Play It, Sam(e)!

S-adenosylmethionine is of fundamental importance in a number of biochemical reactions and has been trialled previously in the treatment of FM. It is quite a mouthful, isn’t it? The abbreviation SAMe (pronounced samm-ee) is much easier to say. Its chemical structure and name are derived from two materials you may (or may not) have heard about already: methionine, a sulfur-containing amino acid; and adenosine triphosphate (ATP), the body’s main energy molecule.

Depression

The evidence for SAMe for the treatment of depression is provocative but far from definitive. Several double-blind, placebo-controlled studies have found it effective in relieving depression, but most were small and poorly reported, and many used an injected form of the supplement.

Fibromyalgia

Four double-blind trials have studied the use of SAMe for FM, three of them finding it to be helpful. Unfortunately, most of these studies used SAMe given either intravenously or as an injection into the muscles, sometimes in combination with oral doses. The effects, when taken in this manner, can be quite different from when you take it orally. For that reason, these studies are of questionable relevance to most of us.

Nonetheless, the one double-blind study that used only oral SAMe did find positive results. In this trial, 44 people with FM took 800 mg of SAMe or placebo for 6 weeks. Compared to the group taking placebo, those taking SAMe had improvements in disease activity, pain at rest, fatigue, and morning stiffness, and in one measurement of mood. In other respects, such as the amount of tenderness in their tender points, the group taking SAMe did no better than those taking the placebo.

However, it isn’t clear whether SAMe is helping FM through its antidepressant effects, or by some other mechanism.

The body makes all the SAMe it needs, so there is no dietary requirement. However, deficiencies in methionine, folate, or vitamin B12 can reduce SAMe levels. SAMe is not found in appreciable quantities in foods, so it must be taken as a supplement.

It has been suggested that the supplement trimethylglycine (TMG) might indirectly increase SAMe levels; however, this is yet to be proven.

sam eA typical full dosage of SAMe is 400 mg taken 3 to 4 times per day (which can be quite expensive). If this dosage works for you, take it for a few weeks and then try reducing the dosage. As little as 200 mg twice daily may suffice to keep you feeling better once the full dosage has “broken through” the symptoms.

However, some people develop mild stomach distress (just what people who suffer with IBS want to hear!) if they start full dosages of SAMe at once. To get around this, you may need to start low and work up to the full dosage gradually.

samE sideSome labelling suggests a dosage of 200 mg twice daily. This dosage makes SAMe appear more affordable (if you’re only taking 400 mg per day, you’ll spend only about a third or a fourth of what you’d pay for the proper dosage), but it is unlikely that SAMe will actually work when taken at such a low dosage.

Safety Issues

  • SAMe appears to be quite safe, according to both human and animal studies. The most common side effect is mild digestive distress. However, SAMe does not actually damage the stomach.
  • Like other substances with antidepressant activity, SAMe might trigger a manic episode in those with bipolar disease (manic-depressive illness).
  • Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
  • SAMe might interfere with the action of the Parkinson’s drug levodopa. In addition, there may also be risks involved in combining SAMe with standard antidepressants. For this reason, you shouldn’t try either combination except under physician supervision.

 

If you’d like to see iHerb’s selection of SAM-e products, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

Int Fibro

Herbs and Supplements for Fibromyalgia

Managing the symptoms of FM or related ailments is not easy. So, many patients turn to alternative therapies for relief of pain and sleep problems. They may use Chinese herbs or over-the-counter supplements such as 5-HTPmelatonin, and SAM-e.

200px-US-NIH-NCCAM-Logo.svgBecause so many people — not just those with FM — are using alternative therapies, Congress has formed the National Center for Complementary and Alternative Medicine (NCCAM). It is part of the National Institutes of Health (NIH), and it helps appraise alternative treatments, including supplements, and define their effectiveness. This organization is now creating safe guidelines to help people choose appropriate alternative therapies that may help their symptoms without making them ill.

