SAMe

S-adenosylmethionine (abbreviated as SAMe or SAM-e) is a natural substance the body makes to facilitate certain chemical reactions. It is synthesized in the body from the amino acid methionine and adenosine triphosphate (ATP). Most of it is created and used in the liver. First discovered in Europe, and available there by prescription since 1975, SAMe has several potential therapeutic benefits. Since all these benefits come from SAMe being a methyl donor, it helps to understand what methylation is and the methylation process.

The Methylation Cycle

As shown in the diagram, the amino acid methionine is converted into a methyl donor called SAMe (S-adenosylmethionine) by adding the energy molecule ATP. SAMe then turns non-methylated molecules (i.e., fats, proteins, neurotransmitters, DNA, toxins) into methylated molecules. After donating its methyl group, it becomes SAH (S-adenosylhomocysteine), which is then converted into homocysteine (HYC).

HYC can then be converted back into the amino acid cysteine with the help of vitamin B6 and zinc, or it can be converted back to methionine with the donation of a methyl group from methylfolate or choline. Vitamin B12, zinc, and betaine facilitate this process of remethylating HYC. Giving up its methyl group transforms methyl folate back into folate, which can also be methylated again to create methyl folate.

Some people have inherited a tendency to normal methylation, while others may undermethylate or overmethylate. SAMe will be a beneficial supplement only for people who tend to undermethylate. Here are some of the signs of undermethylators.

• Physical: High levels of homocysteine and histamine, a greater tendency to inflammatory diseases, including heart disease, a greater tendency to seasonal allergies, but not food allergies, respond well to antihistamines, sparse body hair, high fluid production (saliva, tears), frequent headaches
• Mental and Emotional: Obsessive-compulsive; ritualistic behaviors, high libido, strong-willed, competitive in games and sports, perfectionist, tendency to rumination about the past, tendency to phobias and addiction, depression that responds positively to SSRIs

So, if you or someone you know tends to fit this profile, they may benefit from SAMe as a supplement. Here are some specific issues SAMe for which may be helpful.

Methylation and Detoxification

Methylation is one of the major pathways the liver uses to detoxify. As a methyl-donor, SAMe helps increase methylation, which helps the body get rid of excess hormones and neurotransmitters, including steroidal hormones like estrogen, adrenaline, dopamine, melatonin, histamine and serotonin. It also helps eliminate homocysteine, a compound associated with increased risk of heart disease.

SAMe also helps to increase glutathione production. Glutathione is a major antioxidant in the body and helps protect the liver from free radical damage. It also helps in liver detoxification through a process called glutathione conjugation. Heavy metal poisoning depletes glutathione levels. These properties give SAMe some benefits in situations such as cirrhosis of the liver, chronic viral hepatitis and jaundice related to pregnancy.

SAMe and Depression

Studies have suggested that SAMe can be effective for mild to moderate depression. It helps the body produce more mood-enhancing neurotransmitters such as dopamine and serotonin. It works in conjunction with methylated B12 (methylcobalamin) and B9 (folate) to produce these neurotransmitters. It can also aid energy production. Unfortunately, the dose required to manage depression is quite high. European studies typically use 800 to 1600 mg. (4-8 tablets) daily. SAMe can move a person from depression to mania and is therefore contraindicated with bipolar disorder. It is also not going to help overmethlators who may also suffer from depression.

Other Potential Uses

SAMe also shows promise with arthritis, particularly osteoarthritis. It has been shown to be as effective as nonsteroidal anti-inflammatories in relieving pain without the side effects. It may also prevent cartilage damage and may help rebuild cartilage when taken for long periods of time (more than 3 months).

Several studies have been conducted using SAMe with fibromyalgia. The results are promising, but not conclusive at this point. Patients taking SAMe reported improvements in pain, fatigue, morning stiffness, and mood. Studies suggest that people with Parkinson’s disease have low levels of SAMe. SAMe can slow the progression of Parkinson’s disease in some cases and reduce some symptoms of Alzheimer’s. More research is needed.

Using SAMe

For arthritis, liver detoxification, and other related uses take one 200 mg tablet of SAMe with breakfast and another with lunch. A third may be added at dinner, but taking SAMe at night can cause restlessness. Larger doses are needed for depression (2 tablets twice daily).

Side effects are rare, but may include heartburn, dry mouth, restlessness, diarrhea, headaches, and mania. SAMe is contraindicated in bipolar disorders and is not recommended for use by children. Be cautious when using SAMe with antidepressant medications or other drugs as negative interactions have been reported. SAMe should be considered a medicinal supplement and is not recommended for healthy people, only for assisting people with specific health problems.