Sam-e, or S-Adenosylmethionine, is a substance synthesized from methionine (an amino acid) in the body. Children have seven times more SAM-e than adults. Men have higher quantities of Sam-e than women. Depression is linked to low SAM-e levels in people of all ages. People suffering from Alzheimer's also show lower levels of SAM-e. An exogenous (produced outside of the body) form of SAM-e was developed in the mid-seventies. *

What Does SAMe Actually Do?

SAM-e is a "methyl donor", playing a key role in the methylation process in the body. Methylation is a basic chemical reaction that triggers many vital biological responses throughout the body. SAM-e, as a methyl donor, donates methyl groups to different molecules. SAM-e helps methylate DNA, protein, and phospholipids. Sam-e, through a process called transsulfuration, helps the body's cells produce glutathione, an essential compound for the immune system, and the liver, where it helps in the important job of detoxification.*

How Can SAMe Help Me/My Family?

As a Methyl donor, Sam-e plays a vital role in the production of norepinephrine and serotonin, neurotransmitters important in regulating mood. Sam-e also helps in the methylation of phospholipids helping to keep cell membranes receptive to neurotransmitters. Sam-e can also boost the production of phosphatidylserine, a phospholipid that plays a role in memory and mood. *


SAMe and Osteoarthritis & Joint Health

In studies, Sam-e was shown to increase the production of chondrocytes, the cartilage producing cells in joints. Proteoglycans, molecules important to the lubrication of joints, appear to remain stable, maintaining their effectiveness, with the help of SAMe. SAMe has been featured in "SAMe: The European Arthritis And Depression Breakthrough" by Dr. Sol Grazi.

SAMe and the Liver

As stated earlier, SAMe helps the body produce glutathione an important substance to the chemical processes of the liver. Glutathione helps the liver detoxify alcohol, drugs, and poisons such as insecticides. Glutathione helps make toxic substances water-soluble allowing these substances to be cleansed from the system.
LifeSource Vitamins considers SAMe an excellent product with great potential if taken properly as described by your doctor.

Current Research on SAMe:

The U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) conducted an extensive literature review to determine SAM-e's efficacy for treatment of depression, osteoarthritis, and cholestasis of pregnancy and intrahepatic cholestasis associated with liver disease. The results were released in late 2002 and summarized below, along with other data.

Depression: Depression will affect 10 to 25 percent of women and 5 to 12 percent of men in the United States. Approximately 10 to 15 million people experience clinical depression in any given year. The antidepressant effects of SAMe administration were first documented in 1974. Further research in depressive disorders was reviewed in 1988, 1989, 1994, 2000, and 2002.

The AHRQ included 28 studies in a meta-analysis of the efficacy of SAMe to decrease symptoms of depression. Compared to placebo, SAMe was associated both statistically and clinically with significant improvements in the score of the Hamilton Rating Scale for Depression. When compared to conventional antidepressants, treatment with SAMe was not associated with a statistically significant difference in outcomes suggesting SAMe is as effective as most antidepressant prescription drugs.

A 2002 review concluded that treatment with parenteral or oral SAMe at doses of 200-1600 mg/day was superior to placebo and as effective as tricyclic antidepressants with a faster onset of action.

Two multi-center studies were conducted on patients to confirm the efficacy and safety of SAMe in the treatment of major depression. The first study group received 1600 mg/day of SAMe orally, while the second study group received 400 mg/day SAMe intramuscularly. Both studies compared SAMe to 150 mg a day in a double-blind design. The study concluded the anti-depressive effectiveness of both oral and intramuscular SAMe was comparable to 150-mg imipramine/day. In addition, SAMe had fewer adverse events and was significantly better tolerated.

SAMe has been studied in 16 open uncontrolled trials with a total of 660 patients; 13 randomized, double-blind, placebo-controlled trials with 537 patients; 19 controlled trials of SAMe versus other antidepressants involving 1134 patients. SAMe consistently showed significant anti-depressive effects in all 16 open trials and outperformed placebo in all controlled trials with the exception of one. In 18 controlled trials, SAMe was as effective as imipramine, clomipramine, amitriptyline, nomifensine, and minaprine and caused fewer side effects. The rapid onset of action (5-10 days) was noted in 7 of the depression studies.

Arthritis: There are more than 100 different types of arthritis, ranging from mild tendinitis to severe forms such as osteoarthritis (OA), the most common form of arthritis. Arthritis is often categorized by symptoms such as inflammation, redness, heat, and pain. An estimated 15 percent of Americans suffer from arthritis, and the annual cost to society is estimated at 95 billion. Standard treatment therapies for osteoarthritis include non-steroidal anti-inflammatory medication, non-pharmacological (e.g. exercise, heat treatment), and surgery. Because of side effects from pharmacologic agents, SAMe was studied for its effects on reducing the pain associated with OA. Out of 13 unique studies considered in the ARHQ study, 10 studies were included in a meta-analysis of the efficacy of SAMe to decrease pain of osteoarthritis.

One large randomized clinical trial showed an effect size in favor of SAMe of 0.20 (95 percent CI [-0.39, - 0.02]) compared to placebo, thus demonstrating a decrease in the pain of osteoarthritis.