Are Herbs and Supplements for FM Safe and Effective?

Some preliminary studies indicate that some medicinal herbs and natural supplements may help treat symptoms of FM. Other studies of herbs and natural supplements, though, are less positive. If you want to take a natural approach to treating FM, it’s important to learn as much as you can about the therapies you consider. The herbs and natural supplements described here are just some of the alternative therapies that may have an impact on FM.

How Does 5-HTP Help FM Pain?

5-HTP (5-Hydroxytryptophan) is a building block of serotonin. Serotonin is a powerful brain chemical, and serotonin levels play a significant role in FM pain. Serotonin levels are also associated with depression and sleep.

For those with FM, 5-HTP may help to increase deep sleep and reduce pain. In one study published in the Alternative Medicine Review, researchers reported that supplementation with 5-HTP may improve symptoms of depression, anxietyinsomnia, and FM pains. However, there are some contradictory studies that show no benefit with 5-HTP.

5-HTP is usually well tolerated. But in the late 1980s, the supplement was associated with a serious condition called eosinophilia-myalgia syndrome. It’s thought that a contaminant in 5-HTP led to the condition, which causes flu-like symptoms, severe muscle pain, and burning rashes.

141. sleep deprivationCan Melatonin Help Relieve Sleep Problems Associated With FM?

Melatonin is a natural hormone that’s available as an over-the-counter supplement. It is sometimes used to induce drowsiness and improve sleep patterns. Some preliminary findings show that melatonin may be effective in treating FM pain. Most patients with FM have sleep problems and fatigue, and it’s thought that melatonin may help relieve these symptoms.

Melatonin is generally regarded as safe with few to no side effects. Due to the risk of daytime sleepiness, though, anyone taking melatonin should use caution when driving until they know how it affects them.

Is St. John’s Wort a Helpful FM Herb?

There’s no specific evidence that St. John’s wort is helpful in treating FM. However, this herb is often used in treating depression, and depression is commonly associated with FM.

There are several studies that show St. John’s wort is more effective than placebo and as effective as older antidepressants called tricyclics in the short-term treatment of mild or moderate depression. Other studies show St. John’s wort is as effective as selective SSRI antidepressants such as Prozac or Zoloft in treating depression.

St John’s wort is usually well tolerated. The most common side effects are stomach upset, skin reactions, and fatigue. St. John’s wort should not be mixed with antidepressants and can cause interactions with many types of drugs. If you’re on medication, check with your doctor before taking St. John’s wort or any supplement. In addition, be careful about taking St. John’s wort with other drugs, including antidepressants, as it could make you ill.

How Can SAM-e Help FM Pain and Depression?

289. pain in meIt’s not known exactly how SAM-e works in the body. Some feel this natural supplement increases levels of serotonin and dopamine, two brain neurotransmitters. Although some researchers believe that SAM-e may alter mood and increase restful sleep, current studies do not appear to show any benefit of SAM-e over placebo in reducing the number of tender points or in alleviating depression with FM. Additional study is needed to confirm these findings.

Can L-carnitine Help Improve FM Symptoms?

The studies are limited, but it’s thought that L-carnitine may give some pain relief and treat other symptoms in people with FM. In one study, researchers evaluated the effectiveness of L-carnitine in 102 patients with FM. Results showed significantly greater symptom improvements in the group that took L-carnitine than in the group that took a placebo. The researchers concluded that while more studies are warranted, L-carnitine may provide pain relief and improvement in the general and mental health of patients with FM.

What About the Effect of Probiotics on Digestive Problems Associated With FM?

poo-2Probiotics are dietary supplements that contain potentially beneficial bacteria or yeasts. They may assist with the breakdown and proper absorption of food and help improve digestive problems such as irritable bowel syndrome — a common symptom of FM. Some of the ways probiotics are used include:

  • treating diarrhea
  • preventing and treating infections of the urinary tract or female genital tract
  • treating irritable bowel syndrome

Side effects of taking probiotics are usually mild and include gas or bloating.

