Same
OTHER NAME(S): ademetionine, S-adenosyl-L-methionine, S-adenosylmethionine, SAMe, SAM-e
Overview
S-adenosylmethionine (SAMe) is a supplement that may be used for various reasons, including depression, osteoarthritis, and liver problems. However, its benefits for any use are not well defined. Although SAMe seems to be well tolerated, there is not enough research to know what common side effects it may cause. In very rare cases, it may increase the risk of manic episodes. Before taking SAMe, make sure to tell your health care provider about any health conditions you have or medicines you are taking.
Uses
What is S-adenosylmethionine (SAMe) used for?
S-adenosylmethionine (SAMe) is used for many reasons, but its benefits are not well defined. Some common reasons for using SAMe include the following.
- Depression
- Liver problems
- Osteoarthritis
- To improve memory and thinking skills
Note: The FDA has not reviewed SAMe for safety and effectiveness. Learn more about dietary supplements here.
How does SAMe work (mechanism of action)?
S-adenosylmethionine (SAMe) is a chemical that is naturally made by your body from an amino acid called methionine. SAMe plays an important role in making chemicals that your organs need to function. Methionine is a natural part of the diet and comes from many different foods, especially foods that contain protein. However, the SAMe found in dietary supplements is usually made in a lab.
SAMe helps your body make serotonin, norepinephrine, and dopamine, which are brain chemicals known as neurotransmitters. Some people with certain brain or mental health problems, including dementia and depression, may have low levels of SAMe. But it is not clear if taking SAMe supplements can actually increase the levels of SAMe or any other chemicals in your brain. There is very little research on taking SAMe for dementia. Although there is more research on taking it for depression, the research is mixed. Some studies show that it may help, while others show that it does not. SAMe may also interact with some of the medicines used to treat depression.
SAMe can increase the levels of glutathione, an important antioxidant in the liver. This has led to the use of SAMe to help with certain liver problems, including chronic liver disease and blocked bile flow. But research on taking SAMe for these reasons is limited, and its benefits are unclear.
Over the years, there has been interest in taking SAMe to help with pain from osteoarthritis. However, research shows that SAMe probably does not work any better than a placebo (a pill with no medicine).
How should I store SAMe?
You should store SAMe according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.
Side Effects
What are the most common side effects of SAMe?
SAMe seems to be well tolerated. But there is not enough research to know what the common side effects may be. Tell your health care provider if you have any side effects that bother you.
There may be side effects of SAMe that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of SAMe?
While less common, the most serious side effects of SAMe are described below, along with what to do if they happen.
Severe Allergic Reactions. SAMe may cause allergic reactions, which can be serious. Stop taking SAMe and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching or skin rash
- Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Extremely Elevated Mood (Mania). In rare cases, people who take SAMe have had very high moods (mania or a manic episode). This risk may be higher in people with bipolar disorder or in people who are taking certain medicines. Call your health care provider right away if you have any of the following symptoms of a manic episode.
- Very increased energy
- Significant trouble sleeping
- Racing or fast-paced thoughts
- Reckless behavior
- Unusually grand ideas
- Excessive happiness or irritability
- Talking more or faster than usual
Precautions
Who should not use SAMe?
Allergies to Ingredients. People who are allergic to any of the following should not take SAMe.
- S-adenosyl-L-methionine (SAM-e)
- S-adenosylmethionine (SAMe)
- Any of the ingredients in the specific product
Your pharmacist can tell you all of the ingredients in the specific SAMe products they stock.
What should I know about SAMe before using it?
SAMe is a dietary supplement. It cannot be marketed to treat or cure a disease.
Read and follow the directions on the specific product you are taking, or take it as recommended by your health care provider.
Keep SAMe out of the reach of children.
Some people use SAMe for depression. If you have symptoms of depression, do not try to treat these symptoms on your own. Talk to your health care provider about your treatment options. If you are already taking medicine for depression, talk to your health care provider before starting SAMe. It may interact with certain medicines for depression.
The FDA has not tested SAMe products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.
What should I tell my health care provider before using SAMe?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if SAMe is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions.Tell your health care provider if you have any of the following.
- Bipolar disorder
- Depression
- Liver problems
Other Medicines and Supplements.SAMe may interact with other medicines and supplements. Before taking SAMe, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how SAMe could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.
Breastfeeding. It is not known if SAMe passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.
Interactions
Does SAMe interact with foods or drinks?
There are no known interactions between SAMe and foods or drinks.
It is unknown if drinking alcohol will affect SAMe.
Does SAMe interact with medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are taking any of the following before taking SAMe.
- A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
- A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
- A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- Levodopa, which is a medicine for Parkinson’s disease
The interactions between SAMe and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with SAMe is incomplete. Always check with your health care provider before taking SAMe with any medicines.
Dosing
What should I do if I accidentally use too much SAMe?
If you or someone else has used too much SAMe, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
Read the product label closely, and speak with a health care provider about how to take SAMe safely. Do not take double or extra doses, even if you miss a dose.
References
- The Cochrane Database of Systematic Reviews: “S-adenosyl methionine (SAMe) for depression in adults,” “S-Adenosylmethionine for osteoarthritis of the knee or hip,” “Pharmacological interventions for treating intrahepatic cholestasis of pregnancy.”
- Journal of Alzheimer's Disease: “Effects of S-Adenosylmethionine on cognition in animals and humans: a systematic review and meta-analysis of randomized controlled trials.”
- National Center for Complementary and Integrative Health: “S-Adenosyl-L-Methionine (SAMe): In Depth.”
- Nutrients: “S-Adenosylmethionine (SAMe) for central nervous system health: a systematic review.”
- PLOS One: “S-Adenosyl-L-Methionine for the treatment of chronic liver disease: a systematic review and meta-analysis.”