Evidence

These uses have been tested in humans or animals.  Safety and effectiveness have not always been proven.  Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Key to grades

A
Strong scientific evidence for this use
B
Good scientific evidence for this use
C
Unclear scientific evidence for this use
D
Fair scientific evidence against this use (it may not work)
F
Strong scientific evidence against this use (it likely does not work)

Grading rationale

Evidence gradeCondition to which grade level applies
B

Osteoarthritis

SAMe has been widely studied for the treatment of osteoarthritis. There is evidence that SAMe may reduce the pain of osteoarthritis and may be well tolerated. Results suggest that SAMe may be more effective than placebo and as effective as anti-inflammatory drugs. Doses have ranged from 600 to 1,200 milligrams taken by mouth daily, but the optimal dose still needs to be determined.
C

Attention-deficit hyperactivity disorder (ADHD)

Early evidence suggests that SAMe may benefit adults who have ADHD. Higher-quality studies are needed before conclusions can be made.
C

Bile flow improvement

Some evidence suggests that SAMe may treat symptoms linked to bile flow problems. However, information is still limited. A report has been published on the use of SAMe during tube feeding for the treatment of bile flow problems. Higher-quality research is needed in this area.
C

Bile flow improvement (pregnancy)

Conclusions are unable to be made on the use of SAMe for bile flow problems during pregnancy. One trial suggests that SAMe may be no better than placebo in treating symptoms of the condition. In the available studies, SAMe appears to have been well tolerated and lacking side effects on mothers or newborns. Common doses range from 500 milligrams taken by mouth twice daily to 800 milligrams through an intravenous (IV) tube daily. Information on the use of SAMe before the third trimester is still lacking.
C

Depression

SAMe has been widely studied for use in depression. However, high-quality studies are lacking. Some available evidence suggests that SAMe may be more effective than placebo. Most trials comparing SAMe to antidepressants are short-term only (less than three weeks). It is known that antidepressants require at least 4-6 weeks to show full effectiveness. One trial was conducted over six weeks and suggested that SAMe may not be as effective as antidepressants. Higher-quality research that compares SAMe to other antidepressants and is conducted for at least six weeks is needed. Firm conclusions are lacking at this time.
C

Fibromyalgia (chronic muscle pain)

Fibromyalgia is known to cause chronic pain and depressive symptoms. SAMe has been studied for the relief of these symptoms. Evidence is mixed with regard to possible benefits of SAMe. More research is needed before firm conclusions can be made.
C

Liver disease (general)

Early evidence suggests that SAMe may benefit people who have liver disease. The use of nutrition supplements, such as SAMe, has been studied for liver disease. High-quality clinical trials are needed before conclusions can be made.
C

Schizophrenia

Early research suggests that SAMe may treat some symptoms of schizophrenia. These include aggression, quality of life, and depression. However, SAMe may cause irritability. More research is needed in this area.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acetaminophen toxicity, adjustment disorder, aging, alcoholism, Alzheimer's disease, antioxidant, anxiety, bursitis (inflammation between joints and muscles), cirrhosis (primary biliary, inflammation of bile ducts), dementia, gastritis (inflammation of stomach lining), Gilbert's syndrome (high levels of bilirubin, a toxic substance), head injury, heart disease, hepatitis, hepatitis (in children), high cholesterol, infertility, lead toxicity, liver toxicity (caused by drugs or toxins), male sterility, memory, metabolic abnormalities, migraine, multiple sclerosis, nerve pain, nervous system disorders, pancreatitis (pancreas inflammation), Parkinson's disease, postpartum depression, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), psychiatric illness, rheumatoid arthritis, seizures, Sjögren's syndrome (dry eyes and mouth), spinal cord injury, stroke, systemic sclerosis (autoimmune disease of skin and blood vessels), tendonitis (tendon inflammation).

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com