Purified water, Ethanol, Natural wild berry flavor, Stevia
Recommended Dosage and Use: Adults: For help to support a healthy mood balance, Take 80 drops twice daily. For help to relieve the symptoms and pain of osteoarthritis, take 60 drops twice daily, use minimum of 8 weeks to see beneficial effects. For help to support healthy liver function, take 60 drops twice daily or as directed by your health care practitioner . Take 30 minutes before or after meals mixed with water or juice.
Recommended Duration of Use: Consult a health care practitioner for use beyond 16 weeks for symptoms and pain of osteoarthritis and for supporting healthy liver function, and 6 weeks for supporting healthy mood balance.
Caution/Risk Information: Consult a health care practitioner if you are taking anti-depressants, hepatoxic drugs or any prescription medication, or if you have hyperhomocysteinemia. May cause dry mouth, tachycardia, anorexia,sweating,irritability,fatigue,dizziness and nervousness.
Contraindications: Do not use if pregnant or breastfeeding, or if you have a bi-polar disorder unless you are under medical supervision. Do not take at night since the product may cause anxiety, restlessness and insomnia. Do not use this product within 2 weeks of discontinuing a Monoamine Oxidase Inhibitor (MAO) drug. May cause mild gastrointestinal upsets, mild nausea, headaches, anxiety, hyperactive muscle movements, insomnia and/or hypomania. Keep out of reach of children
S-Adenosylmethionine (SAM(e)) is an important physiological agent formed in the body by combining the essential amino acid methionine with adenosine-triphosphate (ATP). SAM(e) was discovered in Italy in 1952—not surprisingly, most of the research on SAM(e) has been conducted in the country of its discovery.
Because SAM(e) is manufactured from methionine, you might think that dietary sources of methionine provide the same benefits as SAM(e). However, high doses of methionine do not increase levels of SAM(e), nor do they provide the same pharmacological activity as SAM(e). On the contrary, high dosages of methionine are associated with some degree of toxicity.
Normally the body manufactures all the SAM(e) it needs from the amino acid methionine. However, a deficiency of methionine, vitamin B12, or folic acid can result in decreased SAM(e) synthesis. In addition, tissue levels of SAM(e) are typically low in the elderly and in patients suffering from osteoarthritis, depression, and various liver disorders.
SAM(e) is involved in over 40 biochemical reactions in the body. It functions closely with folic acid and vitamin B12 in “methylation” reactions—the process of adding a single carbon unit (a methyl group) to another molecule. SAM(e) is many times more effective in transferring methyl groups than other methyl donors. Methylation reactions are critical in the manufacture of many body components—especially brain chemical—and in detoxification reactions. SAM(e) is also required in the manufacture of all sulfur-containing compounds in the human body, including glutathione and various sulfur-containing cartilage components. The beneficial effects of SAM(e) supplementation are far-reaching because of its central role in so many metabolic processes.
There are five principal conditions where SAM(e) is used: depression, osteoarthritis, fibromyalgia, liver disorders, and migraine headaches.
SAM(e) is necessary in the manufacture of important brain compounds such as neurotransmitters and phospholipids like phosphatidylcholine and phosphatidylserine. Supplementing the diet with SAM(e) in depressed patients results in increased levels of serotonin, dopamine, and phosphatidylserine. It improves binding of neurotransmitters to receptor sites, which causes increased serotonin and dopamine activity and improved brain cell membrane fluidity, all resulting in significant clinical improvement.
The antidepressive effects of folic acid (Vitamin B6) are mild compared to the effects noted in clinical trials using SAM(e). Based on results from a number of clinical studies, it appears that SAM(e) is perhaps the most effective natural antidepressant (although a strong argument could be made for the extract of St. John’s Word standardized to contain 0.3 percent hypericin) Tables 45.1 and 45.2 [following tables] summarize double-blind studies comparing SAM(e) to either a placebo or an antidepressant drug.
Most of the studies cited in Table 45.1 and 45.2 used injectable SAM(e). However, more recent studies using a new oral preparation at a dosage of 400 milligrams four times daily (1600 mg total) demonstrate that SAM(e) is just as effective orally as it is intravenously. The Life Choice™ brand of SAMe is a stabilized liquid form which bypasses the need for absorption, and the standard of effectiveness is the same, if not better than, injectable SAMe. SAM(e) is better tolerated and has a quicker onset of antidepressant action than tricyclic antidepressants.
The most recent study compared SAM(e) to the tricyclic desipramine. In addition to clinical response, the blood level of SAM(e) was determined in both groups. At the end of the 4-week trial, 62 percent of the patients treated with SAM(e) and 50 percent of the patients treated with desipramine had significantly improved. Regardless of the type of treatment, patients with a 50 percent decrease in their Hamilton Depression Scale (HAM-D) score showed a significant increase in plasma SAM(e) concentration. These results suggest that one of the ways tricyclic drugs exert antidepressive effects is by raising SAM(e) levels.
