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What does same do?

S-adenosyl-l-methionine (SAMe) is an important biological agent in the human body, participating in over 40 essential biochemical reactions.

SAMe participates in detoxification reactions and in the manufacture of brain chemicals, antioxidants, joint tissue structures, and many other important components.1 2

SAMe appears to raise levels of dopamine, an important neurotransmitter in mood regulation,3 and higher SAMe levels in the brain are associated with successful drug treatment of depression.4 Oral SAMe has been demonstrated to be an effective treatment for depression in some,5 6 7 8 though not all,9 double-blind studies. While it does not seem to be as powerful as full amounts of antidepressant medications10 or St. John’s wort, its effects are felt more rapidly, often within one week.11

SAMe possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints.12 13 Several double-blind studies have shown that SAMe is useful for people with osteoarthritis, reducing pain, stiffness, and swelling better than placebos and equal to drugs such as ibuprofen and naproxen.14 15 16 17 18 19 20 21

Intravenous SAMe given to fibromyalgia patients reduced pain and depression in two double-blind studies,22 23 but in a short (ten-day) trial no benefit was seen.24 Oral SAMe was tested in one double-blind study and significant beneficial effects were noticed, such as reduced pain, fatigue, and stiffness, and improved mood.25

Oral and intravenous treatment with SAMe replenishes important substances in damaged livers and improves the flow of bile.26 27 Preliminary research has indicated that SAMe may be helpful in a variety of liver conditions, including cholestasis, Gilbert’s syndrome, alcoholic liver injury, and cirrhosis.28 29 30 In alcoholic cirrhosis, damage to the liver prevents the natural formation of SAMe from the amino acid methionine. In a double-blind trial, people with cirrhosis of the liver due to alcoholism who took SAMe for two years had a 47% lower rate of death or need for liver transplantation, compared with those who received a placebo.31 However, the improvement did not quite achieve statistical significance. In people with less severe cirrhosis, the results were more impressive and were also statistically significant.

Preliminary research also suggests oral SAMe may increase sperm activity in infertile men32 and may be helpful in the treatment of migraine headaches.33 One double-blind study found injections of SAMe significantly more helpful than placebo injections for reducing the symptoms of post-concussion syndrome.34

Where is same 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):


Rating Health Concerns
Liver cirrhosis


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 of same?

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.35 Low blood or central nervous system levels of SAMe have been detected in people with cirrhosis of the liver,36 coronary heart disease,37 Alzheimer’s disease, and depression.38

How much same 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 with same?

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.39 40 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.41 42

Are there any drug interactions?

Certain medicines may interact with SAMe. Refer to drug interactions for a list of those medicines.