7 SAM-e Benefits + Side Effects, Dosage & Reviews

How to Use Kava Safely

7 SAM-e Benefits + Side Effects, Dosage & Reviews

Kava (scientific name Piper methysticum) is a tall shrub in the pepper family that grows in the Pacific islands. Pacific Islanders have traditionally used kava in ceremonies to bring about a state of relaxation. The name kava means “bitter” in the Tongan language.

The root of the plant is traditionally used to make beverages that have a mild to moderate sedative effects. It is also said to elicit feelings of euphoria. In some traditional cultures, kava is consumed in the same way that alcoholic beverages are here.

Today, many people buy kava supplement to treat anxiety. Although kava in its traditional form poses an “acceptably low level of health risk” according to the World Health Organization (WHO), kava extracts and supplements may cause liver toxicity if overused or consumed on an ongoing basis.

Verywell / Brianna Gilmartin

  • Kava Kava
  • Kawa Kawa
  • 'Ava (Samoa)
  • 'Awa (Hawaii)
  • Malak (Vanuatu)
  • Rauschpfeffer (German)
  • Sakao (Pohnpei)
  • Yaqano (Fiji)

Beyond its recreational and ceremonial use, kava is commonly used in alternative medicine as a natural anxiolytic (anxiety-reducing) drug. It may also improve sleep in people with insomnia, often with fewer side effects than pharmaceutical or over-the-counter sleep aids.

The compounds in kava root believed to offer mood-altering properties are called kavalactones. There are 18 different kavalactones identified thus far. Little research has been done to pinpoint their exact mechanisms of action or evaluate which compounds are more active than others.

The current body of evidence suggests that kava may aid in the treatment of anxiety, although there remains contention as to how effective a drug it really is.

According to a 2002 review of studies involving seven clinical trials and 645 people, kava was deemed to be an “effective symptomatic treatment option for anxiety,” even though the effect was considered “small” by the researchers.

The findings were supported by a 2011 review from Australia in which kava was considered more effective in treating generalized anxiety disorder (GAD) than a placebo. With that being said, a traditional kava beverage was recommended over supplements for safety reasons, along with regular liver enzyme testing to avoid toxicity.

Most of the research devoted to the use of kava for insomnia is limited to animal studies. It is believed that a specific type of kavalactone, called kevain, may provide the drug's sedative effect.

Of the available human research, one small study from Germany concluded that people provided a daily 200-milligram kava extract experienced significant relief from insomnia after 14 days.

Despite the promising results, the conclusions were undermined by the subjective nature of “quality of sleep” questionnaire. the study measures, even people provided a placebo had significant improvements in sleep.

The use of kava remains controversial. While proponents believe that kava can be safely used for the short-term treatment of anxiety, others contend that the potential risks far outweigh the benefits.

Even for short-term use, side effects indigestion, mouth numbness, rash, headache, drowsiness, and visual disturbances are common. The consequences of long-term use may, in some cases, be catastrophic.

In March 2002, the U.S. Food and Drug Administration (FDA) warned consumers and health professionals about the risk of liver damage associated with kava use. Case reports have linked kava with liver toxicity, including hepatitis, cirrhosis, liver failure, and even death. 

Many of these cases were linked to pre-existing liver disease, excessive kava doses, and heavy alcohol use. It is still unclear whether the liver toxicity was the result of kavalactones, contaminants found in low-quality extracts, or the organic solvents (such as acetone or ethanol) used to make kava extracts and supplements.

Even though the WHO suggests that water-based kava beverages are “safer,” the agency concedes that moderate to heavy consumption can significantly raise liver enzymes. The WHO also warned that toxicity appears linked to the quality of the raw kava root, contamination of the root during storage, and the use of other herbal drugs with kava.

In the aftermath of the warning, several countries have restricted the sale of kava within their borders. To date, only Germany, Canada, Poland, and Switzerland has banned the use of kava in any form. In the United States, kava is classified as a dietary supplement and can be legally purchased for personal use.

