Your body makes many types of chemical substances to regulate cell-level activities as well as hormones. One such substance is SAM-e which is a short form of S-Adenosyl-L-Methionine. Though your body makes it, dietary supplements are gaining popularity over the last few years. The key raw material used for the making of SAM-e is an amino acid known as methionine. Almost all of your cells contain this substance which plays a critical role in many metabolic and cell-level functions. Changes in the levels of SAM-e have led to mood shifts such as depression as well as hepatic disorders like inflammation of liver. Quite interestingly, when people living with depression and arthritis took SAM-e, many of them reported an improvement in their pains. It has the needful clearance to be used for the case management of mental conditions in many countries. As this supplement is gaining a wider acceptance, many other uses of this chemical are fast emerging. However, SAM-e is also known to trigger a few adverse side effects.

In the US, it is called as SAM-e while in Europe it is known as ademetionine or simply, Ado-Met. These names refer the same thing – S-Adenosyl-L-methionine or S-Adenosyl methionine. Though its presence in the human body was discovered before the 1960s, its use is gaining wider acceptance only over last few years. SAM-e is made from amino acids found in foods; the base substance is an amino acid called methionine. Of its many properties, SAM-e is well-known for its ability to streamline cell-level functions. In the US, SAM-e is used as a dietary-supplement.

Those with hepatic disorders as well as mental conditions like mood swings, anxiety or depression are known to have an imbalance of SAM-e. Medical science is now doing in-depth research on the anomalous levels of SAM-e and the impact on hepatic health, mental wellbeing as well as cellular health. Intake of supplements of SAM-e for a longer span of time is not known to trigger any major side effects. The supplement is known to avoid typical side effects of antidepressants such as impotence, drop in libido or other sexual health conditions, increase in body weight, etc. However, it is highly recommended to talk to a qualified medical practitioner before starting to take this supplement.

This amino-acid based chemical is known for its pain relieving capabilities as well as anti-inflammatory properties. The substance is also known to boost the levels of norepinephrine, dopamine as well as serotonin. It is used for the case management of a wide range of conditions such as hepatitis, arthritis, muscular conditions such as cramps, pain or spasms, etc. Despite a wide range of treatment possibilities, the efficacy of SAM-e against most of them is not evidenced yet in full. So, based on known trails as well as beneficial outcomes, the substance is used as a pain-reliever, antidepressant medication, an agent to boost brain activities, etc.

Side effects of SAM-e

It is administered orally on a daily basis. The strength of daily dose varies between 500 to 1,200 mg. The severity of your medical condition, your age and gender are key variables which influence your dosage levels. The levels of initial dosing are kept at a very low level of say, less than 400 mg every day. In order to treat depression or other mood related problems, doses range from 700 to 1300 mg, administered on a daily basis. The doses are often divided into three of four to minimize risks of serotonin build-up and a few other side effects. The medication plan is prescribed for a period of upto 3 months to yield better mental health.

However, for autoimmune conditions like osteoarthritis, the dosage strength is between 500 to 1000 mg each day; administered in more than 2 equally divided doses daily. The duration of the treatment plan is relatively long; in this case, it can be upto 6 to 7 weeks. In case of shots, the dosage levels are much less – they range in the order of 300 to 350 mg, based on your medical condition, age, gender and above all, how well your body responds to these shots. Once your body gets used to the active ingredients and the initial responses are encouraging, the doses are increased based on your age and gender. It is a good practice to study all the dosage-directions printed on the pack.

It is also a good practice to read the medication guide or booklet available at your pharmacist’s during each refill. It is highly recommended to take the drug on empty-stomach. Also, it is important to take it in the morning hours. Intake of SAM-e earlier in the day gives it more time to process the drug. An added advantage of taking SAM-e early is the drug will hardly interrupt your sleeping cycles or disturb your sleep.

