SAM-e  62 A

        

July 2003 Issue, Published by Internal Health.

SAM-e (S-adenosyl-L-methionine) was originally developed by an Italian firm as a pharmaceutical in the early 70's but lacked the resources for a drug approval in the United States. SAM-e has now been the rave for more than 20 years, in over 14 countries. It has been touted as the most potent, multi-purpose, anti-aging, anti-disease therapy ever introduced! Until now, SAM-e was only available in a tablet or capsule form.

Now Liquid SAM-e, a New Delivery System:
Today, we have been able to engineer SAM-e into a stabilized liquid form, creating a unique proprietary blend. SAM-e is held in a liquid suspension and this delivery system increases the fantastic properties of SAM-e, you get all the benefits plus greater absorption.

SAM-e is currently used to treat five principle conditions:

The 'Sammy' Solution
March 22, 1999 Newsweek Magazine stated that a new supplement may help relieve depression and arthritis as well. And according to the USA Today that article from August 10, 1999, set off much of the interest in SAM-e. It was a fairly short article compared to the longer follow-up article that Newsweek ran on July 5, 1999. It says that SAM-e is comparable to state-of-the-art treatments for both depression and arthritis. Established depression drug treatments help about 70 percent of patients and in controlled studies SAM-e also helped about 70 percent of the subjects. Dr. Richard Brown is quoted as saying it is "the best antidepressant I've ever prescribed." The article says that SAM-e aids in the production of dopamine and serotonin.  Like other articles it warns that SAM-e is not appropriate for the treatment of bipolar disorder because is can exacerbate mania.

Antidepressant drugs are part of a billion dollar psychopharmacology industry that, according to some physicians, churns out dangerous, addictive products. While antidepressants work in most patients, there are drawbacks. According to statistics from the Substance Abuse and Mental Health Services Administration (SAMSHA), 53% of drug-related admissions to emergency rooms are due to overdose. People frequently overdose on tricyclic antidepressants during the lag time between the time the drug is prescribed, and when it starts working. In 1994, 90% of the emergency room visits were related to tricyclic antidepressants for overdosing (intentional and unintentional).

SAM-e Improves Mood Fast!
The brain of a healthy person manufactures all the SAM-e it needs from methionine, but SAM-e production is impaired in people who are depressed. Supplementation with SAM-e increases levels of serotonin, dopamine and phosphatides, and improves serotonin and dopamine receptor
site binding. Interestingly, treatment with antidepressant drugs that resulted in improved mood (as determined by a 50% improvement in the Hamilton Depression Inventory) usually also results in increased SAM-e regardless of the drug used.

SAM-e occurs naturally in every living cell and is a co-factor in a process called methylation that affects more than 100 complex biochemical reactions in the human body. SAM-e helps our bodies make and regulate hormones, cell membranes and the neurotransmitters that affect mood. SAM-e promotes "emotional well-being" as well as "joint health". SAM-e also contributes to the building blocks for cartilage, and is involved in making glutathione, which the liver uses to remove poisons such as alcohol. SAM-e is a "methyl donor", meaning that when it reacts with vitamin B12 and folic acid, it gives away units of carbon (a methyl group) to other molecules in the body. That process is critical in the production of "feel good" brain chemicals like dopamine and serotonin.

How, exactly, might taking SAM-e improve a person's mood?
Researchers have identified several possibilities. Normal brain function involves the passage of chemical messengers between cells. SAM-e may enhance the impact of mood-boosting messengers such as serotonin, norepinephrine, and dopamine - either by regulating their breakdown or by speeding up production of the receptor molecules they latch on to (Serotonin is the neurotransmitter the drugs like Prozac elevate).  SAM-e may also make existing receptors more responsive. These molecules float in the outer membranes of brain cells like swimmers treading water in a pool. If the membranes get thick and glutinous, due to age or other assaults, the receptors lose their ability to move and change in response to chemical signals. By methylating fats called phospholipids, SAM-e keeps the membranes fluid and the receptors mobile.

