Ademetionine (SAM)

What is ademetionine?

Ademetionine is a variant of the naturally occurring amino acid, methionine. It is otherwise known as S-adenosylmethionine(SAM)

Ademetionine is produced in the body. Its production is determined by folate, methionine, or vitamin B-12. When any of these are low in the body, ademetionine will also be low in the body. You will never believe ademetionine is not found in any food substance. This implies that when it’s not produced in sufficient amount in the body, you can’t readily supplement it in food.

It can only be synthesized and made available as a supplementary drug. It is available in Europe as a prescription drug.

What ademetionine does in the body?

It is important in the immune system. It is also useful in the maintenance of cell membranes.

It breaks down chemicals in the brain. Examples of such chemicals are dopamine, serotonin, and melatonin.

Its other functions that are yet to be scientifically proven are:

  • Depression treatment option
  • Treatment for liver cirrhosis
  • Treatment option for prolonged viral hepatitis
  • Treatment option for pregnancy-induced jaundice
  • Treatment for Gilbert’s syndrome
  • Fibromyalgia treatment option
  • Management of AIDS-associated nerve abnormalities
  • Treatment of cholestasis

Photo Credit: Wikipedia

The side effects of ademetionine

Although it can be unsafe for most adults, SAM can promote the following side effects:

  • anorexia
  • dry mouth
  • gas
  • vomiting
  • headache
  • serotonin syndrome
  • constipation
  • sweating
  • dizziness
  • diarrhea
  • flushing
  • nervousness
  • skin rashes
  • mild insomnia
  • depression
  • palpations
  • anxiety
  • stomach pains at the onset of administration

To avoid stomach pains and allow the body to adjust to the medication, you can begin with smaller doses and gradually progress to a full one.

Administration of ademetionine

SAM comes in two forms -oral and intravenous.

Mayo Clinic has submitted the following adult doses that have proven to be very effective:

  • for osteoarthritis: 600 – 1200 mg in one to three divided doses daily
  • for cholestasis: up to 1600 mg per day
  • for depression: 800 – 1600 mg every day
  • for fibromyalgia: 400 mg two times daily
  • for liver disease: 600 – 1,200 mg every day

Full dose is 400mg thrice or four times a day.

Ademetionine is unsafe for children.

The benefits of ademetionine

SAM has beneficial use in the following conditions:

  • adult ADHD (attention deficit hyperactivity disorder)
  • depression
  • osteoarthritis
  • liver disease
  • cholestasis
  • fibromyalgia
  • premenstrual syndrome
  • multiple sclerosis
  • heart malfunctioning
  • migraine
  • seizures
  • spinal cord injuries

Some of these conditions have not been scientifically validated to be 100% synthesized ademetionine.

What the risks of ademetionine are?

Consult with a healthcare provider before taking any medications, including herbs and supplements.

Ademetionine is considered safe for most adults. However, it can worsen symptoms in patients with certain disorders, such as bipolar disorder or Parkinson’s disease. Pregnant or breastfeeding women should not take SAM.

Since it affects the central nervous system, SAM may interfere with surgery. Its use should be discontinued at least two weeks prior to surgery.

SAM interacts with serotonin, a chemical in your brain. When combined with medications that also affect serotonin, ademetionine can increase the risk of serotonin syndrome. This is a potentially serious condition caused by too much serotonin. Side effects can include heart problems, shivering, and anxiety.

Ademetionine should not be taken with the following medications: fluoxetine, imipramine, antidepressant drugs, clomipramine, amitriptyline, paroxetine, tramadol, tranylcypromine, dextromethorphan, sertraline, pentazocine, meperidine and phenelzine

Neither should it be taken with herbs and supplements that can raise serotonin levels in the blood. Typical examples are: L-tryptophan, levodopa, St. John’s wort and Hawaiian baby woodrose.

Also, SAM shouldn’t be used with anti-diabetic medications because they make it more potent and increase double the risk developing hypoglycemia.

Ademetionine dose should be taken synthesized and then gradually increased until the full recommended dose has been completely taken. Otherwise, it can trigger stomach upset and some unpleasant digestive side effects.


SAM and nonsteroidal anti-inflammatory drugs share something in common. They both are strongly recommended in relieving osteoarthritis-induced pain.

Its use for treating fibromyalgia, depression, and liver cholestasis are not yet scientifically proven.