Supplemental SAMe is best ingested on an empty stomach using enterically coated tablets to prevent premature destruction of SAMe in the gut. it reaches peak blood levels in about 3 to 5 hours.Unfortunately, a large amount of ingested SAMe is broken down in the liver following oral ingestion. One thing that's important to keep in mind is that SAMe is converted into a potentially toxic amino acid byproduct called homocysteine. On the other hand, this effect is preventable by also ingesting vitamins B6, B12, and folic acid, which activate enzymes that convert homocysteine into a harmless, rapidly excreted form.
Because of its beneficial effect on brain neurotransmitters, SAMe produces an antidepressant effect in the brain. Studies show that in this respect, SAMe is as effective as tricyclic antidepressants, but unlike the drugs, doesn't produce as many side effects. In addition, while drugs can take 4-6 weeks to begin working, SAMe starts to work in about a week. A new study just found that when SAMe is provided in a dose of 800 mgs twice daily to people who had not responded to drug antidepressants, most of the subjects did show marked improvement in their depressive symptoms.Other studies show that SAMe may help in preventing Alzheimer's disease, and prevent mood disturbances in those afflicted with the disease. But those with bipolar disease should avoid using SAMe, since it may increase the mania portion of the disease.
Another use for SAMe may be to treat liver disease. Levels of SAMe are depleted in liver disease, and SAMe is known to help preserve the fluidity of liver cell membranes. It helps to restore depleted levels of glutathione, a major antioxidant and detoxifying factor in the liver. Studies show that SAMe may help releive cholestasis, a slowdown of bile flow in the liver usually caused by liver inflammation. This is a common side effect of high dose oral anabolic steroid usage. Through increasing glutathione levels in the liver, SAMe may prevent or reverse liver toxicity caused by various drugs,alcohol, and toxic chemicals.
SAMe also provides potent anti-inflammatory effects that are coomparable to some drugs.While the drugs work faster than SAMe to relieve pain,SAMe can match the effects of drugs over time. For this purpose, larger doses of SAMe are required, usually in the range of 1,200-1,600 milligrams daily, and this can be quite expensive. But when used in smaller doses, such as 200-400 milligrams daily, SAMe may work synergistically with other joint nutrients, such as glucosamine and chondroitin to help protect joints.
SAMe rarely produces side effects in doses up to 1,600 milligrams daily. Possible rare side effects include gastrointestinal upset, anxiety, insomnia, and hypomania. Good supplemental forms include SAMe tosyls and SAMe 1,4 butanedisulfonate. The tablets should always be enteric coated, and kept very dry, since exposure to moisture rapidly degrades SAMe. SAMe usually comes in 200 milligram tablets, with a recommended dose range of 400 to 1,600 milligrams daily in divided doses. You use lower doses for joint pain, and higher doses for the antidepressant effect. If it works for you, you'll know in about two weeks. At that time, you can reduce the dose to half and still get the benefits. Again, it should be taken on an empty stomach about an hour prior to meals.
Papakostas G, et al. S-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: A double-blind, randomized clinical trial.Am J Psychiatry 2010: in press.
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