Life Extension Magazine June 2003
Exclusive Interview With
SAMe is a naturally occurring compound found in all living cells. Its production is vital in cellular metabolism and has been associated with a host of therapeutic properties that for years have gone largely unnoticed by the medical community.
To uncover the hidden value of SAMe, Life Extension spoke with Dr. Richard Brown, a clinical psychiatrist at Columbia University, SAMe researcher and author of the bestselling book Stop Depression Now.
Life Extension Foundation: Who should take SAMe?
Dr. Richard Brown: That's a broad question. In a nutshell, people with mild depression, liver damage and mild to moderate arthritis will find SAMe highly effective. With depression, SAMe works for about 70% of the people who take it. That's at least equal to, and possibly better than, the results achieved by other antidepressants. Anyone with liver disease, such as that caused by alcohol abuse, can definitely benefit from taking SAMe. Some very well-done studies have found that SAMe is very effective at treating liver damage. In fact, SAMe is really the only good product for treating liver problems.
For arthritis sufferers, many studies have found that it is very effective at relieving pain and in higher doses, it is very good for repairing joint damage. Because of its effectiveness, it is used as a treatment for arthritis throughout Europe and in fact, the head of the Olympic program in Germany has made it standard practice to have all of their athletes on SAMe to prevent against developing arthritis.
LEF: How much SAMe should someone with arthritis take? What about for depression?
Brown: For mild to moderate arthritis, I would suggest taking about 600 mg to 800 mg/day. At this dose, patients should achieve about the same pain-relieving results as they would with NSAIDs. However, what SAMe does that NSAIDs do not is regenerate cartilage. For more advanced problems, such as severe joint damage, patients typically need higher doses of about 1200 mg/day.
For depression, there is a wide range of possible doses - it really depends on how severe the case is. The starting dose for patients with mild-to-moderate depression is 400 mg daily. For cases of severe depression is, the dosage is much higher, about 1600 mg/day. Patients need to evaluate their level of depression before establishing a proper dosage. In my book Stop Depression Now there is a self-assessment test that helps people to determine the severity of their depression.
LEF: How long does it take for patients to see the effects of SAMe?
Brown: Typically for depression, it takes about two weeks to start seeing results. That's faster than what most patients experience with conventional tricyclic antidepressants which often take three or four weeks before patients start seeing results. Of course there are always late bloomers who take a little longer to respond to its effects; these values tend to vary with the person. Also, you can use SAMe in conjunction with the tricyclics to get better results. In this type of scenario, the doses for each are typically cut in half.
For joint problems, SAMe is a little slower than conventional medication, often about three or four weeks. But SAMe is known to regenerate cartilage which other medications can not.
LEF: Are there any side effects associated with taking SAMe?
Brown: All medication has risks. But there have been numerous studies that have shown that patients develop fewer side effects on SAMe than they do on other medications. Rarely, some users experience mild headaches after they first begin taking SAMe, but those usually disappear after the first week or two. Because SAMe makes patients more energetic, some users may also experience minimal bouts of insomnia when first beginning their SAMe treatment. This, too, usually vanishes after a week or so. SAMe should be taken early in the day so that peak brain energizing effects occur during the most productive hours and not at night.
What you don't see with SAMe are weight gain, anxiety attacks and gastrointestinal distress, the common side effects of conventional medications.
LEF: SAMe sounds relatively safe, but are there people who should not take it?
Brown: Anyone who suffers from bipolar disorder (commonly called a "manic/depressive") should not take SAMe, as this can actually make them "manic." In addition, patients who are suicidal should not just start taking SAMe. They need to be monitored by a trained physician so their dosage can be reviewed and adjusted accordingly. However, this fact is not unique to SAMe - that's the case when you are dealing with a suicidal patient beginning any medication.
LEF: Is SAMe addictive? Can you overdose?
Brown: SAMe has not proven to be addictive. While there are no reports of death due to overdosing with SAMe, at high doses, say about 1200 mg/day, patients may experience gastrointestinal distress such as loose bowels. However, even this feature can be beneficial. I know of one elderly patient, for example, that has used that side effect to cure her bouts of constipation!
LEF: Do physicians routinely suggest SAMe to their patients? If not, why not?
Brown: Unfortunately, no. SAMe is still overlooked by much of the medical community. Why? For one, there are no pharmaceutical companies pushing SAMe to physicians - no sales reps coming by, taking them out to lunch discussing the wonders of SAMe. And since doctors routinely do what the pharmaceutical companies tell them, SAMe goes unnoticed.
Also, many doctors just don't take the time to read-up on all of the latest research. There is so much new information always coming out, but because they have so many hassels with billing and insurance companies they don't have any time. I have colleagues that have actually said to me that they "…don't trust SAMe because there is no research on it." But there really are a great many studies that prove its effectiveness and safety for treating depression, arthritis and liver damage.
That's what is so terrific about the Life Extension Foundation. They fill in the void and give patients the ability to get the needed information themselves and then present it to their doctor.
LEF: What other supplements would you suggest for SAMe users?
Brown: There are many supplements you can take along with SAMe, such as folate, glucosamine chondroitin, etc., but SAMe works best in conjunction with adequate B vitamins, such as vitamin B12. B vitamins work synergistically with the methylation pathways in the brain and are required for making methionine, essential for the body's production of SAMe.
LEF: What suggestions do you have for people who want to start taking SAMe?
Brown: One thing that really needs to be addressed is that while many studies confirm SAMe's efficacy, not all brands are created equally. There are many organizations out there that just don't offer quality supplements. Consumers really need to research the companies that they buy from. Companies like Life Extension and consumerlabs.com provide much of this information so that consumers can make an informed choice. Personally, I recommend Life Extension's products.