM-e is a building block for cysteine, glutathione, and taurine -- potent natural antioxidants produced within the body. [18]
- Polyamine production: SAM-e and arginine promote the creation of spermine, spermidine, and putrescine -- polyamines essential for cell growth and differentiation. [19]
From these varied functions come SAM-e's many different uses.
Sources
7 Frezza M, et al. "Oral S-adenosylmethionine in the symptomatic treatment of intrahepaticcholestasis: a double-blind, placebo-controlled study." Gastroenterology 99 (1990): 211-15.
8 Bell, KM et al. "S-adenosylmethionine treatment of depression: a controlled clinical trial." American Journal of Psychiatry 145 (1988): 110-4.
9 Baldessarini RJ. "Neuropharmacology of S-adenosyl-L-methionine." American Journal of Medicine 83 5A (1987): 95-103.
10 Glorioso, S et al. "Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis." International Journal of Clinical Pharmacology Research 5 (1985): 39-49.
11 Domljan, Z et al. "A double-blind trial of ademetionine vs naproxen in activated gonarthrosis."International Journal Of Clinical Pharmacology, Therapy, And Toxicology 27 7 (1989 Jul): 329-33.
12 Berger R, Nowak H. "A new medical approach to the treatment of osteoarthritis. Report of an open phase IV study with ademetionine (Gumbaral)." American Journal of Medicine 83(5A) (1987 Nov 20): 84-8.
13 Frezza M, et al. "Oral S-adenosylmethionine in the symptomatic treatment of intrahepaticcholestasis: a double-blind, placebo-controlled study." Gastroenterology 99 (1990): 211-15.
14 Almasio P, et al. "Role of S-adenosyl-L-methionine in the treatment of intrahepaticcholestasis." Drugs 40 suppl 3 (1990): 111-23.
15 Frezza, M et al. "Reversal of intrahepatic cholestasis of pregnancy in women after high dose S-adenosyl-L-methionine administration." Hepatology 4 2 (1984 Mar-Apr): 274-8.
16 Bottiglieri,T Hyland, K, Reynolds EH. "The clinical potential of ademetionine (S-adenosylmethionone) in neurological disorders." Drugs 48 (1994): 137-52.
17 Friedel, HA, Goa KL, Benfield, P. "S-adenosyl-L-methionine. A review of its pharmacological properties and therapeutic potential in liver dysfunction and effective disorders in relation to its physiological role in cell metabolism." Drugs 38 3 (1989 Sep): 389-416.
18 Duce, P et al. "S-adenosyl-L-methionine synthetase and phospholipid methyltransferase are inhibited in human cirrhosis." Hepatology 865 (1988): 58.
19 De Leo, D. "S-Adenosyl-L-Methionine (SAMe) in clinical practice; preliminary report on 75 minor depressives." Current Therapeutic Research 37 (1985): 658-661.
|
|
|
|
|
Common Uses
Depression and Other Affective Disorders
SAM-e appears effective in treating depression and dementia with relatively few side effects. "Monoamine neurotransmitters" are brain cell messengers closely associated with depression, neurologic disorders, and psychiatric conditions. SAM-e is involved in the production of the monoamine neurotransmitters serotonin, dopamine, norepinephrine, and epinephrine.
Osteoarthritis
Studies indicate that SAM-e is useful for arthritis and osteoarthritis as compared to ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve). [20, 21] It may work faster and have fewer associated side effects than these drugs as well. [22, 23] It is thought to have an effect on cartilage metabolism and anti-inflammatory mediators within cells. It may also inhibit leukotrienes, a substance that regulates inflammation.
Liver Disorders
SAM-e has been shown to improve the condition of people with stoppage of bile flow, or cholestasis. Bile helps the liver break down poisonous chemicals. SAM-e is believed to promote liver cell secretion, which in turn increases bile production. [24] It may also prevent or reverse liver damage due to alcohol, acetaminophen, steroid drugs, and lead. [25]
AIDS-related Myelopathy
In August 1998, SAM-e was designated as an "orphan drug" in the treatment of AIDS-related myelopathy (disease of the spinal cord).
Potential Uses
- Alzheimer's disease
- Migraine
- Sleep alterations
- Alcoholism and acute alcohol intoxication
- Fibromyalgia
- Insulin-dependent diabetes mellitus
- Parkinson's disease
- Peripheral neuropathy
Dosage and Administration
Note: the following are general dosage guidelines. Talk with your doctor prior to using this supplement. He or she can provide you with the dosing schedule that best suits you. Do not exceed the dosages suggested by the manufacturer.
- Osteoarthritis: 600 mg to 1,200 mg per day, divided in up to three doses
- Depression/affective disorder: 200 mg to 800 mg twice per day
- Liver disorders: 800 mg twice per day
- Migraines: 200 mg to 400 mg twice per day
- Fibromyalgia: 200 mg to 400 mg twice per day
Storage
Store SAM-e according to the manufacturer's directions on the packaging. If no storage instructions are supplied, store the supplement in a tightly closed container at room temperature in a dry, dark place. Avoid storing in the bathroom, as moisture may cause the product to break down.
