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S-adenosylmethionine (SAM-e) for Osteoarthritis:

S-Adenosylmethionine (SAM-e – pronounced “sammee”) is a naturally occurring compound that participates in a great many biochemical processes in the body. For example, it plays a powerful role in the immune system, helps maintain cell membranes, and assists in the production and break-down of neurochemicals such as serotonin, melatonin, and dopamine. It also is used in the synthesis of DNA, and cartilage.

The involvement of SAM-e in the production of cartilage logically suggests that it would help those with “cartilage challenges” like osteoarthritis, which involve inflammation and resultant pain and discomfort. And this is exactly what researchers have found in numerous clinical studies.   

In one very telltale double-blind study, SAM-e (1200 mg. daily) was evaluated in comparison with  naproxen (750 mg daily) and a placebo in the treatment of osteoarthritis of the hip, knee, spine, and hand. Eighteen (18) rheumatologic and fifteen (15) orthopedic centers participated in this study. A total of 734 subjects, including 582 with coxarthrosis (hip osteoarthritis) or gonarthrosis (knee osteoarthritis), were ultimately enrolled.

When the study concluded, SAM-e was found to have as much pain-killing activity as naproxen. Both drugs were more effective than placebo. SAM-e was significantly better tolerated than that of naproxen, both in terms of physicians' and patients' impressions and in terms of the number of patients with side effects.

And in a 1987 randomized double-blind (84-day) controlled study, 1200 mgs. oral SAM-e was compared to 20 mgs day of oral piroxicam in people with unilateral knee osteoarthritis. Forty five people completed the study, twenty-two (22) in the SAMe group and twenty-three (23) in the piroxicam group. Both SAM-e and piroxicam proved significantly effective in improving total pain score after 28 days of treatment.  The ability of each drug to maintain these results was also evaluated during a fifty six (56) day follow-up period. Improvements in morning stiffness, the distance patients walked before the onset of pain, etc. started from about day fifty-six (56) in both groups and continued on. No significant difference was found between the two drugs in terms of effectiveness and tolerability

The findings of the two studies cited above were confirmed during a multicenter open trial involving 10 general medicine practitioners. SAM-e (600 mgs daily in divided doses for the first 2 weeks, then 400 mgs. in divided doses thereafter) was given to one hundred and eight (108) patients with osteoarthritis of the knee, hip, and spine for a period of two (2) years. At the end of the two (2) year period, ninety-seven (97) of the patients were still in the study. Doctors conducted separate medical evaluations of each patient knee, hip, cervical spine, and dorsal/lumbar spine, with the severity of such clinical symptoms as morning stiffness, pain at rest, and pain when moving about assessed using scoring prior to treatment, at the end of the first and second weeks of treatment, and then monthly until the end of the two year period.

The oral SAM-e regimen resulted in improvements in clinical symptoms from the first weeks of treatment and continued on to the end of the study. SAM-e use also improved the depression which accompanied osteoarthritis.

And finally, a sixteen (16) week randomized, double-blind study comparing the effectiveness of (1200 mgs) SAM-e to the cyclooxygenase-2 (COX-2) inhibitor (celecoxib – 200 mgs.) for osteoarthritis of the knee was carried out. Researchers were especially interested in pain control, functional improvement and reduction of side-effects

Sixty-one (61) adults diagnosed with OA of the knee were enrolled with fifty-six (56) completing the study. Subjects were tested for pain, functional health, mood status, isometric joint function tests, and side effects.

During the first month of the study, participants on celecoxib experienced a significantly greater reduction in pain than SAM-e. By the second month, there was no significant difference between both groups. On most clinical measures of function both groups showed a notable improvement from initial readings or baseline, however no significant differences between SAM-e and celecoxib was noted. The scientists involved in this study concluded that SAM-e has a slower onset of action but is as effective as celecoxib in managing osteoarthritic knee symptoms.

These studies and many others indicate that SAM-e can help impact the pain, inflammation and depression that characterizes osteoarthritis. Of course, it is important for medical consumers to obtain forms of SAM-e that are truly bioavailable (Usable in the human body). Two products of merit that contain bioavailable forms of SAM-e is SAM-e Plus and SAM-e Sleep both of which are manufactured in a major pharmaceutical laboratory in Geneva (Switzerland) and can be ordered from NutraCAM.

NOTE: Low amounts of folate in the body may lead to reduced levels of SAM-e. One very potent folate-rich product is Nutracene (Nutracene contains folate plus many other B-vitamins in slow release caplet form)  

 “Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease,” Am J Med, 83(5A):66-71 1987 Nov 20

 Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis, Am J Med, 83(5A):72-7 1987 Nov 20

“A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis,” Am J Med, 145(9):89-94 1987 Nov 20

“S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms  a double-blind cross-over trial,“ BMC Musculoskel Disord, 2004 Feb 26;5:6.