Sherry Torkos, BScPharm & Michael Rae
One of the most exciting and promising nutritional supplements to come to market this year is S-adenosyl-methionine, (SAMe).
One of the most exciting and promising nutritional supplements to come to market this year is S-adenosyl-methionine, (SAMe). SAMe (pronounced "Sammy") has been promoted as a safe and effective treatment for depression, osteoarthritis, fibromyalgia, liver disorders and other health conditions.
While new to North America, SAMe has been available and used therapeutically in Europe since the mid-1970s. Because SAMe is a highly unstable molecule, it took several years to develop a form that could be clinically tested. The first stable, supplemental form of SAMe was produced in 1973. Extensive clinical research has since been conducted around the world, exploring the potential health benefits of SAMe.
SAMe is naturally formed in the body from the amino acid methionine, in combination with adenosine triphosphate (ATP), an energy molecule. SAMe’s therapeutic effects have been attributed to its activity as one of the most active methyl donors in the human body. A methyl donor is a molecule that gives up part of itself to another molecule, so that the second molecule can carry out its functions. This process occurs about a billion times per second in the human body. Methylation controls many vital body functions, including neurotransmitter development, regulation of mood, maintenance of cell membranes, detoxification and the manufacture of cartilage compounds. SAMe is helpful in treating such a wide range of health conditions because it works on this molecular level.
Depression is a common psychiatric condition that affects millions of people each year. This condition has been associated with an imbalance or lack of certain neurotransmitters (chemical messengers) in the brain. While prescription medication is helpful in some patients, the side-effects and high costs can be prohibitive.
The anti-depressant effects of SAMe have been extensively studied and attributed to its support of the following aspects of brain health:
Severely depressed patients have shown low levels of SAMe, which rise in response to supplementation. Over 25 clinical trials have confirmed the safety and efficacy of SAMe in the treatment of depression. In the studies that compared SAMe to traditional antidepressants, it was found that SAMe was just as effective as these prescription medications, yet better tolerated. Even at high doses (1600 milligrams per day) SAMe was not associated with any significant negative effects. On the other hand, common side effects of prescription antidepressants include insomnia, agitation, constipation and sexual dysfunction.
SAMe has also shown promise in the treatment of migraine headaches, drug withdrawal, dementia and relieving peripheral neuropathy. The only known contraindication for SAMe is a bipolar (manic-depressive) disorder because it could worsen the manic phase of this disorder.
Also known as degenerative joint disease, osteoarthritis is a chronic debilitating disease marked by deterioration of the cartilage in the joints, leading to pain, stiffness and inflammation. It is estimated that osteoarthritis affects nearly 10 per cent of the population over the age of 60. The most common areas affected by this disease are the spine, hips, knees and fingers.
The conventional approach to the treatment of osteoarthritis focuses on the use of a class of medications known as the non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen. While these drugs offer initial improvement through symptom control, they are associated with many side effects, including gastric ulcers, bleeding, ringing in the ears and fluid retention. Studies have shown that NSAIDs may actually lead to progression of the disease by interfering with tissue and joint repair and inhibiting cartilage synthesis. Considering these negative outcomes, it is surprising that these medications are used at all.
In the SAMe-depression studies, it was found that study participants noticed a marked improvement in their osteoarthritis symptoms. This led researchers to examine the role of SAMe in joint health. SAMe is required for the manufacture of sulfur-containing cartilage compounds that are essential for joint health. Therefore, it is believed that SAMe aids in joint repair. Additionally, SAMe has shown anti-inflammatory and analgesic (pain-relieving) effects.
In clinical studies, SAMe has compared favorably to various NSAIDs. In one study involving 734 subjects, SAMe was compared to naproxen. Both treatments were found to be effective in alleviating symptoms, however toleration was significantly better in the SAMe group.(Caruso, et al, 1987). In addition, animal studies have found SAMe have protective effects on the gastric mucosa, which is the opposite of NSAIDs.
This recently defined, debilitating condition is estimated to affect millions of Americans every year. Fibromyalgia is characterized by chronic pain in the muscles and soft tissues surrounding the joints. Conventional treatment centers upon symptomatic treatment with the use of analgesics, anti-inflammatory drugs and anti-depressants.
Although there have only been six small studies looking at the role of SAMe in the treatment of fibromyalgia, it may prove to be an effective option. It has been suggested that SAMe may be beneficial for the depressive and musculoskeletal aspects of this condition. Preliminary research has shown significant improvement in the symptoms of morning stiffness, fatigue and depression. While more research is needed in this area, SAMe appears to offer some hope for sufferers of this condition.
SAMe appears to play a vital role in liver health through the following mechanisms:
Choosing a SAMe Supplement–What to Look For!
Stability: SAMe is a difficult substance to work with, being naturally quite unstable. SAMe should be delivered in enteric-coated tablets, not capsules. Consumers can further check for signs of product viability, such as smell. A SAMe product which is still good should be virtually scentless, while a sulfurous or "rotten egg" smell is proof of degradation. Also look for an uneven color to the tablet and cracks or pockmarks in the tablet or its coating.
Tosylate vs. Butanedisulfonate: SAMe is always bound to a second molecule. The butanedisulfonate is believed to have an even longer shelf life than the tosylate; however, all the clinical studies published on SAMe have used the tosylate form.
True ionic masses: Just as the actual ("elemental") weight of calcium in 460 mg of calcium citrate is only approximately 100 mg, a product containing 205 mg of SAMe tosylate yields 100 mg of active SAMe ion. When reading labels, be sure that you clearly understand which value is being given.
Authentic SAMe: Many "SAMe" products on the market may contain only SAMe precursors (like methionine), or substances which increase the body’s production of SAMe (like TMG). Consumers may want to insist on seeing lab tests to prove the SAMet content of a product. If a manufacturer will not provide an analysis, then do not purchase the product.