adenosylLmethionine e in Combination with Bitamins and mino cids by: Rachel Olivier, MS, ND, PhD


from the reaction of the amino acid methionine and adenosine triphosphate (ATP), catalyzed by the enzyme methionine adenosyltransferase. Following the donation of a methyl group, SAM-e is converted to S-adenosyl- homocysteine,3


adenosine and homocysteine. In humans, it is found in every living cell, where it functions as a donor of methyl groups.1,2


which is further broken down to


Methylation is a vital biochemical process for many important biological processes, including the metabolism of lipids and the manufacturing of DNA. The body’s ability to methylate declines with age, thus contributing to the aging process. Scientists suspect that adequate methylation of DNA can prevent the expression of harmful genes, such as cancer genes. SAM-e is a labile component and degrades rapidly, however recent modications, which form stable salts have rendered the molecule more stable.


SAM-e functions in the metabolism of all cells as a precursor molecule in three main pathways methylation, transulfuration, and aminopropylation.4


the blood-brain barrier where it affects the synthesis and activation of various brain chemicals, including neurotransmitters. Due to its critical role in cartilage formation it is especially important for joint support and function.


SAM-e is used primarily to support depression, anxiety, heart disease, bromyalgia, osteoarthritis, bursitis, tendonitis, chronic lower back pain, dementia, Alzheimer’s disease, liver disease, Parkinson’s disease, chronic fatigue syndrome (CFS), and improving intellectual performance. It is also used for attention decit-hyperactivity disorder (ADHD), multiple sclerosis, spinal cord injury, seizures, migraine headache, lead poisoning, and decelerates the aging process.5


The hypothesis is that SAM-e increases the availability of the neurotransmitters serotonin and dopamine. Low levels of serotonin and/or norepinephrine are correlated to many conditions, including depression/ moodiness, anxiety, panic attacks, insomnia or sleep issues, PMS symptoms, hypoglycemia, and obesity, among others.


also been correlated with a decrease in the incidence of depression.7,8


SAM-e may also improve sexual dysfunction in men THE ORIGINAL INTERNIST JUNE 2016


Oral consumption of SAM-e has been recognized for its benecial effects in osteoarthritis.6


SAM-e intake has It is able to cross


SAM-e functions as the sole principal methyl group donor in a variety of reactions in the body as a component of cellular methylation reactions.1,2


It is formed in vivo


with depression. A clinical study reports that taking a titrated oral dose of SAM-e 1,600 mg daily in addition to certain antidepressants for 6 weeks improves subjective symptoms of sexual arousal and dysfunction compared to placebo in men with major depressive disorder.9


women use SAM-e for premenstrual syndrome (PMS) and a more severe form of PMS called premenstrual dysphoric disorder (PMDD).10


There has been some preliminary research advocating that SAM-e might reduce ADHD symptoms in adults.11 In clinical trials, SAM-e has been shown to be at least as effective as prescription antidepressants.12


research suggests that taking SAM-e by mouth or intravenously might assist the liver in bilirubin processing, and aide in normalization of liver enzymes thus preventing cholestasis. It may also be benecial for those with schizophrenia demonstrating aggressive behavior.


Importantly, until recently SAM-e’s benet was virtually unknown, due to it is extreme instability at temperatures above 0 C, or in the presence of moisture, both as degradation of the active ingredient intended as the sum of the two diastereoisomers, and as transformation of active (SS)-()-S-adenosyl-L-methionine into inactivate (RS)-()-S-adenosyl-L-methionine (racemisation of the substance). 13


Improved stability utilizing the salts of SAM-e is also directly correlated with the size and shape of the product itself in drying phase. This because the shape and size of the nal powder inuence the hygroscopicity of the product, which determines the stability of the same to the extent that the closer the hygroscopicity value approaches zero, the greater the stability of the salt of SAM-e.13 of SAM-e corresponds to the following conguration13


The salt :


B-vitamins The B-vitamins B6


required cofactor for methionine synthase, while folic acid is a required cofactor for 5, 10-methylenetetrahydrofolate reductase. The second step of this pathway involves the transsulfuration pathway, which converts homocysteine to cysteine and other products. This step is an irreversible process.


vital bodily reactions, and function primarily as cofactors. They are also increasingly becoming a part of nutritional intervention for disease prevention. Vitamin B12


, B12 is a


serves as a coenzyme in well over 100 reactions, most of which are transaminase reactions. It plays an important role in the synthesis of the neurotransmitters -aminobutyric acid (GABA), serotonin, dopamine, nor- epinephrine and epinephrine.14


Vitamin B6


also required for the conversion of tryptophan to niacin and serotonin.19,20


Vitamin B6 steroid hormone action, vitamin B6 in vitamin B6


with modulation of the expression of a diverse array of hormonally responsive genes.21


dopamine release (43% longer with deciency).22


was correlated to a slower extracellular (Continued on next page)


91 In one study a deciency


As a physiological modulator of has been associated


serve to complement the actions of SAM-e. Efcient function of both the nervous and immune systems require an adequate supply of vitamin B6


.15,16,17,18 is In this manner it may and folic acid play a part in many Preliminary Some


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