Hi there
How much do you have to eat for it to be of benefit? Is it spicey? I have some gallbladder issues...would this spice make my gallbladder react?
Have you written about SAM-e and osteoarthritis yet? I have been taking SAM-e for some time for my mood and it works great for me. In my research on this supplement the literature consistently shows that there may be some benefit for arthritis sufferers as well. Just wondered if you have come across anything about this supplement.
By the way...this is Merely Me from over on the depression site. You write some really interesting posts...I will have to visit you more often!
Hi Merely Me,
Great questions. Because most of the research has been with animals (the quadraped variety), I do not think anyone knows the actually dose which would be efficacious for us bipeds. Interestingly, one company is looking into a proprietary blend of Celebrex (celecoxib) with curcumin. That would be very interesting, but I think cooking with Turmeric is more fun.
Just the other day, I added it to a zucchini frittata (lord knows I have enough Zuc's in my garden lately). Tumeric is much milder than curry, not even a warmth to me. Everyone's palate is different.
In regards to your gallbladder, I am a bigger believer that most gallbladder issues can be managed with the correct diet, one that will prevent an attack. Typically, gallbladder attacks are trigger by high saturated fat meals like a cheese burger. I do not necessary believe that spicy foods trigger attacks just because "spicy" does not trigger gallbladder contraction. The bile from the gallbladder helps to breakdown fat in the gut. Beware, a lot of myths and misleading information about the gallbladder are produced by sources interested in selling products.
However, if you have a peptic ulcer, then a spicy food could upper gastrointestinal pain which could be misinterpreted as a gallbladder attack.
You should give a little tsp of Turmeric a try and hopefully be pleasantly surprised.
Dr. Christina Lasich, MD
i am someone really wondering what can be used for oseoarthitis????...i have been going in circles :/ and in really need of help...i know there isnt a cure..but maybe a medication that can (HELP) besides vicodine...
Always ask your doctor for help with your condition.
I am not a doctor but I am a patient who suffers from depression and MS...and I have been taking the supplement SAM-e for awhile. There does seem to be research to show that this supplement can help with osteoarthritis. Here are some things to read about it:
Government Report Favorable for Dietary Supplement SAM-e.
Dietary Supplements for Osteoarthritis
Here is a study abstract on the safety and efficacy of using SAM-e to treat osteoarthritis.
The study authors conclude: SAMe appears to be as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects often associated with NSAID therapies.
Please know...I don't have your condition and have not used SAM-e to treat osteoarthritis. There are some side effects to this supplement and possible interactions with other medications. And if you are taking something as strong as Vicodan...I don't know if SAM-e could compare to that sort of pain relief.
But it may be worth checking with your doctor. Do not take SAM-e without consulting your doctor first.
Please also ask the experts here for their opinion! They know best.
Hope this helps some.
MM
Well, I looked at the information you referred to about SAM-e. The review study only found one randomized controlled trial about SAM-e for the treatment of arthritis pain. (BTW, I could not find that one study). According to their analysis, SAM-e appeared to out perform the placebo (not too difficult to do if a study not designed well). And maybe SAM-e was equally effective as an NSAID per their statement:
"Compared to nonsteroidal anti-inflammatory agents, treatment with SAMe was not associated with a statistically significant difference in outcomes."
But without seeing some more studies and this one study that was referred to in this report, I cannot advocate one way or the other for the use of SAM-e in treating osteoarthritis.
I think the medical evidence supporting use of Tumeric for joint health is much stronger.
Dr. Christina Lasich, MD
Hi again
I am very glad you commented because I was wondering what doctors might say about the use of SAM-e for arthritis. In a previous post by Dr. Grant Cooper on your site...he does say the evidence is inconclusive if this supplement works to decrease symptoms of osteoarthritis but that it may still be worth asking your doctor about.
