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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Cindylou on April 14, 2002, at 20:02:01
Out of sheer desperation, I tried one 200 mg tablet of SAM-e today.
I felt better.
I actually had enough energy/motivation to clean the kitchen ... a RARE occurrence.
I'm thinking this MUST be a placebo effect reaction (especially since the recommended dose is 1200-1600 mg), but if anyone thinks there may be something to this SAM-e for me, let me know.
Ron, I noticed from your earlier posts that you find benefit from only 200 mg SAM-e. Is this still the case for you?
Thanks in advance,
cindy
Posted by Ron Hill on April 15, 2002, at 12:29:34
In reply to Can SAM-e work in one day? (Ron Hill?), posted by Cindylou on April 14, 2002, at 20:02:01
Cindylou,
Great to hear! I'll respond, line by line, to your post:
> Out of sheer desperation, I tried one 200 mg tablet of SAM-e today.
>
> I felt better.
>
> I actually had enough energy/motivation to clean the kitchen ... a RARE occurrence.Good for you!
> I'm thinking this MUST be a placebo effect reaction (especially since the recommended dose is 1200-1600 mg), but if anyone thinks there may be something to this SAM-e for me, let me know.
I suspect the effect you feel is real. For people like you, me, Colin Wallace, and many others on this board who are hypersensitive to medication, 200 mg/day is about the correct dose. If I were you, I'd stay at 200 mg/day for at least a week or two before going up to 400 mg/day. Maybe all you need is 200 mg/day. The higher doses may cause some anxiety.
> Ron, I noticed from your earlier posts that you find benefit from only 200 mg SAM-e. Is this still the case for you?Yes, I am still taking 200 mg/day and obtaining very good results. If fact, I'm considering a trial at 100 mg/day.
Cindylou, since at least one pdoc thinks you may be bipolar, please be on guard for signs of hypomanic behavior while taking SAM-e. Are you completely off Lamictal at this point in time? As we have discussed before, SAM-e can induce hypomania (or mania) in BP patients without a mood stabilizer fully in place. At the same time, I realize that you have reason to believe that you are not bipolar. All I'm saying is please be on the look out for hypomania symptoms.
Also, remember the importance of B-6, folic acid, and bioactive sublingual B-12 (methylcobalanin), at all times but especially when taking SAM-e, to prevent the build up of homocystiene. See article below:
Supercharged SAM-e: B Vitamins, Folate Increase the Supplement’s Effectiveness
by ImmuneSupport.com Staff
12-01-1999 - Homocysteine is a sulfur-containing amino acid involved in several important methyl and sulfur transfer reactions, and is actually beneficial in small amounts. When homocysteine levels begin to rise in the body, excessive accumulation of homocysteine in the body fluid compartments is normally prevented by degradation through two enzymatic reactions called transsulfuration and remethylation. These two processes have to be functioning for homocysteine to be kept in control and for SAM-e to function in the body. Importantly, these same enzyme reactions cannot occur without proper levels of folate, vitamin B 6 (pyridoxal 5- phosphate), and vitamin B12 (cobalamin). If you take SAM-e to promote better health (lighter mood, comfortable joints and a detoxed liver), you also need adequate levels of B vitamins and folic acid to help the SAM-e do its job.
When the body has proper levels of folic acid, Vitamins B6 and B12, the enzymatic break-down of homocysteine occurs either through remethylation, which converts it into methionine, the SAM-e building block; or through transsulfuration, which turns it into glutathione, a powerful antioxidant.
But when those processes become sluggish, the homocysteine levels in the body begin to rise. Large homocysteine levels left unchecked in the body, become an invitation to disease, including heart attack, stroke, cancer, birth defects, depression and perhaps CFS and FM.
A published Swedish study showed results of which demonstrate consistently high homocysteine levels and low concentrations of vitamin B12 in the cerebrospinal fluid (CSF) of patients meeting established clinical criteria for Chronic Fatigue Syndrome and Fibromyalgia.
