S-adenosyl-l-methionine (SAMe) is an important biological agent in the human body, participating in over 40 essential biochemical reactions.
Where is it found?
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.
SAMe has been used in connection with the following conditions (refer to the individual health concern for complete information):
| Science Rating | Health Concerns |
|---|---|
 | Liver cirrhosis Osteoarthritis |
 | Depression Fibromyalgia Hepatitis (for liver cholestasis) Pregnancy and postpartum support (for cholestasis only) |
 | Bipolar disorder Infertility (male) Migraine headaches Post-concussion syndrome |
| Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit. | |
Who is likely to be deficient?
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.1 Low blood or central nervous system levels of SAMe have been detected in people with cirrhosis of the liver,2 coronary heart disease,3 Alzheimer’s disease, and depression.4
How much is usually taken?
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.
Are there any side effects or interactions?
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.5 6 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.7 8
Are there any drug interactions?
Certain medicines may interact with SAMe. Refer to drug interactions for a list of those medicines.
References
1. Bottiglieri T, Hyland K, Reynolds EH. The clinical potential of ademetionine (S-adenosylmethionine) in neurological disorders. Drugs 1994;48:137–52 [review].
2. 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].
3. 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.
4. 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.
5. Bressa GM. S-adenosyl-l-methionine (SAMe) as antidepressant: meta-analysis of clinical studies. Acta Neurol Scand 1994;154(suppl):7–14.
6. Di Padova C. S-adenosyl-methionine in the treatment of osteoarthritis: review of the clinical studies. Am J Med 1987;83(suppl 5A):60–4.
7. Carney MWP, Chary TK, Bottiglieri T, et al. The switch mechanism and the bipolar/unipolar dichotomy. Br J Psychiatry 1989;154:48–51.
8. 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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2006-09-07
