SAMe Treats Osteoarthritis, Depression, and Liver Disease
S-Adenosyl methionine (SAMe) is a useful treatment for several conditions, including depression, osteoarthritis, and liver disease, according to a report issued by the Agency for Healthcare Research and Quality, an agency of the United States Department of Health and Human Services (2002;64:1–3). More than 100 human studies have been published in medical journals showing that SAMe is a safe, effective treatment and, in the cases of depression and osteoarthritis, works as well as conventional medications.
The researchers reviewed 47 studies on depression, 14 on osteoarthritis, and 41 on liver disease. Some studies compared the effectiveness of SAMe with conventional treatment, while others compared SAMe with a placebo. All of the studies included in this analysis were considered to be of good quality.
In people with mild to moderate depression, SAMe produced a significant improvement in the Hamilton Rating Scale for Depression (HAM-D) score; the HAM-D is a questionnaire commonly used to assess the severity of depression. SAMe treatment was significantly better than placebo and worked as well as conventional drug therapy. Little research has been done using SAMe to treat severe depression, so it is unknown whether SAMe would have the same benefits as seen in mild to moderate depression.
Several studies have shown that SAMe significantly reduces pain associated with osteoarthritis of the knee. Other benefits of SAMe include decreased joint stiffness in the morning and improved mobility. Compared with non-steroidal anti-inflammatory medications (for example, Advil® and Aleve®), SAMe was found to be equally effective in reducing knee pain. No serious adverse reactions have been reported with SAMe, whereas long-term use of non-steroidal anti-inflammatory medications has been associated with causing stomach ulcers and liver problems. The authors did not specifically mention the safety of SAMe, but the individual studies show that it has an excellent safety record. In one study, the placebo group had more side effects than the SAMe group.
SAMe may be helpful for liver disease, if the specific problem is related to poor flow of bile through the liver and gallbladder (called cholestasis). Women with cholestasis due to pregnancy had significant decreases in levels of bilirubin (the pigment in blood that can make skin look yellow), indicating an improvement in liver function, after taking SAMe. Itching of the skin, another sign of liver disease, also improved. Similar results were found in individuals with cholestasis due to other types of liver disease. While SAMe was beneficial for cholestasis, it did not work as well as conventional treatment.
For both depression and osteoarthritis, studies have used between 600 and 1,600 mg per day. Some physicians recommend tapering down the amount of SAMe, as symptoms improve, to a maintenance amount of 400 to 600 mg per day. Using SAMe at the higher amounts may be cost prohibitive, since it is a relatively expensive nutritional supplement. Nonetheless, for those who have failed other types of treatment for these conditions, SAMe may be helpful in achieving better health.
Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.
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