--- title: "SAM-e: Research & Side Effects | BodyHackGuide" url: https://www.bodyhackguide.co/compound/sam-e description: "SAM-e (S-adenosylmethionine): mechanism, clinical studies & side effects." lang: en --- Skip to content Compare notes on r/BodyHackGuide (https://reddit.com/r/bodyhackguide) Compare notes with other researchers. Join r/BodyHackGuide (https://reddit.com/r/bodyhackguide) # SAM-e (S-adenosylmethionine) Supplement: https://www.bodyhackguide.co/wiki#cat-supplement Status Dietary supplement Evidence Not graded on a research bench yet SAM-e (S-adenosylmethionine, also called ademetionine or AdoMet) is a molecule that mammalian cells make from the amino acid methionine and ATP, and it is the main donor of methyl groups for the body's methylation reactions. Reviewed 28 October 2026 01 Overview ## What SAM-e (S-adenosylmethionine) is SAM-e has been sold in the United States as a dietary supplement since 1999, while in Italy ademetionine tablets and injections are authorized prescription medicines (PMID: 35383287; Italian Medicines Agency database, checked 25 October 2026). Trials have tested SAM-e mainly in depression, osteoarthritis and liver disease with mixed results, and Cochrane reviews rated the depression evidence low or very low in quality and called the osteoarthritis evidence inconclusive (PMID: 27727432, PMID: 19821403). ### How it works ### How the body makes SAM-e Cells build SAM-e by joining the amino acid methionine to ATP, the reaction Giulio Cantoni reported in 1953 (PMID: 13084611). The enzyme that does this is methionine adenosyltransferase (MAT). In mammals the MAT1A gene works mainly in the liver and MAT2A in the other tissues, and the liver makes the most SAM-e (PMID: 23073625). Read the full mechanism Show less ### Three pathways that start from SAM-e SAM-e feeds three pathways: methylation, transsulfuration and aminopropylation (PMID: 12418493). - **Methylation (transmethylation).** SAM-e is the methyl group donor in more than 35 reactions that modify DNA, proteins, phospholipids and the catecholamine and indoleamine neurotransmitters (PMID: 7524260). Once SAM-e gives up its methyl group it becomes S-adenosylhomocysteine (SAH), the precursor of homocysteine (PMID: 30309036). - **Transsulfuration.** Through this pathway methionine, by way of SAM-e, is turned into the sulfur compounds cysteine, taurine and glutathione (PMID: 2081482). Glutathione is the main antioxidant inside cells (PMID: 22044287). - **Aminopropylation.** The enzyme adenosylmethionine decarboxylase converts SAM-e to decarboxylated SAM-e, which donates an aminopropyl group to build the polyamines spermidine and spermine (PMID: 30309036). ### SAM-e and the liver Much of the basic liver research on SAM-e comes from the groups of Jose Mato in Spain and Shelly Lu in Los Angeles (PMID: 23073625, PMID: 12060674). Their review reports that people with chronic liver disease have lower MAT activity and lower liver SAM-e (PMID: 23073625). - **Too little SAM-e (mice).** Mice lacking the Mat1a gene have low liver SAM-e and develop fatty liver inflammation (steatohepatitis), and more than half developed liver cancer by 18 months of age (PMID: 12060674). - **Too much SAM-e (mice and children).** Mice lacking the enzyme glycine N-methyltransferase (GNMT) build up excess liver SAM-e and develop liver injury, fibrosis and liver cancer, and children with GNMT mutations have raised liver enzymes (PMID: 23073625). - **Glutathione in people.** In a small controlled study at the University of Bari, liver biopsies showed that 6 months of oral SAM-e at 1.2 g a day raised liver glutathione in 9 patients with alcoholic and 7 with non-alcoholic liver disease, compared with 8 placebo-treated patients with alcoholic liver disease (PMID: 2781235). - **Alcohol-fed animals.