The University of Maryland Medical Center states that:
"A number of well-designed clinical trials show that SAMe may reduce pain and inflammation in the joints, and researchers think it may also promote cartilage repair, although they are not clear about how or why this works. In several short-term studies (ranging 4 - 12 weeks), SAMe supplements were as effective as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen in adults with knee, hip, or spine osteoarthritis. SAMe was as effectives as these medications in lessening morning stiffness, decreasing pain, reducing swelling, improving range of motion, and increasing walking pace. Several studies also suggest that SAMe has fewer side effects than NSAIDs. Another study compared SAMe to celecoxib (Celebrex), a type of NSAID called a COX-2 inhibitor, and found that over time SAMe was as effective as celecoxib in relieving pain."
Here are some of the resources given:
Glorioso S, et al. Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis. Int J Clin Pharmacol Res. 1985;5:39-49.
Maccagno A, di Giorio EE, Caston OL, Sagasta CL. Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. Am J Med. 1987;83(suppl 5A):72-77.
Vetter G. Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. Am J Med. 1987;83(suppl 5A):78-80.
This quote is from the Mayo Clinic:
"SAMe has been studied extensively in the treatment of osteoarthritis and depression. Many trials provide evidence that SAMe reduces the pain associated with osteoarthritis and is well tolerated in this patient population."
The following quote is from WebMD:
"SAMe has been available as a dietary supplement in the US since 1999, but it has been used as a prescription drug in Italy since 1979, in Spain since 1985, and in Germany since 1989. Researchers discovered the potential usefulness of SAMe for treating osteoarthritis by accident. They were studying SAMe's effect on depression when the patients they were following reported an unexpected improvement in their osteoarthritis symptoms."
Here are some SAM-e clinical study results but they do come from a website promoting SAM-e.
# Osteoarthritis: In a double-blind, multicenter study of 734 patients, including 582 with osteoarthritis of the hip or knee, responses to 1,200mg daily of SAM were compared with those of placebo and naproxen (750mg daily).Results showed SAM to be as effective and to have fewer side effects than the naproxen.
# Osteoarthritis: In another randomized, double-blind study, 36 patients with osteoarthritis of the knee, hip, and/or spine received 1,200mg daily of SAM or 1,200mg daily of ibuprofen for 4 weeks. Similar improvements with both treatment groups were reported in areas such as morning stiffness, pain at rest, pain on motion, crepitus (crackly feeling in the joint), swelling, and limitations of movement in the affected joints. Both treatments were well tolerated. No patients withdrew.
# Osteoarthritis: In 1987, the American Journal of Medicine published a series of articles entitled "Osteoarthritis: The Clinical Picture, Pathogenesis, and Management with studies on a New Therapeutic Agent, S-Adenosylmethionine". These articles discussed studies using SAMe in treatment for osteoarthritis. The company that manufactures SAMe provided it for the studies, which were spread out among numerous physicians and clinics (in one case, 33 different medical centers). The studies confirmed that SAMe works as well as the most popular treatments on the market.
# Osteoarthritis: Studies had been done in Italy showing the benefits of SAMe. One of the studies involved more than 20,000 patients. This large-scale trial lasted two months. Participants were not allowed to take any pain medication or other arthritis treatment during the study. Doctors found that patients taking SAMe improved steadily from the beginning. At the end of the study, about 80% of the people who took SAMe reported improvement. Seventy percent of the people with the most severe knee pain improved significantly. Side effects were minimal, and only 2.3% of the group stopped taking it because it didn't work. The most severe side effect reported was gastrointestinal upset.
Here is a 2004 study where the researchers concluded:
"SAMe has a slower onset of action but is as effective as celecoxib in the management of symptoms of knee osteoarthritis. Longer studies are needed to evaluate the long-term effectiveness of SAMe and the optimal dose to be used."
