SAMe is a molecule that is made naturally in the body from homocysteine and folate. It can also be made in a lab and taken in supplements.
SAMe is involved in the formation, activation, and breakdown of other chemicals in the body, including hormones, proteins, and certain drugs. The body uses it to make certain chemicals that play a role in pain, depression, liver disease, and other conditions.
People most commonly take SAMe for depression and osteoarthritis. It is also used for anxiety, liver disease, fibromyalgia, schizophrenia, and many other conditions, but there is no good scientific evidence to support these uses.
SAMe has been available as a dietary supplement in the US since 1999, but it has been used as a prescription drug in Italy, Spain, and Germany for many decades.
- Osteoarthritis.  Multiple studies show that oral SAMe can decrease symptoms and improve function in patients with osteoarthritis similarly to non-steroidal anti-inflammatory drugs (NSAIDs), although with a slower onset of action.
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- Cholestasis.  Clinical research suggests that oral or intravenous SAMe is similarly effective to ursodeoxycholic acid (ursodiol) for treatment of cholestasis.
Login for details - Depression.  The available clinical research suggests that oral SAMe has a role in the treatment of depression when used as a second-line agent or in combination with conventional medications.
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- Aging. Login for details
- Alcohol-related liver disease.  It is unclear if oral or intravenous SAMe is beneficial in patients with alcohol-related liver disease.
Login for details - Alzheimer disease. Login for details
- Antidepressant-induced sexual dysfunction.  Oral SAMe might improve sexual dysfunction in males taking antidepressants.
Login for details - Attention deficit-hyperactivity disorder (ADHD).  It is unclear whether oral SAMe is beneficial in patients with ADHD.
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- Cancer-related fatigue.  It is unclear if oral SAMe is beneficial in patients with cancer-related fatigue.
Login for details - Chronic fatigue syndrome (CFS). Login for details
- Cirrhosis.  It is unclear whether oral or intravenous SAMe is beneficial in patients with cirrhosis.
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- Fibromyalgia.  Limited evidence shows that oral or intramuscular SAMe might modestly improve some symptoms of fibromyalgia.
Login for details - Gilbert syndrome.  It is unclear if oral SAMe is beneficial in patients with this condition.
Login for details - Hepatitis C.  It is unclear if oral SAMe is beneficial in patients with hepatitis C.
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- Menopausal symptoms.  It is unclear if oral SAMe is beneficial for menopausal hot flashes.
Login for details - Migraine headache. Login for details
- Multiple sclerosis (MS). Login for details
- Premenstrual syndrome (PMS). Login for details
- Schizophrenia.  It is unclear if oral SAMe is beneficial in patients with schizophrenia.
Login for details - Smoking cessation.  A small clinical study suggests that oral SAMe does not improve abstinence rates in cigarette smokers.
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When taken by mouth: SAMe is likely safe. Side effects might include gas, diarrhea, constipation, dry mouth, headache, and nervousness, especially at higher doses.
Special Precautions & Warnings:
Pregnancy and breast-feeding: There isn't enough reliable information to know if SAMe is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.Bipolar disorder: SAMe can cause people with bipolar disorder to enter a manic state. If you have bipolar disorder, don't use SAMe.
Inherited disorder called Lesch-Nyhan syndrome: SAMe might make symptoms of Lesch-Nyhan syndrome worse.
Parkinson disease: There is some concern that SAMe might make symptoms of Parkinson disease worse.
Surgery: SAMe might affect the central nervous system. This could interfere with surgery. Stop taking SAMe at least 2 weeks before a scheduled surgery.
Levodopa
Interaction Rating=Moderate Be cautious with this combination.
Levodopa is used for Parkinson disease. SAMe can change levodopa in the body and decrease its effects. Taking SAMe along with levodopa might make Parkinson disease symptoms worse. Do not take SAMe if you are taking levodopa.
Serotonergic drugs
Interaction Rating=Moderate Be cautious with this combination.
SAMe might increase a brain chemical called serotonin. Some medications also have this effect. Taking SAMe along with these medications might increase serotonin too much. This might cause serious side effects including heart problems, seizures, and vomiting.
Herbs and supplements with serotonergic properties: SAMe increases a brain chemical called serotonin. Taking it along with other supplements that have this effect might cause serious side effects, including heart problems, seizures, and vomiting. Examples of supplements with this effect include 5-HTP, black seed, L-tryptophan, and St. John's wort.
SAMe should be taken on an empty stomach, either 30-60 minutes before a meal or two hours after a meal.
SAMe has most often been used by adults in doses of 400-1600 mg by mouth daily for up to 12 weeks. Speak with a healthcare provider to find out what dose might be best for a specific condition.
Ademetionine, Adenosylmethionine, Adénosylméthionine, AdoMet, S-Adenosyl Methionine, S-Adénosyl Méthionine, S-Adenosyl-L-Methionine, S-Adénosyl-L-Méthionine, S-Adenosylmethionine, S-Adénosylméthionine, S-Adenosylmethionine Butanedisulfonate, S-Adenosylmethionine Tosylate, S-Adenosylmethionine Tosylate Disulfate, SAM, SAM-e, Sammy, Samyr.
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