** In rats and baboons fed alcohol, liver SAM-e fell before cirrhosis developed, and in baboons oral SAM-e restored liver SAM-e and reduced signs of alcohol-induced oxidative stress and liver injury (PMID: 12163146). ### SAM-e and the brain In a London study, SAM-e in the cerebrospinal fluid (CSF) was lower in severely depressed patients than in neurological controls, and intravenous or oral SAM-e raised CSF SAM-e, which the authors took as evidence that SAM-e crosses the blood-brain barrier in humans (PMID: 2292704). ### Absorption and breakdown Trials have used salts of SAM-e such as the tosylate disulfate and the 1,4-butanedisulfonate (PMID: 19302903, PMID: 12418499). Little of an oral dose reaches the blood: in 20 healthy Chinese volunteers given 1,000 mg of SAM-e tosylate disulfate, plasma exposure after an enteric-coated tablet was about 2 to 3 percent of the exposure after an intravenous infusion (PMID: 19302903). Duke University researchers examined the chemical stability and cell permeability of SAM-e, proposed that SAM-e enters cells only indirectly, and wrote that these properties limit its therapeutic potential (PMID: 35083422). Researchers at Kyoto University and the University of Manchester found that, in mouse and human cell lines, extra SAM-e was broken down to adenine and methylthioadenosine, which inhibit methylation, and that it disrupted circadian rhythms; mice fed SAM-e-enriched food also showed altered daily activity rhythms (PMID: 35383287). ### Studied for - Depression - Osteoarthritis - Liver disease - Intrahepatic cholestasis - Methylation and one-carbon metabolism - Fibromyalgia - Alzheimer's disease ### Benefits listed - Depression scores similar to imipramine in two Italian multicenter trials of 281 and 295 patients (PMID: 12418499) - Hamilton depression response rates as an add-on to serotonin reuptake inhibitors in a 73-patient trial (PMID: 20595412) - Knee osteoarthritis pain compared with celecoxib in a 61-patient crossover trial (PMID: 15102339) - Pain, fatigue and morning stiffness ratings in a 44-patient fibromyalgia trial (PMID: 1925418) Show 3 more Show less - Death or liver transplant in alcoholic cirrhosis, significant only after excluding Child C patients, in a 123-patient trial (PMID: 10406187) - Liver glutathione in a small controlled study of patients with liver disease (PMID: 2781235) - Liver enzymes within 2 weeks in intrahepatic cholestasis, in a systematic review (PMID: 32184941) 02 Research Free with email ## What the research shows No research bench grades SAM-e (S-adenosylmethionine) yet. Benches compare compounds people pair, with the evidence for each. ### Unlock the research summary Enter your email to keep reading. It is free, and it opens these sections on every compound page in this browser. - A summary of the key research - Safety and side effects - A link to the PubMed results You also get the free peptide cheat sheet by email. Unsubscribe anytime. Have an account? Sign in (https://www.bodyhackguide.co/auth) 03 Safety ## SAM-e side effects and interactions ### Side effects #### Common - Stomach discomfort (19 percent) and diarrhea (20 percent) in the SAM-e arm of a 189-patient depression trial (PMID: 24500245) - Abdominal discomfort in 31.3 percent at a doubled SAM-e dose, against 3.8 percent on placebo (PMID: 31733455) - More gastrointestinal side effects than placebo at 1,600 mg a day in a 120-smoker trial (PMID: 22901308) #### Serious events - Switch into hypomania, mania or euphoria in 9 of 11 bipolar patients in a 1989 series (PMID: 2673478) - Two reports of mania or hypomania among 441 SAM-e participants in the 2016 Cochrane review (PMID: 27727432) - A toxic interaction with clomipramine, and serotonin syndrome-like symptoms in one participant of a trial of SAM-e added to antidepressants (PMID: 8434674, PMID: 30115553) - Worse survival associated with SAM-e use during breast cancer chemotherapy in a retrospective cohort of 1,013 women (PMID: 42243831) ### Who should not use it Contraindications **Bipolar disorder.