What is SAM-e?
S-Adenosylmethionine (SAM or SAM-e; pronounced "Sammy") is an amino
acid joined with the human energy molecule ATP. It is an essential molecule
naturally occurring in the cells of plants and animals and takes part in
several biological reactions in the human body. SAM-e is essential for the
body to perform vital functions. SAM-e is not an herb. It was discovered in
1952 in Italy, where it is manufactured to this day. Until recently, however,
it was exceedingly expensive to produce, and therefore unavailable to the
public. As we age, our bodies produce less SAM-e, so some think that
SAM-e may be a helpful supplement when used to treat symptoms of depression.
It has been available in European countries through prescription. SAM-e has
also been studied extensively in Europe for over 20 years and may be one of
the most potent, multi-purpose supplements ever introduced. It has only
recently been available over-the-counter in the US as a supplement.
The body is unable to
synthesize adequate quantities of SAM-e so it must be gathered from our diet.
Like other substances in the body, such as hormones, levels of SAM-e decline
as we age. However, older people are not the only people who can have lower
amounts of SAM-e. Low levels of SAM-e have been found in a great variety of
age groups. Men have higher levels than women, and children have 7 times more
The primary claim of this
supplement is in the treatment of depression. SAM-e has been used to treat
patients, some resistant to other anti-depressants, with great success as well
as for other conditions. It seems to be is winning acceptance among the
psychiatric community. It is also being proponed to
enhance joint health, mobility and joint comfort and supports and promotes
liver health. It is also emerging as an effective therapy for arthritis,
fibromyalgia, memory problems, ADD and ADHD, osteoarthritis, stress, Parkinson's disease,
chronic fatigue syndrome (CFS) and possibly even Alzheimer's disease.
For osteoarthritis, the leading
cause of joint pain and stiffness: 400 to 800 mg daily. Promotes flexibility
of joint cartilage repair. A German study of 20,641 patients found that 71% of
those who took Sam-e supplements for eight weeks reported good or very good
At present, the safety of SAM-e has not been proven. The U.S. Food and
Drug Administration (FDA) does not approve or regulate the
distribution of supplements in the United States. Not all
formulations of SAM-e are the same. Some brands are more
potent than others, depending upon the quality of the ingredients used.
Known Negative Effects / Cautions
SAM-e can have numerous adverse
side effects, including:
Another issue in deciding
whether to use SAM-e is cost. The recommended oral dose is 200 to 800 mg twice
per day. Most studies used 1,600 mg per day to get any positive effects in
relieving depressive symptoms. A 1-month supply of SAM-e at 1,600 mg per day
(this would be the highest dose recommended) could
cost about $228.
If you are taking anti-depressant medications, consult your physician before using this product.
Individuals with bipolar (manic) depression should not use this product unless
under medical supervision.
If you suffer from severe
depression, don't take SAM-e without consulting your doctor first. This
precaution is particularly important if you have a bipolar disorder because
SAM-e could trigger or exacerbate mania (the "up" phase) in such
cases. If you're taking
prescription anti-depressants, don't discontinue them or reduce your dosage
without consulting your doctor. SAM-e should lift depression relatively
quickly. If you don't notice a significant improvement after four weeks, see
your doctor. You may need a different category of anti-depressant.
If improperly handled, the raw
material used to make SAM-e can deteriorate rapidly, making these costly
supplements weak or even inactive. Look for "pharmaceutical grade"
products and opt for a more stable form called "butanedisulfonate"
rather than "tosylate." Look for "enteric coated" it's
more readily absorbed by the body in this form and remains chemically stable
for much longer (the coating protects it from exposure to air). If SAM-e is
bottled freshness cannot be ensured once the bottle has been opened. Cold form
blister packaging ensures the freshness and potency of each SAM-e tablet.
Also, tests have shown that some products professing to contain SAM-e have been
proven to contain little or none. Purchase SAM-e from a reliable
company whose quality standards you trust.
absorption into the body, the best time to take SAM-e is 2
hours before or 3 hours after a meal. It is best absorbed on
an empty stomach. If nausea or heartburn develop, take it
with plenty of water. If
you're particularly sensitive to medications, start out with
half the recommended daily dosage and work up to the full
amount after a week. To prevent insomnia, don't take SAM-e
late in the day. Most people report a mild energy boost with
For optimal mood and emotional
well-being, take 400 mg in the morning and 1 400 mg in the afternoon. Clinical
studies indicate that benefits may be evident in the first two weeks of
supplementation and may continue for a prolonged period of time. As mentioned
prior, taking SAM-e at bedtime may interfere with a good night's rest.
Clinical studies indicate that benefits may be evident within one week of
supplementation. If benefits are not achieved in two weeks, you may require
400 mg 3 times a day -- gradually increase the number of tablets as necessary up
to 8 tablets a day, until benefits are achieved.
SAM-e can safely be combined with other natural anti-depressants such as St.
John's Wort, as well as conventional anti-depressants. Don't
take SAM-e with MAO inhibitor anti-depressants.
To avoid a toxic buildup of
homocysteine molecules (which are formed when SAM-e breaks down) be sure to
take a high-quality vitamin B complex supplement along with SAM-e. These
vitamins disarm homocysteine, which in high concentrations poses the risk of
various health problems including heart attack and stroke. A standard
recommendation is to take 100 mg of a B complex once a day, regardless of the