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SAM-e (S-adenosylmethionine, SAMe)

Reviewed by Melinda Ratini, DO, MS on March 26, 2021
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SAM-e is a compound that's made naturally in the body and plays an important role in normal bodily function. A synthesized form of SAM-e is considered a supplement in the U.S., but SAM-e has been sold as a prescription drug in parts of Europe for decades. Its scientific name is S-adenosylmethionine. SAM-e is also known as ademetionine and SAMe.

Why do people take SAM-e?

SAM-e has some evidence as a treatment for osteoarthritis pain. Some studies have found that oral SAM-e is as effective as NSAID painkillers, such as ibuprofen and Celebrex. SAM-e takes longer to act than drugs do, but it also has fewer side effects than NSAIDs.

SAM-e has also been used to treat depression for many years. Some studies have found that SAM-e might work as well as tricyclic antidepressants in relieving symptoms. However, many of these studies were flawed or too small to be conclusive.

Other uses of SAM-e have not been studied as thoroughly. There's some evidence that SAM-e might help ease the pain of fibromyalgia and spinal cord damage caused by HIV. SAM-e may also help control cholestasis -- a buildup of bile in the liver -- particularly in pregnant women during the third trimester. One trial suggested that SAM-e might be helpful for adults with ADHD. However, more research needs to be done.

Some people use SAM-e as a treatment for other conditions, such as liver disease, Alzheimer's disease, pain, migraine, and bursitis. We don't know the potential risks or benefits of these uses.

How much SAM-e should you take?

There is no established ideal dose of SAM-e. For depression, many studies have started patients at 400 to 600 milligrams daily. For osteoarthritis, 600-1,200 milligrams daily of SAM-e divided into three doses is common. Ask your doctor for advice. Sometimes, the dose of SAM-e is increased gradually over a few weeks. This can help reduce side effects such as restlessness or anxiety.

Can you get SAM-e naturally from foods?

There are no food sources of SAM-e.

What are the risks of taking SAM-e?

  • Side effects. SAM-e seems to be a relatively safe drug. High doses of oral SAM-e can cause symptoms like gas, upset stomach, diarrhea, constipation, dry mouth, headache, dizziness, anxiety, and skin rashes. SAM-e can also trigger an allergic reaction in some people.
  • Risks. If you have any medical issues, check with a doctor before you start using SAM-e supplements. SAM-e might not be safe for people with conditions such as bipolar disorder, Parkinson's disease, and diabetes. Because SAM-e can affect the blood vessels, stop using SAM-e two weeks before getting surgery.
  • Interactions. If you take any medicines regularly, talk to your doctor before you start using SAM-e supplements. SAM-e could be dangerous when combined with antidepressants or supplements that treat depression, like St. John's wort. SAM-e could also interact with some prescription painkillers, cough medicines, and treatments for diabetes and Parkinson's disease. Patients taking MAOIs should not use SAM-e without discussing it with their doctor.

Given the lack of evidence about safety, SAM-e is not recommended for children or for women who are breastfeeding. Although SAM-e has been studied as a treatment for liver problems during pregnancy, pregnant women should only use SAM-e if a doctor recommends it.

Show Sources

SOURCES:

Fundukian, L., ed. The Gale Encyclopedia of Alternative Medicine, third edition, 2009.

Memorial Sloan-Kettering Cancer Center web site: “About Herbs: SAM-e.”

Agency for Healthcare Research and Quality web site: "S-Adenosyl-L-Methionine for Treatment of Depression, Osteoarthritis, and Liver Disease."

Natural Medicines Comprehensive Database web site: “SAMe.”

Natural Standard Patient Monograph: “SAMe.”

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