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SAMe

Uses

S-adenosyl-l-methionine (SAMe) is an important biological agent in the human body, participating in over 40 essential biochemical reactions.

What Are Star Ratings?

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Liver Cirrhosis
1,200 mg daily
Taking SAMe may improve liver function, bile flow, and survival.

Large amounts of (S-adenosylmethionine) may improve survival and liver function in alcoholic liver cirrhosis. A double-blind trial found that 1,200 mg of SAMe per day for two years significantly decreased the overall death rate and the need for liver transplantation in people with alcoholic liver cirrhosis, particularly in those with less advanced liver disease. Preliminary trials suggest that lower amounts of SAMe (180 mg per day in one trial and 800 mg per day in another) may improve liver function in people with liver cirrhosis. SAMe supplementation has been shown to reverse the depletion of glutathione, an important antioxidant required for liver function.It has also been shown to aid in the resolution of blocked bile flow (cholestasis), a common complication of liver cirrhosis.

3 Stars
Osteoarthritis
1200 mg daily
SAMe has anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints and reduce osteoarthritis symptoms.

(S-adenosyl methionine) possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints, though the primary way in which SAMe reduces osteoarthritis symptoms is not known. A very large, though uncontrolled, trial (meaning that there was no comparison with placebo) demonstrated “very good” or “good” clinical effect of SAMe in 71% of over 20,000 osteoarthritis sufferers. In addition to this preliminary research, many double-blind trials have shown that SAMe reduces pain, stiffness, and swelling better than placebo and equal to drugs such as ibuprofen and naproxen in people with osteoarthritis. These double-blind trials all used 1,200 mg of SAMe per day.

Lower amounts of oral SAMe have also produced reductions in the severity of osteoarthritis symptoms in preliminary clinical trials. A two-year, uncontrolled trial showed significant improvement of symptoms after two weeks at 600 mg SAMe daily, followed by 400 mg daily thereafter. This amount was also used in a double-blind trial, but participants first received five days of intravenous SAMe. A review of the clinical trials on SAMe concluded that its efficacy against osteoarthritis was similar to that of conventional drugs but that patients tolerated it better.

2 Stars
Depression
1,600 mg daily
SAMe appears to raise levels of dopamine, an important neurotransmitter in mood regulation.

(S-adenosyl methionine) is a substance synthesized in the body that has recently been made available as a supplement. SAMe appears to raise levels of dopamine, an important neurotransmitter in mood regulation. Higher SAMe levels in the brain are associated with successful drug treatment of depression, and oral SAMe has been demonstrated to be an effective treatment for depression in most, but not all, clinical trials. SAMe has been found to be effective both when used by itself and when used as add-on treatment to antidepressant medication. Most trials used 1,600 mg of SAMe per day. While it does not seem to be as powerful as full applications of antidepressant medications or St. John’s wort, SAMe’s effects are felt more rapidly, often within one week.

2 Stars
Fibromyalgia
800 mg daily
Supplementing with SAMe may increase serotonin levels in the blood and help relieve symptoms.

Intravenous (S-adenosylmethionine) given to people with fibromyalgia reduced pain and depression in two double-blind trials; but no benefit was seen in a short (ten-day) trial. Oral SAMe (800 mg per day for six weeks) was tested in one double-blind trial and significant beneficial effects were seen, such as reduced pain, fatigue, and stiffness, and improved mood.

2 Stars
Hepatitis and Cholestasis
1,600 mg daily
Supplementing with SAMe may help resolve blocked bile flow.

(S-adenosylmethionine) (1,600 mg/day orally or 800 mg/day intravenously) has been shown to aid in the resolution of blocked bile flow (cholestasis), a common complication of chronic hepatitis.

2 Stars
Pregnancy and Postpartum Support and Cholestasis
Refer to label instructions
SAMe (S-adenosylmethionine) supplementation has been shown to aid in the resolution of blocked bile flow (cholestasis), an occasional complication of pregnancy.1, 2
SAMe (S-adenosylmethionine) supplementation has been shown to aid in the resolution of blocked bile flow (cholestasis), an occasional complication of pregnancy.
1 Star
Bipolar Disorder
Refer to label instructions
SAMe is an amino acid that has an impact on serotonin levels, it has shown significant antidepressant effects in clinical trials.

(S-adenosylmethionine) is another amino acid that has an impact on serotonin levels, and it has demonstrated significant antidepressant effects in clinical trials. In both controlled and preliminary studies, SAMe has been shown to be helpful for the depressive symptoms of bipolar disorder. However, some patients have switched from depression to mania while using SAMe at 500 to 1,600 mg daily. This is a known side effect of other antidepressant medications. The mania induced by SAMe resolved when the supplement was discontinued, and in one case resolved spontaneously while the patient continued taking SAMe. Therefore, people with bipolar disorder should supplement with SAMe only under the supervision of a qualified healthcare practitioner.

