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Supplementation

There are innumerable supplements on the market that claim to make us impervious to diseases and to transform our bodies to look younger, be more virile, and to have more strength and musculature. But many supplements have been found to be based on hype and are just a waste of money. So how can we tell if a supplement is helpful, harmful, or just expensive? The best thing we can do as lay people is to research scientific peer-reviewed articles. This website will be investigating supplements and will report on this research.

Our first supplement review is SAMe.

SAMe

SAMe, S-adenosyl methionine, is a supplement used for treating many conditions including aging. The process of aging is separate topic but just assume that treating it properly can help you live longer. SAMe also treats conditions that are usually, but not necessarily, associated with the aging process. WebMD gives an extensive list of uses. "SAMe is used by mouth for depression, anxiety, heart disease, fibromyalgia, abdominal pain, osteoarthritis, bursitis, tendonitis, chronic lower back pain, dementia, Alzheimer's disease, slowing the aging process, chronic fatigue syndrome (CFS), improving mental performance, liver disease, and Parkinson's disease. It is also used for attention deficit-hyperactivity disorder (ADHD), multiple sclerosis, spinal cord injury, seizures, migraine headache, lead poisoning, to break down a chemical in the body called bilirubin, or to help with disorders related to the buildup of a chemical called porphyrin or its precursors" [1]. SAMe is a naturally occurring substance made in the body from one of the amino acids, methionine, but it is not found in foods we eat due to its instability. I don't like to believe just anything on the web so I look for scholarly articles as you will see as you read on. My interest in SAMe is not to treat a disease but to slow the aging process by scavenging free radicals, preventing disease, and extending life, as will be explained in the following.

The Evil Villains and the Superheroes

The evil villains in the body than cause all sorts of problems are a group of atoms and molecules called Free Radicals. They are created continuously by the many biochemical reactions that occur inside our bodies non-stop. But they are usually neutralized before they can cause much damage. The superheroes that neutralize free radicals are called anti-oxidants. This is textbook stuff so I am not quoting any scholarly articles yet. But the Live Science website, has a good description of the evil villains: "The body is under constant attack from oxidative stress. Oxygen in the body splits into single atoms with unpaired electrons. Electrons like to be in pairs, so these atoms, called free radicals, scavenge the body to seek out other electrons so they can become a pair. This causes damage to cells, proteins and DNA. Free radicals are associated with human disease, including cancer, atherosclerosis, Alzheimer's disease, Parkinson's disease and many others. They also may have a link to aging, which has been defined as a gradual accumulation of free-radical damage, according to Christopher Wanjek, the Bad Medicine columnist for Live Science." [2] What Live Science describes is unstable chemicals that look to hook up with something else to become stable. Unfortunately, what they hook up with is usually something that we don't want to change. Remember, these are chemical reactions. The free radical comes along and BAM, it oxidizes something that we don't want changed and whatever it oxidizes is changed for good (actually for bad)! Many cell structures can be changed, therefore mutating the cells, and often causing cancer. So to avoid these problems, we need to have the free radicals overwhelmed by anti-oxidants [3]. It doesn't hurt the anti-oxidants' feelings to be oxidized and it doesn't hurt us. The anti-oxidants protect our cell structures from damage and they are not useful anymore after they react with the free radicals. For that reason, we need a constant supply of anti-oxidants. So what happens here is that one of our normal chemical reactions take place in our body, providing energy, converting food, or something else useful and BAM part of the reaction is a free radical. And instead of destroying something in our cells an anti-oxidant is closer and the second BAM: the free radical is neutralized. We need an overload of these superhero anti-oxidants floating around to overwhelm the evil villain free-radicals. Luckily this is easy as we will discuss later.


Free radicals cause oxidative stress, another buzz word to know and that was mentioned above. It causes the damage mentioned above. A familiar way to think of oxidative stress, or oxidation, is to see what happens to iron when it oxidizes - it rusts. Think of your body as rusting - disintegrating - inside due to free radicals. Free radicals damage DNA and cell membranes among others. If you know much about DNA, our genetic coding, try to imagine what happens when a free radical alters some of the DNA that is used to replicate a cell. The new cell isn't a carbon copy of the original. A flaw is introduced by the free radical's chemical reaction. The new cell is modified from the original, it has mutated. That's how cancer cells can be created. Ugh! So all of this damage that results in the various conditions is due to random chemical reactions, oxidation, by the free radicals. Later we can talk about the various anti-oxidants that we can eat in our meals, found in many herbs and spices, and about the free radical creators such as smoking. But now we will talk about SAMe.

SAMe and Treatment of Diseases

Liver disease including cirrhosis.

Alcoholics cause stress to their livers that results in the liver requiring more SAMe since it uses up more than livers not under alcoholic oxidative stress. Running out of SAMe stops the production of cysteine that in turn reduces the neutralizing of the free radicals. These free radicals can then destroy and mutate the liver cells [4],[5]. SAMe can increase the survival rate of people with cirrhosis of the liver [4]. This seems to be a mainstream treatment of liver disease.

Brain

A study in 2010 suggested that dietary treatment with SAMe will delay the neural degeneration found in ALS. It was a preliminary study and more work is needed but it looks promising [5]. Supplementation with SAMe helps improve cognitive function that sometimes decreases with age [6]. Now here’s something about aging besides just keeping a damaged liver functioning.

