What is it?

S-adenosyl-L-methionine (SAMe), is derived from an amino acid, methionine.  

What does it do?

SAMe supports healthy cell membranes, affects hormones, neurotransmitter formation, DNA, RNA, proteins and thus has far reaching affects on brain chemistry and liver detoxification.  

What is it used for?

SAMe has been the subject of many clinical trials involving osteoarthritis, fibromyalgia, depression and viral, fatty and alcohol related liver disease. In my practice, I use SAMe when a patient has a combination of these conditions. For example, I commonly prescribe SAMe for patients with hepatitis C with depression and muscle/joint pain. I also prescribe SAMe for patients who have a difficult time producing and excreting bile. Toxins can easily build up without proper bile production and flow leading to irritability, flank pain, yellow stools and drug sensitivity.  

What is the dosage?

SAMe must be in a special form “enteric coated” for it to be properly absorbed orally. For this reason SAMe tends to be a more expensive supplement, leading people to under dose. The generally acceptable dose is between 400 and 1600 milligrams (mg) per day on an empty stomach. When I prescribe SAMe, generally I start people on the lowest dose of 200 mg twice daily. Most people find between 800 and 1200 mg to be an effective dose. I do caution people against upping their dose too quickly, as for many chronic conditions SAMe must be taken for at least one month before improvement becomes obvious.  

What if I can’t afford it? 

As part of my Hepatitis C Certification I attended a lecture by a very knowledgeable Naturopathic physician, Lynn Patrick, ND. According to Dr. Patrick all of the building blocks of SAMe: methionine, betaine, folic acid and B 12, are available from dietary sources. The following is her SAMe daily diet prescription:  

One of the following will yield 500 mg of methionine: 1 cup cottage cheese,4 ounces of fish, 5 ounces chicken, 1/3 cup sesame seeds or 2 cups lentils. 

500-3000 mcg of vitamin B12 is easily available from meat and fish (100 mcg/serving) or can be taken as an inexpensive supplement.

For 800 micrograms (mcg) folic acid: 2 cups cooked asparagus + 1 cup cooked beans (black, pinto, navy, etc). Other good sources include avocados, chickpeas, lentils, spinach, broccoli, peas, soy nuts and fortified foods such as rice and breakfast cereals. One of the following will yield 500 mg of betaine:1 cup cooked spinach, 2 cooked beets, 2 cups wheat bran cereal. 

• People with a compromised digestive system may need to take SAMe in supplement form.

Who shouldn’t take SAMe? 

I am very cautious when prescribing SAMe to a person who is currently taking antidepressants because of a possible synergistic reaction. I do not suggest people with bipolar or anxiety disorders take SAMe. Anyone who is pregnant, trying to get pregnant or nursing should ask their health care provider before taking SAMe.

Are there any side effects? 

SAMe is generally very well tolerated. Gastrointestinal side effects are the most commonly reported and seem to be dose dependent.