Recent Research and Updates on SAM-e
In a recent study of the effects of SAM-e on depression, arthritis, and liver disease conducted by Health and Human Services' Agency for Healthcare Research and Quality, SAM-e was found to work effectively for all three conditions. For depression, SAM-e was shown to be as good as standard antidepressant therapy; for liver disease, SAM-e improved intrahepatic cholestasis (cholesterol deposits in the liver, including intrahepatic cholestasis of pregnancy) and reduced serum bilirubin levels, itching associated with intrahepatic cholestasis and jaundice; and for osteoarthritis, SAM-e was shown as effective at relieving joint pain as nonsteroidal anti-inflammatory drugs (NSAID’s). In the studies on liver disease, researchers felt that a larger sample was needed to determine accurately the benefits of the SAM-e, and that overall more studies were needed to determine an optimum doses for each of the disease conditions, but they stated that SAM-e research was clearly worth pursuing.

SAM-e for Pain and Inflammation
Over 40 million Americans with chronic pain use drugs like aspirin, ibuprofen, and acetaminophen. In arthritis-strength dosages, these NSAID's have devastating side effects. Over 100,000 Americans are hospitalized annually from NSAID induced ulcers and more than 16,000 die. In a dozen clinical trails with more than 22,000 patients, researchers found SAM-e as effective as pharmaceutical treatments for pain and inflammation, without any signs of digestive tract damage, sexual dysfunction, dry mouth, or nausea. And instead of speeding the breakdown of cartilage, SAM-e may actually help to restore it. Medical experts from The Arthritis Foundation recently stated that they were satisfied that SAM-e "provides pain relief". Also, SAM-e has shown no signs of drug interaction and can be taken along with most, if not all prescription drugs, under a doctor's supervision.

SAM-e and Arthritis, Here is what we know:

In a study performed in 1990 at the Instituto de Docencia e Investigaciones Biologicas, in Buenos Aires, Argentina, arthritis was induced in the right knee of 24 rabbits. The rabbits were divided into 3 groups and treated intramuscularly with 30, 60 or 0 (diluent only) mg of SAM-e. After 12 weeks the knees were examined and it was found that the greater the amount of SAM-e given to the rabbit, the greater the concentration of proteoglycans was found in the cartilage

Over the last two decades, multiple clinical trials involving thousands of people have shown SAM-e to improve joint health and treat Osteo Arthritis. It has been found to be equal to NSAIDs in clinical studies. Most of this research has been done in Europe, where SAM-e is sold as a drug.

Several studies suggest SAM-e repairs and rebuilds cartilage. These studies however, have only been done in vitro and in animal models. At the moment there is no good human clinical evidence for this.

Fibromyalgia:
Fibromyalgia is one of those mysterious syndromes that can either occur by itself, or accompany other diseases such as lupus and chronic fatigue immune dysfunction syndrome. The main feature of fibromyalgia is persistent pain but not necessarily in the joints, but deep in muscles that occurs for no apparent reason. The symptoms of fibromyalgia include tenderness at several points of the body. In addition, people with fibromyalgia frequently have fatigue, sleep disturbances, numbness, joint swelling, and other symptoms. It is often treated with tricyclic antidepressants.

It has been suggested by several researchers that SAM-e might be a good substitute for tricyclic antidepressants for the treatment of fibromyalgia. Several studies have proven them right. In a study in the Scandanavian Journal of Rheumatology, 800 mg of SAM-e per day for six weeks improved "clinical disease activity", pain, and morning stiffness. Mood improved when measured by the Face Scale, but there was no significant improvement on the Beck Depression Inventory.

In Addition:
Cautions: Avoid if you have bipolar disorder (manic depression). SAM-e may interact with antidepressive medication. Avoid if you are taking monoamine oxidase inhibitors (MAOI). SAM-e may worsen Parkinson's disease.

Symptom relief from SAM-e may take up to twice as long as from NSAIDs, but benefits last longer, continuing after supplementation ends. "Loading" doses, initially starting out with a high dose and then dropping to lower doses later, may work as maintenance. SAM-e works closely with the B vitamins, B12, B6 and folate, so it is important to get enough of the B vitamins when taking this supplement. And it is a good idea to store the liquid SAM-e in the refrigerator to prolong its shelf-life and reduce oxidation.