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THE WONDERS OF
SAMe
Article by herbalist
Dave
Hawkins, MH, CNC
Over the last few months I
have had numerous questions about a supplement called
SAMe.
This article will help to answer some of those questions.
SAMe or s-adenosyl-l-methionine
has been the subject of many clinical trials in Europe and
now in the United States.
SAMe was discovered in Italy
in 1952-- not surprisingly, most of the research on
SAMe
has been conducted in the country of its discovery.
So what is
SAMe?
S-Adenosylmethionine (SAM) is
an important physiological agent formed in the body by
combining the essential amino acid
methionine with
adenosyl-triphosphate (ATP). SAM is involved in over
40 biochemical reactions in the body and it works closely
with vitamins B-12 and folic acid. Normally the body
manufactures all the SAM it needs from the amino acid
methionine. However, a
deficiency of methionine,
vitamin B12, or folic acid can result in decreased SAM
synthesis. In addition, tissue levels of SAM are typically
low in the elderly and in patients suffering from
osteoarthritis, depression, and various liver disorders.
There are five principal conditions where
SAMe
is used: depression, osteoarthritis,
fibromyalgia, liver disorders, and migraine
headaches. SAM is also required in the manufacture of all
sulfur-containing compounds in the human body, including
glutathione and various sulfur-containing cartilage
components.
·
SAMe
is essential for the production of brain neurotransmitters
(chemical messengers) such as dopamine,
norephinephrine, epinephrine
and serotonin. It enhances cell membrane fluidity and
cellular communication. The beneficial effects of
SAMe
supplementation are far-reaching because of its central
role in so many metabolic processes.
Let's look at how same can
be beneficial with depression, osteoarthritis,
fibromyalgia,
migranes and liver disorders.
Depression:
SAMe
is necessary in the manufacture of important brain
compounds such as neurotransmitters and phospholipids like
phosphatidylcholine and
phosphatidylserine.
Supplementing the diet with
SAMe in depressed
patients results in increased levels of serotonin,
dopamine, and phosphatidylserine.
It improves binding of neurotransmitters to receptor sites,
which causes increased serotonin and dopamine activity and
improved brain cell membrane fluidity, all resulting in
significant clinical improvement.
The
antidepressive effects of folic acid (Vitamin B6)
are mild compared to the effects noted in clinical trials
using SAMe.
Based on results from a number of clinical studies, it
appears that SAMe
is perhaps the most effective natural antidepressant
(although a strong argument could be made for the extract
of St. John's
Wort standardized to contain
0.3 percent hypericin). More
recent studies using a new oral preparation at a dosage of
400 milligrams four times daily (1600 mg total) demonstrate
that SAMe
is just as effective orally as it is intravenously.
SAMe is better tolerated and
has a quicker onset of antidepressant action than
tricyclic antidepressants.
In addition to generalized
depression, there are two conditions associated with
depression where
SAMe produces significant effects: the
postpartum (after pregnancy) period and drug
rehabilitation. SAMe benefits
in these conditions probably stem from a combination of its
effects on brain chemistry and liver
Function.
Fibromyalgia:
In a double-blind study,
orally administered
SAMe (800 milligrams
daily) was compared to a placebo for 6 weeks in 44 patients
with fibromyalgia. Researchers
evaluated tender point score, muscle strength, disease
activity, subjective symptoms, mood parameters, and side
effects. Patients given
SAMe demonstrated
improvements in clinical disease activity, pain experienced
during the last week, fatigue, morning stiffness, and mood;
however, the tender point score and muscle strength did not
differ in the two treatment groups.
SAMe was without side effects.
The most recent study
compared SAMe to
transutaneous electrical nerve
stimulation (TENS)-- a popular
treatment for fibromyalgia-- in
30 patients with fibromyalgia.
Patients receiving
SAMe (200 milligrams by
injection and 400 milligrams orally daily) demonstrated
significantly greater clinical benefits---decreased number
of tender points, subjective feelings of pain and fatigue,
and improved mood. TENS offered little benefit on most
symptoms while SAM was deemed "effective in relieving the
signs and symptoms of primary
fibromyalgia."
Migraine:
SAMe
is beneficial in the treatment of migraine headaches. The
benefits manifest gradually and require long-term treatment
for therapeutic effectiveness. This is due to the ability
of same to enhance liver detoxification functions. The
liver depends on same for regeneration, detoxification,
bile production, methylation
and the production of a substance called glutathione, a
liver antioxidant.
This again relates to its
ability in dealing with drug rehabilitation, excessive and
unbalanced estrogen levels, and in conjunctions with
hepatitis c treatments.
Joint and Connective tissue:
SAMe
is essential for the rebuilding of connective tissue and
the manufacture of cartilage components. Numerous clinical
studies indicate that it can reduce pain, stiffness and
inflammation. Doses range from 400mg to 1200 mg daily.
It is recommended to take
SAMe
on an empty stomach preferably one hour before eating.
Usual doses are started at 200mg daily with a gradual
increase every five days until desired effects are felt. It
may take up to four weeks for some to notice the effects
but most will be noticed within one week. Since
SAMe
is unstable at high temperatures it is recommend to be
refrigerated. It is also important to use enteric-coated
tablets to ensure stability, maximum adsorption and to
avoid nausea and gastrointestinal disturbances. It is safe
for pregnancy and lactation. There are no reported negative
interactions with other medications or nutritional
supplements.
SAMe
is converted to homocysteine,
which is known for its increasing risk of cardiovascular
disease, when taken at high levels unless the cofactors of
Vitamin b 6 (50mg), Vitamin b 12 (1000mcg), and folic acid
(800mg) are taken with it. A good quality multiple vitamin
supplement may be adequate but you need to check.
There are two forms of
pharmaceutical grade same, tosylate
and a newer more stable one called
butanedisulfide. Due to the expense of
SAMe
at the current time many cannot afford to use this
supplement. Be aware of companies promoting
SAMe
and be sure to research their sources.
As with any therapy it is
important to consult with your health care practitioner
when treating specific conditions.
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