S-adenosylmethionine

    Written by:
    Thomas Solomon

    Fact-checked

    by:

    Katie Jantz, Conni Covington
    Last Updated: September 2, 2024

    S-adenosylmethionine (SAMe) is a metabolite in the body that helps maintain several important biological reactions. Low levels of SAMe in the body are associated with several conditions, including liver conditions, chronic kidney disease (CKD), coronary artery disease (CAD), depression, and neurodegenerative conditions like dementia and Alzheimer’s disease. Supplementation with SAMe might improve liver health and depression, but further high-quality clinical trials are needed to confirm those benefits.

    63 references on this page
    9,766 participants in 15 trials and 8 meta-analyses

    Overview

    Dosage information

    Formulations: Tablets taken orally, or liquid injected intravenously or intramuscularly.

    Range of dosages studied: 45 to 3200 milligrams per day (mg/day).

    Dosage recommendation: In some studies, the dosage range that has been found to improve depression is approximately 200 to 1,600 mg/day. In some studies, the dosage range that has been found to improve liver health in people with chronic liver conditions is approximately 800 to 1,200 mg/day

    Take with food: S-adenosylmethionine can be taken with or without food.

    Safety information:

    S-adenosylmethionine can interact with several drugs including drugs that affect serotonin, including Selective Serotonin Reuptake Inhibitors and Monoamine Oxidase Inhibitors. Due to the increased risk of mania, S-adenosylmethionine is not recommended for people with bipolar disorder.

