s-adenosylmethionine (generic name)

a nutraceutical product - treats Depression, Osteoarthritis, Cholestasis, Fibromyalgia, Attention deficit hyperactivity disorder, and Liver dis...
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Herbs & Supplements

Synonyms

Ademetionin, ademetionine, adenosylmethionine, Ade-SD4, AdoMet, Geptral (Russian), Gumbaral (German), Heptral (Russian), S-adenosylmethionine, SAM-e, Sammy, Samyr (Italian), sulfoadenosilmethionina (Italian), sulfo-adenosil-L-metionina (Spanish), sulfo-adenosyl-L-methionine sulfate-p-toluensulfonate (stable salt form), sulfo-adenosyl-methionine.

Background

SAMe was first discovered in 1953 by a researcher named Cantoni. It is formed in the body from methionine and adenosine triphosphate in a reaction catalyzed by methionine adenosyltransferase. SAMe functions as a primary methyl group donor in a variety of reactions in the body. After donating a methyl group, SAMe is converted to S-adenosyl-homocysteine.

SAMe is used for psychiatric illnesses, infertility, liver concerns, premenstrual disorders and musculoskeletal disorders, among others.

SAMe has been studied extensively in the treatment of osteoarthritis and depression. Many trials provide evidence that SAMe reduces the pain associated with osteoarthritis and is well tolerated in this patient population. Some evidence is available for the use of SAMe for intrahepatic cholestasis of pregnancy although additional study is needed in this area. Anti-inflammatory and analgesic (pain relieving) activity has also been attributed to SAMe.

Future well-designed clinical trials are required in the areas of depression, fibromyalgia and liver cholestasis before a strong recommendation can be made in these areas.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Osteoarthritis: SAMe has been studied extensively in the treatment of osteoarthritis. SAMe reduces the pain associated with osteoarthritis and is well tolerated in this patient population. Although an optimal dose has yet to be determined, SAMe appears as effective as the non-steroidal anti-inflammatory drugs (NSAIDS). Additional study is warranted to confirm these findings.
Grade: B

Attention deficit hyperactivity disorder (ADHD): Preliminary evidence from an open trial suggests that SAMe may be of benefit for adults with ADHD. More study is needed in this area.
Grade: C

Cholestasis (pregnancy): Curently, there is insufficient available evidence to recommend for or against the use of SAMe for cholestasis (build up of bile in the liver) in pregnant women. It is important to note that there is no information on the use of SAMe prior to the third trimester.
Grade: C

Cholestasis (non-pregnant): SAMe may be beneficial for pruritus (severe itching) and serum bilirubin levels associated with cholestasis associated with non-pregnancy. However, additional study is needed.
Grade: C

Depression: SAMe has been studied for use in depression for many decades, however, currently available trials are inconclusive.
Grade: C

Fibromyalgia: Since fibromyalgia is characterized by chronic pain and depressive symptoms, there is an increased interest in studying SAMe for this indication. Current available evidence, however, does not appear to show any benefit of SAMe over placebo in reducing the number of tender points and in alleviating depression. Additional study is needed to confirm these findings.
Grade: C

Liver disease (general): Preliminary evidence suggests that SAMe may normalize levels of liver enzymes in individuals with liver disease. Additional study is needed in this area.
Grade: C

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