Dear Dr. Roach: Please tell me about the supplement SAMe. I am a woman, 58, who suffers from osteoarthritis from my exercise routine, which is heavy lifting of free weights over three days and 15 miles of jogging each week. I love the workouts, but not the pain it causes in my hands, knees and back.
K.Z.
S-adenosyl methionine, usually referred to as SAMe, is a naturally occurring substance found in the body. It has been used as a supplement in people with depression and those with osteoarthritis. It appears to have effectiveness in both cases. I seldom recommend supplements, but SAMe is one of the few that has good data backing it up. In a meta-analysis of 11 trials, SAMe was found to be about as effective at improving function and pain as ibuprofen-like drugs but with fewer adverse effects. It may take two full months to reach peak effectiveness, based on a 2004 study. This supplement is generally considered safe, but it is always best to speak with your doctor before taking any supplement.
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Dear Dr. Roach: I was admitted to the hospital for aseptic meningitis. I am being treated with Arimidex for a history of ovarian cancer. Could this medication be affecting my immune system?
S.R.
Meningitis is an inflammation of the lining of the brain. There are several different kinds, although we usually think of bacterial meningitis, one of the most serious and immediately life-threatening infectious emergencies.
鈥淎septic鈥� in this context means nonbacterial. Viral infection is the most common cause. Many viruses can cause meningitis, but we especially look for the herpes family of viruses, partially because there is a specific treatment, but also because it can be complicated by encephalitis, inflammation of the brain. Like all meningitis, the primary means of diagnosis is a lumbar puncture, also called a spinal tap. The exact results help guide the clinician to the correct diagnosis. Most cases of viral meningitis go away by themselves.
Arimidex (anastrazole) is an aromatase inhibitor, which prevents the body from making estrogens. I could not find any reports of this medicine causing aseptic meningitis and it does not adversely affect the immune system. There are medicines that can cause aseptic meningitis, the most common of which are ibuprofen and sulfa antibiotics.
In anyone with a history of cancer, I worry about cancer cells getting into the spinal fluid, a condition called carcinomatous meningitis, though this would be rare for ovarian cancers.