Those taking SAM-e should be aware that the healthy benefits they experience are not due to SAM-e alone. SAM-e may be the “team leader” however, folic acid, vitamin B6 and vitamin B12 are crucial members of the team that contribute to its success. It is only by incorporating the entire team that one can achieve the victory of better health and well-being.
Source:
Evarts, Jeremy Lucius. “New Study Links Fibromyalgia and Chronic Fatigue Syndrome to Low Vitamin B12 and High Homocysteine in Cerebrospinal Fluid.” Healthwatch, August 1998.
Cowley, Geoffrey and Underwood, Anne. "What is SAMe?" Newsweek, July 5, 1999.
Brown, Richard, M.D., Bottigileri, Teodoro, Ph.D., Colman, Carol. Stop Depression Now. New York, 1999.
Please keep us posted regarding your SAM-e trial.--Ron
Posted by Cindylou on April 15, 2002, at 18:54:03
In reply to Re: Can SAM-e work in one day? » Cindylou, posted by Ron Hill on April 15, 2002, at 12:29:34
Hi Ron,
Thanks for your input and concern. I am being cautious as far as the bipolar issue -- and I am also going to try that Omega 3 business like we talked about earlier.I also have an appointment scheduled with these doctors who are MDs, but deal with holistic medicine -- looking forward to their input, and plan to have blood tests galore to figure out what exactly I'm deficient in, as far as vitamins and hormones go.
What brand of sublingual vitamin B do you take? Do you have to go to a special health food store for those? And do you use a generic B-complex as well?
I am taking about 15 B-complex vitamins a day made by Standard Process -- they are "all natural" so contain very low doses of the vitamin levels; that's why I need to take so many. A chiropractor/clinical nutritionist got me on these. I am looking forward to see what these holistic doctors think.
Thanks again for your help,
cindy
>
> Cindylou, since at least one pdoc thinks you may be bipolar, please be on guard for signs of hypomanic behavior while taking SAM-e. Are you completely off Lamictal at this point in time? As we have discussed before, SAM-e can induce hypomania (or mania) in BP patients without a mood stabilizer fully in place. At the same time, I realize that you have reason to believe that you are not bipolar. All I'm saying is please be on the look out for hypomania symptoms.
>
> Also, remember the importance of B-6, folic acid, and bioactive sublingual B-12 (methylcobalanin), at all times but especially when taking SAM-e, to prevent the build up of homocystiene. See article below:
>
> Supercharged SAM-e: B Vitamins, Folate Increase the Supplement’s Effectiveness
> by ImmuneSupport.com Staff
> 12-01-1999 - Homocysteine is a sulfur-containing amino acid involved in several important methyl and sulfur transfer reactions, and is actually beneficial in small amounts. When homocysteine levels begin to rise in the body, excessive accumulation of homocysteine in the body fluid compartments is normally prevented by degradation through two enzymatic reactions called transsulfuration and remethylation. These two processes have to be functioning for homocysteine to be kept in control and for SAM-e to function in the body. Importantly, these same enzyme reactions cannot occur without proper levels of folate, vitamin B 6 (pyridoxal 5- phosphate), and vitamin B12 (cobalamin). If you take SAM-e to promote better health (lighter mood, comfortable joints and a detoxed liver), you also need adequate levels of B vitamins and folic acid to help the SAM-e do its job.
> When the body has proper levels of folic acid, Vitamins B6 and B12, the enzymatic break-down of homocysteine occurs either through remethylation, which converts it into methionine, the SAM-e building block; or through transsulfuration, which turns it into glutathione, a powerful antioxidant.
> But when those processes become sluggish, the homocysteine levels in the body begin to rise. Large homocysteine levels left unchecked in the body, become an invitation to disease, including heart attack, stroke, cancer, birth defects, depression and perhaps CFS and FM.
> A published Swedish study showed results of which demonstrate consistently high homocysteine levels and low concentrations of vitamin B12 in the cerebrospinal fluid (CSF) of patients meeting established clinical criteria for Chronic Fatigue Syndrome and Fibromyalgia.