There are other herbs and natural supplements that people say have helped manage FM symptoms. They include echinacea, black cohosh, cayenne, lavender, milk thistle, and B vitamins. Nevertheless, there are no definitive studies on the efficacy of these natural therapies.

Fuzzy shot of pharmacy supplements shelf.How Can I Know Which Herb or Natural Supplement Will Help my FM?

***Before taking any herb or supplement for FM, talk to your doctor or pharmacist about possible side effects or herb/drug interactions. Herbal therapies are not recommended for pregnant women, children, the elderly, or those with weakened immune systems. In addition, some herbs have sedative or blood-thinning qualities, which may dangerously interact with anti-inflammatory painkillers or other pain medications. Others may cause stomach upset if taken in large doses.

If you’d like to see iHerb’s selection of supplements, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

Whatever…Nothing!

Yesterday, I (with my Mommy) was running late for my pain specialist. I hate running late. It stresses me out. I think it is incredibly rude. But, yesterday, when my Mommy was apologising for making us late, I was just ‘whatever.’

Then I thought about it and I’ve been ‘whatever’ for quite a while. It’s not such a bad feeling – it’s stress-less, very laid back and unemotional. But it’s very nothing.

I also noticed that I haven’t been writing anything personal on this blog – it’s been all about research and studies. It’s because there is nothing.

I think I’m on too many drugs…

When I was first diagnosed, (other than a quick dose of steroids) I was immediately put on Lyrica. Anytime I felt more pain, the doctors increased my dosage…my current Lyrica dosage is 225mg both morning and night.

I also take 150mg of Sertraline for depression – it used to 100 mg but during this ‘whatever, nothing’ stage, I felt that I needed something extra. My GP was happy to increase the dose. There’s also 1100ʮg per week of Thyroxine for my under-active thyroid; the Pill (I went off it (because who’s having any sex?) but my periods were unbearable!); and, of course, there’s all the supplements that we’re supposed to take: vitamin D, Red Krill Oil, D-Ribose, Sam-E, CoQ10, and a multi-vitamin.

Anyway, my point is that no-one tried anything except the Lyrica…why not?

So, having visited the pain specialist yesterday, we’re trying something else: I’m running out of all the supplements at the moment, so I’m just going to stop them as the bottles empty; and I’m going to wean off the Lyrica:

doses

Because this ‘whatever, nothing’ just isn’t good enough. I want more. I NEED more!

It’s Delightful, It’s Delicious, It’s D-Ribose


I started taking D-Ribose 2 weeks ago. (I wasn’t able to find it anywhere near me so I buy it online from iHerb.com.) My capsules have 4 250mg of D-Ribose so I thought I should be feeling fabulous.

In a study by Dr Jacob Teitelbaum, D-Ribose treatment led to improvements in all categories:

  • 61.3-percent increase in energy
  • 37-percent increase in overall well-being
  • 29.3-percent improvement in sleep
  • 30-percent improvement in mental clarity
  • 15.6-percent decrease in pain

Improvement began in the first week of treatment, and continued to increase at the end of the three weeks of treatment.

Additionally, in her book, Food That Helps Win the Battle Against Fibromyalgia, naturopathic doctor Deirdre Rawlings states that d-ribose supplements can help FM by improving energy transfer to your muscles.

So where was all my great improvement? I had written a post previously so I knew that I only needed 5mg three times a day (and I was taking heaps more!).

But guess what? I messed up (I’m blaming fibro fog, and it’s fixed now) – it was supposed to read 5 grams three times a day!

So, starting today, I am taking one capsule three times a day – it is a bit short of the 5 grams (just 750mg) so I’m still looking forward to some positive effects.

