SAMe
SAMe (S-adenosyl-methionine), often pronounced "Sammy," is a co-enzyme used by the body to make anything from natural mood elevators like dopamine in the brain to building blocks for joint repair like glucosamine. As a result, SAMe has been prescribed both for depression and arthritis alike. Although less proven than glucosamine as a joint remedy, SAMe has both anti-inflammatory and joint-rebuilding effects, and shows promise as a second-rung supplement for aches and pains.

Since inflammation and the free radicals that result from it are responsible for much of the joint damage post-exercise, SAMe appears to protect joints as well as help rebuild them. Studies suggest that the supplement reduces joint degeneration and arthritis, and SAMe has been recommended for people with fibromyalgia syndrome, a disorder characterized by muscle pain, stiffness, fatigue and other symptoms. SAMe's ability to protect the liver from certain poisons is also noteworthy, and overall this supplement is worth a try in cases where glucosamine, fish oil and conventional medicine have failed to treat or prevent post-workout stiffness and soreness.

Normally, 800-1,200 mg of SAMe per day is used for achy joints and/or inflammation. Take it on an empty stomach as two or three 400 mg doses (morning and noon) with a B-complex vitamin. This will help prevent the rare side effects of dry mouth, restlessness and tummy trouble. Since SAMe is destroyed by light, buy tablets that are individually wrapped in foil or housed in an opaque (not see-through) bottle. Avoid SAMe if you're taking antidepressants or suffering from bipolar syndrome or other psychiatric disorder. SAMe is pricey, so we've included it in our joint cocktail in the "optional" section.

TMG
Also called betaine or trimethylglycine, TMG is related to SAMe in that it helps build glucosamine while also having direct anti-inflammatory effects. TMG is made from beet sugar and, along with certain vitamins, it helps detoxify drugs and poisons and helps protect the liver in a fashion similar to SAMe. TMG regenerates SAMe and may help it work, as well as reduces blood homocysteine levels along with Vitamin B6, folic acid and Vitamin B12 (homocysteine is associated with heart attacks). TMG also reduces gut damage resulting from the use of aspirin, and presumably other anti-inflammatory drugs like Motrin.

About 300-500 mg per day of betaine or TMG has often been taken in conjunction with SAMe. No side effects have been reported at the recommended doses. Don't take betaine during a urinary tract infection, as it may work against your doctor's prescribed medication for treating this condition.

General Prescription
We recommend this supplement "cocktail" for joint problems and generalized aches and pains. Allow at least three months for a noticeable benefit.

• 1,800 mg of fish oil omega-3 fatty acids (EPA plus DHA), either as 6 grams of a 30% omega-3 fish oil extract (usually with 180 mg EPA and 120 mg DHA per one capsule), as 2 grams of 92% omega-3 extract (such as Omega Brite), etc.
• 1,500 mg of glucosamine sulfate (or hydrochloride, if you can find it) as three 500 mg doses throughout the day (1,200 mg chondroitin can be used instead). Never economize on glucosamine or especially chondroitin.

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