Compared to treatment with non-steroidal anti-inflammatory medication, treatment with SAMe was not associated with a statistically significant difference in outcomes (effect size 0.11; 95 percent CI [0.56, 0.35]).

In November 1987, the American Journal of Medicine published 20 papers from a symposium on SAMe and arthritis including 9 clinical trials with more than 22,000 participants. These studies, as well as others, indicate that SAMe exerts anti-inflammatory and analgesic effects equivalent to those of several prescriptions, nonsteroidal, anti-inflammatory drugs, but that it does not cause gastrointestinal bleeding. Anti-inflammatory effects require 3 to 4 weeks of treatment (200-400 mg orally every day) in mild to moderate cases.

Liver Disease: Abnormal SAMe synthesis is associated with liver disease, regardless of the etiology. Loss of activity in the enzyme methionine adenosyltransferase (MAT) results in decreased concentrations of SAMe and depletion of glutathione. The loss of glutathione further impairs SAMe production because glutathione is needed to stabilize MAT and to protect the enzyme from free radical damage.

The AHRQ included 6 studies in a meta-analysis of the efficacy of SAMe to relieve pruritus and decrease elevated bilirubin levels associated with intrahepatic cholestasis caused by a variety of liver diseases. Patients treated with SAMe were twice as likely as placebo-treated patients to have a reduction in pruritus.

The AHRQ included 8 studies in a meta-analysis of the efficacy of SAMe to relieve pruritus and decrease elevated serum bilirubin levels associated with cholestasis of pregnancy. Compared to placebo, treatment with SAMe for cholestasis of pregnancy was associated with a decrease in pruritus and bilirubin levels.

A review of 17 clinical trials shows that SAMe improved symptoms and biochemical markers (serum bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, transaminases, cysteine, taurine, and hepatic glutathione) of liver diseases, including alcoholic and nonalcoholic hepatitis and cirrhosis, oral-contraceptive-induced cholestasis, other forms of cholestasis, and metabolic disorders of porphyrin and bilirubin.

Bottom Line: SAMe is a very safe supplement and a great way to stop disease's mentioned above by taking lower doses as a preventative as well as fighting the current diseases that you may have by taking a little larger doses.

What the Science Says

SAMe has been investigated most extensively for depression, osteoarthritis, and cholestasis associated with pregnancy. For all three conditions, research has not conclusively shown that SAMe is helpful.

About Scientific Evidence on Complementary Health Approaches

Scientific evidence on complementary health approaches includes results from laboratory research as well as clinical trials (studies in people). It provides information on whether an approach is helpful and safe. Scientific journals publish study results, as well as review articles that evaluate the evidence as it accumulates; fact sheets from NCCAM—like this one—base information about research findings primarily on the most rigorous review articles, known as systematic reviews and meta-analyses.

Depression

Overall, the evidence that oral SAMe may be helpful for depression is not conclusive.

• At least 40 clinical trials have evaluated SAMe for depression and many of them showed beneficial effects. However, most of these trials lasted only a few weeks, included a small number of participants, and were not of the highest scientific quality. Also, some used injected SAMe rather than an oral form (taken by mouth).
• People with bipolar disorder (an illness characterized by mood swings, from depression to mania) should not take SAMe for their depressive symptoms except under the supervision of a health care provider because SAMe may worsen symptoms of mania.

Osteoarthritis

The results of research on SAMe for osteoarthritis are mixed.

• Clinical trials have compared oral SAMe with non-steroidal anti-inflammatory drugs (NSAIDs; medicines used to relieve osteoarthritis pain) or placebos (inactive substances) in patients with osteoarthritis of the knee or hip.
• In general, trials that compared SAMe with NSAIDs showed that each had similar pain relief and improvement in joint function, with fewer side effects in the patients taking SAMe.
• The smaller number of trials that compared SAMe with placebo did not consistently show SAMe to be beneficial.

Liver Diseases

Studies involving small numbers of women have suggested that SAMe might be helpful for cholestasis during pregnancy; whether SAMe helps other liver problems has not been established.

• There is some evidence linking decreased levels of SAMe in the body with the development of liver diseases, and animal studies have suggested that SAMe may be of value for liver problems.
• Cholestasis can have a variety of causes. Several small clinical trials have investigated SAMe for a form of cholestasis that can occur during pregnancy and have found hints that SAMe might be helpful. In some of these studies, SAMe was given orally; in others, it was given by injection. Because the number of women who have been studied is small, it is not possible to definitely conclude that the use of SAMe during pregnancy is safe. Pregnant women with cholestasis should use caution if they are considering SAMe and should follow their health care provider’s instructions for the treatment of this condition. Pregnant women should not take SAMe without their provider’s approval.
• Whether SAMe is beneficial for other liver conditions has not been established. One long-term study in patients with alcohol-related liver disease had promising results, but they have not been confirmed by other research.

LifeSource Vitamins - SAM-e, Depression is linked to low SAM-e levels in people of all ages. Helps the liver detoxify alcohol, drugs, and poisons such as insecticides, and can also decrease the pain of osteoarthritis. Helps with depression and anxiety.*

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