Sam-e, or S-Adenosylmethionine, is a substance
synthesized from methionine (an amino acid) in the body. Children have
seven times more SAM-e than adults. Men have higher quantities of Sam-e
than women. Depression is linked to low SAM-e levels in people of all
ages. People suffering from Alzheimer's also show lower levels of
SAM-e. An exogenous (produced outside of the body) form of SAM-e was
developed in the mid-seventies. *
What Does SAMe Actually Do?
SAM-e is a "methyl donor", playing a key role in the methylation process in
the body. Methylation is a basic chemical reaction that triggers many vital
biological responses throughout the body. SAM-e, as a methyl donor, donates
methyl groups to different molecules. SAM-e helps methylate DNA, protein,
and phospholipids. Sam-e, through a process called transsulfuration, helps
the body's cells produce glutathione, an essential compound for the immune
system, and the liver, where it helps in the important job of
How Can SAMe Help Me/My Family?
As a Methyl donor, Sam-e plays a vital role in the production of
norepinephrine and serotonin, neurotransmitters important in regulating
mood. Sam-e also helps in the methylation of phospholipids helping to keep
cell membranes receptive to neurotransmitters. Sam-e can also boost the
production of phosphatidylserine, a phospholipid that plays a role in
memory and mood. *
SAMe and Osteoarthritis & Joint Health
In studies, Sam-e was shown to increase the production of chondrocytes, the
cartilage producing cells in joints. Proteoglycans, molecules important to
the lubrication of joints, appear to remain stable, maintaining their
effectiveness, with the help of SAMe. SAMe has been featured in "SAMe: The
European Arthritis And Depression Breakthrough" by Dr. Sol Grazi.
SAMe and the Liver
As stated earlier, SAMe helps the body produce glutathione an important
substance to the chemical processes of the liver. Glutathione helps the
liver detoxify alcohol, drugs, and poisons such as insecticides.
Glutathione helps make toxic substances water-soluble allowing these
substances to be cleansed from the system.
LifeSource Vitamins considers SAMe an excellent product with great
potential if taken properly as described by your doctor.
Current Research on SAMe:
The U.S. Department of Health and Human Services (HHS) Agency for
Healthcare Research and Quality (AHRQ) conducted an extensive literature
review to determine SAM-e's efficacy for treatment of depression,
osteoarthritis, and cholestasis of pregnancy and intrahepatic cholestasis
associated with liver disease. The results were released in late 2002 and
summarized below, along with other data.
Depression will affect 10 to 25 percent of women and 5 to 12 percent of men
in the United States. Approximately 10 to 15 million people experience
clinical depression in any given year. The antidepressant effects of SAMe
administration were first documented in 1974. Further research in
depressive disorders was reviewed in 1988, 1989, 1994, 2000, and 2002.
The AHRQ included 28 studies in a meta-analysis of the efficacy of SAMe to
decrease symptoms of depression. Compared to placebo, SAMe was associated
both statistically and clinically with significant improvements in the
score of the Hamilton Rating Scale for Depression. When compared to
conventional antidepressants, treatment with SAMe was not associated with a
statistically significant difference in outcomes suggesting SAMe is as
effective as most antidepressant prescription drugs.
A 2002 review concluded that treatment with parenteral or oral SAMe at
doses of 200-1600 mg/day was superior to placebo and as effective as
tricyclic antidepressants with a faster onset of action.
Two multi-center studies were conducted on patients to confirm the efficacy
and safety of SAMe in the treatment of major depression. The first study
group received 1600 mg/day of SAMe orally, while the second study group
received 400 mg/day SAMe intramuscularly. Both studies compared SAMe to 150
mg a day in a double-blind design. The study concluded the anti-depressive
effectiveness of both oral and intramuscular SAMe was comparable to 150-mg
imipramine/day. In addition, SAMe had fewer adverse events and was
significantly better tolerated.
SAMe has been studied in 16 open uncontrolled trials with a total of 660
patients; 13 randomized, double-blind, placebo-controlled trials with 537
patients; 19 controlled trials of SAMe versus other antidepressants
involving 1134 patients. SAMe consistently showed significant
anti-depressive effects in all 16 open trials and outperformed placebo in
all controlled trials with the exception of one. In 18 controlled trials,
SAMe was as effective as imipramine, clomipramine, amitriptyline,
nomifensine and minaprine and caused fewer side effects. The rapid onset of
action (5-10 days) was noted in 7 of the depression studies.
There are more than 100 different types of arthritis, ranging from mild
tendinitis to severe forms such as osteoarthritis (OA), the most common
form of arthritis. Arthritis is often categorized by symptoms such as
inflammation, redness, heat, and pain. An estimated 15 percent of Americans
suffer from arthritis, and the annual cost to society is estimated at 95
billion. Standard treatment therapies for osteoarthritis include
non-steroidal anti-inflammatory medication, non-pharmacological (e.g.
exercise, heat treatment) and surgery. Because of side effects from
pharmacologic agents, SAMe was studied for its effects on reducing the pain
associated with OA. Out of 13 unique studies considered in the ARHQ study,
10 studies were included in a meta-analysis of the efficacy of SAMe to
decrease pain of osteoarthritis.
