S-adenosylmethionine

Ademetionine; SAMe

S-Adenosylmethionine (SAMe) is a naturally-occurring compound found in almost every tissue and fluid in the body. It is involved in many important processes. SAMe plays a role in the immune system, maintains cell membranes, and helps produce and break down brain chemicals, such as serotonin, melatonin, and dopamine. It works with vitamin B12 and folate (vitamin B9). Being deficient in either vitamin B12 or folate may reduce levels of SAMe in your body.

Several studies show that SAMe helps relieve the pain of osteoarthritis. Other studies suggest that SAMe may help treat depression. Researchers have also examined SAMe's use in the treatment of fibromyalgia and liver disease with mixed results. Many of the early studies used SAMe given intravenously or as an injection. Only recently have researchers been able to look at the effects of SAMe taken by mouth.

Depression

Some research suggests that SAMe is more effective than placebo in treating mild-to-moderate depression and is just as effective as antidepressant medications without the side effects (headaches, sleeplessness, and sexual dysfunction). In addition, antidepressants tend to take 6 to 8 weeks to begin working, while SAMe seems to begin more quickly. Researchers are not sure how SAMe works to relieve depression. But they speculate it might increase the amount of serotonin in the brain just as some antidepressants do.

Many studies have examined injectable forms of SAMe, not oral supplements. More research is needed to determine whether SAMe works for depression. Because serious depression is a dangerous illness, you should seek help from your doctor before taking SAMe or any supplement.

Osteoarthritis

A number of well-designed studies show that SAMe may reduce pain and inflammation in the joints, and researchers think it may promote cartilage repair. In several short-term studies (ranging from 4 to 12 weeks), SAMe supplements were as effective as nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen and naproxen) in adults with knee, hip, or spine osteoarthritis, in lessening morning stiffness, reducing pain and swelling, improving range of motion, and increasing walking pace. Several studies also suggest that SAMe has fewer side effects than NSAIDs. Another study compared SAMe to celecoxib (Celebrex), a type of NSAID called a COX-2 inhibitor, and found that over time SAMe was as effective as celecoxib in relieving pain. Other studies show no differences in pain relief or tolerability between treatment with SAMe or habumetone over 8 weeks in people with knee osteoporosis.

Fibromyalgia

SAMe can be effective in reducing symptoms of fibromyalgia, including pain, fatigue, morning stiffness, and depressed mood. But most studies used an injectable form of SAMe. Among studies that examined doses of SAMe by mouth, some found it was effective at reducing these symptoms while others found no benefit.

Liver disease

People with liver disease often cannot synthesize SAMe in their bodies. Preliminary studies suggest that taking SAMe may help treat chronic liver disease caused by medications or alcoholism. A study of 123 men and women with alcoholic liver cirrhosis (liver failure) found that SAMe treatment for 2 years improved survival rates and delayed the need for liver transplants better than placebo. Other studies show that SAMe may help normalize levels of liver enzymes in people with liver disease. Studies in mice show that SAMe protects against and can also reverse liver damage. However, these studies have been small and of short duration. Larger and longer studies are needed to confirm these findings.

Dementia

Preliminary evidence suggests that SAMe may improve cognitive symptoms, such as the ability to recall information and remember words. Researchers suspect SAMe acts on regions of the brain that regulate gene expression of amyloid proteins, one of the hallmarks of Alzheimer disease.

Other

Some studies suggest SAMe can effectively inhibit cancer tumor cells. Other studies suggest that taking the drug levodopa (L-dopa) for Parkinson disease may lower the levels of SAMe in the body, which may contribute to depression and increase the side effects of L-dopa. However, researchers have also found evidence that taking SAMe may make L-dopa less effective. If you have Parkinson disease, do not take SAMe without talking to your doctor first.

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Supporting Research