SAM-e

SAMe has been studied mainly for depression, osteoarthritis, and liver diseases; for all three, research has not conclusively shown it is helpful, though there are hints it might be — and some studies used injected SAMe, which may not act like the oral supplement — per the U.S. National Center for Complementary and Integrative Health (NCCIH).

Information on the long-term safety of SAMe is limited because participants in most studies took it only for short periods; in one study of alcohol-related liver disease, participants took SAMe for 2 years and no serious side effects were reported. Side effects of SAMe are uncommon, and when they do occur they are usually minor problems such as nausea or digestive upsets. People with bipolar disorder should not take SAMe for their depressive symptoms except under the supervision of a health care provider, because SAMe may worsen symptoms of mania. Although SAMe has been used to treat cholestasis during pregnancy, its safety during pregnancy has not been established. There is also a theoretical concern that SAMe may promote Pneumocystis infection in immunocompromised people (such as those who are HIV-positive), since SAMe enhances the growth of this microorganism. NCCIH does not state a .

SAMe may decrease the effects of levodopa (L-dopa), a drug used to treat Parkinson's disease. It might also interact with drugs and dietary supplements that increase levels of serotonin, such as antidepressants, L-tryptophan, and St. John's wort. NCCIH advises consulting a health care provider before using SAMe supplements, especially if you are pregnant, nursing, take medicine or other dietary supplements, have bipolar disorder or Parkinson's disease, or are HIV-positive.