Fibromyalgia sufferers are ready for relief. Their journey to diagnosis takes an average of five years, and treatments that successfully manage pain for everyone across the board are difficult to find. Designing a pain management plan can sometimes take years of trial and error, which is why so many patients may try whatever new supplement is touted to relieve fibromyalgia pain. In this series, we will look at a number of different supplements, examining available research and patient testimonials to see if they live up to the hype. This week, we shine the spotlight on SAM-e for fibromyalgia.
How does SAM-e for fibromyalgia work?
S-Adenosylmethionine (SAM-e) is a naturally-occurring substance found in nearly every tissue in the body. It is essential to many functions in the body, including:
- Helps immune system function
- Pairs with B12 and folate
- Maintains cell membranes
- Works to produce and synthesize chemicals in the brain (e.g., serotonin, melatonin, and dopamine)
SAM-e is not found in food in bioavailable amounts but is produced by methionine and ATP, the source of energy for all cells in the body.
SAM-e for fibromyalgia: The evidence
As with many other supplements for fibromyalgia, there is little research to indicate their efficacy. In 1991, a double-blind study of 44 patients with primary fibromyalgia looked at oral SAM-e’s effect on the following areas:
- Tender point score
- Isokinetic muscle strength
- Disease activity
- Subjective symptoms (e.g., fatigue)
- Mood parameters
When the six-week study concluded, study participants in the SAM-e group experienced improvement in disease activity, pain experienced during the last week, fatigue, morning stiffness, and mood. The study authors found these results promising and went on to recommend further studies.
Another early study found that SAM-e was effective for depression, joint pain, and fibromyalgia but cautioned that supplementation should only occur after a conversation with a healthcare professional due to lack of evidence of efficacy.
After those first promising studies, very little research on SAM-e and fibromyalgia was completed. A study in 2007 was completed but did not post their results. In 2009, a study of 34 fibromyalgia patients found that although there was no improvement in tender point scale ratings between a control group and a group receiving intravenous SAM-e, there was improvement in other parameters such as subjective perception of pain at rest, pain on movement, and overall well-being. Fatigue, morning stiffness, and quality of sleep improved slightly for those patients receiving SAM-e.
Most of the research on SAM-e has focused on its benefits for depression. Many scientifically valid studies since SAM-e was discovered in the 1950s have indicated that SAM-e is just as effective for depression as many anti-depressants but without the side effects.
As for fibromyalgia, the few scientifically valid studies that exist are promising but small-scale and not current. Another big problem with the study of SAM-e for fibromyalgia is that most studies have administered SAM-e intravenously, an option not currently available over the counter.
Despite this lack of research, anecdotal evidence (and the research that does exist) points to SAM-e’s potential for relief of some fibromyalgia symptoms. If it doesn’t directly relieve the tender point scale scores, SAM-e does appear to help with other secondary symptoms, such as depression and certain types of joint pain possibly associated with fibromyalgia.
Dosage varies depending on the goal of supplementation. The following guidelines are based on available research. Most patients have easy access to SAM-e in capsule or tablet form, but an injection may be available through a physician’s office.
- Fibromyalgia: An oral dose of 400 milligrams twice daily is the standard of care, but SAM-e can also be injected into the muscle daily. Your doctor may recommend a combination of injection and oral supplementation.
- Depression: Daily doses of oral SAM-e between 800 and 1,200 milligrams are common. Many patients must work up to this amount, as starting with this level of SAM-e may cause stomach upset. For depression caused by opiate use, the dosage varies and is usually delivered via injection.
- Children: SAM-e is generally not recommended for children under 18 but may be used to treat hepatitis. Dosing levels vary depending on the age of the child and can range from 75 milligrams for 35 days to 150 milligrams given over the same period.
Potential side effects and interactions
Potential side effects of moderate doses of SAM-e include:
- Dry mouth
Others report sweating, dizziness, and heart palpitations. Because SAM-e can be a mood elevator, it should not be taken at bedtime.
In large doses, some patients may experience mania that includes a feeling of elation.
SAM-e has potential interactions with antidepressants and levodopa, reducing the latter’s effectiveness in the treatment of Parkinson’s disease. Other potential dangerous interactions include the risk of serotonin syndrome, a condition caused by having too much serotonin in your body and potentially caused by taking SAM-e in combination with some medications.
Women who are pregnant or breastfeeding should not take SAM-e. Those being treated for bipolar disorder should also avoid SAM-e.
Is SAM-e right for you?
This is a question that can only be answered in conversation with your doctor. While there is some evidence that SAM-e for fibromyalgia pain can help, research is sparse and involves small groups of study participants. The relatively mild side effects of SAM-e may make this supplement worth a try if you are finding that your fibromyalgia symptoms are not responding to other treatments. Always talk to your doctor, though, before starting any new supplement routine.
Have you ever tried SAM-e for fibromyalgia?