In addition to generalized depression, there are two conditions associated with depression where SAM(e) produces significant effects: the postpartum (after pregnancy) period and drug rehabilitation. SAM(e)’s benefits in these conditions probably stem from a combination of its effects on brain chemistry and liver function. In the study in postpartum depression (after-pregnancy “blues”), the administration of SAM(e) (1,600 milligrams per day) produced significantly better mood scores than a placebo group. As for the use of SAM(e) in drug detoxification, SAM(e) (1,200 milligrams daily) significantly reduced psychological distress (chiefly anxiety and depression) in the detoxification and rehabilitation of opiate abusers.
Fibromyalgia is a recently recognized disorder, which is regarded as a common cause of chronic musculoskeletal pain and fatigue. Fibromyalgia shares many common features with another recently termed syndrome, the chronic fatigue syndrome (CFS). The only difference in diagnostic criteria for fibromyalgia and CFS is the requirement of musculoskeletal pain in fibromyalgia and fatigue in CFS. The likelihood of being diagnosed as having fibromyalgia or CFS depends on the type of physician consulted. Specifically, if the patient consults a rheumatologist or orthopedic specialist, he or she is much more likely to be diagnosed with fibromyalgia than CFSs. Depression is often an underlying finding in both fibromyalgia and CFS.
Diagnosis requires fulfillment of all the following major criteria and four or more minor criteria.
The major criteria are:
- Generalized aches or stiffness of at least three anatomic sites for at least three months. Six or more typical, reproducible tender points, and exclusion of other disorders that can cause similar symptoms
The minor criteria are:
- Generalized fatigue, Chronic headache, Sleep disturbance, Neurological and psychological complaints, Joint swelling, numbing or tingling sensations, Irritable bowel syndrome, Variation of symptoms in relation to activity, stress, and weather changes
Three clinical studies show SAM(e) produces excellent benefits in patients suffering from fibromyalgia. The first study was a double blind, crossover study of 17 patients with fibromyalgia. During treatment with SAM(e) (200 milligrams daily by injection for 21 days), subjects demonstrated significant reduction in the number of trigger points and painful areas and improvements in mood.
In another double-blind study, orally administered SAM(e) (800 milligrams daily) was compared to a placebo for 6 weeks in 44 patients with fibromyalgia. Researchers evaluated tender point score, muscle strength, disease activity, subjective symptoms, mood parameters, and side effects. Patients given SAM(e) demonstrated improvements in clinical disease activity, pain experienced during the last week, fatigue, morning stiffness, and mood; however, the tender point score and muscle strength did not differ in the two treatment groups. SAM(e) was without side effects.
The most recent study compared SAM(e) to transcutaneous electrical nerve stimulation (TENS)—a popular treatment for fibromyalgia—in 30 patients with fibromyalgia. Patients receiving SAM(e) (200 milligrams by injection and 400 milligrams orally daily) demonstrated significantly greater clinical benefits—decreased number of tender points, subjective feelings of pain and fatigue, and improved mood. TENS offered little benefit on most symptoms while SAM(e) was deemed “effective in relieving the signs and symptoms of primary fibromyalgia.”
SAM(e) is beneficial in the treatment of migraine headaches. The benefits manifest gradually and require long-term treatment for therapeutic effectiveness.
In general, the longer SAM(e) is used, the more beneficial the results. It is perfectly suited for long-term use because of its excellent safety profile. Here are the dosage ranges for the various clinical indications.
- Depression: Four hundred milligrams three to four times daily. Because SAM(e) can cause nausea and gastrointestinal disturbances in some people, it should be started at a dosage of 200 milligrams twice daily for the first day, increased to 400 milligrams twice daily on day three, 400 milligrams three times daily on day ten, and finally to the full dosage of 400 milligrams four times daily after 20 days if needed.
- Fibromyalgia: Two hundred milligrams to 400 milligrams two times daily.
No significant side effects have been reported with oral SAM(e) other than the occasional nausea and gastrointestinal disturbances. Because Life Choice™ SAMe is in liquid form, higher doses can be more easily absorbed by the stomach, minimizing such gastrointestinal discomfort. However, individuals with bipolar (manic) depression should not take SAM(e) unless under strict medical supervision. SAM(e)’s antidepressant activity may lead to the manic phase in these individuals. This effect is exclusive to some individuals with bipolar depression.
Helps to promote a healthy mood balance. Helps to relieve the symptoms and pain of osteoarthritis. Helps to relieve the symptoms and pain of fibromyalgia. Helps to support healthy liver function.
SAM(e) functions very closely with vitamin B12, folic acid, vitamin B6, and choline in methylation reactions. Because of SAM(e)’s effects on the liver, it may enhance the elimination of various drugs from the body. The clinical significance of this particular effect has not been fully determined.