One large randomized clinical trial showed an effect size in favor of SAMe
of 0.20 (95 percent CI [-0.39, - 0.02]) compared to placebo, thus
demonstrating a decrease in the pain of osteoarthritis.
Compared to treatment with non-steroidal anti-inflammatory medication,
treatment with SAMe was not associated with a statistically significant
difference in outcomes (effect size 0.11; 95 percent CI [0.56, 0.35]).
In November 1987, the American Journal of Medicine published 20 papers from
a symposium on SAMe and arthritis including 9 clinical trials with more
than 22,000 participants. These studies, as well as others, indicate that
SAMe exerts anti-inflammatory and analgesic effects equivalent to those of
several prescriptions, nonsteroidal, anti-inflammatory drugs, but that it
does not cause gastrointestinal bleeding. Anti-inflammatory effects require
3 to 4 weeks of treatment (200-400 mg orally every day) in mild to moderate
Abnormal SAMe synthesis is associated with liver disease, regardless of the
etiology. Loss of activity in the enzyme methionine adenosyltransferase
(MAT) results in decreased concentrations of SAMe and depletion of
glutathione. The loss of glutathione further impairs SAMe production
because glutathione is needed to stabilize MAT and to protect the enzyme
from free radical damage.
The AHRQ included 6 studies in a meta-analysis of the efficacy of SAMe to
relieve pruritus and decrease elevated bilirubin levels associated with
intrahepatic cholestasis caused by a variety of liver diseases. Patients
treated with SAMe were twice as likely as placebo-treated patients to have
a reduction in pruritus.
The AHRQ included 8 studies in a meta-analysis of the efficacy of SAMe to
relieve pruritus and decrease elevated serum bilirubin levels associated
with cholestasis of pregnancy. Compared to placebo, treatment with SAMe for
cholestasis of pregnancy was associated with a decrease in pruritus and
A review of 17 clinical trials shows that SAMe improved symptoms and
biochemical markers (serum bilirubin, alkaline phosphatase, gamma-glutamyl
transpeptidase, transaminases, cysteine, taurine, and hepatic glutathione)
of liver diseases, including alcoholic and nonalcoholic hepatitis and
cirrhosis, oral-contraceptive-induced cholestasis, other forms of
cholestasis, and metabolic disorders of porphyrin and bilirubin.
SAMe is a very safe supplement and a great way to stop disease's mentioned
above by taking lower doses as a preventative as well as fighting the
current diseases that you may have by taking a little larger doses.
What the Science Says
SAMe has been investigated most extensively for depression, osteoarthritis,
and cholestasis associated with pregnancy. For all three conditions,
research has not conclusively shown that SAMe is helpful.
About Scientific Evidence on Complementary Health Approaches
Scientific evidence on complementary health approaches includes results
from laboratory research as well as clinical trials (studies in people). It
provides information on whether an approach is helpful and safe. Scientific
journals publish study results, as well as review articles that evaluate
the evidence as it accumulates; fact sheets from NCCAM—like this one—base
information about research findings primarily on the most rigorous review
articles, known as systematic reviews and meta-analyses.
Overall, the evidence that oral SAMe may be helpful for depression is not
At least 40 clinical trials have evaluated SAMe for depression and many
of them showed beneficial effects. However, most of these trials lasted
only a few weeks, included a small number of participants, and were not
of the highest scientific quality. Also, some used injected SAMe rather
than an oral form (taken by mouth).
People with bipolar disorder (an illness characterized
by mood swings, from depression to mania) should not take SAMe for
their depressive symptoms except under the supervision of a health care
provider because SAMe may worsen symptoms of mania.
The results of research on SAMe for osteoarthritis are mixed.
Clinical trials have compared oral SAMe with non-steroidal
anti-inflammatory drugs (NSAIDs; medicines used to relieve
osteoarthritis pain) or placebos (inactive substances) in patients with
osteoarthritis of the knee or hip.
In general, trials that compared SAMe with NSAIDs showed that each
had similar pain relief and improvement in joint function, with
fewer side effects in the patients taking SAMe.
The smaller number of trials that compared SAMe with placebo did
not consistently show SAMe to be beneficial.
Studies involving small numbers of women have suggested that SAMe might be
cholestasis during pregnancy; whether SAMe
helps other liver problems has not been established.
There is some evidence linking decreased levels of SAMe in the body
with the development of liver diseases, and animal studies have
suggested that SAMe may be of value for liver problems.
Cholestasis can have a variety of causes. Several small clinical trials
have investigated SAMe for a form of cholestasis that can occur during
pregnancy and has found hints that SAMe might be helpful. In some of
these studies, SAMe was given orally; in others, it was given by
injection. Because the number of women who have been studied is small,
it is not possible to definitely conclude that the use of SAMe during
pregnancy is safe. Pregnant women with cholestasis should use caution
if they are considering SAMe and should follow their health care
provider’s instructions for treatment of this condition. Pregnant women
should not take SAMe without their provider’s approval.
Whether SAMe is beneficial for other liver conditions has not been
established. One long-term study in patients with
alcohol-related liver disease had promising results,
but they have not been confirmed by other research.
LifeSource Vitamins - SAM-e, Depression is linked to low SAM-e levels in
people of all ages. Helps the liver detoxify alcohol, drugs, and poisons
such as insecticides, and can also decrease the pain of osteoarthritis.
Helps with depression and anxiety.*
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