D-ribose is a type of simple sugar (a 5-carbon sugar; unlike 6-carbon glucose sugar)  that plays a role in energy metabolism and specifically in the formation of ATP, or adenosine triphosphate, the fuel that every cell in your body uses for its energy production. In fact, the ATP energy molecule is made of ribose. Ribose is found in limited amounts in meat and vegetables, though your body usually manufactures enough ribose from glucose to meet its daily needs. However, researchers believe that people with FM may have a deficit in ATP production, which accounts for the lack of energy and feelings of fatigue.

No side effects are associated with the use of ribose supplements, according to Tufts Medical Center; however, no long-term safety studies have yet been conducted. The only significant (bad) side effect seen, so far, is feeling hyper/over-energised (oh! wouldn’t that be nice!) in which case you should lower the dose or take it with food.

As with any nutritional supplement, inform your doctor if you plan to use D-Ribose.

I’ll let you know when (I’m being positive) I start feeling fantastic!

If you’d like to see iHerb’s selection of D-Ribose products, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

Fighting (and Losing) Against the Clock

It appears that a biological measurement of premature ageing may be linked to FM pain. I wonder if this explains why my body feels eighty instead of forty…

In a new research study, researchers examined the length of telomeres, which are specialized structures at the ends of chromosomes that deal with replication and stability of genetic material. A telomere is a repeating DNA sequence at the end of the body’s chromosomes. The easiest way to think about it is to imagine them as the aglets (plastic tips) on the ends of shoelaces that keep them from fraying.

*** The human body is an organism formed by adding many organ systems together. Those organ systems are made of individual organs. Each organ contains tissues designed for specific functions like absorption and secretion. Tissues are made of cells that have joined together to perform those special functions. Each cell is then made of smaller components called organelles, one of which is called the nucleus. The nucleus contains structures called chromosomes that are actually “packages” of all the genetic information (DNA) that is passed from parents to their children.***

Over time, as cells divide, telomeres shorten and as such are regarded as a marker of the aging process.

When comparing telomeres from women with FM to those of healthy women (sorry, men were ignored again), researchers discovered that the telomeres from the FM sufferers tended to be slightly shorter, but not to a significant degree. However, higher pain levels were associated with shorter telomere length. Further, those with higher pain and higher depression scores had the shortest telomeres, with the difference being approximately equal to six years of ageing – not quite the forty extra years I was looking for.

Additionally, shorter telomeres were linked to higher pain sensitivity and lower gray-matter volume in brain regions dealing with pain.

Researchers concluded that premature cellular ageing appears to be linked to chronic pain, which implies that chronic pain is a more serious condition than has typically been recognized – which hopefully means that more research will be conducted into chronic pain conditions like FM.

Unlike FM (oops, just a bit cynical!), there is a huge interest in slowing the aging process so a fair bit of research has gone into which nutrients help keep your telomeres long. (It is not known yet if this slows the ageing process, or whether it merely slows premature aging due to FM – but both would help us!)

Nutrients that appear to affect telomere length include:

  • Omega-3
  • Vitamin B12
  • Vitamin D3
  • Zinc
  • Iron
  • Vitamin C
  • Vitamin E

Omega-3, B12 and D3 are among the most commonly recommended supplements for FM.

If you’d like to see iHerb’s selection of supplements, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

 

Play It Again, SAM (-e)!

Do you know about ClinicalTrials.gov? ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. As of today, ClinicalTrials.gov currently lists 134,739 studies with locations in 180 countries. (You might want to keep an eye on this site!)

Aside 1: I love to learn new things and research

Aside 2: I started SAM-E (at 400mg) this week (not feeling any better – in fact, this week has been my worst week in as long as I can remember!)

I’ve had AUSTRALIA and FIBROMYALGIA bookmarked with ClinicalTrials.gov for quite a while but nothing much is happening here.

However, one thing I noticed was a Double-Blind, Placebo-Controlled Trial of the Impact of S-Adenosyl-L-Methionine (SAM-e) on the Mood and Other Symptoms in Fibromyalgia.1 The phase 2 trial was completed in March 2007 but there were no results published – zip, nada!

