SAM-e better than nothing for mood

Dear Dr. Roach: I am a 52-year-old woman coming out the other side of menopause. I’ve had occasional mood swings. I’ve been taking SAM-e since I found out about it on the internet. I have found it to be very helpful. Recently, I have had a few people tell me that SAM-e can cause various issues, most notably thyroid malfunctions and cancers. Can you please speak to both the efficacy and potential harm of SAM-e for women in my situation?

J.A.

Answer: S-adenosyl methionine is a naturally occurring substance commonly used as a supplement in the U.S. for arthritis and depression.

The evidence on SAM-e is mixed. My opinion is that while it is a lot better than nothing, SAM-e is not as effective as the betterstudied prescription drugs for depression.

This may not be applicable to mood swings.

Since it does seem to be working for you, I can reassure you on one point: There is no reliable evidence that SAM-e increases risk of cancers or thyroid disease. The major side effects, which are rare, are upset stomach and dizziness.

Dear Dr. Roach: My wife had a fatal heart attack. Five or six months earlier, she called me quite often by a former friend’s name. I am wondering if blood was not getting to her brain or if she was starting to get dementia?

G.M.

Answer: I am very sorry about your wife.

People who have blockages in the heart often have blockages in other blood vessels, such as those in the leg, but also those going to the brain. Poor blood flow to the brain may cause changes to memory and other specific problems.

A stroke is very much like a heart attack. Most strokes are caused by poor blood flow to a specific area of the brain, and if it is severe enough, long enough, brain tissue will die, causing loss of function.

People who have had multiple strokes are more frequently affected by dementia, called vascular dementia. I don’t know if this was the case for your wife, but it is certainly plausible.