Sources
20 Glorioso, S et al. "Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis." International Journal of Clinical Pharmacology Research 5 (1985): 39-49.
21 Domljan, Z et al. "A double-blind trial of ademetionine vs naproxen in activated gonarthrosis."International Journal Of Clinical Pharmacology, Therapy, And Toxicology 27 7 (1989 Jul): 329-33.
22 Friedel, HA, Goa KL, Benfield, P. "S-adenosyl-L-methionine. A review of its pharmacological properties and therapeutic potential in liver dysfunction and effective disorders in relation to its physiological role in cell metabolism." Drugs 38 3 (1989 Sep): 389-416.
23 Baldessarini RJ. "Neuropharmacology of S-adenosyl-L-methionine." American Journal of Medicine 83 5A (1987): 95-103.
24 Frezza M, et al. "Oral S-adenosylmethionine in the symptomatic treatment of intrahepaticcholestasis: a double-blind, placebo-controlled study." Gastroenterology 99 (1990): 211-15.
25 Angelico, M et al. "Oral S-adenosyl-L-methionine (SAMe) administration enhances bile salt conjugation with taurine in patients with liver cirrhosis." Scandinavian Journal of Clinical and Laboratory Investigation 54 6 (1994 Oct): 459-64.
|
|
|
|
|
How to Use SAM-e Safely
Do not use SAM-e if you are pregnant or plan to breastfeed. Though SAM-e appears safe for use in pregnant women, little is known about its potential effect on the fetus, or whether it is transmitted via breast milk. Discuss with your doctor the potential benefits versus the risks if you are considering taking this supplement while pregnant or breastfeeding.
Though studies have shown few adverse effects, SAM-e (like all dietary supplements and herbal remedies) is neither approved nor regulated by the U.S. Food and Drug Administration. As with any herbal product or dietary supplement, it is advisable to consult with your doctor prior to use, particularly if you are being treated for a medical condition.
Possible Side Effects
Because SAM-e is a dietary supplement, SAM-e manufacturers are not required to perform vigorous testing to establish its safety and effectiveness. Therefore, SAM-e's effect with other drugs and in various medical conditions is not well known. If you experience unusual symptoms while taking this supplement, contact your doctor immediately.
The most commonly reported side effects include the following:- Anxiety
- Gastrointestinal symptoms (upset stomach, nausea, vomiting)
- Hypomania (mild hyperactivity) in manic depressive patients
|
|
|
|
|
Websites, Organizations & Manufacturers
- Grazi, S, Costa, M. SAM-e (S-adenosylmethionine): The European Arthritis and Depression Breakthrough. Rocklin, CA: Prima Publishing. 1999.
- Baumel, S. Natural Antidepressants: Tried and True Remedies From Nature's Pharmacy. Conn: Keats Publishing Inc. 1998. [Online excerpt from "S-Adenosylmethionine (SAM, SAM-e)".]
- Alessandro Di Rocco, M.D.
U.S.F.D.A. Orphan Drug Sponsor for
Treatment of AIDS myelopathy with methionine/L-methionine.
New York, NY
Phone: (212) 844-8652
Fax: (212) 844-8407
- onHealth
- NutraLife Health Products, Inc. [manufacturer of SAM-e]
1328 River Ave. Suite 151
Lakewood, NJ 08701
(877) 688-7254
(718) 258-5682 USA
Info@nutralife.com
Sources & Further Reading
Articles
1. Almasio, P, et al. "Role of S-Adenosyl-L-Methionine in the Treatment of Intrahepatic Cholestasis." Drugs. 40(suppl 3):111-123. 1990.
2. Almasio, P, Pagliaro, L. ["Ademetionine: The Start of the Art and Future Prospects."] Annali Italiani di Medicina Interna. 8(suppl):52S-55S. 1993 Oct.
3. Angelico, M et al. "Oral S-adenosyl-L-methionine (SAMe) administration enhances bile salt conjugation with taurine in patients with liver cirrhosis." Scandinavian Journal of Clinical and Laboratory Investigation 54 6 (1994 Oct): 459-64.
4. Anonymous. "Ademetionine: A New Approach to the Treatment of Degenerative Joint Diseases." Drugs Today. 24:165-8. 1988.
5. Baldessarini, RJ. "Neuropharmacology of S-Adenosyl-L-Methionine." American Journal of Medicine. 83(suppl 5A):95-103. 1987.
6. Bell, KM, et al. "S-Adenosylmethionine Treatment of Depression: A Controlled Clinical Trial." American Journal of Psychiatry. 145:110-14. 1988.