> Those taking SAM-e should be aware that the healthy benefits they experience are not due to SAM-e alone. SAM-e may be the “team leader” however, folic acid, vitamin B6 and vitamin B12 are crucial members of the team that contribute to its success. It is only by incorporating the entire team that one can achieve the victory of better health and well-being.
> Source:
> Evarts, Jeremy Lucius. “New Study Links Fibromyalgia and Chronic Fatigue Syndrome to Low Vitamin B12 and High Homocysteine in Cerebrospinal Fluid.” Healthwatch, August 1998.
> Cowley, Geoffrey and Underwood, Anne. "What is SAMe?" Newsweek, July 5, 1999.
> Brown, Richard, M.D., Bottigileri, Teodoro, Ph.D., Colman, Carol. Stop Depression Now. New York, 1999.
>
>
> Please keep us posted regarding your SAM-e trial.
>
> --Ron
Posted by Ron Hill on April 15, 2002, at 20:19:00
In reply to Re: Can SAM-e work in one day? » Ron Hill, posted by Cindylou on April 15, 2002, at 18:54:03
Cindylou,
> What brand of sublingual vitamin B do you take?
The brand name is "Enzymatic Therapy", but I'm sure there are plenty of good name brands on the market. However, from what I understand, it is important to buy a BIOACTIVE sublingual form of B-12 (methylcobalamin as opposed to the more typical cobalamin). And the sublingual is needed since some (most?) people do not absorb B-12 very effectively when taken orally (down-the-hatch).
>Do you have to go to a special health food store for those?
I get mine at the local Living Earth nutritional store. However, I'm sure you could find some on-line if you live in the outback.
>And do you use a generic B-complex as well?
Yes, I take a B-100 complex.
> I am taking about 15 B-complex vitamins a day made by Standard Process -- they are "all natural" so contain very low doses of the vitamin levels; that's why I need to take so many.Funny you would mention this since this is the direction I plan to go after using up my current B-100 complex supply. I want to spread out my B vitamin supplementation throughout the day as opposed to mega-dosing once daily. Can you tell me more about this "Standard Process". Is this the brand name? If not, what is the brand name?
I suppose you took your 200 mg of SAM-e today. How did it make you feel?
-- Ron
Posted by Cindylou on April 16, 2002, at 19:02:50
In reply to Re: Can SAM-e work in one day? » Cindylou, posted by Ron Hill on April 15, 2002, at 20:19:00
> Funny you would mention this since this is the direction I plan to go after using up my current B-100 complex supply. I want to spread out my B vitamin supplementation throughout the day as opposed to mega-dosing once daily. Can you tell me more about this "Standard Process". Is this the brand name? If not, what is the brand name?
Hi Ron,
Standard Process is a brand name, and it is widely used by chiropractors. In fact, you usually can't buy it in a health food or vitamin store; you have to go to a chiropractor or order it online. Their website has a lot of information -- www.standardprocess.com (I can never figure out how to make a link ... sorry).Anyway, the chiropractor I go to is into alternative medicine (like they all are), and he does muscle testing to determine how much of this vitamin B I need. This muscle testing is kind of a new-age thing, and a lot of people don't believe in it ... I'm still on the fence. I think these MDs I'm going to see practice muscle testing, which tells me there probably IS something to it -- I'll know more after I see them on the 30th.
> I suppose you took your 200 mg of SAM-e today. How did it make you feel?
I did take 200 mg SAM-e yesterday, but felt pretty rotten. Very tired, and very anxious. I felt the same way today. I am not blaming that on the SAM-e -- mostly on my own depression, and possibly some withdrawal from the Lamictal -- (yesterday was the first day I was completely off of it.)
I will probably wait a few days before taking the SAM-e again just to be sure I don't blame some side effect on it that's really caused by Lamictal withdrawal or just my illness.
I will let you know what these "holistic MD's" tell me about vitamins, SAM-e, etc. after my appointment on the 30th.
