S Adenosyl L Methionine Same
How much do we know about SAMe?
Research
has evaluated several potential uses of SAMe, and a substantial number
of studies on depression and liver diseases have been completed.
However, some of the studies used injected SAMe, which may not have the
same effects as SAMe taken as a
dietary
supplement.
What do we know about the effectiveness of SAMe?
SAMe
has been studied primarily for depression, osteoarthritis, and liver
diseases. Although there are hints that it might be helpful for these
conditions, the evidence is not conclusive.
What do we know about the safety of SAMe?
-Data on the long-term safety of SAMe and its safety for use during
pregnancy are too limited to draw any conclusions.
-SAMe may not be safe for people with bipolar disorder.
-SAMe may interact with some medicines or other
dietary supplements.
-There’s theoretical reason to believe that taking SAMe may promote
Pneumocystis infection
in people who are immunocompromised, such as those who
are HIV-positive.
What Is SAMe?
S-Adenosyl-L-methionine
(also called S-adenosyl methionine, S-adenosylmethionine, SAMe, or
SAM-e in the United States or ademetionine in Europe, and also often
abbreviated as SAM and AdoMet) is a chemical that is found naturally in
the body. SAMe is sold in the United States as a
dietary supplement.
SAMe
was discovered in the early 1950s. It’s made in the body from
methionine, an amino acid found in foods. It has been found to regulate
key functions in living cells.
Abnormal
levels of SAMe in the body have been reported in liver diseases and
depression. This prompted researchers to investigate whether SAMe might
be helpful in treating these conditions. The idea that SAMe might be
helpful for osteoarthritis came from studies of SAMe for depression.
Some of the participants in the depression studies who also had
osteoarthritis said their joint symptoms improved when they
took SAMe.
What the Science Says About the Effectiveness of SAMe
SAMe
has been investigated most extensively for depression, osteoarthritis,
and liver diseases. For all three conditions, research has not
conclusively shown that SAMe is helpful.
Depression
Overall,
the evidence that oral SAMe may be helpful for depression is
not conclusive.
At
least 40 studies in people have evaluated SAMe for depression, and many
of them showed evidence of beneficial effects. However, most of these
trials lasted only a few weeks, included a small number of
participants, and were not of the highest scientific quality. Also,
some studies used injected SAMe rather than an oral form (taken
by mouth).
Osteoarthritis
The
results of research on SAMe for osteoarthritis are mixed.
Studies
in people have compared oral SAMe with nonsteroidal anti-inflammatory
drugs (NSAIDs; medicines used to relieve osteoarthritis pain) or
placebos (inactive substances) in patients with osteoarthritis of the
knee or hip.
In general, studies that compared SAMe with NSAIDs
showed that each had similar pain relief and improvement in joint
function, with fewer side effects in the patients taking SAMe.
The smaller number of studies that compared SAMe with placebo did not
consistently show SAMe to be beneficial.
Liver Diseases
There’s
some evidence linking decreased levels of SAMe in the body with the
development of liver diseases, and animal studies have suggested that
SAMe may be of value for liver problems. However, whether SAMe is
beneficial for liver diseases in people has not
been established.
Cholestasis is
a condition in which the flow of bile from the liver is slowed or
blocked. Several studies have evaluated SAMe for a type of cholestasis
called intrahepatic cholestasis of pregnancy (ICP). ICP usually occurs
during the third trimester of pregnancy and has itching as a
characteristic symptom. The studies had conflicting results, and
current data are insufficient to show whether SAMe is helpful
for ICP.
SAMe has also been studied for other liver diseases, including
alcoholic liver cirrhosis,
hepatitis C,
various types of cholestasis,
and
nonalcoholic steatohepatitis,
as well as for the prevention of
liver cancer, but
research is inconclusive.
