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Guidelines for sites linking to mayoclinic.orgMay 2, 2008
Dear Mayo Clinic:
Friend of mind has been taking something called SAM-e. She swears by it to relieve
her joint pain and it's nonprescription. What is SAM-e, and does it help
joint pain?
Answer:
SAM-e — pronounced sam-EE — is short for S-adenosyl-methionine.
It's not found in food. Rather, it's a compound that occurs naturally
in the body. Among its other functions, SAM-e helps produce and regulate hormones
and maintain the cell membranes.
There have been multiple trials indicating that SAM-e can relieve pain from osteoarthritis as effectively as can nonsteroidal anti-inflammatory drugs (NSAIDs) — including the prescription COX-2 inhibitor celecoxib (Celebrex) — and with fewer side effects. However, significant pain relief may take up to four weeks with SAM-e, compared with two weeks with NSAIDs. The exact mechanism of SAM-E in reducing pain of osteoarthritis isn't known.
Talk with your doctor before making any changes in your osteoarthritis treatment regimen. SAM-e products are dietary supplements. They haven't gone through the Food and Drug Administration's prescription drug approval process for safety and effectiveness.
Limited data has suggested SAM-e might interact adversely with commonly used antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and some tricyclic compounds, possibly increasing their effects or side effects. There have also been questions about whether SAM-e use might increase homocysteine, which is associated with heart disease. However, data from a recent small trial found no effect on homocysteine levels.
Consumer testing has noted inconsistencies in SAM-e amounts from what's stated on the label of some products. A typical SAM-e dose of 800 milligrams (mg) may cost as much as $2 a day. Most studies used either 600 mg or 1,200 mg of SAM-e a day. The optimal safe and effective dose for osteoarthritis is unknown.
— Brent Bauer, M.D., Complementary and Integrative Medicine Program, Mayo Clinic, Rochester, Minn.
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