SAMe (S-Adenosyl-L-Methionine)

Othermethyl donorModerate dose evidence

Also known as: S-adenosyl-L-methionine, S-adenosylmethionine, ademetionine, SAM-e, SAMe tosylate disulfate, SAMe 1,4-butanedisulfonate

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SAMe is the body's principal methyl donor, made from methionine and ATP, and participates in neurotransmitter synthesis, phospholipid methylation, and cartilage proteoglycan production. As a supplement it is used for mood support and joint comfort. A 2024 meta-analysis of 23 trials found SAMe monotherapy superior to placebo for depressive symptoms with good acceptability, and older trials in knee and hip discomfort showed small effects. It is unstable and hygroscopic, so it is sold as a stabilized salt in enteric-coated, blister-packed tablets.

Research summary

Donates methyl groups for monoamine neurotransmitter synthesis and membrane phospholipid methylation; supports glutathione synthesis via transsulfuration.

Dosage

Daily amounts, of compound.

Lowest studiedTypical rangeHighest studiedUpper limit
400 mg400–1,600 mg

400–1,600 mg of SAMe ion daily, usually 400 mg once or twice daily to start, taken on an empty stomach in the morning. Doses refer to the SAMe ion; the stabilized salts (tosylate disulfate or 1,4-butanedisulfonate) are roughly 40–50% SAMe by weight, so verify the ion content on the supplier CoA. Mood trials commonly ran 6–12 weeks; joint trials often took several weeks for effect.

Standardization: stabilized SAMe salt assayed as SAMe ion (≥ 80% S,S-isomer)

Source material: yeast fermentation, stabilized as tosylate disulfate or butanedisulfonate salt

As supplied: Assumes a salt that is 50% SAMe ion (2 mg raw material per 1 mg SAMe). Tosylate disulfate grades are closer to 40%, requiring 2.5 mg per mg.

Format suitability

  • Capsule
  • Powder
  • Tablet
  • Softgel
  • Gummy
  • Liquid

Extremely hygroscopic and acid-labile; enteric-coated tablets in blister packs are the standard format. Capsules require moisture-protective packaging and stabilized grades. Not suited to powders, gummies, or liquids.

Formulation notes

Serotonergic: interacts with antidepressants (SSRIs, MAOIs), tramadol, dextromethorphan, and St. John's Wort. Can trigger mania in bipolar disorder. Often paired with B12 and folate.

  • Notable drug interactions

Sources

  1. Efficacy and acceptability of S-adenosyl-L-methionine (SAMe) for depressed patients: A systematic review and meta- analysis. (Limveeraprajak, 2024)PubMed
  2. S-Adenosylmethionine for osteoarthritis of the knee or hip. (Rutjes, 2009)PubMed

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