Sam-E is Helping My Fibromyalgia, Arthritis, and Depression
by Kathy Batesel
What's Wrong with Me?
My good friend Amber told me she's used SAM-e for depression. It helped her immensely, but I hardly dreamed it would solve my own medical problems. Disabling arthritis or fibromyalgia symptoms besieged me in 2000, thirteen years ago. Upon waking, my knees were so stiff and sore I had to wait several minutes before I could walk. My wrists, fingers, and ankles ached constantly, too.
"For heaven's sake!" I thought at the time, "I'm only 32!" I had only been out of the military for a couple of years, and while I was no G.I. Jane, I was otherwise in pretty good shape.
Arthritis symptoms weren't my only concerns. Within a short time after these painful wakings began, I started experiencing strange heart fibrillation once in a while, and I noticed my energy level dropping sharply. One day, I became winded from climbing a set of stairs! What happened to my stamina?
I made the first of many doctor appointments.
Basics about Fibromyalgia
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What is Fibromyalgia?
- Fibromyalgia Symptoms - What Fibromyalgia Feels Like
What is fibromyalgia, how does it feel, and what makes the symptoms worse? This link from the fibromyalgia network explains common symptoms about the disorder.
Fibro, Myalgia, or Fibromyalgia?
The doctor examined me thoroughly. He sent me to a rheumatologist who concluded that I did not have rheumatoid arthritis. He ordered X-rays of my heart to see if it was enlarged. Nope. He tested for Lyme disease and ruled out lupus. He asked about my sleep patterns (what sleep patterns?) checked for tender spots around my neck, spine, and a few other areas to see if I had fibromyalgia.
Fibromyalgia, also called fibro, is an autoimmune disease that affects soft tissues and muscles. It causes widespread, disabling pain. Although I met most of the diagnostic criteria for it, I didn't meet the most crucial one doctors use for making a firm diagnosis: tender spots. Health Magazine's article on fibro reveals the points on the body known to trigger a pain response, but I only felt pain at a couple of points, and doctors hesitate to diagnose fibromyalgia if at least eleven of the eighteen points don't cause pain.
"Non-specific myalgia" wrote the doctor. He advised me to take anti-inflammatory, over-the-counter medicine daily to see if it helped. Because the pain could improve or worsen for weeks or months at a time, I couldn't really tell if it worked. I didn't notice immediate improvements when I took them, and the pain decreased on its own (but never went away completely) even when I stopped taking them.
Have you ever been diagnosed with fibromyalgia, clinical depression, or arthritis?
Progressive Symptoms and Troubling Treatments
In the years since, my symptoms worsened. I gained weight, found myself experiencing depressions more often, the joint pain became unbearable, and I still had profound disturbances in my sleep. I rarely could get to sleep before 2:00 a.m., and sometimes at all. My thought processes got fuzzier. I had trouble focusing on complex ideas that never would have caused me problems before. My creativity dulled. I lost a great deal of ability to feel joy or pleasure.
And the rounds of doctors continued. Repeated blood testing revealed that I had a "high sed rate" in my blood - an indicator of inflammation within my body. I also had a positive rheumatoid factor, which can indicate rheumatoid arthritis, but isn't a reliable indicator.
A chiropractor I spoke with encouraged me to take a supplement called Cyruta-Plus, a nutritional supplement that seemed about as effective as the ibuprofen I'd taken years before.
My general practitioner prescribed high doses of Vitamin D and encouraged me to take magnesium supplements. I didn't experience a noticeable improvement after a month of these.
I visited psychiatrists who tried me on anti-depressant medications that proved largely unhelpful. I had some benefit from Cymbalta, but I'm scared to taking any medication for too long and I went off it after it cleared my thinking a little bit.
Another M.D. ruled out multiple sclerosis and sent me to another rheumatologist, who ruled out ankylosing spondylitis, then said I probably had sleep apnea, but a sleep study ruled that out, too. He encouraged me to take melatonin to help me sleep and also suggested ibuprofen. The melatonin worked for a few days but stopped working for me in less than a week.
A third rheumy ordered X-rays of my spine, fingers, and knee joints. He diagnosed me with non-aggressive rheumatoid arthritis, showing me areas of joint inflammation on my upper and lower spine and in my fingers. "But there is none in your knees or ankles," he said, despite the chronic pain I had there. He prescribed an anti-malaria medicine that worsened the pain, and I stopped taking it, but I continued to take the Tramadol he prescribed, which seemed to provide a small measure of relief.
By this time, I'd spent a great deal of time doing research on the Internet, and although I am not a doctor, I was forming a few theories of my own as I spent hours looking up words and trying to figure out the complex studies I read about.
Auto-Immune Diseases Affect 1 in 5 Americans
Nearly everything that had been tested for fell under the category of auto-immune disorders. An auto-immune disorder is essentially a condition where our bodies don't fight off the bad stuff and instead, let it thrive.
I started feeling convinced that with so many kinds of symptoms affecting so many body functions, the answer had to be connected to some kind of chemical or cell that was present throughout the body, but I had no idea what that might be, and the docs didn't seem helpful either.
In fact, when reading about how auto-immune disorders come about or how depression is treated, I constantly came upon the same sentence. "Scientists do not understand...."
Over the last couple of years, I became increasingly desperate as my ability to feel joy and pleasure dropped off sharply. Frequently, I felt numb and empty even though my life is the best it has ever been, with a warm, devoted husband who treats me like his queen and and wonderful grandchildren that have come into my life. I discovered that there's a technical term for this condition: Anhedonia.
Again, I found that disclaimer that said the condition was poorly understood. But I also ran across something else - a reference to Sam-E, the same supplement my friend had told me about helping her depression a few years ago.
