SAM-e (S-Adenosyl-L-Methionine) has been studied and used in Europe for decades to relieve depression and the pain of arthritis. More recently it was also found that SAM-e can heal liver damage caused by certain types of liver disease including fatty liver disease. What is SAM-e and what do the studies actually say?
What is SAM-e
SAM-e is short for S-Adenosyl-L-Methionine and pronounced Sammy is present in all human cells and made naturally in our body by combining the amino acid methionine and adenosine triphosphate (ATP). SAM-e is what is known as a methyl donor. Naturally occurring SAM-e decreases in our body as we age and our diet cannot provide enough SAM-e. Even though SAM-e is present throughout our body, it is concentrated in the liver and the brain. The liver converts the methionine into SAM-e.
Fatty Liver Disease
People might think that liver disease can only happen with heavy alcohol use. But another type of liver disease has been increasing in the United States. This type of liver disease is called Non-alcoholic fatty liver disease. It is believed that the increase of this type of liver disease is due to the worsening of our diets and the increased consumption of sugar and high corn fructose syrup. At times this disease has no symptoms and can progress until discovered causing liver damage and even failure if it continues. Alcohol and non-alcohol fatty liver diseases cause fat to accumulate in the liver which causes inflammation and scarring of the liver.
Alcohol (ethanol) harms the liver by depleting the body and the liver of nutrients including the natural SAM-e. Fructose from sugar or high fructose corn syrup turns into ethanol in the liver causing fatty deposits in the liver.
Alcohol and soda pop aren’t the only reasons for liver damage. Many different medications can cause liver damage. A poor high-fat diet and obesity can cause liver damage.
Keeping the Liver Healthy
Oxidative stress is a major factor in causing different types of liver disease from alcohol abuse to the toxins the liver cleanses daily. Our body has a natural defense against oxidative stress and these liver diseases, it is called reduced glutathione. Glutathione is one of the body’s most powerful antioxidants we have to fight this oxidative damage and free radicals. Reduced glutathione is a state of glutathione; don’t let the word reduced confuse you, it doesn’t mean less.
Scientists use the difference or ratio between the good reduced glutathione and oxidized glutathione within cells to determine cellular toxicity. More reduced glutathione, the better.
Healing the Liver
One condition of the liver is reduced bile production; this can be the first step towards what is called cholestasis. Cholestasis is a symptom and means a reduced state of bile formation or bile flow. Studies have shown that SAM-e opposes or wards off this cholestasis state of the liver.
Another cause of liver damage is scarring or fibrosis that ends in cirrhosis. This scarring is actually caused by excessive healing of the liver. SAM-e has been shown to alleviate this over-healing process.
SAM-e The Studies
A study published in 1986 did show that SAM-e was effective in rats at rebuilding the levels of reduced glutathione in the liver and caused a large reduction in the acetaldehyde levels. Acetaldehyde is what alcohol or ethanol is broken down to in the liver [1,2].
In people with liver diseases, the levels of SAM-e and glutathione are decreased. When SAM-e was given to baboons with liver disease, glutathione was replenished, mitochondrial lesions were reduced and the mortality rate was reduced significantly [3].
A 1989 study used 34 patients divided into 4 groups.
Group A: 9 patients who had alcoholic liver disease were treated with SAM-e
Group B: 7 patients with non-alcohol liver disease were treated with SAM-e
Group C: 8 patients with alcohol liver disease were given a placebo.
Group D: 15 patients who had no liver disease were used as a control group.
At the start of the study, all patients in groups A, B, and C had significantly low levels of glutathione as compared to the control group D. The conclusion of the study found that SAM-e significantly increased glutathione levels in groups A and B but not in the placebo group C [4].
In 1999, a 2-year double-blind randomized study used 123 patients with alcoholic cirrhosis of the liver. 62 patients received SAM-e and 61 patients were given a placebo.
At the end of the study, the conclusion was that SAM-e may improve survival or delay the need for a liver transplant in patients with alcohol liver cirrhosis, especially in the less advanced cases [5].
