Posted by Ron Hill on April 28, 2002, at 22:09:22
In reply to SAMe- Are additional vitamins needed for it?, posted by 3 Beer Effect on April 28, 2002, at 17:16:01
3BE,
> I just bought the Nature Made 200 mg SAMe 80 pack for $36 from Costco. I take a Centrum Multivitamin that has the 100% RDA of everything every day- is it necessary to take additional vitamins in order for SAMe to work properly?
As you know, SAM-e is a methylating agent. Once it has donated its methyl group, it becomes homocysteine. In order to avoid elevated levels of homocysteine, it is important to take plenty of B-6, B-12, and folate. Also bear in mind that some (most?) humans do not absorb B-12 efficiently when taken orally. Therefore, it is very important to take a sublingual (under tongue) tablet (or get B-12 injections). Further, buy the bioactive form of B-12 (Methylcobalamin). I take one B-100 complex tablet and a 1000 mcg sublingual tablet of bioactive B-12(methylcobalamin) each day after breakfast. As an aside, I believe several of the B's are instrumental in maintaining good mental health, but that's a subject for another thread. Here is an article that discusses the SAM-e, homocysteine, B vitamin connection:
Supercharged SAM-e: B Vitamins, Folate Increase the Supplement’s Effectiveness
by ImmuneSupport.com Staff12-01-1999 - Homocysteine is a sulfur-containing amino acid involved in several important methyl and sulfur transfer reactions, and is actually beneficial in small amounts. When homocysteine levels begin to rise in the body, excessive accumulation of homocysteine in the body fluid compartments is normally prevented by degradation through two enzymatic reactions called transsulfuration and remethylation. These two processes have to be functioning for homocysteine to be kept in control and for SAM-e to function in the body. Importantly, these same enzyme reactions cannot occur without proper levels of folate, vitamin B 6 (pyridoxal 5- phosphate), and vitamin B12 (cobalamin). If you take SAM-e to promote better health (lighter mood, comfortable joints and a detoxed liver), you also need adequate levels of B vitamins and folic acid to help the SAM-e do its job.
When the body has proper levels of folic acid, Vitamins B6 and B12, the enzymatic break-down of homocysteine occurs either through remethylation, which converts it into methionine, the SAM-e building block; or through transsulfuration, which turns it into glutathione, a powerful antioxidant.
But when those processes become sluggish, the homocysteine levels in the body begin to rise. Large homocysteine levels left unchecked in the body, become an invitation to disease, including heart attack, stroke, cancer, birth defects, depression and perhaps CFS and FM.
A published Swedish study showed results of which demonstrate consistently high homocysteine levels and low concentrations of vitamin B12 in the cerebrospinal fluid (CSF) of patients meeting established clinical criteria for Chronic Fatigue Syndrome and Fibromyalgia.
Those taking SAM-e should be aware that the healthy benefits they experience are not due to SAM-e alone. SAM-e may be the “team leader” however, folic acid, vitamin B6 and vitamin B12 are crucial members of the team that contribute to its success. It is only by incorporating the entire team that one can achieve the victory of better health and well-being.
Source:
Evarts, Jeremy Lucius. “New Study Links Fibromyalgia and Chronic Fatigue Syndrome to Low Vitamin B12 and High Homocysteine in Cerebrospinal Fluid.” Healthwatch, August 1998.
Cowley, Geoffrey and Underwood, Anne. "What is SAMe?" Newsweek, July 5, 1999.
Brown, Richard, M.D., Bottigileri, Teodoro, Ph.D., Colman, Carol. Stop Depression Now. New York, 1999.> The instructions say to take 400 mg/day, but i've also heard that many people only take 200 mg/day- I figured i'd just do what the Nature Made instructions say, especially since in many SAMe studies the subjects were usually taking large doses, something like 800-1200 mg intravenously. Do you get more side effects by starting out at 400 mg?- I have to go to work tommorrow, I can't be in the bathroom the whole time!
Starting at 400 mg sounds like a wise choice. I currently take 200 mg/day, and I am considering a trial at 100 mg/day. It is my observation that med hypersensitive patients are served well by these low doses of SAM-e. However, if my memory serves me correctly 3BE, you are not particularly med hypersensitive and, therefore, 400 mg/day is a good place to start the trial. You may have to increase from there, but if I were you, I'd give it at least a week or so at the 400 mg/day level before increasing. Initially, I could only take one 200 mg tablet of SAM-e every other day. If I took more, I would experience side effects (flush, nausea, confused thinking, general ill feeling, "skin crawling"). It felt like an overstimulation kinda thing.
> About how long does it take to respond to SAMe usually?
I felt it the first day and the full beneficial effect occurred within about a week. But remember, I'm med hypersensitive.
> I'm not getting any anti-depressant response so far from Lamictal 175mg, which I am titrating to 200 mg on Friday.Would it be best to make one change at a time so that you know without a doubt if it's the increase in Lamictal or the add-on of SAM-e that provides benefit, if any?
Best wishes in your SAM-e trial. As you know, SAM-e increases the amount of serotonin and dopamine in the patient’s brain. SAM-e saved my life, and I hope it does well for you also. Please post your results.
-- Ron
poster:Ron Hill
thread:104324
URL: http://www.dr-bob.org/babble/20020425/msgs/104384.html