Columbia Psychiatrist on SAM-e (Barbara Walters Interview)
No over-the-counter product, including Sam-E, should replace a medical doctor's care! Talk to your doctor about the potential benefits and problems of using Sam-E. Certain people should not use this product for any medical conditions.
Stomach pain and dry mouth may be a problem for some users. You should thoroughly read reviews and talk to your physician before trying Sam-E.
Sam-E - What it Does
I read basic information about Sam-E plus approximately a hundred reviews of Sam-E from actual users. WebMD's reviews were the first ones I read. was surprised by the overwhelmingly positive reviews I found there. While a few said it took a while for it to help them, most reported fast improvement in mood, energy level, mental clarity, and even arthritis and fibromyalgia conditions. A few of them said they had stomach pain from using it, and did not report improvement (about six percent of reviews reported this being a side effect that made them stop using it.) No other side effects were mentioned.
You can imagine how hopeful I felt. They were saying that a single, over-the-counter supplement was addressing every single complaint I'd been having for nearly a decade and a half! I figured I could deal with a bellyache if it'd fix the rest, but I needed to know more first.
I looked deeper into what Sam-E contains, studies that have been performed, and how it works. It has a number of complex scientific names, like S-Adenosyl Methionine, but I'll keep it simple here. I ignored reports that appeared biased or were published by a drug manufacturer or retailer.
I discovered that Sam-E supplements replicate an amino acid that's naturally in our bodies but is not found in food sources. This was consistent with what my suspicion about a single, system-wide deficiency possibly causing my health problems.
This amino acid is a protein. The way it works in our bodies is explained well in this 1999 article from Newsweek magazine, reprinted by Biopsychiatry online. A natural process called methylation transforms the beneficial SAM-e amino acids into homocysteines that are toxic. A healthy body with adequate B-vitamins normally will recycle the homocysteines back into SAM-e, but our levels of SAM-e naturally decrease with age. Poor nutrition choices and frantic lifestyles can challenge our bodies to work at optimal efficiency.
Because it has been in use in European countries as a prescription or non-prescription drug since the 1960s, there are many existing studies on SAM-e's effects, but most have not been sponsored by a major U.S. research facility, so American doctors may be reluctant to recommend it. It's sold as an over-the-counter nutritional supplement. As such, it is not monitored the the Food and Drug Administration (FDA).
There is strong evidence that it helps as well or better than most prescription anti-depressant drugs for people experiencing major depression, and sizable evidence that it helps with osteoporosis. There is conflicting evidence or a lack of strong evidence for help with other conditions it's thought could benefit from Sam-E: liver function, ADHD, fibromyalgia, and pre-menstrual conditions like PMS (pre-menstrual syndrome) and PMDD (pre-menstrual dismorphic disorder). For an overview of scientific findings, dosage information, and precautions, visit these links:
SAM-e in Scientific Circles
- NYU Langone Medical Center
NYU Langone Medical Center is one of the nation’s premier centers of excellence in healthcare, biomedical research, and medical education. This page reviews studies completed to date on Sam-E.
- S-Adenosyl-L-Methionine (SAMe): An Introduction | NCCAM
S-adenosyl-L-methionine, also called SAMe, may be helpful for depression, osteoarthritis, and cholestasis. From the U.S. National Institutes of Health.
- University of Maryland Medical Center
An overview of S-adenosylmethionine (Sam-E) uses, dosage, side effects, and warnings.
People who should not take SAM-e without their doctor's strict approval:
Anyone with bipolar disorder / manic-depression
Anyone with AIDS
Anyone with Parkinson's disease
SAM-e on Amazon
SAM-e Complete is the product I use. It contains Mannitol, which is thought to be the possible cause of stomach upset in those who experience this side effect.
I have not tried this brand, which is more highly rated than the NatureMade brand I'm using. This one doesn't contain Mannitol and is reported to suitable to vegans/vegetarians.
Rate SAM-e if You Have Tried It
My Experience with SAM-e
I decided to give SAM-e a try because the type of side effects weren't severe and the risk seemed reasonable after reading so many positive reviews. If it helped even one of my symptoms well - the low energy, chronic pain, fatigue, and poor sleep - I'd be a happy camper. If it didn't, I'd be out the cost of another doctor visit or two.
The same day, I drove to a nearby store, where I found two versions of SAM-e. Both contained the ingredient thought to cause upset stomach - (mannitol) but the one labelled SAM-e COMPLETE specifically described improved mood and joint functioning, so that's the one I chose. I'd hoped to find one without mannitol, but I'd either have to chance it or wait for an online order to arrive. After fifteen years of pain, it probably would have been okay to wait a few more days, but I decided to gamble.
I took the recommended dosage of 400mg on an empty stomach as advised. Although much of what I'd read encouraged users to take the supplement each morning, I took my first dose in the early evening.
The next morning, I paid particular attention to how I felt climbing out of bed.
I had no pain at all in my knees, ankles, or feet!
I'd expected to see a little improvement, but a complete absence of pain far exceeded my wildest hopes. I tested a bit more. A gentle squeeze on the middle joint of my pinkie finger revealed that it still felt tender, and so did the center knuckle of my middle finger. By the next day, their pain was diminished significantly, too.
Believe me, the disappearance of so much pain was a mood lifter all by itself! Getting up from a chair, dressing myself, and letting the dogs in and out no longer felt like challenges.
I don't know if it's just feeling better because I've been pain-free or if it's due to SAM-e, but I've felt more energy and motivation than I have in a long time, too. My husband has noticed the changes. He told me I "seem upbeat" lately.
You know what? He's right.