 Overheard
at a recent day in clinic:
Patient
"Doc, what do you know about SAMe?"
A doctor
who wishes to remain nameless, but well known to the author, "Sammy?
Sammy who? Is he a patient of mine?"
OK,
I admit I didnt know much about this medication until it was recently
featured on the cover of Newsweek magazine. Since then, patients
have been asking my opinion on this drug, and its claims of curing
everything from depression to liver disease. Although used by many
Europeans for several years, it is now making it way to our shores.
Heres what we do and we dont know of the drug with the funny name:
S-adenosylmethionine
or SAMe (pronounced Sammy) is not an herb or vitamin but a molecule
that can be found in all living cells. Studied in Italy for over
twenty years, it has been approved as a drug in many European countries
for the treatment of depression and arthritis. SAMe works by being
involved in methylation, which occurs in the body through various
functions such as neural membrane maintenance and cellular repair.
Through
its activity as a methyl donor, it produces sulfate groups that
are responsible for joint cartilage healing. Scientists note that
the elderly have low levels of this molecule, which has led to the
proposition that an important component of SAMe could be a factor
in slowing the aging process. It has not been approved nor tested
in the US by the Federal Drug Administration so it is commonly found
in alternative health stores as an over the counter supplement.
Current
ailments that SAMe has been reported to help include:
Pain
relief: SAMe is quite popular among migraine suffers
and arthritic patients. The Arthritis Foundation states that SAMe
is equivalent to todays anti-inflammatory medications like ibuprofen
and Aleve. Unlike medications like ibuprofen though, it is not thought
to interfere with the stomach lining and cause ulcers and gastrointestinal
bleeding. The Arthritis Foundation currently has a "wait and see"
stance to see if it will help with joint function improvement.
Depression:
Seen in some studies to improve depression seen in Parkinsons disease
by increasing levels of serotonin and dopamine, two neurotransmitters
decreased in depressed patients. It may also work quicker in comparison
(10 days as compared to 3-4 weeks) with tricyclic antidepressants
and cause less harmful side effects. Clinicians are encouraged by
these studies, but suggest more trials need to be completed and
they worry it could worsen patients with bipolar disorder (manic
depressants).
Heart
Disease: SAMe, along with the Vitamins B6 and B12, helps
decrease the amount of homocysteine in the body, a substance that
has been elevated in many patients with heart attacks and stroke.
SAMe and homocysteine are actually the same molecule with the exception
that SAMe has been methylated.
Gallbladder
and liver disease: Studies have seen improvement in liver
function and may help with cholestasis (bile duct obstruction).
Cirrhosis may also be slowed or even be reversed in patients taking
SAMe scientists suggest.
Since
it is not yet regulated in the United States, it has been found
that some imported SAMe tablets may not have enough active ingredients.
SAMe comes in two forms, and butanedisulfonate, the latter being
newer and thought to be more reliable. It is also not cheap, SAMe
costing about $100.00 for a months supply.
To
reiterate, SAMe has not been subjected to the vigorous testing in
the United States nor have the previous Italian studies been large
enough to verify the various claims of SAMe. It is also wrong for
people to start believing this is a miracle drug and taking it for
their illnesses without first getting approval by their own physician.
However if the studies do hold up, we could be looking at an innovative
and safe medication that could be revolutionary on how we look at
treatments for todays diseases.
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