1 Star
Male Infertility
Refer to label instructions
Preliminary research suggests that oral SAMe may also increase sperm activity in infertile men.

Preliminary research suggests that oral (S-adenosyl-L-methionine), in amounts of 800 mg per day, may also increase sperm activity in infertile men.

1 Star
Migraine Headache
Refer to label instructions
Preliminary research suggests that supplementing with SAMe may reduce symptoms for some migraine sufferers.

Preliminary research also suggests that oral supplements of (S-adenosyl-L-methionine) may reduce symptoms for some migraine sufferers.

How It Works

How to Use It

Healthy people do not need to take this supplement. Researchers working with people suffering from a variety of conditions have been using these amounts of SAMe: depression, 1,600 mg per day; osteoarthritis, 800–1,200 mg per day; fibromyalgia, 800 mg per day; liver disorders, 1,200 mg per day; and migraine, 800 mg per day.

Where to Find It

SAMe is not abundant in the diet, though its precursor, the amino acidmethionine is plentiful in many protein foods. It is not known whether increasing one’s intake of methionine will increase the body’s production of SAMe. Supplements of SAMe have been available in the U.S. since 1997.

Possible Deficiencies

SAMe is normally produced in the liver from the amino acidmethionine which is abundant in most diets. Folic acid and vitamin B12 are necessary for the synthesis of SAMe, and deficiencies of these vitamins results in low concentrations of SAMe in the central nervous system.3 Low blood or central nervous system levels of SAMe have been detected in people with cirrhosis of the liver,4coronary heart disease,5Alzheimer’s disease, and depression.6

Interactions

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • Amoxapine

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • Amitriptyline

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Clomipramine

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Desipramine

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Doxepin

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Imipramine

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Nortriptyline

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Protriptyline

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

  • Trimipramine

    SAMe may improve the clinical response to imipramine (Tofranil®). In a double-blind trial, depressive symptoms decreased earlier in the people who received SAMe injections (200 mg per day) in combination with imipramine than in those who received imipramine with placebo injections. Oral supplementation with SAMe has demonstrated antidepressant activity, independent of its combination with imipramine.

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Clinical trials in thousands of people for up to two years have demonstrated that SAMe is very well tolerated, much better than the medications with which it has often been compared.7, 8 Occasional gastrointestinal upset may be experienced by some people. Researchers treating people with bipolar disorder (manic depression) have reported that SAMe could cause them to switch from depression to a manic episode.9, 10

References

1. Frezza M, Surrenti C, Manzillo G, et al. Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study. Gastroenterology 1990;99:211-5.

2. Frezza M, Centini G, Cammareri G, et al. S-adenosylmethionine for the treatment of intrahepatic cholestasis of pregnancy. Results of a controlled clinical trial. Hepatogastroenterology 1990;37 Suppl 2:122-5.

3. Bottiglieri T, Hyland K, Reynolds EH. The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 1994;48:137-52 [review].

4. Osman E, Owen JS, Burroughs AK. S-adenosyl-L-methionine-a new therapeutic agent in liver disease? Aliment Pharmacol Ther 1993;7:21-8 [review].

5. Loehrer FM, Angst CP, Haefeli WE, et al. Low whole-blood S-adenosylmethionine and correlation between 5-methyltetrahydrofolate and homocysteine in coronary artery disease. Arterioscler Thromb Vasc Biol 1996;16:727-33.

6. Bottiglieri T, Godfrey P, Flynn T, et al. Cerebrospinal fluid S-adenosylmethionine in depression and dementia: effects of treatment with parenteral and oral S-adenosylmethionine. J Neurol Neurosurg Psychiatry 1990;53:1096-8.

7. Bressa GM. S-adenosyl-l-methionine (SAMe) as antidepressant: Meta-analysis of clinical studies. Acta Neurol Scand 1994;154(suppl):7-14.

8. Di Padova C. S-adenosylmethionine in the treatment of osteoarthritis. Review of the clinical studies. Am J Med 1987;83:60-5 [review].

9. Carney MWP, Chary TKN, Bottiglieri T, Reynolds EH. The switch mechanism and bipolar/unipolar dichotomy. Br J Psychiatry 1989;154:48-51.

10. Carney MWP, Chary TK, Bottiglieri T, et al. Switch and S-adenosyl-methionine. Alabama J Med Sci 1988;25:316-9.

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