It is SAM-e, pronounced Sammy and it is short for S-Adenosyl-L-Methionine. It is touted as an osteoarthritis pain reliever, mood enhancer and cures depression. Find out how SAM-e can also relieve the pain of osteoarthritis and fibromyalgia and learn about the studies behind this wonderful supplement.
S-Adenosyl-L-Methionine (SAM-e) is present in all human cells and is made naturally in our body by combining the amino acid methionine and adenosine triphosphate (ATP). Naturally occurring SAM-e decreases in our body as we age.
SAM-e for Osteoarthritis and Joint Pain
There have been numerous studies in the United States and Europe with SAM-e to find out if it can relieve the joint pain from osteoarthritis.
The US Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ) reviewed 14 reports, clinical studies, and meta-analysis of SAM-e and osteoarthritis joint pain.
Their conclusion was that SAM-e was more effective than a placebo with reducing pain due to osteoarthritis. When compared to the NSAID (non-steroidal anti-inflammatory drugs) SAM-e was equally effective relieving pain and without the side effects of the NSAID pain relievers.
The NSAID medications would include the COX-1 and COX-2 inhibitor drugs like Celebrex. These drugs can have side effects that include stomach ulcers and increased risk of bleeding.
SAM-e Studies
One study had 61 patients with osteoarthritis knee pain divided into two groups. One group used 600 mg (milligrams) of a SAM-e supplement twice daily for 8 weeks followed by 8 weeks of 100 mg of celecoxib (Celebrex).
The second group did the same thing except in reverse. The second group received 100 mg of Celebrex for 8 weeks and then followed that with 8 weeks of 600 mg of SAM-e twice daily for 8 weeks.
A 1987 double-blind study with 734 patients diagnosed with hip or knee osteoarthritis were given one of the following for 30 days:
- 1,200 mg of SAM-e or,
- 750 mg of Naproxen, which is an NSAID or,
- A placebo
Several areas were evaluated, day pain, night pain, pain with certain activities like sitting, walking and walking up the stairs.
Doctors concluded that SAM-e and the Naproxin reduced the pain by the same amount and a significant reduction in pain when compared with the placebo. More good news was that patients tolerated the SAM-e better than the medication, Naproxin [1].
A 1987 study that lasted for 84 days compared 1,200 mg of SAM-e with 20 mg of the NSAID piroxicam. Both the SAM-e and piroxicam reduced the overall pain significantly after 28 days.
After 56 days, the distance a person had to walk before feeling pain, stiffness and mobility showed significant improvement. The patients taking the SAM-e maintained this improvement longer after the study than the patients taking the piroxicam [2].
Two studies compared SAM-e to ibuprofen and found that there was a significant improvement for hip and back pain from osteoarthritis and an “objective” improvement in range of motion in the knee, hip and cervical spine compared to ibuprofen [3].
SAM-e and Cartilage Health
SAM-e breaks down into homocysteine, which then breaks down into glutathione, which produces sulfate groups.
The sulfate groups help to generate proteoglycans. Proteoglycans are present in the cartilage around joints. For this reason, it is thought that SAM-e could also help repair damaged cartilage.
In a study using animals with induced osteoarthritis of the knees, the animals that were given SAM-e showed a significant increase in depth of the cartilage and number of cells, which suggests that SAM-e could retard the degradation of cartilage [4].
SAM-e and Fibromyalgia
A study in Denmark with 44 patients, were given 800 mg of SAM-e daily or a placebo for 6 weeks. There was a significant improvement in pain, fatigue and morning stiffness in the SAM-e group [6].
How to Take SAM-e
Take a vitamin B-complex supplement with SAM-e. Folic acid, vitamin B6 and vitamin B12 are required for SAM-e to be metabolized properly.
You should not take more than 1600 mg per day. For osteoarthritis and fibromyalgia pain, most start with 400 mg per day working up to 1200 mg if needed.
It is best to split up the dosage throughout the day.
Enteric-coated capsules are best so they are absorbed properly and can prevent stomach discomfort. Take it on an empty stomach about a half an hour to an hour before meals.
Since it is expensive, buy from the most reputable manufacture to make sure you get what you pay for.
SAM-e Side Effects and Warnings
SAM-e may interact with some anti-depressant medications. Do not use SAM-e if you are taking Monoamine Oxidase Inhibitors (MAOIs).
SAM-e is not recommended for people with bipolar disorder. Side effects might include nausea, diarrhea, constipation, dizziness, insomnia and sweating.
If you take any medications or have any medical conditions, talk to your doctor before taking SAM-e.
Conclusion
The combined studies involved more than 22,000 patients with various stages of joint pain from osteoarthritis and the majority of studies found that SAM-e relieved joint pain as well as NSAID pain relievers did.
The tolerance and side effects were less with SAM-e than with many of the NSAID drugs like Celebrex.
Some studies found that SAM-e took longer to start becoming effective as a pain reliever than the NSAID drugs, but also found that this relief lasted longer than the drugs did after the study completions.
In addition to a pain reliever, SAM-e has also been proven to provide more flexibility and less stiffness of joints.
The Arthritis Foundation has said that it is satisfied as to the effectiveness of SAM-e as a pain reliever due to osteoarthritis, but they are not convinced that SAM-e can repair joint cartilage.
If you have tried glucosamine for joint pain and it didn’t work for you, you can try SAM-e and find out if that will work for you instead of NSAIDs.
Always talk to your doctor before taking any supplements. Supplements can be dangerous when taken with medications.
About the Author
Sam Montana is a certified Food Over Medicine instructor from the Wellness Forum Health Center and certified in optimal nutrition from the Harvard T.H. Chan School of Public Health.
Copyright © 2010-2019 Sam Montana
References:
[2] American Journal of Medicine Volume 83, Issue 5, Supplement 1, Pages 72-77 (20 November 1987)
[3] NCBI - S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease
[4] American Journal of Medicine Volume 83, Issue 5, Supplement 1, Pages 55-59 (20 November 1987)
[5] American Journal of Medicine Volume 83, Issue 5, Supplement 1, Pages 107-110 (20 November 1987)
[6] PubMed - Jacobsen S, Danneskiold-Samsøe B, Andersen RB. Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation. Scand J Rheumatol. 1991;20(4):294-302. doi: 10.3109/03009749109096803. PMID: 1925418.