Call your doctor if you experience signs of liver toxicity, including persistent fatigue, weakness, nausea, vomiting, loss of appetite, dark urine, clay-colored stools, or the yellowing of the skin or eyes (jaundice).

If you intend to use kava for recreational or medicinal purpose, there are several things you should consider beforehand:

  • Kava's effect on the neurological system is poorly understood. As such, it should not be used in people with clinical depression, bipolar disorder, or schizophrenia.
  • Kava should be avoided in people with Parkinson's disease as it can potentially make the symptoms worse.
  • Kava may interfere with blood clotting. It should not be used by people with bleeding disorders. You would also need to stop using kava at least two weeks before surgery to avoid excessive bleeding.
  • Kava can cause drowsiness and impair your judgment, reflexes, and visual acuity. Do not use kava if you plan to drive or operate heavy machinery.
  • Kava should be avoided in people with alcoholism, liver disease, pulmonary hypertension, low blood pressure (hypotension), or kidney disease.

Due to the lack of safety research, kava should never be used in children, pregnant women, or nursing mothers. Some studies have suggested that kava can be readily transmitted in breastmilk.

Kava can interact with a number of drugs and supplements. In some cases, it may enhance the effects of the accompanying drug. In others, it may reduce the effectiveness of the accompanying by competing for the same liver enzymes, called CYP450, used to metabolize kava.

Speak with your doctor if you are using (or intend to use) kava with any of the following medications:

There are no guidelines for the appropriate use of kava. Kava is generally sold in the United States in capsule, soft gel caps, extract, powder, and tea forms. There are also “wild-crafted” dried root used to make tinctures, teas, and beverages.

Most capsule formulations are offered in doses ranging from 50 milligrams to 100 milligrams. Most expert recommend that you take no more than 250 milligrams per day and limit your use to no more than three months.

Be advised that liver damage has been known to occur after one month of kava use with normal doses.

Kava, all dietary supplements, is largely unregulated in the United States. Do not assume that this means the drug is safe.

The classification simply means that the manufacturer is responsible for ensuring the safety of the supplement, not the FDA.

While this relieves the manufacturer of the burden of clinical research, it can sometimes leave the consumer vulnerable to harms, both known and unknown.

What a manufacturer cannot do is market their supplements as a cure for any disease or medical condition. This doesn't mean the manufacturer can't suggest possible health benefits; many do. To better protect yourself, try to not be swayed by health claims that may or may not be true no matter how desperate you are for relief.

Because the quality and safety of kava can vary from one brand to the next, stick with manufacturers you know and trust. If also helps to buy brands certified organic under the regulations of the U.S. Department of Agriculture (USDA). This is especially true of wild-crafted dried kava.

How do I make kava tea or beverage?

Traditionally, kava drinks in the South Pacific are made from the fresh root, which is either chewed or pulverized before water is strain through the fibrous pulp.

Since fresh kava root is rarely available in the United States, you can make it make it with dried kava. For this, you would need a piece of cheesecloth, a tea strainer, and some wild-crafted kava chips or powder (usually found online or thorough speciality herbalist stores).

To make a 6- to 8-ounce glass of traditional kava drink:

  1. Put 1/4 to 1/3 cup of wild-crafted kava in a piece of cheesecloth. Tie it into a loose bundle with a piece of string .
  2. Heat one cup of water so that it is warm to the touch.
  3. Place the kava bundle in a small bowel and cover it with the warm water.
  4. Knead and squeeze the bundle for 10 to 15 minutes, applying a lot of pressure.
  5. When finished, pour the liquid through a tea strainer into a glass and drink.

Source: https://www.verywellmind.com/kava-kava-what-you-need-to-know-89703

SAMe (S-adenosylmethionine)

7 SAM-e Benefits + Side Effects, Dosage & Reviews

What Is It?

SAMe (pronounced “sammy”) is short for S-adenosylmethionine, a molecule that the body continually produces to fuel numerous vital body functions.