Take care!
cindy
Posted by beardedlady on April 17, 2002, at 12:02:00
In reply to Re: Can SAM-e work in one day? » Cindylou, posted by Ron Hill on April 15, 2002, at 20:19:00
There's a special message just for you and Colin--new thread. Go look!
beardy
Posted by Ron Hill on April 18, 2002, at 16:46:10
In reply to Re: Can SAM-e work in one day? » Ron Hill, posted by Cindylou on April 16, 2002, at 19:02:50
> Standard Process is a brand name, and it is widely used by chiropractors. In fact, you usually can't buy it in a health food or vitamin store; you have to go to a chiropractor or order it online. Their website has a lot of information -- www.standardprocess.com
Thanks much, Cindy!
>(I can never figure out how to make a link ... sorry).
This is how I do it: Bring up the web page of interest; block, and copy (under Edit) the website address presented in the address bar of your browser; go to the pbabble dialog box where you want the link to appear; and then click paste (under Edit).
> I did take 200 mg SAM-e yesterday, but felt pretty rotten. Very tired, and very anxious. I felt the same way today. I am not blaming that on the SAM-e -- mostly on my own depression, and possibly some withdrawal from the Lamictal -- (yesterday was the first day I was completely off of it.)
Some of your ill feelings may be due to the SAM-e. Initially, I could only take one 200 mg tablet of SAM-e every other day. If I took more, I would experience side effects (flush, nausea, confused thinking, general ill feeling, "skin crawling"). It was about two or three weeks before I could take 200 mg every day without these side effects. From the time I was able to start taking 200 mg each day, until about a week or so ago (a period of about five months), I felt that 200 mg/day was the correct dose for me. However, in the last week or so I'm begining to think that 200 mg/day might be too much for me. Therefore, after I have finshed my current supply of 200 mg tablets, I plan to conduct a trial at 100 mg/day. Previously, Colin Wallace posted a link to a site where 100 mg tablets can be obtained. Tablet sizes less than 200 mg are not very common. Here is the link:
http://www.fibromyalgiasupport.com/shop/product.cfm/Product__Code/n0165
I do not have any information (good or bad) regarding the product quality assurance of this brand. Please continue to post (as you see fit) regarding your on-going experience with SAM-e.
-- Ron
Posted by BarbaraCat on April 22, 2002, at 12:28:27
In reply to Re: Can SAM-e work in one day? » Cindylou, posted by Ron Hill on April 15, 2002, at 12:29:34
I currently take 2 blister pak SAM-e with 500 mg glucosamine included (Joint Action by Nature's Made). I want to try increasing it, but am unclear as to whether to take all of it at once or in divided doses. When, before a meal or with? Is it important to take the B vitamins along with the dose(s) or can they be another time of the day? Also, where do you get the methylcobalamin? I take B-12 injections of cyanocobalamin because of my fibromyalgia/chronic fatigue. I've heard that that form is bound to cyanide and a no-no in general. I'd like to continue the injections (pills don't get assimilated in my gut), but can't find the methyl form anywhere, nor does my pharmacist know of a source. I'd settle for methyl sublingual but haven't found a source yet. Thanks for your help. - BarbaraCat
Posted by Ron Hill on April 22, 2002, at 15:44:31
In reply to SAM-e dosage question for Ron » Ron Hill, posted by BarbaraCat on April 22, 2002, at 12:28:27
Barb,
> I currently take 2 blister pak SAM-e with 500 mg glucosamine included (Joint Action by Nature's Made). I want to try increasing it, but am unclear as to whether to take all of it at once or in divided doses.
You can do it either way, but divided doses provide at least two advantages that come to mind:
1. Less nausea (if that's a problem for you).
2. Provides more even blood levels throughout the day. However, do not take last dose past about 5 or 6 pm to avoid possible SAM-e induced insomnia.
>When, before a meal or with? Is it important to take the B vitamins along with the dose(s) or can they be another time of the day?
Take vitamins with meal. Take SAM-e on relatively empty stomach. Currently I take one dose of 200 mg per day, but at one time I was taking 400 mg/day in a divided dose. Here is what my "divided dose schedule" looked like:
1. Get up in the morning and eat a good healthy breakfast within thirty minutes of rising.
2. Immediately after breakfast, take oral (down-the-hatch) vitamins followed by sublingual (under the tongue) B-12.
3. Wait for an hour or so, and then take a 200 mg tablet of SAM-e. This wait time is important because SAM-e is adsorbed in the small intestines more effectively if there is not food present to compete for absorption. IMHO, I think it is important to have the B vitamins in the body ready and waiting for the SAM-e dose, but this opinion may fall under the category of "Another One of Ron's Baloney Theories".