** In a 1989 series, 9 of 11 bipolar patients given SAM-e switched into hypomania, mania or euphoria (PMID: 2673478). A 2022 review wrote that, given the potential for mania in bipolar disorder, a physician able to assess an underlying bipolar tendency should evaluate SAM-e use (PMID: 33900393). Two industry-sponsored ademetionine trials excluded people with a history of major depression or bipolar disease (ClinicalTrials.gov NCT01754714, NCT02200029). Read all the contraindications and cautions Show less **Serotonergic antidepressants.** A toxic interaction with clomipramine (PMID: 8434674), a serotonin syndrome-like reaction in a trial participant taking antidepressants (PMID: 30115553) and mania with psychotic features during combined SAM-e and SSRI use (PMID: 29950497) have been reported. Controlled trials have also given SAM-e together with serotonin reuptake inhibitors and other antidepressants (PMID: 20595412, PMID: 30115553). **Cancer chemotherapy.** In a retrospective Chinese cohort, SAM-e use during breast cancer chemotherapy was associated with worse survival (PMID: 42243831), and in mice SAM-e increased cisplatin kidney toxicity (PMID: 19064128). **Inherited disorders of methionine metabolism.** The same two industry-sponsored ademetionine trials excluded people with known genetic defects of the methionine cycle that cause homocystinuria or high homocysteine (ClinicalTrials.gov NCT01754714, NCT02200029). **Pregnancy and breastfeeding.** Those two trials also excluded pregnant and breastfeeding women (ClinicalTrials.gov NCT01754714, NCT02200029). SAM-e has been tested in intrahepatic cholestasis of pregnancy, where the 2020 Cochrane review found the evidence insufficient to show whether SAM-e works (PMID: 32716060). ### Interactions 3 pairings in our record: 3 with a caution. - Serotonergic antidepressants (SSRIs, clomipramine) Caution A 1993 letter reported a toxic interaction between SAM-e and clomipramine (PMID: 8434674). One participant in a trial of SAM-e added to antidepressants had serotonin syndrome-like symptoms (PMID: 30115553), and a case report described mania with psychotic features during combined SAM-e and SSRI use (PMID: 29950497). Controlled trials have also combined SAM-e with serotonin reuptake inhibitors (PMID: 20595412). - 5-HTP Caution A 42-year-old man developed hypomania about a week after starting SAM-e together with 5-HTP for depression (PMID: 29955516). - Cisplatin and other cancer chemotherapy Caution SAM-e increased cisplatin-related kidney dysfunction in mice (PMID: 19064128), and SAM-e use during breast cancer chemotherapy was associated with worse survival in a retrospective study of 1,013 women (PMID: 42243831). This interaction data is compiled from published research and community reports. It may not be exhaustive. Always consult a healthcare professional before combining compounds. Need bloodwork before starting? Full hormone + metabolic panels from Anabolic Insights. Code CHONCH for first-order discount. Order Bloodwork (https://anabolicinsights.ai/?ref=nwm2zjb) 04 Dosing Free with email ## Dosing No dose on record Our record lists no dose for SAM-e (S-adenosylmethionine). This section holds what it does list. ### Unlock the Dosing section - Route 05 Prices ## SAM-e (S-adenosylmethionine) prices No listings We do not track a vendor for SAM-e (S-adenosylmethionine) yet, so this page states no price. 06 Chemistry ## Chemistry and structure Molecular formula C15H22N6O5S Molecular mass 398.4 g/mol CAS number 29908-03-0 Half-life About 1.7 hours: after a single 400 mg oral dose in 14 healthy adults, plasma SAM-e fell back to baseline with a half-life of 1.7 hours (PMID: 9262350). In a 2009 study of 20 healthy Chinese volunteers given 1,000 mg of SAM-e tosylate disulfate, the terminal half-life averaged about 6 hours after enteric-coated tablets and about 4 hours after an intravenous infusion (PMID: 19302903). View on PubChem (https://pubchem.ncbi.nlm.nih.gov/compound/34755) 07 Related ## Related to SAM-e (S-adenosylmethionine) ### In the same category - 5-HTP (5-hydroxytryptophan)Phase 2 5-HTP (5-hydroxytryptophan) is an amino acid that the body makes from tryptophan on