Supplements

Methionine & S-Adenodylmethionine (SAMe )

Methionine is an essential amino acid that assists in the breakdown of fats, helping to prevent a buildup of fat in the liver and arteries that might obstruct blood flow to the brain, heart, and kidneys. The synthesis of the amino acids cysteine and taurine may depend on the availability of methionine.

Methionine helps the digestive system to detoxify harmful lead and other heavy metals. It helps diminish muscle weakness, prevents brittle hair, and protects against radiation.

Like taurine, N-acetyl cysteine, and glutathione, methionine contains sulfur, which inactivates free radicals and helps prevent skin and nail problems.

Methionine transforms into SAMe (s-adenodylmethionine), producing as much as 8 grams per day. Liver disease, osteoarthritis, and the overuse of prescription drugs or over-the counter mediations can diminish the body's SAMe production; when that happens supplements could prove to be effective.

SAMe's major application is probably to help alleviate depression. A dose of 800-1,600 mg per day helped to elevate mood and disposition among people who were moderately clinically depressed. Methionine has been widely used by psychiatrists for treating depression for several decades now.

SAMe is an effective anti-inflammatory. In studies of more than twenty-two thousand people with osteoarthritis, it both decreased pain and encouraged joint healing. No SAMe users complained of gastric side effects at therapeutic dosages.

A daily 1 gram dosage of SAMe worked for a sizable number of fibromyalgia sufferers in one study, due to its anti-inflammatory properties.

A British study on Chronic Fatigue syndrome pointed to methionine and SAMe as part of an effective treatment. More than half of the twenty-one chronic fatigue sufferers were deficient in methionine, while no more than three of them lacked any other amino acid.

For women who are on oral contraceptives or estrogen replacement therapy, the nutrients (methionine and SAMe) help the liver to convert the stronger, more carcinogenic estradiol into estriol, a safe form of the female hormone that is associated with a lesser cancer risk.

A daily dosage of 1,600 mg of SAMe has been remarkably effective against hepatitis or cirrhosis, according to the research. Because of the benefits to the liver, SAMe may be a good addition to a nutrient-oriented rehabilitation program for alcoholism.

Neurological abnormalities have been treated with both methionine and SAMe. For a small group of people with Parkinson's disease, a daily dose of 5 grams of methionine reduced limb rigidity and, to a lesser degree, tremors, two common symptoms of the affliction. Adding some SAMe might have improved the results, because it is better at helping to make dopamine, the brain chemical that people with Parkinson's lack.

Preliminary research has been conducted with SAMe in the areas of Parkinson's disease, cardiovascular disease, migraine, attention-deficit/hyperactivity disorder, rare infantile skin disorders, gastrointestinal protection (from NSAIDs), and cellular aging.

SAMe was first introduced into the U.S. dietary supplement market in 1999. It has been available in Europe since 1975. SAMe is an approved treatment for arthritis in Germany and a popular antidepressant drug in Italy.

Deficiency: Most people don't need methionine supplements. Exceptions might include strict vegetarians or those on a low-protein diet.

Depleting Agents: Liver disease, prescription drugs, osteoarthritis, over-the-counter medications may cause a depletion of methionine. Because the body uses methionine to derive a brainfood called choline, it is wise to supplement the diet with choline or lecithin to ensure that the supply of methionine is not depleted.

Sources: Methionine is not synthesized in the body. Good food sources of methionine include beans, eggs, fish, garlic, lentils, meat, onions, soybeans, seeds, and yogurt.

Precautions: SAMe is contraindicated in bipolar disorder. It may exacerbate manic episodes. The safety of SAMe has not been assessed in children or pregnant or nursing women. Side effects associated with SAMe include dry mouth, elation, nausea, and restlessness. No toxic effects have been reported in humans.

Dosage Ranges and Duration of Administration:

Depression: The majority of studies have used between 800 and 1,600 mg SAMe per day for treating depression. The daily dosage is typically split between morning and afternoon.

Osteoarthritis: A dosage of 600 mg (200 mg tid) for the first two weeks and thereafter 400 mg (200 mg bid) for another 22 weeks has been shown to improve clinical symptoms of osteoarthritis. Another study demonstrated clinical improvement using 1,200 mg (400 mg tid) for 30 days.

Fibromyalgia: A dosage of 800 mg per day for six weeks was shown to improve clinical symptoms in patients.

Alcoholic liver disease: 1,200 mg/day orally for six months enhanced glutathione levels.

Intrahepatic cholestasis: 800 mg/day IV or 1,600 mg/day orally improved symptoms.

SAMe should not be taken at night because it may cause restlessness. Dosage and timing may vary according to individual body physiology and the condition being treated.

INTERACTIONS

Acetaminophen
Intraperitoneal administration of SAM-e (2.5 mmol/kg) within 1 to 5 hours of reduced the lethality of toxic doses of acetaminophen (APAP) (2 to 3 mmol/kg) in mice; lower doses of SAM-e (0.5 mmol/kg) did not reduce mouse mortality (Bray et al. 1992). SAM-e reduced the hepatotoxic effects of APAP by metabolizing the active moiety to glutathione. SAM-e may be a useful antidote, along with N-acetylcysteine, for the treatment of APAP poisoning.

Clomipramine; Imipramine
In a double-blind, placebo-controlled trial, 40 patients with moderate to severe depression received imipramine (titrated from 50 mg/day to 150 mg/day) with either SAM-e (200 mg/day IM) or placebo; improvements on the Hamilton Rating Score for Depression (HRSD) occurred as early as day 4 for patients treated with both SAM-e and imipramine (Berlanga et al. 1992). However, there is a case report of serotonin syndrome associated with the combination of tricyclic antidepressants and SAM-e (Iruela et al. 1993). Specifically, a 71-year-old female became increasingly anxious, agitated, and confused within 48 to 72 hours after ingesting a higher dose of clomipramine (75 mg/day) while she was taking SAM-e (100 mg/day IM). Patients should be cautioned about this possible interaction.