SAMe I am: amino acid metabolite offers more than a mood boost

Better Nutrition, Jan, 2005 by Kim Schoenhals

A supplement known for its multiple beneficial uses, SAMe (pronounced "Sammy") is short for S-adenosylmethionine or S-adenosyl-L-methionine. This natural by-product of metabolism is manufactured from the amino acid methionine, and it plays a part in countless metabolic reactions, including the production of several brain chemicals.

Depression

Perhaps due to its essential role in the synthesis of neurotransmitters, SAMe has been studied thoroughly for its effects on mental wellness, and it has been deemed safe and beneficial compared to both pharmaceuticals and other dietary supplements. In fact, SAMe is as effective as standard antidepressants and may enhance their efficacy, according to a November 2002 Harvard research review in The American Journal of Clinical Nutrition.

Some of the same researchers reported in the December 2003 issue of Current Psychiatry Reports that SAMe has been more extensively studied for depression than any other dietary supplement, and the literature supports its antidepressant activity.

In a head-to-head comparison with the antidepressant imipramine, SAMe performed equally well for major depression after 4 weeks, as noted in the December 2002 issue of The International Journal of Neuropsychopharmacology. One important note in this trial: SAMe recipients had fewer negative side effects than the imipramine group.

Marisa M. Silveri, PhD, and her team from Harvard's McLean Hospital delved into the mechanism of action behind SAMe's efficacy in depression and reported their findings in the October 2003 issue of Biological Psychiatry. Nondepressed subjects taking SAMe exhibited increases in brain levels of phosphocreatine (PCr), which is a resource the brain uses to maintain constant energy levels. This is important because, as Silveri explains, "decreased levels of brain energy may indicate decreased energy utilization in the brain, which may be a neurobiological mechanism underlying depression.

"So given that depression has been associated with decreased endogenous SAMe levels and reduced beta NTP, it is an empirical question as to how SAMe might improve the neurochemistry of depression," Silveri says. "But now that we know what SAMe does in healthy (nondepressed) individuals, we have a place to start to look for changes and/or differences."

Arthritis

As is the case with depression, SAMe has been on par with pharmaceuticals for alleviating fire symptoms of osteoarthritis. In fact, SAMe showed up in the literature as early as 1975 for its effects against arthritis when Italian researchers deemed SAMe an effective anti-inflammatory agent comparable to indomethacin, but without the negative side effects of the drug.

More recently, SAMe has been compared to nonsteroidal anti-inflammatory drugs (NSAIDs). A meta-analysis of 11 clinical trials published in the May 2002 issue of The Journal of Family Practice indicated that the supplement was superior to a placebo in increasing functionality--plus it was as effective as NSAIDs in reducing pain and improving function, but without the negative side effects caused by pharmaceuticals. The same conclusions were reported by a different group of researchers in the January 2003 American Family Physician.

SAMe also performs similarly to COX-2 inhibitors. Researchers from the University of California, Irvine, compared SAMe to a COX-2 inhibitor in 61 adults with osteoarthritis of the knee. In the first month of the trial, the pharmaceutical was more effective for reducing pain, but by the second month, the two treatments were equally effective, as noted in February 2004 in BMC Musculoskeletal Disorders.

Fibromyalgia

Still considered somewhat of a phantom disease in some circles, fibromyalgia is very real for the people with the condition, which causes fatigue as well as musculoskeletal aches and stiffness. SAMe has been studied for alleviating symptoms of fibromyalgia, although there have been conflicting results.

In a 1987 issue of The American Journal of Medicine, researchers from Italy's University of Pisa reported that SAMe reduced the number of trigger points and elevated mood in 17 study participants. This led to the conclusion that SAMe was an effective treatment for fibromyalgia.

Conversely, in a 1997 issue of the Scandinavian Journal of Rheumatology, researchers from Frederiksberg Hospital in Copenhagen, Denmark, reported that SAMe was not effective for treating fibromyalgia. The short-term study involved 34 outpatients who were given intravenous SAMe treatments for 10 days. While there was a tendency toward improvement in the perception of pain and overall well-being in the SAMe group, researchers reported only slight improvements in fatigue, quality of sleep and morning stiffness.

Liver Disease

In addition to being used to treat depression, osteoarthritis and fibromyalgia, SAMe may improve symptoms of liver disease caused by excessive alcohol intake. Natural SAMe levels are known to decline with chronic drinking, according to animal research published in the August 2004 issue of Hepatology. Although it would seem logical that SAMe could improve alcohol-caused liver damage by restoring SAMe levels, researchers at the University of California, San Francisco, noted that the classic treatment for alcoholic liver disease is abstinence, and SAMe's role in potentially improving the healing rate is still under investigation.