Discovered in 1952, the popularity of SAMe has soared recently with talk of its ability to ease depression as effectively as prescription antidepressants.

(Proponents say SAMe also works faster than antidepressants and with virtually no side effects.)

Long prescribed by European doctors for both arthritis and depression, SAMe recently became available in the United States as an over-the-counter supplement. It is also emerging as an effective therapy for arthritis, fibromyalgia, certain liver disorders, and possibly even Alzheimer’s disease.

Health Benefits

The body manufactures SAMe from methionine, an amino acid found in protein-rich foods, and adenosine triphosphate (ATP), an energy-producing compound found in all the body’s cells.

The SAMe molecule then donates a piece of itself (a methyl group) to body tissues and organs, providing a critical link in methylation, a chemical reaction that occurs billions of times a second throughout the body.

In giving up a part of itself, SAMe promotes cell growth and repair.

SAMe also contributes to the formation of key compounds in the brain, including the neurotransmitter dopamine and the mood-enhancer serotonin.

In addition, it helps to maintain desirable levels of glutathione, a major antioxidant that protects against cell damage from oxygen molecules called free radicals.

Taken as a supplement, SAMe compensates for any deficiencies and encourages the body to run efficiently.

Specifically, SAMe may help to:

Relieve depression and stress-related blues. Several studies indicate that SAMe eases mild to moderately severe depression.

A sweeping review of dozens of small clinical trials (called a “meta-analysis”) testing SAMe for depression concluded that it appears to work as well as the frequently prescribed tricyclic antidepressants (imipramine, amitriptyline, desipramine) in easing depression.

Just as importantly, it works faster, often starting to improve mood within a week. This contrasts significantly with standard antidepressants, whose effects can take several weeks to become apparent.

In a University of California study of 17 severely depressed adults, 62% of the participants who took SAMe for four weeks (1,600 mg daily) showed significant improvements in symptoms, compared to 50% of those who used desipramine (a conventional antidepressant). Un many prescription antidepressants, which often cause unpleasant side effects such as as drowsiness, dry mouth, and constipation, SAMe appears to cause few if any side effects.

Treat chronic fatigue syndrome (CFS).
conventional antidepressants used to treat chronic fatigue, SAMe appears to benefit CFS sufferers by countering depression. It alters the brain’s response to pain and improves the quality of badly needed sleep.

As a result, both chronic fatigue syndrome and a condition with which it’s commonly confused–chronic fatigue syndrome-fibromylagia (CFS-FM)–are ly to respond to SAMe.

CFS-FM, which is actually more common than CFS, appears to be a physical response to chronic stress and depression.

Lessen arthritis-related pain and inflammation. The eventual breakdown of SAMe in the body yields substances that help to keep the gel- cartilage that cushions joints intact. In the common degenerative joint disease osteoarthritis, cartilage wears down over time.

Studies in thousands of osteoarthritis sufferers have demonstrated that SAMe can be as effective at increasing joint mobility and reducing swelling and pain as such NSAIDs (nonsteroidal anti-inflammatories) as ibuprofen and aspirin.

Moreover, SAMe doesn’t pose the risk of stomach bleeding or kidney damage that are serious risks with NSAIDs. It also doesn’t wear down joints, damage cartilage, or block the pain signals that could signal a worsening condition.

Although it’s not exactly clear how SAMe works for arthritis, very preliminary but intriguing animal studies actually point to a role in repairing cartilage and lubricating joints, properties that may well extend to humans. Clearly more research is needed.

Control back pain. SAMe may improve back pain when taken for several weeks, a function of its ability to reduce swelling and pain.

The theory is that SAMe takes part in the repair and restoration of spinal discs, cartilage, and the articulating surfaces of joints. Obviously, this takes time.

So if you’re using SAMe for back pain, don’t expect the immediate symptom relief that you get with NSAIDs such as Motrin or COX-2 inhibitors such as Vioxx and Celebrex.

