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A SAM-e Self-Experiment

April 27, 2023

The SAM-e Supplement: say goodbye to depression? TBD.

One year ago, as I was browsing the supplement aisle of Costco, a woman approached beside me. She started to fill her cart with boxes of SAM-e Complete. I was clearly contemplating whether or not to purchase some myself because she turned to me and told me that her daughter’s mood and mental health improved drastically after taking it. She couldn’t recommend it enough. Being easily swayed by others’ suggestions, I threw a couple in my cart. I took 400mg of SAM-e for 120 days — every morning before breakfast. It was with me through some of the darkest times of the semester, but looking back, I wouldn’t say it made much of difference (other than to my wallet). It might not have worked for me, but there’s a chance it could work for you.

Understanding Depression

Affecting more than 300 million people worldwide, depression is a common mood disorder that can strike at any age. Its symptoms can range from a lost of interest in activities and sleep problems to feelings of worthlessness and suicidal ideation (“Depression: Types of Depressive Disorders and Their Causes,” 2021). Depression impacts many aspects of an individual’s life and may require medication to treat. However, even with antidepressants, people continue to experience minimal responses to them. Or, they might suffer from one of its many side effects, driving them away from sticking to their medication. Situations like these have sparked the interest in natural remedies for treating depression. Research is still limited, but the over-the-counter supplement S-adenosyl-l-methionine (SAM-e) shows promise and an encouraging future.

A Little History

In Italy, Spain, and Germany, SAM-e has been available by prescription for decades. Only recently has the US started to sell it on its shelves. Still, only a handful of psychiatrists and clinicians have recommended it due to the uncertainty of its safety and effectiveness. Hopefully we’ll see more evidence come to light since many patients might be interested in an OTC option (D’Epiro, 2000).

How It Works

SAM-e is a methyl-donor molecule involved in metabolic pathways. It is found naturally in the body as a common amino acid in the blood. Amino acids are molecules that combine to make proteins, which are essential in supporting the growth and repair of tissue (Farnsworth, 2022). Unfortunately, the form of SAM-e found in food isn’t stable and our bodies can only generate a small amount.

SAM-e helps to produce and regulate hormones as well as maintain cell membranes (“SAMe,” 2020). Since it plays such an important in regulating key functions in the the body’s cells, abnormal levels can lead to depression and liver disease (“S-adenosyl-L-methionine (same): In depth,” 2017).

SAM-e levels in the body are dependent on Folate and B12. Depression is linked to deficiencies of these vitamins, which suggests that they could be linked to reduced SAM-e. 

Simply put, a deficiency in folate → not able to metabolize folate properly → lower levels of SAM-e → less synthesis of neurotransmitters such as dopamine, serotonin, and norepinephrine. 

With the help of SAM-e, depression symptoms can be reduced by stimulating the synthesis of these key neurotransmitters (Mischoulon, 2018).

The Evidence

SAM-e trials to test efficacy have ranged from 2 to 12 weeks and doses of 200mg to 3200mg. In a number of controlled experiments, SAM-e has been found to be more effective than placebo and just about equal to antidepressants when administered into veins or muscles. (Less evidence is available to support the use of oral SAM-e.) Data also suggests that SAM-e can be useful when taken in addition to antidepressants (Papakostas, 2009).

Current findings highlight the need for larger and longer studies to truly understand the value of SAM-e.

Why Could SAM-e Be Better For Me?

SSRIs, a widely used antidepressant, blocks the reabsorption of serotonin, leaving more available for the neurons to use for signaling. SAM-e aids with the actual synthesis of serotonin (Majeed, 2022).

One of the major benefits of SAM-e is its minimal list of side effects. These include digestive problems, mild insomnia, irritability, and anxiety, which tend to resolve after a couple of weeks. Typical antidepressants can cause weight gain, sexual dysfunction, sedation, or cognitive interference (“SAM-e”, n.d.).

Antidepressants typically take 6 to 8 weeks before they begin working, while SAM-e seems to begin in as little as 2 weeks time (“S-adenosylmethionine,” n.d.). Tablets can also be combined safely with other drugs since it doesn’t have many interactions.

How Is SAM-e Not More Popular?

SAM-e has been shown to have a positive effect on depression treatment, but many of those studies were poorly designed or had a small sample size. Data on long-term safety has been limited as well. The perfect dose hasn’t been established either. 

Should You Take SAM-e?

Patients who would benefit most from SAM-e are those with mild to moderate depression who would prefer not to see a doctor, are taking a treatment that isn’t working, or wish to avoid the adverse side effects of common antidepressants. The cost, unfortunately, may turn some away from trying out the supplement — one 400mg pill can cost between $.75 and $1.25. Although SAM-e is available as a safe and effective supplement, it is not recommended to treat major depression without advice from a doctor and it should not be considered a replacement for prescribed medication (D’Epiro, 2000).

Even though SAM-e supplements didn’t have a noticeable effect on me, it changed the daughter of the woman at the grocery store’s life. If you are considering an OTC supplement to relieve mild depression symptoms, it could be worth a try!

 

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About Author

Hi everyone. My name is Julia, and I am a second year CS major. I joined StemComm and the Charged team to share my interests in food science, psychology, and computing!

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  Timothy Durham was convicted of rape when a test showed his DNA genotype matched the DNA recovered from the crime scene. Eye witnesses testified that Durham was in a different state at the time of the incident, but he wasn’t exonerated from his 3000 year sentence until follow up DNA analysis showed that the preliminary forensic analysis used in the trial was misinterpreted (Thomas et al.). DNA testing serves an invaluable part in our criminal justice system, but it comes with complications and bias that can lead to wrongful convictions and misinformed juries.  