Depression

SAMe was found to significantly reduce the symptoms of depression in HIV/AIDS patients. And it did this within one week [7]. SAMe was also determined to be at least as effective as normal anti-depressants but was better tolerated [12].

Osteoarthritis

Oral doses of SAMe were given to patients with osteoarthritis of the knee, hip, and spine. Relief from the symptoms occurred in the first weeks of taking SAMe and relief continued throughout the trial period. Depression related to the osteoarthritis was also substantially decreased [8]. Most of the comparisons of SAMe have been with NSAIDs (Nonsteroidal Anit-inflammatory drugs) such as Tylenol. A study comparing SAMe with a cox-inhibitor showed SAMe not relieving as much pain in the first week but by the second week there was no significant difference between the two [9]. OK, now here is another aging issue.


Is it Safe?

WebMD, previously cited [1] it says "SAMe is LIKELY SAFE when taken by mouth, given intravenously (by IV), or when injected as a shot, appropriately. It can sometimes cause gas, vomiting, diarrhea, constipation, dry mouth, headache, mild insomnia, anorexia, sweating, dizziness, and nervousness, especially at higher doses. It can also make some people with depression feel anxious." Much of the research was done with injections of SAMe but there are several done on the safety and efficacy of SAMe taken orally that show that it is both efficient AND safe to take orally [10], [11]. In most of the articles I have cited stated that SAMe was better tolerated than the alternative and that any side-effects were minor. On example is a study of SAMe for the treatment of depression. Not only was SAMe found to be as effective as TCAs (tricyclic anti-depressants), commonly used anti-depressant drugs, but it was found to be better tolerated with fewer side effects [12].


It appears that SAMe is effective in treating many diseases as well and neutralizing the evil villain free radicals. Since free radicals seem to be a major culprit in the aging process, SAMe seems to be talking to me. So this all sounds good to me but something that really sounds better is that SAMe is a naturally occurring molecule created by our own bodies. So it’s not some complex molecule found by accident when a scientist was trying to create a better drain cleaner. I also like that it has few side effects and can be taken orally. I give it a thumbs up.


Please note that I am not selling SAMe or any other supplements. I am just researching it and other supplements for my own use and I am sharing my research with you. I am not even recommending SAMe. Like anything else, you should consult your doctor and, if you begin taking SAMe, do it in a controlled way. In other words, don't start taking multiple supplements or even new prescription drugs at the same time. In that way, if you have one of the side effects, you can be pretty sure it is the SAMe and not something else.

REFERENCES

[1] https://www.webmd.com/vitamins-supplements/ingredientmono-786-same.aspx?activeingredientid=786&activeingredientname=same

[2] https://www.livescience.com/54901-free-radicals.html

[3] Sies H. Oxidative Stress: oxidants and antioxidants. Experimental Physiology 1997, Vol 82, Issue 2, pp 291-295.

[4] Lieber CS. S-Adenosyl-L-methionine: its role in the treatment of liver disorders. Am J Clin Nutr 2002;76(suppl);1183S-7S.

[5] Ambade, A., & Mandrekar, P. (2012). Oxidative Stress and Inflammation: Essential Partners in Alcoholic Liver Disease. International Journal of Hepatology, 2012, 853175. http://doi.org/10.1155/2012/853175

[5] Suchy, J., Lee, S., Ahmed, A. et al. Neuromol Med (2010) 12: 86. https://doi.org/10.1007/s12017-009-8089-7

[6] Duthie SJ, Whalley LJ, Collins AR, Leaper S, Berger K, and Deary IJ. Homocysteine, B vitamin status, and cognitive function in the elderly. Am J Clin Nutr May 2002 vol. 75 no. 5 908-913

[7] Shippy RE, Mendez D, Jones K, Cergnul I, Karpiak SE. S-adenosylmethionine (SAM-e) for the treatment of depression in people living with HIV/AIDS. BMC Psychiatry20044:38

https://doi.org/10.1186/1471-244X-4-38

[8] König B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J of Med 1987, Vol 83, Issue 5, Suppl 1, 20 Nov, Pp 89-94.

[9] Najm W, Reinsch S, Hoehler F, Tobis JS and Harvey PW. S-Adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. BMC Musculoskeletal Disorders 2004 5:6

[10] Delle C R, Pancheri P, Scapicchio P. Efficacy and tolerability of oral and intramuscular S-adenosyl-L-methionine 1,4-butanedisulfonate (SAMe) in the treatment of major depression: comparison with imipramine in 2 multicenter studies. Am J Clin Nutr 2002; Nov;76(5):1172S-6S.

[11] Giangrandi I, Dinu M, Pagliai G, Sofi F, Casini A (2016) Efficacy of Oral Supplementation with Silymarin and S-Adenosyl-L-Methionine in Patients with Non Alcoholic Fatty Liver Disease – A Pilot Study. Altern Integr Med 5:224. doi:10.4172/2327-5162.1000224

[12] Pancher P, Scapicchio P, and Chiaie RD. A double-blind, randomized parallel-group,

efficacy and safety study of intramuscular S-adenosyl-L-methionine 1,4-butanedisulphonate

(SAMe) versus imipramine in patients with major depressive disorder. Inter J Neuropsychopharmacology 2002, 5, 287–294.

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