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What is SAM-e?
S-Adenosylmethionine (SAM or SAM-e; pronounced "Sammy") is an amino acid joined with the human energy molecule ATP. It is an essential molecule naturally occurring in the cells of plants and animals and takes part in several biological reactions in the human body. SAM-e is essential for the body to perform vital functions. SAM-e is not an herb. It was discovered in 1952 in Italy, where it is manufactured to this day. Until recently, however, it was exceedingly expensive to produce, and therefore unavailable to the public.  As we age, our bodies produce less SAM-e, so some think that SAM-e may be a helpful supplement when used to treat symptoms of depression. It has been available in European countries through prescription. SAM-e has also been studied extensively in Europe for over 20 years and may be one of the most potent, multi-purpose supplements ever introduced. It has only recently been available over-the-counter in the US as a supplement. 

The body is unable to synthesize adequate quantities of SAM-e so it must be gathered from our diet. Like other substances in the body, such as hormones, levels of SAM-e decline as we age. However, older people are not the only people who can have lower amounts of SAM-e. Low levels of SAM-e have been found in a great variety of age groups. Men have higher levels than women, and children have 7 times more than adults.


The primary claim of this supplement is in the treatment of depression. SAM-e has been used to treat patients, some resistant to other anti-depressants, with great success as well as for other conditions. It seems to be is winning acceptance among the psychiatric community. It is also being proponed to enhance joint health, mobility and joint comfort and supports and promotes liver health. It is also emerging as an effective therapy for arthritis, fibromyalgia, memory problems, ADD and ADHD, osteoarthritis, stress, Parkinson's disease, chronic fatigue syndrome (CFS) and possibly even Alzheimer's disease.

For osteoarthritis, the leading cause of joint pain and stiffness: 400 to 800 mg daily. Promotes flexibility of joint cartilage repair. A German study of 20,641 patients found that 71% of those who took Sam-e supplements for eight weeks reported good or very good results


At present, the safety of SAM-e has not been proven. The U.S. Food and Drug Administration (FDA) does not approve or regulate the distribution of supplements in the United States. Not all formulations of SAM-e are the same. Some brands are more potent than others, depending upon the quality of the ingredients used.

Known Negative Effects / Cautions

SAM-e can have numerous adverse side effects, including:

  • Nausea.

  • Diarrhea.

  • Headache.

  • Anxiety.

  • Flatulence (gas).

  • Causing a change from bouts of depression to periods of intense energy (mania).

Another issue in deciding whether to use SAM-e is cost. The recommended oral dose is 200 to 800 mg twice per day. Most studies used 1,600 mg per day to get any positive effects in relieving depressive symptoms. A 1-month supply of SAM-e at 1,600 mg per day (this would be the highest dose recommended) could cost about $228.

If you are taking anti-depressant medications, consult your physician before using this product. Individuals with bipolar (manic) depression should not use this product unless under medical supervision.

If you suffer from severe depression, don't take SAM-e without consulting your doctor first. This precaution is particularly important if you have a bipolar disorder because SAM-e could trigger or exacerbate mania (the "up" phase) in such cases. If you're taking prescription anti-depressants, don't discontinue them or reduce your dosage without consulting your doctor. SAM-e 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 anti-depressant.

If improperly handled, the raw material used to make SAM-e 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." Look for "enteric coated" 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). If SAM-e is bottled freshness cannot be ensured once the bottle has been opened. Cold form blister packaging ensures the freshness and potency of each SAM-e tablet. Also, tests have shown that some products professing to contain SAM-e have been proven to contain little or none. Purchase SAM-e from a reliable company whose quality standards you trust.

Dosage (Tablet form)

For optimal absorption into the body, the best time to take SAM-e is 2 hours before or 3 hours after a meal. It is best absorbed on an empty stomach. If nausea or heartburn develop, take it with plenty of water. 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. To prevent insomnia, don't take SAM-e late in the day. Most people report a mild energy boost with the supplement.

For optimal mood and emotional well-being, take 400 mg in the morning and 1 400 mg in the afternoon. Clinical studies indicate that benefits may be evident in the first two weeks of supplementation and may continue for a prolonged period of time. As mentioned prior, taking SAM-e at bedtime may interfere with a good night's rest. Clinical studies indicate that benefits may be evident within one week of supplementation. If benefits are not achieved in two weeks, you may require 400 mg 3 times a day -- gradually increase the number of tablets as necessary up to 8 tablets a day, until benefits are achieved. SAM-e can safely be combined with other natural anti-depressants such as St. John's Wort, as well as conventional anti-depressants. Don't take SAM-e with MAO inhibitor anti-depressants.

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


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