the way to serotonin and melatonin, and the L form sold in supplements has been extracted commercially from the seeds of the West African plant Griffonia simplicifolia.: https://www.bodyhackguide.co/compound/5-htp - Agmatine SulfatePhase 2/3 Agmatine sulfate is the sulfate salt of agmatine, a molecule made by removing a carboxyl group from the amino acid arginine, which is found in mammalian brain, in gut bacteria and in many foods.: https://www.bodyhackguide.co/compound/agmatine - GABA (gamma-aminobutyric acid)Phase 2 GABA (gamma-aminobutyric acid) is an amino acid that serves as the main inhibitory chemical messenger (neurotransmitter) in the brain; the body makes GABA from glutamate, and GABA is also found in foods such as green tea, tomatoes and fermented cheese.: https://www.bodyhackguide.co/compound/gaba - L-GlutaminePhase 3 L-glutamine is an amino acid the body makes for itself, which researchers call conditionally essential because the body's needs may outrun its own production during severe illness or stress.: https://www.bodyhackguide.co/compound/l-glutamine - ProbioticsDietary Supplement Probiotics — defined by the joint FAO/WHO 2001 consensus as "live microorganisms which, when administered in adequate amounts, confer a health benefit on the host" — are the most widely sold and most widely misunderstood category of dietary supplement.: https://www.bodyhackguide.co/compound/probiotics All compounds (https://www.bodyhackguide.co/wiki) ### Compare SAM-e (S-adenosylmethionine) - Alternatives to SAM-e (S-adenosylmethionine): https://www.bodyhackguide.co/alternatives-to/sam-e ### Research tools - Peptide Calculator Reconstitution and syringe units: https://www.bodyhackguide.co/tools/reconstitution - Reconstitution Guide How to mix, step by step: https://www.bodyhackguide.co/guides/how-to-reconstitute-peptides - Nasal Spray Calc mL per actuation: https://www.bodyhackguide.co/tools/intranasal - Half-Life Visualizer Decay curves: https://www.bodyhackguide.co/tools/halflife All articles (https://www.bodyhackguide.co/blog) 08 Questions ## Frequently asked questions What is SAM-e? SAM-e (S-adenosylmethionine, also called ademetionine) is a molecule that mammalian cells make from the amino acid methionine and ATP, and SAM-e is the body's main methyl group donor (PMID: 23073625, PMID: 13084611). SAM-e also feeds the transsulfuration pathway that leads to glutathione and the aminopropylation pathway that builds polyamines (PMID: 12418493, PMID: 2081482, PMID: 30309036). Is SAM-e a supplement or a prescription drug? SAM-e has been sold in the United States as a dietary supplement since 1999 (PMID: 35383287). SAM-e is not an FDA-approved drug: a Drugs@FDA search on 25 October 2026 found no application for ademetionine or S-adenosylmethionine. In Italy, SAM-e is an authorized prescription medicine under the name ademetionine, available as tablets and injections, according to the Italian Medicines Agency database checked on 25 October 2026. Does SAM-e help depression? SAM-e depression trials disagree: two Italian multicenter trials found SAM-e similar to imipramine (PMID: 12418499), while a 189-patient trial found neither SAM-e nor escitalopram better than placebo (PMID: 24500245). Meta-analyses of SAM-e also disagree: the 2016 Cochrane review found only low or very low quality evidence (PMID: 27727432), and a 2024 analysis of 23 trials found that SAM-e alone beat placebo while SAM-e added to antidepressants did not (PMID: 38423354). A 2022 international guideline graded SAM-e added to antidepressants as weakly recommended and SAM-e alone as not currently recommended for unipolar depression (PMID: 35311615). Does SAM-e help osteoarthritis? A 2009 Cochrane review of four placebo-controlled SAM-e trials in 656 people with knee or hip osteoarthritis found only a small pain effect, with a confidence interval that included no effect, and called the evidence inconclusive (PMID: 19821403). In a 61-patient crossover trial, SAM-e reduced knee osteoarthritis