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SAMe Uses, Dosage, & Side Effects
SAMe (s-adenosyl-methionine) is beneficial for musculoskeletal conditions like osteoarthritis and fibromyalgia and shows great promise for persons with Alzheimer's disease. This prized supplement is also used to treat acute liver disease provided a blood test is taken to ascertain effectiveness. And, SAMe has also been shown to be an anti-depressant. SAMe enhances the function of amino acids, hormones, lipids, minerals and neurotransmitters and is found in almost every tissue of the body.
SAMe Dosage Guidelines
SAMe tablets are enterically coated to enable them to pass through the stomach intact and be absorbed in the small intestine. Best results are obtained when SAMe is taken on an empty stomach but it can be taken with meals if necessary to avoid stomach irritation. Since SAMe is unstable at higher temperatures, it should be kept refrigerated whenever possible.
It is probably best to take SAMe during the day and avoid evening doses because the bodys natural rhythm is to have SAMe levels high during the day and low at night. This is a complement to the melatonin cycle which has melatonin levels low in the day and high at night. SAMe facilitates the conversion of serotonin to melatonin.
Below are dosage ranges of SAMe that have been used as nutritional support for various conditions.
SAMe can cause nausea and gastrointestinal upset in some sensitive people, so we recommend starting with the lower dosage and increasing the dosage as tolerated. Some individuals may benefit from lower dosages as well.
Depression -- Four hundred milligrams, three to four times daily. Start at a dosage of 200 milligrams twice daily for the first day. Increase to 400 milligrams twice daily on day three, 400 milligrams three times daily on day ten, and finally to the full dosage of 400 milligrams four times daily after 20 days, if required.
Osteoarthritis -- Start by following the guidelines for depression. After 21 days at a dosage of 1,200 milligrams daily, reduce dosage to a maintenance dosage (minimum dosage required to alleviate symptoms) of two hundred milligrams a day.
Fibromyalgia -- Two hundred milligrams to four hundred milligrams, two times daily.
Liver Disorders -- Two hundred milligrams to four hundred milligrams, two to three times daily.
Migraine Headaches --Two hundred milligrams to four hundred milligrams, two times daily (Requires long term use of SAMe for maximum effectiveness).
SAMe Side Effects & Precautions
SAMe is extremely safe and non-toxic. In clinical studies, SAMe is typically compared against placebo and other compounds for benefits and side effects. While SAMe usually produces beneficial effects superior to drugs and other nutrients, it often produces an incidence of side effects that are lower than the placebo!
While antidepressants can cause liver damage, SAMe has been shown in numerous studies to be liver-protective. SAMe also has no withdrawal reaction, commonly found when antidepressants are stopped abruptly.
After beginning SAMe supplementation, a positive response is often felt within a week of starting the program, and often within days, but it may take as long as four weeks.
In a few sensitive individuals, SAMe may cause gastric irritation or an upset stomach. While it is preferable to take SAMe on an empty stomach, it can be taken with meals if necessary to avoid upset stomach.
SAMe's antidepressant activity may lead to the manic phase in individuals with bipolar (manic) depression.
Though not reported in the literature, higher doses may occasionally lead to anxiety even in non-bipolar individuals. If the anxiety continues even on the lowest dose, the product should be discontinued.
SAMe should not be combined with anidepressan medications or supplements without a doctor's approval. SAMe may cause increased levels of serotonin. In worst case scenarios, SAMe could contribute to serotonin syndrome when combined with prescription antideressant medications or serotonin boosting supplements like St. John's Wort, 5-htp, and tryptophan. There are also other drugs and supplements which may interact with SAMe to raise serotonin levels. Always check with your pharmacist about possible interactions between any drugs, herbs or supplements that you are taking.
To avoid conversion of SAMe into high levels of homocysteine you should also be taking the cofactors, vitamin B6 (50 mg), vitamin B12 (1000 mcg), and folic acid (800 mcg), to enhance production of the SAMe precursor, methionine. Homocysteine has been implicated as a contributing factor in heart disease, osteoarthritis and other degenerative conditions.