Reduce fibromyalgia symptoms. SAMe may minimize certain complications of this often debilitating disorder, such as muscle pain, depression, and fatigue. The 44 fibromylagia sufferers in a Danish study who took 800 mg of SAMe daily for six weeks reported some relief from morning stiffness and muscle aches. They also noted an improvement in mood.

The results from other studies have been mixed, however. For example, a 1997 study to test the effectiveness of intraveneously administered SAMe for fibromylagia failed to show significant benefits.

However, given that no single therapy for fibromyalgia is uniformly satisfactory, a trial of SAMe for this often puzzling condition is certainly reasonable.

Treat hepatitis and other liver disorders. By producing the extremely powerful antioxidant glutathion, which enhances the liver’s ability to clear out toxins, SAMe promotes efficient liver function. Research indicates that SAMe may benefit liver function impaired by alcohol-induced cirrhosis, drug toxicity, hepatitis, and cholestasis.

Protect against Alzheimer’s and age-related brain disorders. Preliminary research indicates that SAMe levels are very low in individuals suffering from Alzheimer’s disease.

In one study of 40 elderly individuals with problems related to alertness and cognition, improvements in such areas as memory, mood, and ability to carry out everyday activities of life occured upon administration of a regimen of oral, intravenous, and intramuscular SAMe.

Additional research is now underway to determine what role supplemental SAMe might play in antioxidant production and in disorders of the aging brain.
Note: SAMe has also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for SAMe.



Dosage Information

Special tips:

–Look for enteric-coated SAMe; it’s more readily absorbed by the body in this form and remains chemically stable for much longer (the coating protects it from exposure to air).

To avoid a toxic buildup of homocysteine molecules (which are formed when SAMe breaks down) be sure to take a high-quality vitamin B complex supplement along with SAMe.

These vitamins disarm homocysteine, which in high concentrations poses the risk of various health problems including heart attack and stroke.

A standard recommendation is to take 100 mg of a B complex once a day, regardless of the SAMe dose.

If you’re particularly sensitive to medications, start out with half the recommended daily dosage and work up to the full amount after a week.

For depression, arthritis, fibromylagia, and liver disorders: Take 400 mg of SAMe twice a day. If symptoms fail to improve after three weeks, try increasing your dose to 400 mg three times a day.

On the other hand, if symptoms lessen with 400 mg twice a day, you can try to lower the dose to 200 mg twice a day.

Be sure to check out our Dosage Recommendations Chart, which has therapeutic dosages for specific ailments at a glance.

Guidelines for Use

SAMe is best absorbed on an empty stomach, so try to take it about one hour before or two hours after meals. If nausea or heartburn develop, take it with plenty of water.

To prevent insomnia, don’t take SAMe late in the day. Most people report a mild energy boost with the supplement.

SAMe can safely be combined with other natural antidepressants such as St. John’s wort, as well as conventional antidepressants.

Purchase SAMe from a reliable company whose quality standards you trust. If improperly handled, the raw material used to make SAMe can deteriorate rapidly, making these costly supplements weak or even inactive. Look for “pharmaceutical grade” products and opt for a more stable form called “butanedisulfonate” rather than “tosylate.”

General Interaction

Don’t take SAMe with MAO inhibitor antidepressants.
Note: For information on interactions with specific generic drugs, see our WholeHealth Chicago Drug/Nutrient Interactions Chart.

Possible Side Effects

SAMe seems to be free of significant side effects, even when taken for long periods of time.

In rare cases, daily doses of 400 mg or higher may cause mild stomach upset, dry mouth, and insomnia.

At extremely high doses, the supplement may cause diarrhea and heartburn.


If you suffer from severe depression, don’t take SAMe without consulting your doctor first. This precaution is particularly important if you have a bipolar disorder because SAMe could trigger or exacerbate mania (the “up” phase) in such cases.

If you’re taking prescription antidepressants, don’t discontinue them or reduce your dosage without consulting your doctor.

SAMe should lift depression relatively quickly. If you don’t notice a significant improvement after four weeks, see your doctor. You may need a different category of antidepressant.