Background:

Forensic genetics aims to identify the origin of a biological sample. It can be traced back to Karl Landsteiner who discovered human ABO blood groups. With blood groups, suspects could be eliminated based on their blood type. For example, if a suspect had type A blood and there was type B blood left at the scene by the perpetrator, the investigators could rule out the suspect. Unfortunately, the reverse didn’t work. If the suspect and perpetrator both had the same blood type, it can’t be concluded that the suspect was guilty. Blood identifiers evolved into 8 distinct categories which improved the ability to eliminate suspects, but could only conclude that (if the system matched) it might be the perpetrator or this person might be related to the perpetrator (Jobling and Gill). The field evolved in the 1980s with the discovery of Minisatellites, lines of repetitive DNA that don’t encode proteins. Minisatellite patterns in DNA create what we know today as the DNA fingerprint, and it has a much higher accuracy rate than previous methods (Augustyn et al.). Around the same time, a breakthrough for victims of sexual assault was discovered. In the case of assault, bodily fluids of both the victim and the assaulter can get mixed. A process called differential lysis was created which could selectively increase the concentration of sperm in a fluid sample thereby allowing for accurate DNA testing (Jobling and Gill). Forensics evolved to use single-locus probe testing after several years because of its ease of interpretation. It looked at specific minisatellites that had high variability between subjects. This was the first DNA-based method to be used in a criminal investigation. Two murder homicides from several years apart were connected using DNA evidence. The evidence was then used to exonerate an innocent man, and the guilty party was found when he tried to evade mandatory DNA testing for all men in the small town. His guilt was then reinforced when the DNA profiles matched, and he gave a confession (Jobling and Gill). Finding DNA at a crime scene doesn’t guarantee that you’ll find a murderer. There are issues with non-pure samples and limited samples that make DNA work difficult, and accreditation of facilities and new techniques and take time (Jobling and Gill).  

Subjectivity of DNA Interpretation:

In a 2009 publication, the National Academy of Science discusses the possibility for subjective influence in lab based forensics. The interpretation bias happens in complex cases where, for example, there could be a mixture of DNA. A study published in 2011 looked specifically at this issue. A gang rape happened in Georgia, and the mixture in DNA from the case was used to prosecute one suspect after another suspect took a plea bargain to testify against him. With DNA mixtures, there are three possible conclusions: suspect excluded, suspect cannot be excluded, and inconclusive. If the suspect is excluded, it means that there’s little to no possibility that his DNA is part of the sample. If the suspect cannot be excluded, it means that there’s a possibility that his DNA is part of the sample. In the trial, the DNA examiners who knew the context of the case concluded that the suspect being prosecuted could not be excluded. The 2011 study gave the DNA evidence from this case and the DNA profiles of the suspects to 17 forensic examiners. These examiners had no context of the case, and they all worked independently. Of the 17, only 1 came to the same conclusion (suspect cannot be excluded) as the examiners who knew the context of the case. Twelve of the 17 concluded that the suspect who was prosecuted and convicted had no relation to the DNA found in the sample. Not only does this show that subjectivity occurs due to the context of the case, but the 17 examiners came up with different findings based on their past experiences meaning that not all DNA analysis is objective. Some organizations like the Scientific Working Group on DNA Analysis Methods say that quantitative statistical evidence should be presented with every categorical conclusion, but the US doesn’t require this (Dror and Hampikian).

False Positives:

There are two categories that cause wrongful identification in a DNA report: coincidental matches and false positives. Coincidental matches are DNA matches between two unrelated people. The probability of these matches is about 1 to 500,000 for white individuals and about 1 to 350,000 for black individuals. This small probability of coincidental matches makes people feel confident in DNA evidence. False positives, on the other hand, are matches between DNA and test DNA that result from issues in the forensics lab. There have been multiple cases of forensics labs accidentally switching victim and suspected rapist DNA which lead to convictions that were later overturned when the lab realized the error. There are also cases of misreading or misunderstanding a sample. In a case from 1993, a man was convicted of rape because someone interpreted a mixed sample of victim and perpetrator DNA as an individual sample. The conviction was again overturned. To prevent false convictions, retesting DNA is allowed, but it’s not an efficient solution. Many people are pushing for statistical information on the probability of false positives, so that the jurors can make accurate judgements based on DNA evidence (Thomas et al.).  

Conclusion:

DNA analysis is a useful tool for the criminal justice system, but subjectivity can be an issue in forensic testing. To combat wrongful convictions, there are organizations like The Innocence Project who use DNA testing to free the innocent, but reformed forensic testing standards should be put in place to prevent subjectivity and to ensure juries are correctly informed during trials. https://www.innocenceproject.org/    

Citation:

Augustyn , Adam, et al. “DNA Finerprinting.” Encyclopedia Britannica , 26 Apr. 2018, www.britannica.com/science/DNA-fingerprinting#ref153186. Dror, Itiel E., and Greg Hampikian. “Subjectivity and Bias in Forensic DNA Mixture Interpretation.” Science & Justice, vol. 51, no. 4, 2011, pp. 204–208., doi:10.1016/j.scijus.2011.08.004. Jobling, Mark A., and Peter Gill. “Encoded Evidence: DNA in Forensic Analysis.” Nature Reviews: Genetics, vol. 5, no. 10, Oct. 2004, pp. 739–751., doi:10.1038/nrg1455. Thompson, William C, et al. “How the Probability of a False Positive Affects the Value of DNA Evidence.” Journal of Forensic Sciences, vol. 48, no. 1, Jan. 2003, pp. 1–8., doi:10.1520/jfs2001171.