7. Berger, R, Nowak, H. "A New Medical Approach to the Treatment of Osteoarthritis: Report of an Open Phase IV Study with Ademetionine (Gumbaral)." American Journal of Medicine. 83(5A):84-8. 1987 Nov 20.
8. Bergmann, M, Gullotta, F, Kuchelmeister, K, Masini, T, Angeli, G. "AIDS-Myelopathy: A Neuropathological Study." Pathology, Research and Practice. 189(1):58-65. 1993 Feb.
9. Bombardeeri G., Nilani A., Bernard L. and Rossi L. "Effects of S-Adenosyl-L-Methionine (SAMe) in the Treatment of Gilbert's Syndrome." Current Therapeutic Research. 37: 580-585. 1985.
10. Bottiglieri, T, Chary, TK, Laumdy, M, Carney, MWP, God Frey, P, et al. "Transmethylation in Depression." Alabama Journal of Medical Sciences. 25:296-301 1988.
11. Bottiglieri, T, et al. "The Clinical Potential of Ademetionine (S-Adenosylmethionine) in Neurological Disorders." Drugs. 48:137-52. 1994.
12. Bressa, GM. "S-Adenosyl-L-methionine as an Antidepressant: Meta-Analysis of Clinical Studies." Acta Neurologica Scandinavica. 154(suppl):7-14. 1994.
13. Caballeria, E, Moreno, J. "Therapeutic Effects of S-Adenosylmethionine (SAMe) in Hepatic Steatosis." Acta Theriologica. 16:253-64. 1990.
14. Cerutti, R, et al. "Physiological Distress During Peurperium: A Novel Approach Using S-Adenosyl-L-methionine." Current Therapeutic Research, Clinical and Experimental. 53:707-17. 1993.
15. Cozens DD, Barton SJ, Clark, R, Gibson, WA, Hughes, EW, Masters RE, Offer, JM, Perkin, CJ, Stramentinoli, G. "Reproductive Toxicity Studies of Ademetionine." Arzneimittelforschung. 38(11):1625-9. 1988 Nov.
16. De Leo, D. "S-Adenosyl-L-Methionine (SAMe) in clinical practice; preliminary report on 75 minor depressives." Current Therapeutic Research 37 (1985): 658-661.
17. De Leo, D. "S-Adenosylmethionine as an Antidepressant: A Double-Blind Trial versus Placebo." Current Therapeutic Research, Clinical and Experimental. 41:865-70. 1987.
18. Di Padova, C. "S-Adenosyl-L-methionine in the Treatment of Osteoarthritis: Review of the Clinical Studies." American Journal of Medicine. 83(suppl 5A):60-64. 1987.
19. Domljan, Z, et al. "A Double-Blind Trial of Ademethionine vs. Naproxen in Activated Gonarthrosis." International Journal of Clinical Pharmacology, Therapy, And Toxicology. 27:329-33. 1989.
20. Duce, P et al. "S-adenosyl-L-methionine synthetase and phospholipid methyltransferase are inhibited in human cirrhosis." Hepatology 865 (1988): 58.
21. Frezza, M, et al. "Oral S-Adenosylmethionine in the Symptomatic Treatment of Intrahepatic Cholestasis: A Double-Blind, Placebo-Controlled Study." Gasteroenterology. 99:211-5. 1990.
22. Frezza, M et al. "Reversal of intrahepatic cholestasis of pregnancy in women after high dose S-adenosyl-L-methionine administration." Hepatology 4 2 (1984 Mar-Apr): 274-8.
23. Frezza, M. ["A Meta-Analysis of Therapeutic Trials with Ademetionine in the Treatment of Intrahepatic Cholestasis."] Annali Italiani di Medicina Interna. 8(suppl):48S-51S. 1993 Oct.
24. Friedel, HA, Goa, KL, Benfield, P. "S-Adenosyl-L-methionine: A Review of its Pharmacological Properties and Therapeutic Potential in Liver Dysfunction and Affective Disorders in Relation to its Physiological Role in Cell Metabolism." Drugs. 38(3):389-416. 1989 Sep.
25. Glorioso, S et al. "Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis." International Journal of Clinical Pharmacology Research 5 (1985): 39-49.
26. Kagan, BL, et al. "Oral S-Adenosylmethionine in Depression: A Double-Blind, Placebo-Controlled Trial." American Journal of Psychiatry. 147:591-5. 1990.
27. Osman, E, Owen, JS, Burroughs, AK. "S-Adenosyl-L-methionine: A New Therapeutic Agent in Liver Disease?" Alimentary Pharmacology and Therapeutics. 7:21-23. 1993.
28. Pezzoli, C, Galli-Kienle, M, Stramemtinoli, G. "Lack of Mutagenic Activity of Ademetionine In Vitro and In Vivo." Arzneimittelforschung. 37(7):826-9. 1987 Jul.
| |
|
