SAM-e is a compound that is made naturally in your body and plays an important role in normal bodily function.
“Our body generates it constantly, every day, every second,” says Mikhail Kogan, MD, a chief medical officer of the GW Center for Integrative Medicine in Washington, D.C.
SAM-e helps with a process called methylation, which happens throughout your body. Methylation helps make neurotransmitters, which are the chemical “messengers” that allow your nerve cells to communicate with each other and with other cells.
A lab-made form of SAM-e is sold as a supplement in the U.S., but SAM-e has been sold as a prescription drug in parts of Europe for decades. Its scientific name is S-adenosylmethionine. SAM-e is also known as ademetionine and SAMe.
If your body isn’t doing enough methylation, taking SAM-e can help boost it.
Why Do People Take SAM-e?
People take SAM-e for conditions such as osteoarthritis and depression. But studies haven’t proven that SAM-e helps with these conditions. The SAM-e your body makes does play a role in your ability to recognize and manage your emotions. Some research shows taking it as a drug or supplement could help with inflammation.
SAM-e supplements might be appealing if you want an alternative to traditional medications.
“It might be that people want something that feels a little bit more natural, a little gentler,” says Greta Kuphal, MD, director of the Osher Center for Integrative Health at the University of Wisconsin-Madison. “People may feel more comfortable starting with a trial of a supplement like SAM-e that the body makes naturally, rather than jumping to a pharmaceutical that changes their chemistry a bit more.”
Osteoarthritis pain relief
There’s some scientific evidence for SAM-e as a treatment for osteoarthritis pain. Some studies on people with knee or hip osteoarthritis found that oral SAM-e was as effective as nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib (Celebrex, Elyxyb) and ibuprofen ,in easing joint pain and improving movement. SAM-e takes longer to act than drugs, but it also has fewer side effects than NSAIDs.
SAM-e may help treat osteoarthritis because of its anti-inflammatory properties. “It seems to decrease the activity of some chemicals in the body that contribute to inflammation and pain,” Kuphal says.
The idea to use SAM-e for osteoarthritis came from studies that focused on treating depression with this supplement. In those studies, some participants who also had osteoarthritis said their joint symptoms got better when taking it.
Depression management
If you have depression, you may have low levels of SAM-e in your body. Researchers think SAM-e supports and boosts some of the same signaling chemicals, called neurotransmitters, that antidepressants work on, such as serotonin, norepinephrine, and dopamine.
Many studies have found some evidence that it can help treat depression, but most of the studies were small and lasted only a few weeks. Some studies were of low quality, and some used injected SAM-e instead of the kind you’d take by mouth.
One review study found that SAM-e is probably effective in treating depression, but it’s not clear how it compares to antidepressants. While some people take SAM-e with antidepressants, this review didn’t find clear proof that taking them together helps.
We need more research into how well SAM-e can treat depression.
Other uses for SAM-e
Some people use SAM-e as a treatment for other conditions, but there is limited research to support these uses.
People with liver disease sometimes have low levels of SAM-e in their bodies, and there are studies on whether SAM-e can help treat liver diseases. For example, researchers have looked at whether this supplement can help control intrahepatic cholestasis (a buildup of bile in the liver) during pregnancy. But research has shown mixed results.
Some people use SAM-e supplements for other conditions such as Alzheimer’s disease, fibromyalgia, migraine, bursitis, and attention deficit hyperactivity disorder (ADHD). But we need more research on the potential risks and benefits of these uses.
SAM-e, by itself, is unlikely to be an effective treatment for any of these conditions. “It has to be a part of the whole package of care,” says Kogan, an associate professor of medicine at the George Washington University School of Medicine & Health Sciences. This might include other treatments as well as lifestyle modifications, such as diet and exercise.
How Much SAM-e Should You Take?
There’s no set ideal dose of SAM-e. For depression, many study participants have started at 400-600 milligrams daily. For osteoarthritis, 600-1,200 milligrams of SAM-e daily, divided into three doses, is common. Ask your doctor for advice. Sometimes, the dose of SAM-e is raised gradually over a few weeks. This can help lessen side effects such as restlessness or anxiety.
