SAM-e, a nonpharmaceutical supplement that has been championed anecdotally as effective in treating fibromyalgia and a wide range of other disorders, may not be the wonder drug that so many are seeking to help ease their pain.
The National Institutes of Health (NiH) describes fibromyalgia syndrome as a common, chronic disorder characterized by widespread pain, diffuse tenderness, and a number of other symptoms. Often considered an arthritis-related condition, fibromyalgia is not truly a form of arthritis because it does not cause inflammation or damage to joints, muscles, or other body tissues.
But like arthritis, fibromyalgia can cause significant pain and fatigue, and can interfere with a person’s ability to carry on daily activities. It is also considered a rheumatic disorder — a medical condition that impairs the joints and or soft tissues and causes widespread chronic pain. Other symptoms include debilitating fatigue, sleep disturbance and joint stiffness.
Currently, only three medications — duloxetine (Cymbalta), milnacipran (Savella), and pregabalin (Lyrica) — are approved by the U.S. Food and Drug Administration (FDA) for treating fibromyalgia. Duloxetine was originally developed as an antidepressant, but is used to treat other disorders, such as chronic migraines.
Milnacipran is similar to another anti-depressant drug, but is FDA-approved only for fibromyalgia. Pregabalin was developed to treat chronic pain caused by damage to the nervous system.
Some people with fibromyalgia report varying degrees of success with complementary and alternative therapies, including massage, movement therapies such as Pilates and the Feldenkrais method, chiropractic, acupuncture, light therapy, reflexology, and various herbs and dietary supplements.
The resource site Fibromyalgia Symptoms notes that while study into the effectiveness of medical marijuana in treating fibromyalgia has been limited, some research suggests that cannabis works to help relieve chronic pain associated with the condition as well as alleviating depression.
Produced in the body from methionine, an amino acid found in foods, SAM-e was shown in early research to be involved in a variety of body functions, especially in the brain and liver.
The NiH National Institute of Complimentary and Integrative Health (NCCIH) reports that during clinical trials investigating the possible value of SAM-e as a treatment for mental illnesses and liver diseases, researchers noted that people with depression, and some study participants who also had osteoarthritis, reported that their joint symptoms improved when they were taking SAM-e, and began to investigate it as a possible treatment for osteoarthritis.
The NIH notes that SAM-e has now been investigated most extensively for depression, osteoarthritis, and cholestasis associated with pregnancy, and that for all three conditions, research has not conclusively shown SAM-e to be helpful.
The agency also states that while SAM-e has also been investigated for other conditions, including fibromyalgia, migraine, schizophrenia, Alzheimer’s disease, cancer, ALS, and ADHD, there isn’t sufficient evidence to reach conclusions about its effect.
The NCCIH also points out that while small studies have examined various natural products including SAM-e for treating fibromyalgia, a 2010 systematic review concluded that there is not enough evidence to determine whether any of these products provide a health benefit.
The NiH cites the Natural Medicines Comprehensive Database which rates a medicine’s effectiveness based on scientific evidence, noting that the database rates SAM-e as “likely effective” for fibromyalgia, and that some research suggests taking SAM-e orally improves fibromyalgia symptoms.
However, the database also reports that evidence on the use of SAM-e intravenously for fibromyalgia is inconsistent, with some research suggesting it may reduce symptoms, while other research does not.
The University of Maryland Medical Center (UMMC) says SAM-e’s activity in the body is complex, with the naturally-occurring compound found in almost every body tissue and fluid and involved in many important processes, including functioning of the immune system, maintenance of cell membranes, and production and breakdown of brain chemicals such as serotonin, melatonin, and dopamine.
It works with vitamin B12 and folate (vitamin B9), and UMMC notes that being deficient in either vitamin B12 or folate may reduce levels of SAM-e in your body.
UMMC cautions that SAM-e’s use in the treatment of fibromyalgia and liver disease has been examined with mixed results, and that many of the early studies used SAM-e intravenously or as an injection. They note that only recently have researchers been able to investigate the effects of SAM-e taken by mouth, and that among studies that examined oral doses of SAM-e, some found it effective at reducing symptoms of fibromyalgia, including pain, fatigue, morning stiffness, and depression, while others found no benefit.
The Mayo Clinic notes that SAM-e has been studied for relief of fibromyalgia symptoms such as chronic pain and depression, but rates it a C (for “unclear scientific evidence”) for this use, reporting that evidence is mixed about any possible benefits of SAM-e for fibromyalgia. The Mayo Clinic says the supplement has also been studied for potential anti-inflammatory and pain-relieving effects, but that higher-quality studies are needed before firm conclusions can be made.
So as for science and SAM-e for fibromyalgia, the jury is still out.
National Institutes of Health (NiH)
NiH National Institute of Complimentary and Integrative Health (NCCIH)
The University of Maryland Medical Center (UMMC)
The Mayo Clinic