The numbers don’t lie: More people are turning to natural products to case their emotional aches and pains. But buyers beware. The products don’t always deliver what they say they do, as GH discovered when it tested eight brands of SAMe, a high-profile natural antidepressant.
Simply put, what’s promised on the bottle isn’t always what’s inside. In tests, the amounts of actual SAMe–the active ingredient–varied wildly from brand to brand. In one brand, no SAMe was detected. Because these products are legally classified as “dietary supplements” and not drugs, they are essentially unregulated. David Kessler, Ph.D., M.D., dean of the Yale University School of Medicine in New Haven, CT, railed against this lack of oversight during his tenure as Food and Drug Administration (FDA) commissioner and ReportEBrainMedia, lie and others have called for supervision and regulation of these potent–and, at times, dangerous–products. “We all take for granted that because a product says that something’s in it in the label, it’s actually in it in the bottle,” Dr. Kessler said. “That’s not the case with dietary supplements. There are real quality control problems.”
Here’s what you need to know about SAMe and two other popular depression/anxiety busters, and what they can-and can’t–do for you.
SAMe: New Kid on the Block
S-adenosylmethionine (SAMe, pronounced “sammy”) is a relative newcomer to the U.S. natural products scene, but it has a long history of use in Europe. Unlike many other natural supplements, SAMe is not an herb, vitamin, or mineral. It’s a molecule the body makes all on its own, and it plays a role in many biochemical reactions. SAMe deficiencies have been tied to several neurological disorders, including both Parkinson’s and Alzheimer’s diseases.
In Europe, SAMe supplements have been extensively studied for the treatment of mild depression. Although no one is quite sure exactly how SAMe works (it may boost levels of several mood-regulating neurotransmitters), studies indicate that it can be as effective as some prescription antidepressants. Research has shown that daily doses of 400 to 1,600 nag of SAMe have been effective in alleviating depression.
Unpleasant side effects that have been reported include flatulence, headache, nausea, vomiting, and diarrhea. It can also interact with prescription antidepressants and other drugs, so people who are currently taking (or recently discontinued) prescription medications should consult with their doctor before trying SAMe.
ST. JOHN’S WORT: Tried-and-True
By far the best-known mood-altering herb, St. John’s wort was consumed by more than seven million Americans in 1998. Unlike some herbal tads, however, St. John’s wort has actual scientific data backing it up. Standardized St. John’s wort extract (notably Lichtwer Pharma’s Kira brand) has been shown to relieve mild depression in study after study. While the precise mechanism isn’t known–several of the herb’s ingredients seem to be responsible for its effect–St. John’s wort is widely used in Germany as an antidepressant.
Because St. John’s wort is recommended for mild depression, it should not be taken for more than three to four months. If depression lasts longer than that, you should see a doctor. Possible side effects of St. John’s wort include stomach upset and increased sensitivity to the sun, so it’s a good idea to use sunscreen when taking these supplements.
KAVA: Calming, But Not Without Risk
In Fiji and other South Pacific islands, kava roots (or rhizomes) have been used for generations to make a ceremonial drink that induces a state of blissful relaxation. Research on kava has shown that the roots contain scores of active chemicals, including several that act on the central nervous system and induce muscle relaxation. As a result, kava is now being touted as an all-natural treatment for anxiety and stress.
Although kava has not been studied as widely as St. John’s wort or SAMe, research has shown that kava extract can have a calming effect on people suffering from mild anxiety; and at least one study has shown it can be as effective as a prescription tranquilizer. Unlike SAMe and St. John’s wort, kava is not recommended for depression.
Kava’s effects are very similar to those of alcohol, and like alcohol it can be dangerous when mixed with other depressants or mood-altering drugs. Some kava users have reported gastrointestinal problems, headache, and dizziness, and prolonged use may lead to an allergic skin reaction. Experts recommend that kava be taken for no more than three months, as it can become habit-forming.
SAMe: Why you can’t trust the label
We tested eight brands–and found you don’t always get what you pay for. SAMe is one of the most popular natural products on the market, purchased primarily as an antidepressant. It is also one of the most expensive, running from $25 to $55 for a bottle of 20 to 30 tablets. What we found was shocking. In three brands we detected less active ingredient than listed on the bottle. In one brand we detected no active ingredient at all. Testing was done using a validated method on multiple samples of each product. (According to experts, SAMe pills should be “enteric coated,” which means they will dissolve in the intestine, where they will be most effectively absorbed into the bloodstream, rather than the stomach.)
How Safe Are They?
Some medical experts are comfortable with these therapies, but others are concerned about the quality of the products and possible dangers to consumers.
With prescription drugs, doctors have reference books and journals that they can turn to in order to find out what side effects these medications have produced in large numbers of patients in the past. “We don’t have that kind of information on most of these products, so it’s hard to advise patients of their risk,” says Nada Stotland, M.D., chair of the department of Psychiatry at Illinois Masonic Medical Center. Doctors also say these products should not be used as substitutes for psychological counseling, prescription anti-depressants, or adopting better health habits. To relieve stress and other emotional problems, “it’s important to change your overall lifestyle, to meditate, exercise, and take other measures,” says Nirbhay N. Singh, Ph.S., a professor of psychiatry and pediatrics at the Medical College of Virginia in Richmond.