SAMe (S-adenosylmethionine)

What Is It?

SAMe (pronounced "sammy") is short for S-adenosylmethionine, a molecule
that the body continually produces to fuel numerous vital body
functions. Discovered in 1952, the popularity of SAMe has soared
recently with talk of its ability to ease depression as effectively as
prescription antidepressants. (Proponents say SAMe also works faster
than antidepressants and with virtually no side effects.)

Long prescribed by European doctors for both arthritis and depression,
SAMe recently became available in the United States as an
over-the-counter supplement. It is also emerging as an effective therapy
for arthritis, fibromyalgia, certain liver disorders, and possibly even
Alzheimer's disease.

Health Benefits

The body manufactures SAMe from methionine, an amino acid found in
protein-rich foods, and adenosine triphosphate (ATP), an
energy-producing compound found in all the body's cells. The SAMe
molecule then donates a piece of itself (a methyl group) to body tissues
and organs, providing a critical link in methylation, a chemical
reaction that occurs billions of times a second throughout the body. In
giving up a part of itself, SAMe promotes cell growth and repair.

SAMe also contributes to the formation of key compounds in the brain,
including the neurotransmitter dopamine and the mood-enhancer serotonin.
In addition, it helps to maintain desirable levels of glutathione, a
major antioxidant that protects against cell damage from oxygen
molecules called free radicals. Taken as a supplement, SAMe compensates
for any deficiencies and encourages the body to run efficiently.

Specifically, SAMe may help to:

# Relieve depression and stress-related blues. Several studies indicate
that SAMe eases mild to moderately severe depression. A sweeping review
of dozens of small clinical trials (called a "meta-analysis") testing
SAMe for depression concluded that it appears to work as well as the
frequently prescribed tricyclic antidepressants (imipramine,
amitriptyline, desipramine) in easing depression. Just as importantly,
it works faster, often starting to improve mood within a week. This
contrasts significantly with standard antidepressants, whose effects can
take several weeks to become apparent. In a University of California
study of 17 severely depressed adults, 62% of the participants who took
SAMe for four weeks (1,600 mg daily) showed significant improvements in
symptoms, compared to 50% of those who used desipramine (a conventional
antidepressant). Unlike many prescription antidepressants, which often
cause unpleasant side effects such as as drowsiness, dry mouth, and
constipation, SAMe appears to cause few if any side effects.

# Treat chronic fatigue syndrome (CFS).
Like conventional antidepressants used to treat chronic fatigue, SAMe
appears to benefit CFS sufferers by countering depression. It alters the
brain's response to pain and improves the quality of badly needed sleep.
As a result, both chronic fatigue syndrome and a condition with which
it's commonly confused--chronic fatigue syndrome-fibromylagia
(CFS-FM)--are likely to respond to SAMe. CFS-FM, which is actually more
common than CFS, appears to be a physical response to chronic stress and
depression.

# Lessen arthritis-related pain and inflammation. The eventual breakdown
of SAMe in the body yields substances that help to keep the gel-like
cartilage that cushions joints intact. In the common degenerative joint
disease osteoarthritis, cartilage wears down over time. Studies in
thousands of osteoarthritis sufferers have demonstrated that SAMe can be
as effective at increasing joint mobility and reducing swelling and pain
as such NSAIDs (nonsteroidal anti-inflammatories) as ibuprofen and
aspirin. Moreover, SAMe doesn't pose the risk of stomach bleeding or
kidney damage that are serious risks with NSAIDs. It also doesn't wear
down joints, damage cartilage, or block the pain signals that could
signal a worsening condition. Although it's not exactly clear how SAMe
works for arthritis, very preliminary but intriguing animal studies
actually point to a role in repairing cartilage and lubricating joints,
properties that may well extend to humans. Clearly more research is needed.

# Control back pain. SAMe may improve back pain when taken for several
weeks, a function of its ability to reduce swelling and pain. The theory
is that SAMe takes part in the repair and restoration of spinal discs,
cartilage, and the articulating surfaces of joints. Obviously, this
takes time. So if you're using SAMe for back pain, don't expect the
immediate symptom relief that you get with NSAIDs such as Motrin or
COX-2 inhibitors such as Vioxx and Celebrex.

# Reduce fibromyalgia symptoms. SAMe may minimize certain complications
of this often debilitating disorder, such as muscle pain, depression,
and fatigue. The 44 fibromylagia sufferers in a Danish study who took
800 mg of SAMe daily for six weeks reported some relief from morning
stiffness and muscle aches. They also noted an improvement in mood. The
results from other studies have been mixed, however. For example, a 1997
study to test the effectiveness of intraveneously administered SAMe for
fibromylagia failed to show significant benefits. However, given that no
single therapy for fibromyalgia is uniformly satisfactory, a trial of
SAMe for this often puzzling condition is certainly reasonable.

# Treat hepatitis and other liver disorders. By producing the extremely
powerful antioxidant glutathion, which enhances the liver's ability to
clear out toxins, SAMe promotes efficient liver function. Research
indicates that SAMe may benefit liver function impaired by
alcohol-induced cirrhosis, drug toxicity, hepatitis, and cholestasis.

# Protect against Alzheimer's and age-related brain disorders.
Preliminary research indicates that SAMe levels are very low in
individuals suffering from Alzheimer's disease. In one study of 40
elderly individuals with problems related to alertness and cognition,
improvements in such areas as memory, mood, and ability to carry out
everyday activities of life occured upon administration of a regimen of
oral, intravenous, and intramuscular SAMe. Additional research is now
underway to determine what role supplemental SAMe might play in
antioxidant production and in disorders of the aging brain.