Anxiety and Panic 400-800 mg twice a day on an empty stomachArthritis 400 mg twice a day for 14 days; then 200 mg twice a day as maintenanceBack Pain 400 mg twice a day. Must be taken on an empty stomach, one hour before or two hours after a meal.

Chronic Fatigue Syndrome 400 mg twice a dayChronic Pain 400 mg twice a dayDepression 400-600 mg twice a day on an empty stomach (either one hour before, or two hours after a meal)Fibromyalgia 400-600 mg twice a dayHepatitis 400 mg twice a day

Stress 400 mg twice a day

Doctor Recommendations
David Edelberg, M.D.

One of the hottest new supplements, SAMe has garnered lots of press coverage lately because it seems to ease depression as well as prescription antidepressants do for many people.


I’d certainly apply the word natural to SAMe (S-adenosylmethionine) because it appears in every cell in the body. This complex molecule is derived from the amino acid methionine and adenosine triphosphate (ATP), an energy-producing compound found throughout the body.


Tips for choosing and taking SAMe Forms. There are two types of SAMe – tosylate and butanedisulfonate. Both work equally well. Enteric coating. Because the SAMe molecule is absorbed in the small intestine and can be destroyed by stomach acid, you’re better off with an enteric-coated tablet.

The coating protects the SAMe as it passes through your stomach and it’s then released and absorbed. Between meals. Food will block the absorption of SAMe, so you need to take it on an empty stomach. Effectiveness. SAMe works fairly quickly, usually in a week or two.

You may have to increase your dose a bit to get the full effect.


What I tell patients is that unless you eat during the very first hour after you open your eyes in the morning, have your first dose ready and waiting next to the bed and take it just as you awaken. Then, assuming you eat supper around 6 P.M., take your second dose around 3:00 in the afternoon.

SAMe will work best if you have good amounts of B vitamins in your system; a B-complex vitamin can be taken any time of the day. Now, concerning price. What manufacturers charge can be outrageous. And you shouldn’t have to refinance your house to treat your depression.

Just remember, more expensive is not necessarily better. A good SAMe supplement should simply have: A reliable manufacturer Enteric coating A usable form (tosylate or butanedisulfonate) A fresh product, with the expiration date at least a year ahead.

After that, try to get the least-expensive product you can find. And prices should drop, so be willing to change brands.

Source: https://wholehealthchicago.com/2009/05/19/714/

What is a SAM-e Supplement?

7 SAM-e Benefits + Side Effects, Dosage & Reviews

Supplements have surged in popularity due to more people focused on alternative ways to improve wellness and treat health-related concerns. One of these is the SAM-e supplement. The full name of this compound is S-adenosylmethionine.

What is SAM-e Made From?

SAM-e is compound naturally created inside the body. In Europe, a synthesized version of this compound has been available for sale for a long time, but it is relatively new in the U.S, where it is currently considered as a supplement.

SAM-e cannot be obtained naturally from eating foods, so the use as a supplement helps people who want an additional source.

Why Do People Buy SAM-e Supplements?

The most common reason for people to purchase these supplements is due to issues with osteoarthritis. Some research has reportedly found that, when used instead of NSAID painkillers, the supplement might be more effective at addressing the underlying pain from this medical condition.

There are fewer side effects for people who report taking this supplement on a regular basis, but the supplement does reportedly take a longer period of time to take effect in the body.

Although osteoarthritis is one of the newer reasons for people to turn to SAM-e supplements, it has been taken as a depression treatment for people for many years. The research on the effectiveness of the drug for that purpose has had mixed results.

Other less well-researched uses for SAM-e supplements are for migraines, liver disease, Alzheimers’ disease, and bursitis.

What is Osteoarthritis?


, according to medshadow.org, is a medical condition that is the most common type of arthritis. It is believed to impact over 30 million people in the U.S.

People who have a diagnosis of osteoarthritis can experience swelling and pain in the joints that gets worse over time. People are most ly to suffer these side effects in the neck, hips, hands, and knees.

How Does SAM-e Affect the Body?