In general, SAM-e is unlikely to trigger any major side effects. Some of the common side effects this supplement is likely to trigger include abdominal discomforts such as nausea, indigestion, diarrhea, flatulence, bloating, formation of gas, dehydration or dryness of mouth, etc. It can also lead to a few other conditions like being in a restless state of mind, sleep disorders, stress and anxieties. People with prior mental conditions such as depression, manic disorders or bipolar conditions are advised not to take this drug. People with such mental disorders who took this drug have reported worsening of their condition; especially, people living with bipolar conditions may soon witness acute spells of manic disorders upon taking SAM-e. A few people have also reported signs such as excessive sweating, being in an irritated state of mind, feeling dizzy or drowsy as well as difficulties to pass stools or constipation. Among those with compromised immunity levels, intake of SAM-e is known to have triggered bacterial infections.

Drug interactions and possible side effects of SAM-e

Like most supplements, SAM-e is likely to interact with a few drugs. SAM-e is available in multiple variants can be taken through several routes namely, oral, intravenous (IV) and as shots. It is known to interact adversely with antidepressants; especially, those which can increase serotonin levels. People who took this supplement along with mood altering meds reported an increased presence of serotonin. In some instances, increased serotonin has also led to conditions like toxicity. The typical side effects of such a condition include tremors, being restless, erratic or rapid heartbeats, etc. You are hence advised not to co-administer drugs like amitriptyline, fluoxetine, sertraline, paroxetine, imipramine, etc. SAM-e is also known to decrease the effectiveness of drugs used for the treatment of conditions like Parkinson’s disease. For example – drugs like levodopa are known may lose their efficacy when co-administered with this supplement.

SAM-e is also likely to interact adversely with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, etc. or other painkilling drugs. It may also cause a few adverse reactions as well as discomforts when taken along with cough medicines or drugs used for the treatment of common cold. Stay careful and talk to your treating physician prior to taking SAM-e if you are living with diabetes mellitus, Parkinson’s disease, etc. Those who are taking MAO inhibiting drugs need to talk to their treating doctor as well as pharmacist. Those who are taking drugs like tramadol must talk to their treating physician before starting your medication plan involving the intake of SAM-e; the common side effects of co-administration are being in a confused state of mind, stiffening of muscles, shivers, tremors, etc.

People who are living with liver conditions such as inflammation of liver or damage of the liver due to cirrhosis and are taking drugs for treating these conditions need to stay away from taking SAM-e. This supplement is known to minimise or reduce the efficacy of most drugs whose metabolism or further breaking down depends on your liver. If you are planning to undergo a surgery, your surgeon may advise you to stop taking this supplement at least 15 days prior to the date of surgery. The same precaution is also needed for dental interventions. The key reason behind this measure is – SAM-e is known to influence the condition of your blood vessels, and thus may alter the flow of blood. As a surgery or dental procedure may involve bruising and bleeding, SAM-e is avoided to minimise the loss of blood during interventions or surgeries.

Pregnant women and breastfeeding women

Women who are planning to get pregnant or those who are already pregnant are advised not to take it. This mainly because the side effects of this supplement during pregnancy – both early stages as well as advanced stages – are not fully evidenced. Hence, there is very limited research available on the impact of this supplement on health of fetus as well as expecting mothers. Similarly, it is not very clear if SAM-e and its active ingredients pass through mother’s milk. Owing to such limited level of research, it is generally prescribed to women who are nursing a baby or breastfeeding women.

Administration of SAM-e onto infants and children is known to have triggered toxicity. It is not recommended to administer this drug onto younger people without talking to a qualified medical professional, or preferably to a pediatrician. Also, if you have any prior allergies to amino acids or other dietary supplements, you need to share needful details with your physician. Typical allergic reactions include inflammation of oral organs like throat, tongue, etc., breathing problems, loss of consciousness or passing out. Upon witnessing any of these adverse side effects, you are advised to promptly call 911 or contact a local poison control center. Those living in Canada: you are advised to immediately call Health Canada or contact the nearest poison control center located in your province, without any delay.


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