Well, that was not particularly helpful. BUT I am an alumnus of the university where the study was run. So, one email later, I had the draft report in my grubby little hands (or inbox).

Available from iHerb.com

Quick background: SAM-e is of fundamental importance in a number of biochemical reactions and has been trialled previously in the treatment of FM. This study aimed to examine the clinical impact of SAMe-B-ForteTM – a complex containing 400mg of SAM-e – in the treatment of fibromyalgia in the light of possible melatonin (MLT) mediated circadian enhancing properties (basically, sleep).

Statistics: FM is the third most common disorder in rheumatologic practice after rheumatoid arthritis and osteoarthritis and its prevalence in the general population has been estimated to be between 1% and 4%.2,3,4 The prevalence of FM in primary care settings (at GP level) is much higher, where it is estimated to be between 5% and 20%.3,5 Studies examining the outcome in FM patients suggest that the probability of complete recovery in the short-term is low.6

As we know, no treatment (medical or psychological/behavioral) has been demonstrated to be clearly and reliably effective (or we all would have shared it by now!)

Patients were randomly allocated into two groups (placebo and active treatment). The SAMe-B-ForteTM group received capsules containing SAM-e 400mg, over an 8 week period.  The placebo group received capsules that were of identical appearance. All participants were instructed to take one of the capsules in the morning with food (the directions on my box of SAM-e state to take it without food?) Only 49 patients completed the trial.

It appears that the 4th week was the breakthrough week – SAM-e was effective in reducing global symptoms, sleep onset insomnia, and bowel dysregulation. While the results failed to support previous findings that SAM-e could aid depression, the dose given (400mg) and the short time period may not have allowed for optimal antidepressant action of SAM-e and future trials would be required, including a range of doses, in order to better examine dose-response data.

Conclusion: The SAMe-B-ForteTM complex tested shows promise in alleviating symptoms in FM. The promising results confirm there is a potential benefit of SAM-e administration in FM but also that this finding needs further exploration.

Well, I don’t want to wait (really sick of waiting – and it’s taken 5 years for researchers to produce a draft report!) so, as I said earlier, I am giving it a try. Hopefully, the next few weeks will be better than this one.

 

  1. Luke Xantidis, Gregory Tooley, Daniel Lewis and Laurence Lacey
  2. Doron Y, Peleg R, Peleg A, Neumann L, Buskila D: The clinical and economic burden of fibromyalgia compared with diabetes mellitus and hypertension among Bedouin women in the Negev. Fam Pract 2004, 21(4):415-419.
  3. Kirmayer LJ, Young A, Hayton BC: The cultural context of anxiety disorders. Psychiatr Clin North Am 1995, 18(3):503-521.
  4. Staud R, Domingo M: Evidence for abnormal pain processing in fibromyalgia syndrome. Pain Med 2001, 2(3):208-215.
  5. Al-Allaf AW, Dunbar KL, Hallum NS, Nosratzadeh B, Templeton KD, Pullar T: A case-control study examining the role of physical trauma in the onset of fibromyalgia syndrome. Rheumatology (Oxford) 2002, 41(4):450-453.
  6. Dobkin PL, De Civita M, Bernatsky S, Kang H, Baron M: Does psychological vulnerability determine health-care utilization in fibromyalgia? Rheumatology (Oxford) 2003, 42(11):1324-1331.

 

 

Extra suitcase, anyone?

Umm…anyone got an extra suitcase?

And in case, you see anything about a suspected drug importer entering Bali on Sunday – please start a fund for my legal fees ASAP.

 

D-Ribose Availability

I had some requests about where to buy D-Ribose, so GOOGLE, here I come!

Firstly, the report I read stated (at the end) that Douglas Laboratories exclusively distributes Bioenergy’s Corvalen for professional use; Nutri-Health Supplements, LLC, sells Corvalen through direct-to-consumer channels; and Sedona Labs distributes Corvalen to the retail health food store market.