According to Brain MD, the compound powers numerous enzymes for cell growth, specialization, and maturation. The supplement has been referenced as a way to generate mood-related neurotransmitted, make energy, and enhance connectivity in the body.

What Are the Side Effects of SAM-e?

As with all medications and supplements, users face the risk of problematic side effects. Most people report that these side effects are rare and mild. Use of this supplement can cause side effects such as mild insomnia, upset stomach, nausea, irritability, sweating, and diarrhea.

Are These Supplements Falsely Labeled?

Certain brands selling SAM-e supplements have been accused of putting their bottles to market with a very low amount of SAM-e inside. In fact, some consumers claim that seven brands contain as little as 12 to 18 percent of what’s advertised on the product.

This could mean that not only might the companies be involved in false advertising, but could put the users at risk for varying side effects because of inaccurate dosing details. The brands that might have bottles with false advertising information include We Vitamins, Vitamins Because You Are Worth It, NusaPure, aSquaredNutrition, HealthWay, BoostCeuticals, and Mental Refreshment.

The makers of SAM-e supplements are far from the first to be hit with allegations of false advertising. GNC has been hit with allegations of false advertising and using dangerous supplement fillers. The makers of Hydroxycut paid $8 million to settle allegations of misleading consumers about their weight loss supplement.

Source: https://topclassactions.com/lawsuit-settlements/consumer-products/supplements/what-is-a-sam-e-supplement/

S-Adenosylmethionine (SAMe) for osteoarthritis

7 SAM-e Benefits + Side Effects, Dosage & Reviews

This summary of a Cochrane review presents what we know from research about the effect of S-Adenosylmethionine on osteoarthritis.

The review shows that in people with osteoarthritis:

– We are uncertain whether S-Adenosylmethionine affects pain or your ability to use your knee because of the low to moderate quality of the evidence.  
– S-Adenosylmethionine may not have any side effects.  We often do not have precise information about side effects and complications. This is particularly true for rare but serious side effects. 

What is osteoarthritis and what is S-Adenosylmethionine (SAMe)?

Osteoarthritis (OA) is a disease of the joints, such as your knee or hip. When the joint loses cartilage, the bone grows to try to repair the damage.

Instead of making things better, however, the bone grows abnormally and makes things worse. For example, the bone can become misshapen and make the joint painful and unstable.

 This can affect your physical function or ability to use your knee.

S-Adenosylmethionine is popular dietary supplement available over the counter in drug stores or health food stores.  It is also a naturally occurring chemical that is produced in the body. SAMe is not found in foods, so it must be taken as a supplement.

Best estimate of what happens to people with osteoarthritis who take S-Adenosylmethionine (SAMe)


– People with S-Adenosylmethionine and people with placebo are equally ly to respond to treatment (difference of 0%). This could be the result of chance.

– People who took S-Adenosylmethionine had an improvement in their pain of about 2 on a scale from 0 (no pain) to 10 (extreme pain) after using it up to 3 months.

– People who took a placebo had an improvement in their pain of also about 2 on a scale from 0 (no pain) to 10 (extreme pain) after using it up to 3 months.

Physical Function

– People with S-Adenosylmethionine and people with placebo are equally ly to respond to treatment (difference of 0%). This could be the result of chance.

– People who took S-Adenosylmethionine had an improvement in their physical function of about 1 on a scale of 0 (no disability) to 10 (extreme disability) after using it up to 3 months.

– People who took a placebo had an improvement in their physical function of also about 1 on a scale of 0 (no disability) to 10 (extreme disability) after using it up to 3 months.

Side effects

– 4 more people experienced side effects with S-Adenosylmethionine than with placebo (difference of 4%). This could be the result of chance.

– 19 people 100 who used S-Adenosylmethionine experienced side effects (19%).

– 15 people 100 who used a placebo experienced side effects (15%).

Authors' conclusions: 

The current systematic review is inconclusive, hampered by the inclusion of mainly small trials of questionable quality.