4. About mid-afternoon, at least an hour after lunch and at least an hour before dinner, I take my second 200 mg tablet of SAM-e
>Also, where do you get the methylcobalamin? I take B-12 injections of cyanocobalamin because of my fibromyalgia/chronic fatigue. I've heard that that form is bound to cyanide and a no-no in general. I'd like to continue the injections (pills don't get assimilated in my gut), but can't find the methyl form anywhere, nor does my pharmacist know of a source. I'd settle for methyl sublingual but haven't found a source yet.
I buy my supply at a local Living Earth nutrition store, but you can obtain it at a number of on-line stores. Here is the link to one such store, but you may want to use a search engine to find others and compare prices.
http://www.vitaminshoppe.com/search/results.jhtml;$sessionid$YACHYOSMCAZZRQFIAI0CF3WAVABDEI5G?_DARGS=%2Fglobal%2Fleft_column%2Fleft_column.jhtml
-- Ron
Posted by Ron Hill on April 22, 2002, at 15:58:52
In reply to SAM-e dosage question for Ron » Ron Hill, posted by BarbaraCat on April 22, 2002, at 12:28:27
Barb,
Here is a link to the Enzymatic Therapy brand of methylcobalamin that I take. For some reason it did not show up on the link I provided in my prior post. Remember, there are plenty of good brands. I use this 'cause that's what they had at the local nutrition store.
Wow, world's longest link?
-- Ron
Posted by BarbaraCat on April 22, 2002, at 16:03:32
In reply to Re: SAM-e dosing question » BarbaraCat, posted by Ron Hill on April 22, 2002, at 15:44:31
Thanks Ron! SAM-e has been very beneficial for me and I think your wealth of knowledge on the subject is much appreciated. - BCat
Posted by Ron Hill on April 22, 2002, at 16:18:57
In reply to Re: SAM-e dosing question » Ron Hill, posted by BarbaraCat on April 22, 2002, at 16:03:32
> Thanks Ron! SAM-e has been very beneficial for me and I think your wealth of knowledge on the subject is much appreciated. - BCat
--------------------------
Barb,Your kind words are nice. Thank you.
-- Ron
P.S. Because of you, I no longer skin cats.
Posted by BarbaraCat on April 22, 2002, at 16:27:25
In reply to Another Link » BarbaraCat, posted by Ron Hill on April 22, 2002, at 15:58:52
Ron,
What do you think about cyanocobalamin B-12 shots? Even though there's some extra work in stripping off the cyanide, it eventually converts to the active methyl form and I'd think that I'm getting a pretty good active dose of the usable form since it's being directly injected. Your thoughts on this?
Posted by BarbaraCat on April 22, 2002, at 17:53:32
In reply to Re: SAM-e dosing question » BarbaraCat, posted by Ron Hill on April 22, 2002, at 16:18:57
> Barb,
>
> Your kind words are nice. Thank you.
>
> -- Ron
>
> P.S. Because of you, I no longer skin cats.Well, because of you, my cats are now very happy since starting their Three Mice Gone regimen.
Posted by Ron Hill on April 22, 2002, at 23:04:16
In reply to Re: Another Link » Ron Hill, posted by BarbaraCat on April 22, 2002, at 16:27:25
> Ron,
> What do you think about cyanocobalamin B-12 shots? Even though there's some extra work in stripping off the cyanide, it eventually converts to the active methyl form and I'd think that I'm getting a pretty good active dose of the usable form since it's being directly injected. Your thoughts on this?
-----------------------Barb,
I know nothing about B-12 shots. However, I have every confidence that the medical community knows what they are doing and that the cyanocobalamin B-12 shots are safe and effective.
-- Ron
This is the end of the thread.
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