SAM-e (S-adenosylmethionine) is thought to increase chondrocytes (the cells that make up cartilage), cartilage thickness and possibly decrease chondrocyte damage. SAM-e has become a popular dietary supplement used to treat osteoarthritis. Here are 10 things you should know about SAM-e.
1 - SAM-e, which stands for S-adenosylmethionine, is a naturally occurring compound in the body.
SAM-e, which is sold as a dietary supplement, is either made from fermented yeast or totally synthesized. SAM-e is produced by methionine (a sulfur-containing amino acid) and ATP (adenosine triphosphate) in the body.
2 - SAM-e is found in every human cell of the body.
SAM-e is thought to be involved in more than 35 biochemical processes in the body. As a dietary supplement, SAM-e has several therapeutic indications:
- treats pain, stiffness, swelling of the joints
- improves mobility
- rebuilds cartilage and relieves osteoarthritis symptoms
- eases symptoms of fibromyalgia
- eases symptoms of bursitis and tendinitis
- relieves chronic low back pain
- treats depression
3 - SAM-e works relatively fast.
SAM-e is recognized as an effective anti-inflammatory and analgesic (pain-reliever) for patients with osteoarthritis. If SAM-e is an effective treatment for you, results may be felt in about a week.
4 - SAM-e works together with B vitamins.
When taking SAM-e, it is important to also supplement your diet with vitamin B12, vitamin B6 and folate. Chemically-speaking, with the help of B-vitamins, SAM-e gives up a methyl group to surrounding tissues and organs and regulates several biochemical processes. For example, SAM-e helps maintain cell membranes, removes toxic substances from the body, and produces mood-enhancing neurotransmitters.
5 - SAM-e should not be taken without a doctor's supervision.
SAM-e is available in tablet form. For the treatment of osteoarthritis, 600 mg to 1,200 mg per day is the usual dose. In osteoarthritis studies, SAM-e was taken in doses of 200 to 400 mg, three times per day. The usual dose for fibromyalgia is 800 mg per day, after the dose is gradually increased from a starting dose of 200 mg per day.
6 - SAM-e is a prescription medication in Europe and a dietary supplement in the United States.
SAM-e has been used for over 20 years in Europe to treat arthritis and depression. Since it is not marketed as a prescription medication in the United States as it is in Europe, be careful and cautious about the brand and quality of SAM-e that you purchase. Choose a dietary supplement brand with a good reputation.
7 - SAM-e has been shown to be as effective as NSAIDs (nonsteroidal anti-inflammatory drugs) for the treatment of osteoarthritis.
Many clinical trials performed in Europe and also in the United States have concluded that SAM-e is as effective as NSAIDs in reducing pain and improving functional limitations in osteoarthritis patients. There also appeared to be fewer adverse effects with SAM-e than with NSAID use.
8 - In clinical trials, SAM-e was found to have slower onset of action than Celebrex.
In a randomized trial comparing 1,200 mg SAM-e with 200 mg Celebrex for 16 weeks:
- Celebrex showed significantly more pain reduction than SAM-e in the first month.
- There was no significant difference between SAM-e and Celebrex by the second month.
Researchers concluded SAM-e was slower to act, but over time was as effective as Celebrex for the management of knee osteoarthritis.
9 - SAM-e can cause certain side effects, especially at higher doses.
SAM-e can cause:
10 - There are certain warnings associated with SAM-e.
SAM-e may interact with certain antidepressants. SAM-e should not be used if you are taking monoamine oxidase inhibitors (MAOIs). SAM-e should not be used if you have bipolar disorder. There is also a possibility of worsening Parkinson's disease with SAM-e use.
SAM-e. Arthritis Today Supplement Guide. Arthritis Foundation. Accessed 5/14/2008.
Safety and efficacy of S-adenosylmethionine (SAM-e) for osteoarthritis. Soeken KL et al. The Journal of Family Practice. May 2002.
S-Adenosyl methionine (SAM-e) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. BMC Musculoskeletal Disorders. Wadie I Najm et al. February 2004.