The effects of SAMe on both pain and function may be potentially clinically relevant and, although effects are expected to be small, deserve further clinical evaluation in adequately sized randomised, parallel-group trials in patients with knee or hip osteoarthritis. Meanwhile, routine use of SAMe should not be advised.

Read the full abstract…


Osteoarthritis is the most common form of joint disease and the leading cause of pain and disability in the elderly. S-Adenosylmethionine may be a viable treatment option but the evidence about its effectiveness and safety is equivocal.


We set out to compare S-Adenosylmethionine (SAMe) with placebo or no specific intervention in terms of effects on pain and function and safety outcomes in patients with knee or hip osteoarthritis.

Search strategy: 

We searched CENTRAL, MEDLINE, EMBASE, CINAHL and PEDro up to 5 August 2008, checked conference proceedings and reference lists, and contacted authors.

Selection criteria: 

Randomised or quasi-randomised controlled trials that compared SAMe at any dosage and in any formulation with placebo or no intervention in patients with osteoarthritis of the knee or hip.

Data collection and analysis: 

Two independent authors extracted data using standardised forms. We contacted investigators to obtain missing outcome information. We calculated standardised mean differences (SMDs) for pain and function, and relative risks for safety outcomes. We combined trials using inverse-variance random-effects meta-analysis.

Main results: 

Four trials including 656 patients were included in the systematic review, all compared SAMe with placebo. The methodological quality and the quality of reporting were poor. For pain, the analysis indicated a small SMD of -0.17 (95% CI -0.34 to 0.

01), corresponding to a difference in pain scores between SAMe and placebo of 0.4 cm on a 10 cm VAS, with no between trial heterogeneity (I2 = 0). For function, the analysis suggested a SMD of 0.02 (95% CI -0.68 to 0.71) with a moderate degree of between-trial heterogeneity (I2 = 54%).

The meta-analyses of the number of patients experiencing any adverse event, and withdrawals or drop-outs due to adverse events, resulted in relative risks of 1.27 (95% CI 0.94 to 1.71) and 0.94 (95% CI 0.48 to 1.

86), respectively, but confidence intervals were wide and tests for overall effect were not significant. No trial provided information concerning the occurrence of serious adverse events.

Source: https://www.cochrane.org/CD007321/MUSKEL_s-adenosylmethionine-same-for-osteoarthritis

What to Know About SAMe Supplements

7 SAM-e Benefits + Side Effects, Dosage & Reviews

Terry Vine/Gett Images

If you live with a condition osteoarthritis or depression, you may already know how it can affect other aspects of your health, contributing to issues weight gain, difficulty sleeping, and chronic pain.

One remedy said to ease depression, arthritis, and other conditions is the supplement SAMe, also known as ademetionine or S-adenosylmethionine. SAMe is the synthetic form of a compound that is produced naturally in the body from methionine (an essential amino acid) and adenosine triphosphate (an energy-producing compound).

  • SAMe
  • SAM-e
  • ademetionine
  • S-adenosylmethionine

SAMe isn't found naturally in food. The body typically makes what it needs for good health, however, some disease states and low levels of methionine, folate, or vitamin B12 are believed to contribute to low levels of SAMe.

It's thought that SAMe can help promote the production of chemicals known to play a key role in a variety of processes in the body, such as mood regulation, immune function, and pain perception.

SAMe is typically used for the following health issues:

  • Anxiety
  • Depression
  • Fibromyalgia
  • Osteoarthritis
  • Pain
  • Premenstrual syndrome (PMS)

SAMe is also said to enhance mental performance, boost liver health, slow the aging process, and help people quit smoking.

Here's a look at some of the research on the possible benefits of SAMe.

SAMe shows promise in the treatment of osteoarthritis of the knee or hip. It is said to relieve pain and have anti-inflammatory properties, and some research suggests that it may promote cartilage repair.

