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Nutritional Supplement

SAMe

Also indexed as:S-Adenosyl-L-Methionine

Possible Deficiencies

SAMe is normally produced in the liver from the amino acidmethionine which is abundant in most diets. Folic acid and vitamin B12 are necessary for the synthesis of SAMe, and deficiencies of these vitamins results in low concentrations of SAMe in the central nervous system.15 Low blood or central nervous system levels of SAMe have been detected in people with cirrhosis of the liver,16coronary heart disease,17Alzheimer’s disease, and depression.18

Side Effects

Clinical trials in thousands of people for up to two years have demonstrated that SAMe is very well tolerated, much better than the medications with which it has often been compared.19,20 Occasional gastrointestinal upset may be experienced by some people. Researchers treating people with bipolar disorder (manic depression) have reported that SAMe could cause them to switch from depression to a manic episode.21,22

References

1. 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].

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. Konig B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J Med 1987;83:89-94.

13. Bradley JD, Flusser D, Katz BP, et al. A randomized, double blind, placebo controlled trial of intravenous loading with S-adenosylmethionine (SAM) followed by or SAM therapy in patients with knee osteoarthritis. J Rheumatol 1994;21:905-11.

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

15. Bottiglieri T, Hyland K, Reynolds EH. The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 1994;48:137-52 [review].

16. Osman E, Owen JS, Burroughs AK. S-adenosyl-L-methionine-a new therapeutic agent in liver disease? Aliment Pharmacol Ther 1993;7:21-8 [review].

17. Loehrer FM, Angst CP, Haefeli WE, et al. Low whole-blood S-adenosylmethionine and correlation between 5-methyltetrahydrofolate and homocysteine in coronary artery disease. Arterioscler Thromb Vasc Biol 1996;16:727-33.

18. Bottiglieri T, Godfrey P, Flynn T, et al. Cerebrospinal fluid S-adenosylmethionine in depression and dementia: effects of treatment with parenteral and oral S-adenosylmethionine. J Neurol Neurosurg Psychiatry 1990;53:1096-8.

19. Bressa GM. S-adenosyl-l-methionine (SAMe) as antidepressant: Meta-analysis of clinical studies. Acta Neurol Scand 1994;154(suppl):7-14.

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

21. Carney MWP, Chary TKN, Bottiglieri T, Reynolds EH. The switch mechanism and bipolar/unipolar dichotomy. Br J Psychiatry 1989;154:48-51.

22. Carney MWP, Chary TK, Bottiglieri T, et al. Switch and S-adenosyl-methionine. Alabama J Med Sci 1988;25:316-9.

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