For the last year the sulfur-bearing compound SAMe, or S-adenosylmethionine, has been delivering on its promises to help minimize the pain of depression, osteoarthritis, fibromyalgia, joint damage and other conditions. In fact, due to its remarkable track record and mild side effects, this supplement has quickly become one of the top sellers in drugstore chains and general retail outlets. However, users of this wonder pill should be aware that through the natural metabolism of SAMe, the amino acid homocysteine is created—a situation that can lead to artery damage and even heart disease.

The breakdown of protein in the body produces SAMe, which controls everything from the regulation of pain to brain function. SAMe exerts these effects through the process of methylation, which means that it donates an active methyl group (made up of one carbon and three hydrogen molecules) to a neighboring molecule. Then, once it is free of this methyl group, SAMe is further broken down into homocysteine.

Although certain scientific studies have shown homocysteine can cause arterial damage if allowed to build up within cells, others have demonstrated that by simply upping one's intake of the vitamins B6, B12 and folic acid, this potential hazard can be avoided.^1,2 In other words, because these B vitamins are responsible for the proper metabolism of homocysteine, it is imperative that SAMe users take in adequate amounts of these nutrients. So, when recommending SAMe, be sure to suggest a good B complex vitamin as well. Or better yet, recommend one of the new SAMe products with the B's built right in.

Linda Knittel

References:

1. Devlin TM, et al.
   Textbook of Biochemistry with Clinical Correlations.
   New York: John Wiley-Liss Inc. 4th edition. 1997. 470-4
   

2. Guttormsen AB, et al.
   Determinants and vitamin responsiveness of intermediate hyperhomocysteinemia (>or=40 micromol/liter).
   The Hordaland Homocysteine Study.
   J Clin Invest 1996 Nov;98(9):2174-83