Tagged with 'SAMe'

Osteoarthritis, Liver Cirrhosis, Depression…what do they all have in common??  It would seem, not much, but surprisingly there is something and it’s called S-Adenosyl Methionine, also known as SAMe. 

SAMe is a form of the amino acid methionine and most people get enough.  However, there are some instances, taking extra SAMe just may be your solution.

Liver Cirrhosis

For example, in the unfortunate situation you have or know someone with alcoholic liver cirrhosis, supplementing with large amounts of SAMe may improve survival and liver function.  

How?

SAMe has been shown to reverse the depletion of glutathione, an important antioxidant required for liver function¹.  It has also been shown to aid in the resolution of blocked bile flow (cholestasis), a common complication of liver cirrhosis^{2, 3}.

How much would you need to take?

Well, one double-blind trial found that 1,200 mg of SAMe per day for two years significantly decreased the overall death rate and the need for liver transplantation in people with alcoholic liver cirrhosis, particularly in those with less advanced liver disease⁴.

Osteoarthritis

Do you have achy, painful joints caused from osteoarthritis?  SAMe possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of your joints^{5, 6}. 

How?

The primary way in which SAMe reduces osteoarthritis symptoms is not known but here are some interesting research findings: 

A very large, though uncontrolled, trial (meaning that there was no comparison with placebo) demonstrated “very good” or “good” clinical effect of SAMe in 71% of over 20,000 osteoarthritis sufferers⁷.  In addition to this preliminary research, many double-blind trials have shown SAMe reduces pain, stiffness, and swelling better than placebo and equal to drugs such as ibuprofen and naproxen in people with osteoarthritis.^{8, 9, 10, 11, 12, 13, 14, 15}.  A review of the clinical trials on SAMe concluded its efficacy against osteoarthritis was similar to that of conventional drugs but patients tolerated it better ¹⁶.

How much SAMe to take?

These double-blind trials all used 1,200 mg of SAMe per day.

Depression

Millions of people worldwide have some form of depression. Taking SAMe by mouth or by injection seems to reduce symptoms of depression.  

How?

 It appears to raise levels of dopamine, an important neurotransmitter in mood regulation. 

Interesting research findings: 

Several studies have shown SAMe can be beneficial and might be as effective as some prescription medications used for depression (tricyclic antidepressants).  Some research also shows taking SAMe might be helpful for people who don’t have a good response to a prescription antidepressant.  But keep in mind, SAMe should not be taken in combination with a prescription antidepressant without the monitoring of a health professional.

How much? 

Most trials used 1,600 mg of SAMe per day¹⁷.

Bottom Line:

SAMe shows some promising results for several devastating problems.  Ask your health care provider about using SAMe if it sounds like something you may benefit from.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1.  Loguercio C, Nardi G, Argenzio F, et al. Effect of S-adenosyl-L-methionine administration on red blood cell cysteine and glutathione levels in alcoholic patients with and without liver disease.  Alcohol 1994;29:597–604.

2.  Frezza M, Centini G, Cammareri G, et al. S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepatogastroenterology 1990;37 Suppl 2:122–5.

3.  Frezza M, Surrenti C, Manzillo G, et al. Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study. Gastroenterology 1990;99:211–5.

4.  Mato JM, Camara J, Fernandez de Paz J, et al. S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial. J Hepatol 1999;30:1081–9.

5.  Schumacher HR. Osteoarthritis: the clinical picture, pathogenesis, and management with studies on a new therapeutic agent, S-adenosylmethionine. Am J Med 1987;83(Suppl 5A):1–4 [review].

6.  Harmand MF, Vilamitjana J, Maloche E, et al. Effects of S-adenosylmethionine on human articular chondrocyte differentiation: an in vitro study. Am J Med 1987;83(Suppl 5A):48–54.

7.  Berger R, Nowak H. A new medical approach to the treatment of osteoarthritis. Report of an open phase IV study with ademetionine (Gumbaral). Am J Med 1987;83:84–8.

8. Domljan Z, Vrhovac B, Durrigl T, Pucar I. A double-blind trial of ademetionine vs naproxen in activated gonarthrosis. Int J Clin Pharmacol Ther Toxicol 1989;27:329–33.

9. Müller-Fassbender H. Double-blind clinical trial of S-adenosylmethionine in versus ibuprofen in the treatment of osteoarthritis. Am J Med 1987;83(Suppl 5A):81–3.

10. Vetter G. Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. Am J Med 1987;83(Suppl 5A):78–80.

11. Maccagno A. Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. Am J Med 1987;83(Suppl 5A):72–7.

12. Caruso I, Pietrogrande V. Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease. Am J Med 1987;83(Suppl 5A):66–71.

13. Marcolongo R, Giordano N, Colombo B, et al. Double-blind multicentre study of the activity of s-adenosyl-methionine in hip and knee osteoarthritis. Curr Ther Res 1985;37:82–94.

14. Glorioso S, Todesco S, Mazzi A, et al. Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis. Int J Clin Pharmacol Res 1985;5:39–49.

15. Montrone F, Fumagalli M, Sarzi-Puttini P, et al. Double-blind study of S-adenosyl-methionine versus placebo in hip and knee arthrosis. Clin Rheumatol 1985;4:484–5.

16. Di Padova C. S-adenosylmethionine in the treatment of osteoarthritis. Review of the clinical studies. Am J Med 1987;83:60–5 [review].

17. Natural Products Foundation Vitamins and Herbs A-Z:  SAMe.

Plants are getting serious attention as the source of effective therapies for depression and may help to alleviate problems of anxiety, stress, agitation and sleeplessness that accompany low moods. 