What Are the Risks of Taking SAM-e?
SAM-e seems to be a relatively safe drug. Still, there isn’t much evidence of its long-term safety because most studies have been pretty short.
SAM-e side effects
If you’re taking SAM-e, the side effects will probably be pretty minor. Common side effects include:
- Upset stomach
- Diarrhea
- Constipation
- Dry mouth
- Headache
- Dizziness
- Anxiety
- Sweating
- Gas
- Feeling irritable
- Trouble falling asleep
SAM-e can also trigger an allergic reaction in some people.
If you take too much SAM-e, a common side effect is feeling overstimulated. You might feel jittery.
Because the side effects of SAM-e are usually mild, people may think it’s fine to take them without consulting a health care professional. But it’s important to talk to your doctor before taking SAM-e, in part to make sure you take the right dose. That’s especially true if you take any medicines or other supplements.
SAM-e interactions
SAM-e could be dangerous when combined with antidepressants or supplements that treat depression, such as St. John’s wort.
SAM-e could also interact with some cough medicines, prescription painkillers, treatments for diabetes and Parkinson’s disease, and monoamine oxidase inhibitors (MAOIs). If you’re taking any of these medications, don’t take SAM-e without your doctor’s approval.
Other things to keep in mind
Using SAM-e supplements might not be safe if you have certain health conditions. If you have bipolar disorder, SAM-e might make mania worse. If you have a history of bipolar disorder, hypomania, or depression and you notice symptoms like sleeplessness, extra agitation, racing thoughts, or behaviors that aren’t typical for you, stop the supplement and let your doctor know right away. Given the lack of evidence about safety, SAM-e isn’t recommended while you’re nursing. It’s also not recommended for kids. Although SAM-e has been studied as a treatment for liver problems during pregnancy, don’t use it while you’re pregnant unless your doctor recommends it.
If you’re going to take SAM-e, check to make sure the supplement you’re buying is of good quality. One way to do that is to look on the label for a US Pharmacopeia (USP) or Good Manufacturing Practice (GMP) symbol, which shows the product has been checked for at least some markers of quality, Kuphal says.
Takeaways
SAM-e is a substance that your body makes naturally. It plays a role in normal body function and mood regulation. People take SAM-e supplements for conditions such as depression and osteoarthritis. But we need more research to tell for sure how effective SAM-e is at treating these conditions. The side effects of SAM-e are usually minor. Still, it’s important to check with your doctor before taking it. It can cause problems if you have certain health conditions or if you already take other supplements or drugs.
SAM-e FAQs
Here are some commonly asked questions about SAM-e.
Does SAM-e cause hair loss?
No, SAM-e is unlikely to cause hair loss.
What does SAM-e do to the brain?
SAM-e supports neurotransmitters, such as serotonin. These are chemicals that carry messages between your nervous system and the rest of your body.
Can you take SAM-e every day?
When taking SAM-e, you should follow your doctor’s directions. Usually, this means taking the supplement every day, in a dose that ranges from 400-1,200 milligrams daily. But keep in mind, researchers don’t have enough information to say for sure how much SAM-e is safe to take.
How quickly does SAM-e start working?
It may take a few weeks of taking SAM-e to notice a difference.
Who shouldn’t take SAM-e?
Don’t take SAM-e if you’re nursing. This supplement may also cause problems if you have bipolar disorder or other health conditions. It’s important to check with your doctor before taking it.
Does SAM-e improve energy?
SAM-e may boost your energy. For example, when SAM-e works well for depression, people notice having more energy, Kuphal says. That energy can feel productive and good at times, but for some, it may feel like anxiety and agitation.
Can you get SAM-e naturally from foods?
There are no food sources of SAM-e.
Does SAM-e cause weight gain?
No, SAM-e isn’t thought to cause weight gain.
