SAMe for Osteoarthritis: A New Supplement for PTs?

The TLDR:

• SAMe for Osteoarthritis: The supplement SAMe ($S$-adenosylmethionine) shows emerging evidence of benefiting those with osteoarthritis by stimulating cartilage production and reducing joint inflammation and stiffness, with some studies showing its effects are comparable to anti-inflammatory drugs.
• Dual Benefit with Depression: SAMe also functions as a powerful antidepressant, with effectiveness similar to tricyclic antidepressants. This presents a potential dual-action treatment for osteoarthritis patients, who often experience depression due to chronic pain and reduced mobility.
• Need for Further Research in Physical Therapy: Current studies are limited because they don't compare SAMe supplementation against physical therapy interventions like exercise. More research is needed to understand how to integrate SAMe into a comprehensive rehabilitation plan.

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Transcript:

Hello everyone, Dr. Wells here from nutritionalphysicaltherapy.com. Hope you're having a great day. I'm here in my sauna, this is one of my favorite spots to work on some of my joint aches and pains. And we as physical therapists and rehab professionals, we often recommend our clients to use things like saunas and different supplements and exercise for things like osteoarthritis.

And so today I'm going to touch on one supplement in particular that we don't talk about in our courses a lot. So in our board approved courses we go into depth in our orthopedic section as well as in our separate section for supplements on osteoarthritis and things that can help, things that are a waste of money and time. And so today I'm highlighting something that we don't really talk a lot about in those courses and that's a compound called SAMe.

SAMe which in the chemical formula is S-adenosylmethionine. It's a compound that's actually produced in every cell in the body. And in particular it's important, it has important roles in production of neurotransmitters and also being a methyl donor.

So its role has a lot of variable implications in health and sometimes SAMe levels can be low particularly in those that have like liver disease, chronic inflammation, and then possibly with older age as well. So what is SAMe? Well it it has this multifactorial role but really today I want to focus on the osteoarthritis, its role there. And it has the ability to help produce cartilage by stimulating chondrocytes and what we're seeing now is emerging evidence that supplementing with SAMe can produce some pretty decent benefits.

Now I will say that these early studies they're fairly limited in size, their quality may not be as robust. However it's certainly piquing my interest because a lot of these are things that we deal with like knee, hip, and spine osteoarthritis, helps with joint inflammation stiffness. So it's a lot of these are compared to anti-inflammatory studies.

So me as a physical therapist I find that a little limiting right because we know that we can provide supplementation as well as exercise manual therapy or dry needling and have these different modalities. So unfortunately these SAMe studies kind of are limited for us as PTs to look at this and go well how much how much better is this compared to some of the things that I'm already doing in my practice right. But on a side note it does have also an impact with depression.

So as I mentioned earlier it has an effect on neurotransmitters and so it does affect the dopamine system. In my last research update for my fourth of July I mentioned about methylene blue and having its impact on depression as well. Unfortunately I think I overstated I should have said it does not the effects of methylene blue is not as strong as tricyclic antidepressants.

However with SAMe, SAMe is as strong as tricyclic antidepressants. So in other words SAMe may have some benefits with producing more dopamine and serotonin for those that have depression. But what I find interesting is that then is if it has that effect on depression so does this drug I mean it not only affects cartilage but if it's affecting depression are we then sort of treating two different pathways for our patients with osteoarthritis because we know that some of them suffer from depression particularly if they have a painful like knee or hip they're not doing as much activity and they're not doing as much participation in life so they may actually be withdrawn and sort of more more likely to be depressed right so in my opinion this this compound may have some promising studies and we need to look at how to study this compound through the physical therapy lens so using SAMe with exercise with other modalities obviously compared to a placebo but more to come and hopefully we can start including this within our courses uh as for now check out our courses nutritionalphysicaltherapy.com and sign up today have a good one