What is SAMe?
S-adenosylmethionine (SAMe) is a natural substance found in the body that was first identified in 1952 and first used medically in Europe in 1972. Synthetic SAMe is created in a laboratory to mirror the SAMe present in the body. SAMe has been available as a supplement in the United States since 1999 but has been used as a prescription medication in Europe since the 1970s.
Medicinal Components
SAMe is known to be active in many different physiologic functions. It is created as the result of a reaction between the essential amino acid methionine and adenosine triphosphate (ATP) (1), an energy carrying molecule. In our bodies, SAMe is recognized for the role that it plays in mood, pain and other conditions (2).
Conditions This Can Treat
Research supports the use of SAMe in the treatment of many conditions. Research is still taking place today and will likely continue as there are many conditions that have not fully been evaluated.
SAMe has been used to treat (2) the following conditions: anxiety, depression, osteoarthritis, chronic pain, fibromyalgia, dementia, Alzheimer’s, chronic fatigue, liver disease, Parkinson’s, ADHD, multiple sclerosis, seizures, migraines, premenstrual syndrome and premenstrual dysphoric disorder.
This supplement’s effects on osteoarthritis were accidentally discovered by researchers who were studying its impact on the treatment of depression. The researchers found that patients who were taking the SAMe for treatment of depression simultaneously noticed improvement in their osteoarthritis symptoms. There are several published studies supporting the use of SAMe as a treatment option for patients with osteoarthritis. One study (3) in particular concluded the SAMe was just as effective as NSAIDS at treating symptoms of osteoarthritis.
SAMe also decreases the risk of gastrointestinal bleeding associated with chronic use of NSAIDS. Another study (4) compared SAMe at the dose of 1200mg with the use of Celebrex in the treatment of osteoarthritis. This study concluded no significant difference in outcomes in both patient groups; essentially concluding that SAMe was as effective as Celebrex.
SAMe has been found to be effective in reducing symptoms of depression (5). There are several studies that have found SAMe to be as effective as certain antidepressants. This supplement may also be a great option for patients who have been intolerant to or unable to take other antidepressants. It’s very important to note that SAMe should not be taken in conjunction with other antidepressants without the close monitoring of a health care provider.
The National Institute of Health (2) states that SAMe may be possible effective in treating symptoms of AIDS-related nerve problems, Fibromyalgia, Liver Disease and Sexual dysfunction. SAMe provided intravenously was found to relieve nerve symptoms caused by AIDS. The studies conducted around the use of SAMe and the treatment of Fibromyalgia have been inconclusive. Some studies indicated that the supplement eased Fibromyalgia symptoms while other studies did not. SAMe may be useful in treating liver disease during pregnancy. There is some research to support that SAMe taken with antidepressants can improve sexual dysfunction in depressed men.
There is not enough evidence to support the use of SAMe in the treatment of alcohol related liver disease. Some studies support this use but others found that the supplement unable to impact certain liver function tests.
There is not significant enough research to support the use of SAMe in the treatment of ADHD. There is early research that suggests this indication however it is not proven.
Early studies indicate that SAMe could be helpful in reducing aggressive behavior in people with schizophrenia.
Dose Recommendations
Dose recommendations are dependent upon the particular condition being treated. The recommended dose for the treatment of depression is 400mg-1600mg daily, usually taken in divided doses. One suggested dose for osteoarthritis is 200mg three times daily. For the treatment of these and other conditions, you should speak to your health care provider about the appropriate dosing.
Cautions
There are several interactions between SAMe and prescription medications. Antidepressant medications (SSRIs and MAOIs) and Dextromethorphan may have major interactions and can lead to the development of serotonin syndrome. Patients should be cautious when combining SAMe with Levodopa, Demerol, Talwin, and Ultram.
Side Effects
SAMe has been deemed as possibly safe by the NIH. The most common side effects include gas, diarrhea, constipation, headache, sweating, dizziness, and vomiting. It may cause increased anxiety in patients with depression or mania in patients with Bipolar disorder. SAMe can cause a decline in patients with Parkinson’s. It should not be taking for at least 2 weeks prior to any surgery.
Wrap Up
SAMe offers an alternative treatment for patients with osteoarthritis and/or depression. It offers less risk of gastrointestinal bleeding when compared to NSAIDS in the treatment of chronic osteoarthritis. Research supports SAMe as being as effective as many antidepressants in the treatment of depression. If you’re considering trying SAMe, talk to your health care provider.
References
(1) http://www.mayoclinic.org/drugs-supplements/same/background/hrb-20059935
(2) https://nccih.nih.gov/health/supplements/SAMe
(3) J Fam Practice. 2002; 51:425-430
(4) BMC Musculoskeletal Disorders. 2004; 5:6
(5) Sarris J. Clinical depression: an evidence-based integrative complementary medicine treatment model. Altern.Ther.Health Med. 2011;17(4):26-37.
