What Is SAM-e (S-adenosylmethionine)?

SAM-e May Benefit Osteoarthritis and Depression

Woman taking supplement with water.
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Hype and warnings often circulate around dietary supplements. SAM-e (S-adenosylmethionine) is among the popular dietary supplements that claim to have beneficial effects for treating osteoarthritis and depression.

What Is SAM-e?

SAM-e (S-adenosylmethionine) is not an herbal remedy, but rather a compound produced by our bodies from methionine, an amino acid found in protein-rich foods. As a supplement, SAM-e is either made from fermented yeast or completely synthesized.

How Does SAM-e work?

With additional help from vitamin B-12 and folic acid, SAM-e relinquishes a methyl group from its composition to surrounding tissues and organs. Through this action, SAM-e helps with the maintenance of cell membranes, removal of toxic substances from the body, and the production of mood-enhancing neurotransmitters.

Altogether, SAM-e appears to regulate more than 35 different mechanisms. With the breakdown of SAM-e, other molecules are spawned which may help maintain joint cartilage. It is thought that SAM-e increases the cells that make up cartilage (known as chondrocytes), affects cartilage thickness, and possibly decreases damage to chondrocytes.

How Was SAM-e Discovered?

SAM-e has been used for decades in Europe to treat arthritis and depression. The substance was discovered in the 1950's at the National Institutes of Health. In the 1970's, after an Italian lab learned to produce it in cell cultures, SAM-e was researched as an anti-depressant. Some of the first patients who were given SAM-e for depression also suffered with osteoarthritis. The anti-arthritic potential of SAM-e was realized when these patients reported relief from their joint pain, as well as their depression.

The anti-arthritic effects suggest SAM-e may relieve stiffness and swelling, as well as pain. It may improve mobility consequently. It may relieve symptoms of fibromyalgia, bursitis, and tendinitis, and low back pain, as well as offer beneficial effects for osteoarthritis.

What Did Studies Reveal?

Arthritis patients have participated in studies comparing SAM-e to placebo or other NSAIDs (non-steroidal anti-inflammatory drugs). In a meta-analysis, published in the Journal of Family Practice, May 2002, SAM-e patients got as much relief as patients taking NSAIDs. In another trial (BMC Musculoskeletal Disorders 2004), which was a randomized trial that compared 1,200 mg SAM-e to 200 mg Celebrex (celecoxib) for 16 weeks, it was concluded that SAM-e was slower to act but as effective as Celebrex over time for knee osteoarthritis. There are no current plans to conduct double-blind, placebo controlled studies in the United States which are necessary studies to prove the effectiveness of medicines.

Are There Any Side Effects Associated With SAM-e?

The usual dose of SAM-e for osteoarthritis is 600 to 1,200 mg per day. There may be side effects, with more potential for adverse effects at higher doses. The side effects may include nausea, flatulence, diarrhea, and headache.

The Bottom Line

SAM-e is sold as an over-the-counter supplement in the United States. In Europe, it is sold by prescription. The marketing claim states that it promotes "joint health" and "emotional well-being". The Food and Drug Administration, which oversees the dietary supplement market, does not allow medical claims on the packaging of supplements.

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