pain more slowly than celecoxib, with no significant difference between SAM-e and celecoxib by the second month (PMID: 15102339). Has SAM-e been tested in liver disease? In a 2-year trial of 123 people with alcoholic cirrhosis, SAM-e did not significantly reduce death or liver transplant overall (16 against 30 percent, p=0.077), and the difference became significant only after the 8 patients with Child C disease were excluded (PMID: 10406187). A 24-week SAM-e trial in 37 people with alcoholic liver disease found no difference from placebo in liver tests or liver biopsies (PMID: 22044287). The 2020 Cochrane review found the evidence insufficient to show whether SAM-e works in intrahepatic cholestasis of pregnancy (PMID: 32716060). What side effects has SAM-e shown in trials? Stomach discomfort and diarrhea were the most common SAM-e side effects in a 189-patient depression trial, reported by 19 and 20 percent of the SAM-e group (PMID: 24500245). In a 1989 trial series, 9 of 11 people with bipolar disorder who were given SAM-e switched into hypomania, mania or euphoria, and case reports describe mania during SAM-e use (PMID: 2673478, PMID: 29950497). What is known about SAM-e and antidepressants? Trials have added SAM-e to serotonin reuptake inhibitors with mixed results on depression (PMID: 20595412, PMID: 30115553). Case reports describe a toxic interaction of SAM-e with clomipramine and mania with psychotic features when SAM-e was taken with an SSRI (PMID: 8434674, PMID: 29950497). One participant in a 2018 trial of SAM-e added to antidepressants had serotonin syndrome-like symptoms (PMID: 30115553). Free 2026 Peptide Cheat Sheet (PDF) 38 compounds and blends: vial sizes, BAC water volumes, dosing ranges and bloodwork markers. 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All rights reserved. - Terms: https://www.bodyhackguide.co/terms - Privacy: https://www.bodyhackguide.co/privacy ## Structured data ```json [ { "@context": "https://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://www.bodyhackguide.co/" }, { "@type": "ListItem", "position": 2, "name": "Compounds", "item": "https://www.bodyhackguide.co/compare" }, { "@type": "ListItem", "position": 3, "name": "SAM-e (S-adenosylmethionine)" } ] }, { "@context": "https://schema.org", "@type": "MedicalWebPage", "name": "SAM-e (S-adenosylmethionine)", "description": "SAM-e (S-adenosylmethionine, also called ademetionine or AdoMet) is a molecule that mammalian cells make from the amino acid methionine and ATP, and it is the main donor of methyl groups for the body's methylation reactions (PMID: 23073625, PMID: 13084611). 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SAM-e has been sold in the United States as a dietary supplement since 1999, while in Italy ademetionine tablets and injections are authorized prescription medicines (PMID: 35383287; Italian Medicines Agency database, checked 25 October 2026). Trials have tested SAM-e mainly in depression, osteoarthritis and liver disease with mixed results, and Cochrane reviews rated the depression evidence low or very low in quality and called the osteoarthritis evidence inconclusive (PMID: 27727432, PMID: 19821403).", "activeIngredient": "SAM-e (S-adenosylmethionine)", "administrationRoute": "Oral, Intravenous, Intramuscular", "mechanismOfAction": "How the body makes SAM-e Cells build SAM-e by joining the amino acid methionine to ATP, the reaction Giulio Cantoni reported in 1953 (PMID: 13084611). The enzyme that does this is methionine adenosyltransferase (MAT). In mammals the MAT1A gene works mainly in the liver and MAT2A in the other tissues, and the liver makes the most SAM-e (PMID: 23073625). Three pathways that start from SAM-e SAM-e feeds three pathways: methylation, transsulfuration and aminopropylation (PMID: 12418493). Methylation (transmethylation). SAM-e is the methyl group donor in more than 35 reactions that modify DNA, proteins, phospholipids and the catecholamine and indoleamine neurotransmitters (PMID: 7524260). Once