Other Conditions
SAMe
has also been studied for other conditions, including fibromyalgia, migraine, schizophrenia, Alzheimer’s disease,
and attention-deficit hyperactivity
disorder, but there isn’t enough evidence to reach
conclusions about its effects in these conditions. A trial of SAMe as a quit-smoking aidshowed
that it didn’t increase the quit rate or reduce
withdrawal symptoms.
Safety and Side Effects of SAMe
Information
on the long-term safety of SAMe is limited because the participants in
most studies took it only for short periods of time. However, in one
study of alcohol-related liver disease, participants took SAMe for 2
years; in that study, no serious side effects were reported.
People with
bipolar disorder (an
illness characterized by mood swings, from depression to mania) should
not take SAMe for their depressive symptoms except under the
supervision of a health care provider because SAMe may worsen symptoms
of mania.
Although SAMe has been used to treat cholestasis during pregnancy, its
safety during pregnancy has not been established.
SAMe
may decrease the effects of levodopa (L-dopa), a drug used to treat
Parkinson’s disease. It’s also possible that SAMe might interact with
drugs and dietary supplements that increase levels of serotonin (a
chemical produced by nerve cells), such as antidepressants,
L-tryptophan, and St. John’s wort.
There’s a theoretical
concern about the use of SAMe by people who are immunocompromised (such
as those who are HIV-positive). Immunocompromised people are at risk for
Pneumocystis carinii infection,
and SAMe enhances the growth of this microorganism.
Side
effects of SAMe are uncommon, and when they do occur they are usually
minor problems such as nausea or digestive upsets.
NCCIH-Funded Research
Current
studies supported by the National Center for Complementary and
Integrative Health (NCCIH) are investigating:
The role of SAMe in nonalcoholic fatty liver disease
The possible roles of SAMe and an enzyme involved in its formation for
colon cancer.
More To Consider
Don’t use SAMe to postpone seeing a health care provider about a
medical problem.
Consult
your health care provider about using SAMe supplements. If you’re
pregnant or nursing a child, if you take medicine or other dietary
supplements, if you have bipolar disorder or Parkinson’s disease, if
you’re HIV-positive, or if you’re considering giving SAMe to a child,
it’s especially important to consult your (or your child’s) health
care provider.
Tell all your health care providers about any
complementary or integrative health approaches you use. Give them a
full picture of what you do to manage your health. This will help
ensure coordinated and safe care.
Key References
- Carpenter DJ. St.
John’s wort and S-adenosyl methionine as “natural” alternatives to
conventional antidepressants in the era of the suicidality boxed
warning: what is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16(1):17–39.
- De
Silva V, El-Metwally A, Ernst E, et al. Evidence
for the efficacy of complementary and alternative medicines in the
management of osteoarthritis: a systematic review. Rheumatology. 2011;50(5):911–920.
- Gurung
V, Stokes M, Middleton P, et al. Interventions
for treating cholestasis in pregnancy. Cochrane Database of Systematic
Reviews. 2013;(6):CD000493 [edited 2014]. Accessed at
www.cochranelibrary.com on August 11, 2015.
- Lu
SC, Mato JM. S-Adenosylmethionine
in liver health, injury, and cancer.Physiological Reviews. 2012;92(4):1515–1542.
- Mato
JM, Lu SC. S-Adenosylmethionine. In: Coates PM, Betz JM, Blackman MR,
et al., eds. Encyclopedia of Dietary
Supplements, 2nd ed. New York, NY: Informa
Healthcare; 2010.
- Rutjes
AWS, Nuesch E, Reichenbach S, et al. S-Adenosylmethionine
for osteoarthritis of the knee or hip. Cochrane Database of Systematic
Reviews. 2009;(4):CD007321. Accessed at
www.cochranelibrary.com on January 27, 2012.
- Sood
A, Prasad K, Croghan IT, et al. S-Adenosyl-L-methionine
(SAMe) for smoking abstinence: a randomized clinical trial. Journal of Alternative and
Complementary Medicine. 2012;18(9):854–859.
-NIH