Then, I did my own search:

Better Health International sells Corvalen D-Ribose 9.9 oz (280 g) (containing Pure D-Ribose) for US $30.99 and Corvalen M 12 oz (340 g) (Containing Malate and Magnesium in addition to D-Ribose) for US $33.75.

Biovea Australia sells D-RIBOSE 1000mg 60 Fruit Chewable Tablets by Source Naturals® for AU $35.95.

iHERB.com has 25 different versions ranging from US $25.99 to US $49.08 – this also includes powder form

Amazon is selling NOW D-RIBOSE 100% PURE POWDER for US $20.00

The recommended dosage for us FM sufferers is 5 grams three times a day (this amount was suggested by Dr Teitelbaum).

If you’d like to see iHerb’s selection of D-Ribose products, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.

Please consult your doctor as to which brand/form is appropriate for your use, and to discuss side effects.

Ribose Aids Fibromyalgia

 

According to Dr Jacob Teitelbaum, D-ribose provides the key building block for producing the ‘energy molecule’ adenosine triphosphate (ATP) in every cell.

In a recent multicentre study led by Dr Teitelbaum, D-ribose supplementation improved energy levels, sleep, mental clarity, pain relief and well-being in patients suffering from fibromyalgia

This open-label, unblinded study included 257 patients in 53 US clinics with a diagnosis of CFS and FM. All subjects were given D-ribose (as Corvalen™ from Bioenergy), a naturally occurring pentose carbohydrate, 5 g t.i.d. for three weeks.

In the 203 patients who completed the trial, D-ribose treatment led to both statistically and clinically highly important average improvements in all categories:

  • 61.3-percent increase in energy
  • 37-percent increase in overall well being
  • 29.3-percnet improvement in sleep
  • 30-percent improvement in mental clarity
  • 15.6-percent decrease in pain

Improvement began in the first week of treatment, and continued to increase at the end of the three weeks of treatment. The D-ribose was well tolerated.

These findings confirmed results of an earlier pilot study published in the Journal of Alternative and Complementary Medicine, involving 36 patients from a single medical centre, who took D-ribose for an average of 25 days. Approximately 66 percent of patients experienced significant improvement while on D-ribose, with an average increase in energy of 45 percent and an average improvement in overall well-being of 30 percent.

“Our hypothesis all along has been that giving D-ribose to people with chronic fatigue syndrome and fibromyalgia will jump-start their mitochondrial energy furnaces,” said Dr Teitelbaum. “We’re pleased that the larger multicentre trial corroborated our earlier study, showing the same benefits for fibromyalgia and chronic fatigue syndrome patients from multiple locations.”

 

(Vita)minimally Beneficial

We’re back at the day that I organise my dosette (a reusable device that allows medicines to be housed in grid like compartments, in preparation for sequential dosing according to a prescribed regime). Now, approximately 90 days ago, I ordered a tonne of supplements because I read that they might help my FM – and now I’m running out.

I never bothered to research them. I just kinda asked my GP is it okay to take them, and off I went.

I mean, really, how many of you have been told of miracle supplements that will make you better, energise you, and let you go back to work?

As such, I had a bit of a look around the net and put together a little table (here). By no means does it have all the information about each supplement, nor does it have every supplement. So, I’m suggesting (strongly) to you that, prior to trying, adding, reducing any of your supplements, please talk to your doctor.

Questions to ask your doctor include:

  1. What’s the right dosage for me?
  2. Should I take it with food?
  3. What time of day should I take it?
  4. Will this supplement interact badly with my prescriptions?
  5. Does it have side effects that might mimic or aggravate my fibro symptoms (such as depression or sleep difficulties)?

 

If you’d like to see iHerb’s selection of supplements, click here. Use Coupon Code LHJ194 to get $10 off any first time order over $40 or $5 off any first time order under $40.