SAM-e gives up its methyl group it becomes S-adenosylhomocysteine (SAH), the precursor of homocysteine (PMID: 30309036). Transsulfuration. Through this pathway methionine, by way of SAM-e, is turned into the sulfur compounds cysteine, taurine and glutathione (PMID: 2081482). Glutathione is the main antioxidant inside cells (PMID: 22044287). Aminopropylation. The enzyme adenosylmethionine decarboxylase converts SAM-e to decarboxylated SAM-e, which donates an aminopropyl group to build the polyamines spermidine and spermine (PMID: 30309036). SAM-e and the liver Much of the basic liver research on SAM-e comes from the groups of Jose Mato in Spain and Shelly Lu in Los Angeles (PMID: 23073625, PMID: 12060674). Their review reports that people with chronic liver disease have lower MAT activity and lower liver SAM-e (PMID: 23073625). Too little SAM-e (mice). Mice lacking the Mat1a gene have low liver SAM-e and develop fatty liver inflammation (steatohepatitis), and more than half developed liver cancer by 18 months of age (PMID: 12060674). Too much SAM-e (mice and children). Mice lacking the enzyme glycine N-methyltransferase (GNMT) build up excess liver SAM-e and develop liver injury, fibrosis and liver cancer, and children with GNMT mutations have raised liver enzymes (PMID: 23073625). Glutathione in people. In a small controlled study at the University of Bari, liver biopsies showed that 6 months of oral SAM-e at 1.2 g a day raised liver glutathione in 9 patients with alcoholic and 7 with non-alcoholic liver disease, compared with 8 placebo-treated patients with alcoholic liver disease (PMID: 2781235). Alcohol-fed animals. In rats and baboons fed alcohol, liver SAM-e fell before cirrhosis developed, and in baboons oral SAM-e restored liver SAM-e and reduced signs of alcohol-induced oxidative stress and liver injury (PMID: 12163146). SAM-e and the brain In a London study, SAM-e in the cerebrospinal fluid (CSF) was lower in severely depressed patients than in neurological controls, and intravenous or oral SAM-e raised CSF SAM-e, which the authors took as evidence that SAM-e crosses the blood-brain barrier in humans (PMID: 2292704). Absorption and breakdown Trials have used salts of SAM-e such as the tosylate disulfate and the 1,4-butanedisulfonate (PMID: 19302903, PMID: 12418499). Little of an oral dose reaches the blood: in 20 healthy Chinese volunteers given 1,000 mg of SAM-e tosylate disulfate, plasma exposure after an enteric-coated tablet was about 2 to 3 percent of the exposure after an intravenous infusion (PMID: 19302903). Duke University researchers examined the chemical stability and cell permeability of SAM-e, proposed that SAM-e enters cells only indirectly, and wrote that these properties limit its therapeutic potential (PMID: 35083422). Researchers at Kyoto University and the University of Manchester found that, in mouse and human cell lines, extra SAM-e was broken down to adenine and methylthioadenosine, which inhibit methylation, and that it disrupted circadian rhythms; mice fed SAM-e-enriched food also showed altered daily activity rhythms (PMID: 35383287).", "legalStatus": "Dietary supplement" } }, { "@context": "https://schema.org", "@type": "FAQPage", "mainEntity": [ { "@type": "Question", "name": "What is SAM-e?", "acceptedAnswer": { "@type": "Answer", "text": "SAM-e (S-adenosylmethionine, also called ademetionine) is a molecule that mammalian cells make from the amino acid methionine and ATP, and SAM-e is the body's main methyl group donor (PMID: 23073625, PMID: 13084611). SAM-e also feeds the transsulfuration pathway that leads to glutathione and the aminopropylation pathway that builds polyamines (PMID: 12418493, PMID: 2081482, PMID: 30309036)." } }, { "@type": "Question", "name": "Is SAM-e a supplement or a prescription drug?", "acceptedAnswer": { "@type": "Answer", "text": "SAM-e has been sold in the United States as a dietary supplement since 1999 (PMID: 35383287). SAM-e is not an FDA-approved drug: a Drugs@FDA search