S-Adenosylmethionine (SAMe) is synthesized in the body from methionine. As a methyl- group donor, it plays a role in folate and monoamine metabolism, as well as in membrane function and neurotransmission. SAMe has been known to have analgesic and anti-inflammatory effects and to stimulate the synthesis of proteoglycans by articular chondrocytes. SAMe is required in the production of dopamine, norepinephrine and serotonin.
The following is a list of the primary uses for SAMe:
- Cirrhosis: SAMe therapy has been found to benefit liver function of patients with cirrhosis, particularly those suffering greater ischemia reperfusion injury
- Depression: Studies have found that taking SAMe orally significantly improves symptoms of major depression. It has also been recognized as a an effective option and potential alternative to conventional antidepressants for mild to moderate depression.
- Fibromyalgia: Other studies have found that by improving the depressive state and reducing the number of trigger points, SAMe proves to be an effective and safe therapy in the management of fibromyalgia 
- Osteoarthritis: A number of clinical trials have found that taking SAMe orally is comparable to NSAIDs, for decreasing symptoms associated with osteoarthritis.
- Chronic Fatigue Syndrome: As Chronic fatigue syndrome is frequently associated with symptoms of depression, studies have found SAMe to be useful as an antidepressant in the treatment of this disorder.
- Pruritis: SAMe has also been found to improve symptoms of pruritis, particularly associated with intrahepatic cholestasis
The recommended dosages have not yet been established. To determine what your specific requirements are talk to your naturopathic doctor or other trained medical professional.
- Oral dosage of SAMe in most clinical trials has ranged from 400-1,600 mg/day
- Osteoarthritis: oral dose of 200mg three times daily
- Cirrhosis: oral dose of 1200, 1600 mg/day for up to 24 months
- Fibromyalgia: oral dose of 800 mg/day
The safety precautions of SAMe include:
- Occasional mild gastrointestinal side effects
- Anxiety as a side effect
- In patients with bipolar disorder, SAMe treatment has often caused a switch from depression to hypomania or mania
- Supportive or Beneficial:
- Treatment with SAMe of 200mg, three times per day, was found to prevent the increase in the bile cholesterol saturation index and reversed abnormalities of liver function tests in women taking oral contraceptives. This suggests that SAMe may help prevent oral contraceptive-induced gallstones and hepatotoxicity
- Gaby, Alan R. (2011)Nutritional Medicine, Fritz Perlberg Publishing, Concord, NH
- Su, Z.R., Cui, Z.L., Ma, J.L., Li, J.S., Ge, Y.S., Yu, J.H., Pan, J.H., Xu, G.L., Jia, W.D.(2013)Beneficial effects of S-adenosyl-L-methionine on post-hepatectomy residual liver function: a prospective, randomized, controlled clinical trial,Hepatogastroenterology;60(125):1136-41.
- SAMe Monograph: Natural Medicines Comprehensive Database, Retrieved February 6, 2014, from http://ezproxy.ccnm.edu:2076/nd/Search.aspx cs=&s=ND&pt=100&id=786&ds=&name=SAMe&searchid=45027006
- Tavoni, A., Vitali, C., Bombardieri, S., Pasero, G. (1987)Evaluation of S-adenosylmethionine in primary fibromyalgia. A double-blind crossover study,The American Journal of Medicine;83(5A):107-10.
- Goodnick, P.J., Sandoval, R.(1993)Psychotropic treatment of chronic fatigue syndrome and related disorders,The Journal of Clinical Psychiatry;54(1):13-20
- Frezza, M., Surrenti, C., Manzillo, G., Fiaccadori, F., Bortolini, M., Di Padova, C.(1990)Oral S-adenosylmethionine in the symptomatic treatment of intrahepatic cholestasis. A double-blind, placebo-controlled study,Gastroenterology;99(1):211-215