In a report published in the Cochrane Database of Systematic Reviews in 2009, researchers analyzed four previously published clinical trials (with a total of 656 participants) and found that the use of SAMe may help reduce pain and improve function in people with osteoarthritis. Since the reviewed trials were of poor quality, however, the review's authors deemed these findings inconclusive.

SAMe was superior to a placebo when used with selective serotonin reuptake inhibitor (SSRI) antidepressants, but the evidence was considered low quality. Compared to imipramine, fewer participants experienced adverse effects when treated with an injectable form of SAMe. SAMe wasn't different from the placebo or antidepressants such as imipramine or escitalopram when used alone.

In their conclusion, the review's authors state that the use of SAMe for depression needs to be investigated further in larger and better-planned trials “given the absence of high-quality evidence and the inability to draw firm conclusions that evidence.”

In a research review published in the Journal of Complementary and Alternative Medicine in 2010, scientists looked at 70 previously published clinical trials evaluating the use of various types of complementary therapies for chronic fatigue syndrome and fibromyalgia. Along with magnesium, L-carnitine, acupuncture, and several types of meditation practice, the review's authors named SAMe among the therapies with the most potential for further research on their effectiveness against these conditions.

SAMe may improve liver function in people with chronic liver disease, suggests a research review published in the journal PLoS One in 2015. However, in evaluating the 12 previously published clinical trials included in the review, the authors also found that SAMe may of limited benefit in the treatment of certain liver conditions such as viral hepatitis and cholestasis.

Side effects of SAMe include anxiety, constipation, diarrhea, dry mouth, headache, heartburn, insomnia, gas, low blood sugar, nausea, nervousness, skin rash, and vomiting. Large amounts of SAMe may cause mania (an abnormally elevated mood). There's also some concern that the use of SAMe can trigger an allergic reaction in some people. 

If you have bipolar disorder, Lesch-Nyhan syndrome, Parkinson's disease, or other health conditions, you should only use SAMe under the supervision of your healthcare provider as it may worsen symptoms. 

It's important to note that there may be risks when combining SAMe with medication or other supplements.

You shouldn't take SAMe in combination with antidepressants, cough medicine, diabetes medication, levodopa (L-dopa), L-tryptophan, medications that affects serotonin levels, St.

John's wort, or other medication unless you are being monitored by a health professional. SAMe should be discontinued at least two weeks before a scheduled surgery.

The safety of SAMe in children, pregnant or nursing women, or people with kidney or liver disease hasn't been established. You can get tips on using supplements safely, but you should speak with your primary care provider before taking SAMe to discuss whether it's appropriate for you. Keep in mind that SAMe shouldn't be used as a substitute for standard treatment.

SAMe supplements are sold as capsules, tablets, and powder. There is no recommended daily allowance for SAMe and no standard dose has been set. The following doses have been studied for these conditions:

  • Depression: 800 mg to 1,600 mg a day
  • Osteoarthritis: 200 mg to 400 mg three times a day

Look for SAMe supplements with an enteric coating, which helps protect the supplement from being released in the stomach, where stomach acid and enzymes can destroy the main ingredients. This allows the supplement to stay intact until it reaches the small intestine.

Can you get SAMe naturally from food?

SAMe is not found in food and is produced naturally in the body. However, people with low levels of methionine, folate, or vitamin B12 may have difficulty producing enough SAMe.

Living with any chronic condition isn't easy. While some studies suggest that SAMe may offer some benefits, we can't be as solid about the connection until there are well designed, large-scale clinical trials (the type of research you would want to see to put full stock in a treatment).

It's also important to keep in mind that SAMe shouldn't be used in conjunction or in place of treatment recommended by your doctor. If you're considering trying a SAMe supplement, be sure to talk with your doctor to weigh the pros and cons and discuss whether it's appropriate for you.

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  • Galizia I, Oldani L, Macritchie K, et al. S-adenosyl Methionine (SAMe) for Depression in Adults. Cochrane Database Syst Rev. 2016;10:CD011286. doi: 10.1002/14651858.CD011286.pub2

Source: https://www.verywellhealth.com/same-what-should-i-know-about-it-90004