Here is a comparison of supplements and natural treatments of osteoarthritis from About.com writer Carol Eustice:
She reports on SAM-e: "Studies on SAM-e for osteoarthritis have been consistent and positive. SAM-e was found to be more effective than placebo and comparable to NSAIDs for osteoarthritis pain relief. A more recent trial compared SAM-e to the drug Celebrex (celecoxib). During the first month, Celebrex was a more effective pain reliever than SAM-e, but there was no difference between SAM-e and Celebrex in terms of pain relief after two months of treatment. They were equally effective."
This author has this to say about Tumeric:
"Turmeric is a spice used in curry powders. Curcumin, the pigment that gives yellow color to foods, is the active ingredient in turmeric. Curcumin has anti-inflammatory properties, as it inhibits COX-2, prostaglandin, and leukotrienes. But, no clinical trials have evaluated turmeric for osteoarthritis. Until more studies are done, turmeric is not recommended for osteoarthritis."
Yet on the Dr. Weil site he has this to say on the use of tumeric:
"Turmeric extract worked as well as a non-steroidal anti-inflammatory drug for treatment of osteoarthritis of the knee in a study published in the August 2009 issue of the Journal of Alternative and Complementary Medicine."
Here is my question and that is...when a patient goes on the internet and researches as I have just done...and finds all of these statements from medical sites and research...how do we make sense of it all in order to find something that works for our condition? How does the average person decide which information is hype and which information has some scientific merit?
Thanks for putting up with my lengthy response. I am just very interested in the underlying issue of how one decides which supplements, therapies, diets, methods...etc...to use for one's health condition(s). I am very interested in hearing from a doctor on what you think about this decision process and which factors you find most pertinent in making such choices.
Thanks so much!
MM
Well, out of all of that information. The only information that truely interested me as a doctor was the actual 2004 study from UC Irvine. The first thing I look at when reading journal articles is where it came from, which journal published it, and who are the authors. Then I look at study design, methods, statistics, and results. The authors draw there own conclusions, I draw mine. The flaws of the study in question are the limited number in the cohort, the lack of a placebo or control, and the limited time. Who is to say that the natural history of this particular cohort would not have been to naturally improve or that Celebrex or SAM-e performed better than a placebo. Unless these results are duplicated, the conculsions cannot be validated.
The rest of this information is just what other people are saying which all needs to be taken with a grain of salt (some more than others).
Yes, SAM-e may be as effective as a COX-2 inhibitor or an NSAID at relieving pain. Personally, I would like to see it head to head with a placebo because the placebo effect is very powerful indeed.
At least with Tumeric, a mechanism of action is being revealed in the animal studies. That is something I can hang my lab coat on.
I am more comfortable recommending Tumeric than SAM-e. But you can draw your own conclusions.
Dr. Christina Lasich, MD
Increasing your Omega 3 intake by using fish oil works well only if you also reduce your Omega 6 intake. Omega 6 is found in red meats and products made with corn oil (most snack foods). The ratio of Omega 3 and Omega 6 needs to be rebalanced. Usually people are too high in Omega 6 too low in Omega 3 and prone to inflammatory diseases like arthritis.
Dr. Christina Lasich, MD
Great! Just remember to lower your Omega 6 intake too because Omega 3 is just one half of this balancing act and can smell a bit fishy.
Dr. Christina Lasich, MD
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Eating a diet geared to the arthritis sufferer may be a valuable way to manage your symptoms. You may want to eliminate foods with a high sugar content, caffeine, dairy products, wheat, flour, citrus, salt and red meat. It is an advantage to replace these foods with healthy choices such as fruit and vegetables. Avocado, carrots, and sprouts are good choices that often get forgotten. Add seeds to your diet. Pumpkin seeds and flax seeds are excellent choices. Add whole grains, such as brown rice and barley. Try to cut down on processed foods, and instead prepare and plan meals with fresh groceries.
Absolutely! All excellent pieces of advice that not just those with arthritis should follow. Healthy lives comes from healthy foods.
Dr.Christina Lasich, MD