on 25 October 2026 found no application for ademetionine or S-adenosylmethionine. In Italy, SAM-e is an authorized prescription medicine under the name ademetionine, available as tablets and injections, according to the Italian Medicines Agency database checked on 25 October 2026." } }, { "@type": "Question", "name": "Does SAM-e help depression?", "acceptedAnswer": { "@type": "Answer", "text": "SAM-e depression trials disagree: two Italian multicenter trials found SAM-e similar to imipramine (PMID: 12418499), while a 189-patient trial found neither SAM-e nor escitalopram better than placebo (PMID: 24500245). Meta-analyses of SAM-e also disagree: the 2016 Cochrane review found only low or very low quality evidence (PMID: 27727432), and a 2024 analysis of 23 trials found that SAM-e alone beat placebo while SAM-e added to antidepressants did not (PMID: 38423354). A 2022 international guideline graded SAM-e added to antidepressants as weakly recommended and SAM-e alone as not currently recommended for unipolar depression (PMID: 35311615)." } }, { "@type": "Question", "name": "Does SAM-e help osteoarthritis?", "acceptedAnswer": { "@type": "Answer", "text": "A 2009 Cochrane review of four placebo-controlled SAM-e trials in 656 people with knee or hip osteoarthritis found only a small pain effect, with a confidence interval that included no effect, and called the evidence inconclusive (PMID: 19821403). In a 61-patient crossover trial, SAM-e reduced knee osteoarthritis pain more slowly than celecoxib, with no significant difference between SAM-e and celecoxib by the second month (PMID: 15102339)." } }, { "@type": "Question", "name": "Has SAM-e been tested in liver disease?", "acceptedAnswer": { "@type": "Answer", "text": "In a 2-year trial of 123 people with alcoholic cirrhosis, SAM-e did not significantly reduce death or liver transplant overall (16 against 30 percent, p=0.077), and the difference became significant only after the 8 patients with Child C disease were excluded (PMID: 10406187). A 24-week SAM-e trial in 37 people with alcoholic liver disease found no difference from placebo in liver tests or liver biopsies (PMID: 22044287). The 2020 Cochrane review found the evidence insufficient to show whether SAM-e works in intrahepatic cholestasis of pregnancy (PMID: 32716060)." } }, { "@type": "Question", "name": "What side effects has SAM-e shown in trials?", "acceptedAnswer": { "@type": "Answer", "text": "Stomach discomfort and diarrhea were the most common SAM-e side effects in a 189-patient depression trial, reported by 19 and 20 percent of the SAM-e group (PMID: 24500245). In a 1989 trial series, 9 of 11 people with bipolar disorder who were given SAM-e switched into hypomania, mania or euphoria, and case reports describe mania during SAM-e use (PMID: 2673478, PMID: 29950497)." } }, { "@type": "Question", "name": "What is known about SAM-e and antidepressants?", "acceptedAnswer": { "@type": "Answer", "text": "Trials have added SAM-e to serotonin reuptake inhibitors with mixed results on depression (PMID: 20595412, PMID: 30115553). Case reports describe a toxic interaction of SAM-e with clomipramine and mania with psychotic features when SAM-e was taken with an SSRI (PMID: 8434674, PMID: 29950497). One participant in a 2018 trial of SAM-e added to antidepressants had serotonin syndrome-like symptoms (PMID: 30115553)." } } ] }, { "@context": "https://schema.org", "@type": "Organization", "@id": "https://www.bodyhackguide.co#organization", "name": "BodyHackGuide", "alternateName": "BHG", "url": "https://www.bodyhackguide.co", "logo": { "@type": "ImageObject", "url": "https://www.bodyhackguide.co/logo.png", "width": 512, "height": 512 }, "description": "Evidence-based research reference for peptides and nootropics. 273 compound profiles, interactive dosing calculators, vendor price comparisons, and trust-scored vendor reviews scored on a public, reproducible methodology applied to every vendor. 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