Promising remedies for mood disorders:

St. John’s wort: 

Generally used for anxiety, mild to moderate depression, and seasonal affective disorder, St. John’s wort is an affordable antidepressant that some research suggests is as effective as selective serotonin reuptake inhibitors (SSRIs) in treating mild to moderate clinical depression (5).  Most studies are short-term use of St. John’s wort (2).  Side effects, which are mild, include dizziness, headache, dry mouth, confusion and nausea.  Dosages range from 900 to 1,800 mg per day.  Caution:  St. John’s wort interacts with SSRI’s, anticoagulants, oral contraceptives and a number of other drugs (1, 5).  Just to be safe, do not take with ANY other medications.

Kava: 

This mild sedative is made from roots of the kava kava tree.  Studies show it can relieve clinical anxiety, stress, insomnia and restlessness without causing drug dependency, and it has been suggested as a viable alternative to tranquilizers and sleeping pills (3).  Side effects are generally mild, and include fatigue, impaired reflexes, headache, stomach problems and tremor.  Serious liver problems, although rare, have also been reported.  Kava—which interacts with alcohol, sedatives, barbiturates and benzodiazepines—should be used with care, particularly among those with liver disease.  Dosage is 60 to 300 mg per day.

Valerian: 

This mild tranquilizer and sedative is made from the root of the valerian plant.  It helps relieve anxiety, sleep problems, and restlessness.  Side effects are mild, and include headaches and possible morning drowsiness.  Valerian’s effects are compounded when used with barbiturates, sleeping pills, tranquilizers or sedatives.  Take it 30 minutes before bedtime as a tea made of 1 tsp. dried root steeped in 1 cup boiling water, or as one 600 mg capsule containing 0.8% valerenic acid (4). 

S-adenosyl-L-methionine (SAMe):  

A naturally occurring molecule present in all human cells.  People with depression have low levels of serum and cerebral spinal fluid SAMe, and supplementation raises levels of SAMe, dopamine, and other neurotransmitters in the brain.  SAMe is associated with a significant improvement in depression.  Although it's one of the more expensive supplements, it remains popular as a remedy for depression.  Typical daily dose are 800-1,600mg (2, 5).  Avoid if you suffer from bipolar.

Nutrition for Depression:  

The goal is to eat optimal amounts of essential nutrients while avoiding or minimizing intake of toxic substances. 

Here are some important Nutrition Tips:

--Promote stable blood sugar by eating foods with a low glycemic index such as proteins, complex carbohydrates, and other high fiber foods.

--Always eat breakfast and include protein to promote stable blood sugar throughout the day.

--Drink plenty of pure, filtered water.

--Eat fresh fruits and vegetables, beans & legumes, whole grains, and fish.

--If you eat dairy and meat, choose organic, locally raised products whenever possible.  

--Minimize the use of processed foods.

--Avoid sweetened beverages, processed foods, fatty foods, fried foods and junk food (6-9).

Before proceeding, caution is in order.  Botanicals are Drugs, too!

Many consumers view herbal supplements as “natural” and therefore harmless, but experts warn this is far from true.  Botanical remedies contain a variety of chemical ingredients that can cause unwanted side effects.  Just as with manufactured drugs, it is possible to overdose on herbal supplements.  They may also aggravate existing health problems or interact negatively with other drugs you are taking.  The long-term safety of many remedies is unknown and herbal supplements typically aren’t safe for pregnant or breastfeeding women.

More investigating needs to be done to learn who responds to botanicals, how effective and safe they are, and potential toxic reactions and interactions with other drugs.  For this reason, I do not recommend combining any botanicals or herbs with prescription anti-depressants! Use natural remedies at their recommended doses, and always talk to your health care provider before introducing a new supplement.

Bottom Line:

  If you haven't noticed, depression is hard to sort out.  Please do not try to on your own.  Talk to your health care provider about your interest in trying a natural remedy and start slowly.

Please let me know if you have any questions.

In Health and Happiness,

Kelly Harrington, MS, RD

Registered Dietitian Nutritionist for Healthy Goods

References:

1.  Rahimi R, Abdollahi M.  An update on the ability of St. John’s wort ot affect the metabolism of other drugs.  Expert Opin Drug Metab Toxicol.  2012 Jun;8(6):691-708.

2.  Nahas R.  Complementary and alternative medicine for the treatment of major depressive disorder.  Canadian Family Physician.  2011 Jun;57(6):659-663.

3.  Lakhan S, Vieira K.  Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review.  Nutr J. 2010;9:42

4.  Donath F, et al.  Critical evaluation of the effect of valerian extract on sleep structure and sleep quality.  Pharmacopsychiatry.  2000 Mar;33(2):47-53. 

5.  Kemper K.  CAM Therapies to Promote Healthy Moods.  Pediatr Clin North Am.  2007 Dec: 54(6): 901-x. 

6.  Ludwig DS. Clinical update: the low-glycaemic-index diet. Lancet. 2007 Mar 17;369(9565):890–892. 

7.  Kleinman RE, Hall S, Green H, et al. Diet, breakfast, and academic performance in children. Ann Nutr Metab. 2002;46 (Suppl 1):24–30.   

8.  Fulkerson JA, Sherwood NE, Perry CL, Neumark-Sztainer D, Story M. Depressive symptoms and adolescent eating and health behaviors: a multifaceted view in a population-based sample.  Prev Med. 2004 Jun;38(6):865–875.  

9.  Allgower A, Wardle J, Steptoe A.  Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychol. 2001 May;20(3):223–227.