    Frequently asked questions

    Update History

    Examine Database References

    1. Homocysteine - F M Loehrer, R Schwab, C P Angst, W E Haefeli, B FowlerInfluence of oral S-adenosylmethionine on plasma 5-methyltetrahydrofolate, S-adenosylhomocysteine, homocysteine and methionine in healthy humansJ Pharmacol Exp Ther.(1997 Aug)
    2. Homocysteine - Thompson MA, Bauer BA, Loehrer LL, Cha SS, Mandrekar JN, Sood A, Wahner-Roedler DLDietary supplement S-adenosyl-L-methionine (AdoMet) effects on plasma homocysteine levels in healthy human subjects: a double-blind, placebo-controlled, randomized clinical trialJ Altern Complement Med.(2009 May)
    3. Homocysteine - Gören JL, Stoll AL, Damico KE, Sarmiento IA, Cohen BMBioavailability and lack of toxicity of S-adenosyl-L-methionine (SAMe) in humansPharmacotherapy.(2004 Nov)
    4. Depression Symptoms - A Di Rocco, J D Rogers, R Brown, P Werner, T BottiglieriS-Adenosyl-Methionine improves depression in patients with Parkinson's disease in an open-label clinical trialMov Disord.(2000 Nov)
    5. Osteoarthritis Symptoms - Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BMSafety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritisJ Fam Pract.(2002 May)
    6. Osteoarthritis Symptoms - Kim J, Lee EY, Koh EM, Cha HS, Yoo B, Lee CK, Lee YJ, Ryu H, Lee KH, Song YWComparative clinical trial of S-adenosylmethionine versus nabumetone for the treatment of knee osteoarthritis: an 8-week, multicenter, randomized, double-blind, double-dummy, Phase IV study in Korean patientsClin Ther.(2009 Dec)
    7. Osteoarthritis Symptoms - Caruso I, Pietrogrande VItalian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint diseaseAm J Med.(1987 Nov 20)
    8. Osteoarthritis Symptoms - Wadie I Najm, Sibylle Reinsch, Fred Hoehler, Jerome S Tobis, Phillip W HarveyS-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495]BMC Musculoskelet Disord.(2004 Feb 26)
    9. Osteoarthritis Symptoms - Hardy ML, Coulter I, Morton SC, Favreau J, Venuturupalli S, Chiappelli F, Rossi F, Orshansky G, Jungvig LK, Roth EA, Suttorp MJ, Shekelle PS-adenosyl-L-methionine for treatment of depression, osteoarthritis, and liver disease.Evid Rep Technol Assess (Summ).(2003 Aug)
    10. Osteoarthritis Symptoms - Rutjes AW, Nüesch E, Reichenbach S, Jüni PS-Adenosylmethionine for osteoarthritis of the knee or hip.Cochrane Database Syst Rev.(2009 Oct 7)
    11. Fibromyalgia Symptoms - Jacobsen S, Danneskiold-Samsøe B, Andersen RBOral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluationScand J Rheumatol.(1991)
    12. Liver Fibrosis - Medici V, Virata MC, Peerson JM, Stabler SP, French SW, Gregory JF 3rd, Albanese A, Bowlus CL, Devaraj S, Panacek EA, Richards JR, Halsted CHS-adenosyl-L-methionine treatment for alcoholic liver disease: a double-blinded, randomized, placebo-controlled trialAlcohol Clin Exp Res.(2011 Nov)
    13. Cholestasis - Binder T, Salaj P, Zima T, Vítek LRandomized prospective comparative study of ursodeoxycholic acid and S-adenosyl-L-methionine in the treatment of intrahepatic cholestasis of pregnancyJ Perinat Med.(2006)
    14. Cholestasis - Walker KF, Chappell LC, Hague WM, Middleton P, Thornton JGPharmacological interventions for treating intrahepatic cholestasis of pregnancy.Cochrane Database Syst Rev.(2020 Jul 27)
    15. Depression Symptoms - Papakostas GI, Mischoulon D, Shyu I, Alpert JE, Fava MS-adenosyl methionine (SAMe) augmentation of serotonin reuptake inhibitors for antidepressant nonresponders with major depressive disorder: a double-blind, randomized clinical trialAm J Psychiatry.(2010 Aug)
    16. Depression Symptoms - Sarris J, Papakostas GI, Vitolo O, Fava M, Mischoulon DS-adenosyl methionine (SAMe) versus escitalopram and placebo in major depression RCT: efficacy and effects of histamine and carnitine as moderators of responseJ Affect Disord.(2014 Aug)
    17. Depression Symptoms - Ilaria Galizia, Lucio Oldani, Karine Macritchie, Erica Amari, Dominic Dougall, Tessa N Jones, Raymond W Lam, Guido Jacopo Massei, Lakshmi N Yatham, Allan H YoungS-adenosyl methionine (SAMe) for depression in adultsCochrane Database Syst Rev.(2016 Oct 10)
    18. Depression Symptoms - Peng TR, Cheng HY, Wu TWS-Adenosylmethionine (SAMe) as an adjuvant therapy for patients with depression: An updated systematic review and meta-analysis.Gen Hosp Psychiatry.(2024 Jan-Feb)
    19. Depression Symptoms - Limveeraprajak N, Nakhawatchana S, Visukamol A, Siripakkaphant C, Suttajit S, Srisurapanont MEfficacy and acceptability of S-adenosyl-L-methionine (SAMe) for depressed patients: A systematic review and meta- analysis.Prog Neuropsychopharmacol Biol Psychiatry.(2024 Jun 8)
    20. Attention - Levkovitz Y, Alpert JE, Brintz CE, Mischoulon D, Papakostas GIEffects of S-adenosylmethionine augmentation of serotonin-reuptake inhibitor antidepressants on cognitive symptoms of major depressive disorderJ Affect Disord.(2012 Feb)
    21. Early Virologic Response - Jordan J Feld, Apurva A Modi, Ramy El-Diwany, Yaron Rotman, Emmanuel Thomas, Golo Ahlenstiel, Rachel Titerence, Christopher Koh, Vera Cherepanov, Theo Heller, Marc G Ghany, Yoon Park, Jay H Hoofnagle, T Jake LiangS-adenosyl methionine improves early viral responses and interferon-stimulated gene induction in hepatitis C nonrespondersGastroenterology.(2011 Mar)
    22. Liver Enzymes - Santini D, Vincenzi B, Massacesi C, Picardi A, Gentilucci UV, Esposito V, Liuzzi G, La Cesa A, Rocci L, Marcucci F, Montesarchio V, Groeger AM, Bonsignori M, Tonini GS-adenosylmethionine (AdoMet) supplementation for treatment of chemotherapy-induced liver injuryAnticancer Res.(2003 Nov-Dec)
    23. Bilirubin - Tao Guo, Lei Chang, Yusha Xiao, Quanyan LiuS-adenosyl-L-methionine for the treatment of chronic liver disease: a systematic review and meta-analysisPLoS One.(2015 Mar 16)