The Parable of the SAMe

SAMe is a drug well known to help depression. For example, “a popular dietary supplement called SAMe may help depressed patients who don’t respond to prescription antidepressant treatment, a new study shows.” But there’s something important few people know about SAMe.

While talking to a Seattle woman about how Vitamin D3 first thing in the morning helped her with depression, she told me the following story:

When I was 47, I just wanted to be healthier. I kept gaining weight. I knew what foods are healthy. I just didn’t seem to eat them. A naturopath suggested SAMe. I tried it — Twin Labs SAMe. That was really fabulous for me. For the first time I got a glimpse of what being not depressed was like. Cravings weren’t there any more. Went from a size 24 to a size 14. Lost 70 pounds. I’m 5′ 8″. I didn’t feel deprived. I was eating plenty of food. going to yoga. Feeling really great.

Then Twin Labs discontinued it. It was made in Japan. I tried every other SAMe out there, eight different brands. None of them worked. I gave each of them a month. I tried different dosages.

I started slipping back into depression. Not being able to cope. I was sleeping more. Sugar cravings returned.

[why did Twin Labs stop making it?]

It wasn’t a good seller for them. So fucking wrong. I wrote letters to try to get them to start making it again. I did a campaign. People found pockets of what was left in the country and sent it to me. But it finally ran out.

The moral(s) of the story? 1. So much for word of mouth. You might have thought it would make the good SAMe sell well, better than the bad SAMe. Apparently not. 2. So much for the placebo effect. 3. Clinical studies (e.g., of SAMe) may higher-quality versions of what they are testing than the versions available to the rest of us. 4. So much for quality control in the supplement industry — except maybe in Japan. There can be substantial quality variation among supplements, undetected by the industry. I have to believe the companies selling the useless SAMe didn’t realize it. Surely they thought that good SAMe would be a better product for them than bad SAMe.

This resembles the Vitamin D3 story I have been telling. Tara Grant said she’d heard countless times that Vitamin D is good. She hadn’t heard once that it must be taken in the morning. I’ve heard countless times that SAMe is good. This was the first time I heard about huge quality control issues. In both cases individual self-observation uncovered a crucial truth that an industry had overlooked. They didn’t want to miss it. The Vitamin D Council didn’t want to miss the time-of-day effect. They just did.

This also resembles what I said about ultrasound machines: A lot of them are broken, unbeknownst to their operators and the people (often pregnant women) being scanned. The countless “experts” (doctors) who recommend ultrasound don’t seem to know this.

Which is why personal science (trusting data, not experts) is more valuable than experts want you to think.

4 thoughts on “The Parable of the SAMe

  1. > 2. So much for the placebo effect.
    Que? I see zero mention of anything like blinding.
    Seth: All brands should have been equally effective placebos.

    (Some Muslims get so upset about some cartoons being drawn or books being burned they will kill dozens of people over it. Proof that paper is a drug more powerful than testosterone or steroids at inducing rage!)

  2. What brands did she try? Surely someone makes a high quality SAMe today. Did she try Jarrow? Consult consumerlabs.com?
    Perhaps twin labs’ version was actually the wrong chemical?
    Seth: She tried all brands for sale in the US.

  3. When I trained as an Occupational Therapist, one of the things we were warned about was that not all prescription drugs are equal – sadly the fillers and colours can change the drugs affect/ absorption rate etc. I was working in the NHS at the time NICE came into being, which was going to limit people’s (and their doctors’) choice of manufacturer of their drug, and we knew that many people were going to get a less satisfactory outcome.
    I personally have a problem with drugs with a pink colouring – it slows the absorption rate for me. I found this out with Indomethecin – our British ‘cheap’ indomethecin has bright pink colour on it, and takes about 45 mins to start to help me, whereas the ‘white’ ones start to work in 10 mins. This is a serious delay for any drug with a time base to it. Luckily I have a very on-the-ball pharmacist who hunts out and stocks the ‘right’ coloured medication for me.

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