A double-blind placebo-controlled study published in 1990 used 220 inpatients. 26% of these patients had chronic active hepatitis, 68% had cirrhosis and 6% had primary biliary cirrhosis.
After the administration of 1600 mg per day of SAM-e, cholestasis decreased significantly as did the symptoms of fatigue, pruritus and the general ill feeling. The placebo group had no differences in these symptoms. The study’s conclusion is that SAM-e was more effective than a placebo in improving cholestasis [6].
SAM-e for Hepatic Cholestasis of Pregnancy
Studies have already confirmed that SAM-e counteracts estrogen-induced bile secretion failure. A study published in 1990 was done to confirm this with 30 women in their last trimester of pregnancy that had ICP. They were given either 800 mg per day (IV) of SAM-e or a placebo until delivery (average 18 days).
The study did confirm that SAM-e was more effective than a placebo. SAM-e also was effective in significantly reducing pruritus where the placebo had no effect. No adverse reactions were found in the mother or the child from the SAM-e [7].
How to Buy and Take SAM-e
Since SAM-e (S-Adenosyl-L-Methionine) is expensive, you should buy only from reputable companies. Buy only enteric coated SAM-e, this helps with the absorption and reduces any stomach problems. It is best if you buy SAM-e that is in blister or foil packs so they stay fresh.
Look for a product that is USP verified (US Pharmacopeia). Natures Made and Puritan’s Pride are.
B vitamins are also required for SAM-e to be metabolized by the body correctly. The B vitamins that are important are B-12, B6 and folate, take a B-complex or a good multivitamin.
Some people have complained of severe stomach cramps when taking SAM-e. Take it on an empty stomach; that means not eating anything an hour before and you shouldn’t eat anything for an hour after taking SAM-e. Start with a low dose of 200 mg per day.
SAM-e Warnings
Those with bipolar disorder should not take SAM-e since it could cause manic episodes in some people. Do not take SAM-e with another anti-depressant drug. It has been reported that SAM-e taken with any kind of anti-depressant could cause what is known as the serotonin syndrome, which requires immediate medical attention.
Do not use SAM-e if you are taking Monoamine Oxidase Inhibitors (MAOIs). If you take any medications or have any medical conditions, talk to your doctor before taking SAM-e.
Conclusion about SAM-e and Liver Disease
All of the studies I could find concerning SAM-e and liver disease dealt primarily with alcohol-related liver disease, cirrhosis, and ICP. Other liver disorders also show low levels of glutathione which SAM-e increases. It does look like SAM-e can increase the health and heal the damage done to the liver. There are two new studies that should be completed by now and hopefully, the results will be released soon when they are I will add them to this article.
More Health Benefits of SAM-e
Studies show SAM-e (S-Adenosyl-L-Methionine) to be as effective at relieving the pain of osteoarthritis and fibromyalgia as prescription and over the counter medicines. Studies also show that SAM-e is just as effective at relieving depression as prescription medicines do and without the terrible side effects of these medicines.
Note: Always check with your doctor before taking SAM-e (S-Adenosyl-L-Methionine) or any supplements. Supplements taken with medications can be dangerous.
About the Author
© 2010 Sam Montana
Resources
[1] AJCN - S-Adenosyl-l-methionine: its role in the treatment of liver disorders. Am J Clin Nutr November 2002 vol. 76 no. 5 1183S-1187S
[2] PubMed - Effect of the variations of S-adenosyl-L-methionine liver content on fat accumulation and ethanol metabolism in ethanol-intoxicated rats. Toxicol Appl Pharmacol. 1986 Apr;83(2):331-41.
[4] PubMed - Effects of oral S-adenosyl-L-methionine on hepatic glutathione in patients with liver disease. Scand J Gastroenterol 1989 May;24(4):407-15.
[5] PubMed - S-adenosylmethionine in alcoholic liver cirrhosis: a randomized, placebo-controlled, double-blind, multicenter clinical trial. J Hepatol.1999 Jun;30(6):1081-9
[6] PubMed - Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study. Gastroenterology. 1990 Jul;99(1):211-5
[7] PubMed - S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepatogastroenterology. 1990 Dec;37 Suppl 2:122-5
