What is SAM-e, and should I be taking it for my knee osteoarthritis?
SAM-e (S-adenosylmethionine) is a supplement that is a synthetic form of a compound found naturally in the body. SAM-e is involved in well over 30 biochemical processes in the body. It has been available for years by prescription in Europe for the treatment of depression and osteoarthritis. In the United States, it is not available by prescription but can be found as a supplement.
Does SAM-e work for osteoarthritis?
Research suggests that SAM-e may help with the pain of osteoarthritis. Najm et al. reported in a 2004 study in BMC Musculoskeletal Disorders in which patients with knee osteoarthritis were randomized into two groups. One group received 1200mg of SAM-e and the other group received 200mg of celecoxib (Celebrex) for 16 weeks in an attempt to reduce pain. In the first month, celecoxib worked significantly better than SAM-e. However, by the second month, both treatments were equally effective. The authors concluded that SAM-e "has a slower onset of action but is as effective as celecoxib in the management of symptoms of knee osteoarthritis."
While the evidence is not conclusive, other studies have concurred with these findings - it may take four to six weeks for SAM-e to reduce symptoms, but if taken regularly, SAM-e may be as effective as non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of osteoarthritis.
In addition, there is evidence that SAM-e may also decrease feelings of depression in some people. This is not insignificant when you consider that all the frustrations encountered by people dealing with painful joints may lead to some feelings of sadness. However, do not take SAM-e to treat yourself for depression. If you are experiencing or developing symptoms of sadness, helplessness, significant appetite or weight changes, significant sleep changes, chronic fatigue, irritability, thoughts of hurting yourself or loss of interest in normal activities, talk to your doctor about it.
Is SAM-e right for you?
Only your doctor can determine if SAM-e might be appropriate for you and your symptoms. You should not take SAM-e if you are taking an anti-depressant medication, have a history of bipolar disorder, have a history of anxiety disorder, have or at risk of heart disease, have Parkinson's disease, are pregnant, thinking of becoming pregnant, nursing, or under the age of 18. Make sure that you discuss all medications you are taking with your doctor as some medications may interact with SAM-e and other supplements.
As with other supplements, if you and your doctor decide that SAM-e may be right for you, be sure to ask your doctor to monitor your kidney and liver function tests while you are taking it. Also ask your doctor to monitor your homocysteine level as SAM-e may interfere with that level as well. If you buy SAM-e, make sure you only buy from a reputable company. One major drawback to SAM-e is its cost. A month's supply may cost more than 120 dollars per month. Recommended dosages range from 800 mg to 1,200 mg per day. While generally well-tolerated in people with no contraindications to the supplements, side effects may include but are not limited to gastrointestinal complaints (nausea, diarrhea) as well as dry mouth, low blood glucose, increased urination, headache, anxiety, insomnia, and hyperactivity. If you develop any side effects from the supplement, stop taking it and call your doctor.
Najm WI. Reinsch S. Hoehler F. Tobis JS. Harvey PW. S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. BMC Musculoskeletal Disorders. 5:6, 2004 Feb 26.
Morelli V. Naquin C. Weaver V. Alternative therapies for traditional disease states: osteoarthritis American Family Physician. 67(2):339-44, 2003 Jan 15.
Published On: January 29, 2009