S-adenosyl-L-methionine (SAMe)

Definition:

S-adenosyl-L-methionine (SAMe) is a compound found naturally in the body. SAMe helps produce and regulate hormones and maintain cell membranes.

  • A synthetic version of SAMe is available as a dietary supplement in the U.S. In some countries in Europe, SAMe is a prescription drug.
  • SAMe can be taken orally, through a muscular injection, or by IV. People generally use SAMe to treat depression, osteoarthritis, and liver disease. However, SAMe can also interact with antidepressant medications.
  • S-adenosylmethionine (SAMe) is synthesized in vivo from methionine. It functions as a methyl group donor and plays a role in folate and monoamine metabolism, as well as in membrane function and neurotransmission. SAMe has been reported to exert analgesic and anti-inflammatory effects and to stimulate the synthesis of proteoglycans by articular chondrocytes.

What the research says

  • While research has shown that SAMe has a positive effect in treating depression, most studies weren’t well designed and included a small number of people.
  • Liver disease. More studies are needed to determine whether SAMe is beneficial for people who have liver disease.
  • Many studies comparing the use of SAMe with nonsteroidal anti-inflammatory drugs showed that each provided similar pain relief and improvement in joint function, but SAMe produced fewer side effects. A smaller number of studies haven’t shown the same results.

Adverse effects

  • Oral SAMe is generally well tolerated, although occasional mild gastrointestinal side effects have occurred.
  • A few patients treated with SAMe for depression have experienced anxiety as a side effect.
  • In patients with bipolar disorder, treatment with SAMe has frequently caused a switch from depression to hypomania or mania.
  • Although methionine supplementation has been reported to increase plasma homocysteine levels, administration of 800 mg/day of SAMe for 4 weeks to healthy volunteers had no effect on homocysteine levels.

Drug interaction

  • Contraceptives, oral. Treatment with SAMe (200 mg 3 times per day) prevented the increase in the bile cholesterol saturation index and reversed abnormalities of liver function tests in women taking oral contraceptives. These findings suggest that SAMe may help prevent oral contraceptive-induced gallstones and hepatotoxicity.

Dosage and administration

  • The oral dosage of SAMe in most clinical trials has ranged from 400–1,600 mg/day.

Sources: Mayo Clinic, Nutritional Medicine Dr. Gaby

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