Is SAMe for Real?

By Christine Gorman

Although I take 250 mg of vitamin C each day, I'm pretty much a skeptic when it comes to dietary supplements. Most of the ones I've seen are basically patent medicines whose proponents, seizing on a few isolated facts about the body, tout a treatment plan that has more to do with magic than medicine. But occasionally a supplement like SAMe (pronounced sam-me) comes along that piques even my interest. It's supposed to combat depression, ease aching joints and possibly revitalize the liver. I'm not convinced these claims are true, but I think they're worth a closer look.

First, a note of caution. If you're suicidal or severely depressed, get professional help. Don't try treating yourself with SAMe or any other compound on your own.

If supplements were movies, SAMe would be the sleeper hit of the summer. Introduced in the U.S. in March, it is now the fourth most popular individual supplement in drugstore chains and general retail outlets. General Nutrition Centers reports that SAMe is surpassing even St. John's wort in sales. Two breathless guidebooks have already been published, and three more are coming in the fall.

Biochemists have known about SAMe for years, although they usually call it SAM, which is short for S-adenosylmethionine, a compound made by every cell in the body. (I don't know why it was renamed. Maybe the dietary-supplements folks think Sammy sounds sexier than Sam.) Turns out that SAM or SAMe plays a pivotal role in hundreds of biochemical reactions in the body. It's a methyl donor, meaning that it can attach a molecule made of one carbon atom and three hydrogen atoms to various proteins, lipids and even snippets of DNA. Such methylation reactions are important in the production of many critical substances, including neurotransmitters in the brain and enzymes that help repair joints and the liver.

Much of the evidence for SAMe's effectiveness comes from Europe. Researchers in Italy documented its apparent anti-depressant qualities in several small studies in the 1970s. (A couple of more recent U.S. studies found similar results.) Doctors in Germany think it may reverse some of the damage caused by osteoarthritis, the wear-and-tear form of arthritis.

The results, though not definitive, are intriguing enough so that several U.S. psychiatrists have started offering SAMe, both in addition to more conventional treatments and by itself. Rheumatologists have been more wary. "It does seem to offer pain relief," says Dr. William Arnold, who is chief medical editor of a book on alternative medicines that the Arthritis Foundation is publishing in October. "But the arthritis experiments were very uncontrolled." He's more impressed by another natural compound, glucosamine, which is the subject of a study being funded by the National Institutes of Health.

Even if SAMe is not the wonder cure its proponents claim, it so far appears to be safe. Some minor side effects, such as hot, itchy ears, have been reported. As with any antidepressant, a few people who take it develop mania, an uncontrolled frenzy of emotion and activity. Who knows what else may turn up if millions of people start using it? Maybe that's one reason SAMe is still a prescription drug in Europe. So, if you do decide to try it, it's not a bad idea to let your doctor know so that he or she can watch for anything unusual.

For more information about SAMe, visit us on the Web at time.com/personal You can send Christine e-mail at gorman@time.com