A long-term study revealed that SAM supplementation may be helpful in reducing the incidence of migraines in
sensitive individuals.40
Dosage Range
For most conditions the therapeutic dosage range is typically 400 mg, two or three times daily. SAM can cause
nausea and gastrointestinal disturbances in some people, thus, some patients may benefit from starting with 200 mg
doses and working their way up to 400 mg per individual dose.5
1. Depression and Anxiety: 400 mg, three times per day
2. Osteoarthritis: 400 mg, two or three times per day
3. Fibromyalgia: 400 mg, two times per day
4. Liver Disorders: 400 mg, three times per day
5. Migraine Headache: 400 mg, two times per day (as a preventative intervention).2
Adverse Side Effects, Toxicity and Contraindications
SAM should not be taken by individuals with bipolar (manic) depression, which may trigger a manic phase in these
individuals. No other significant side ef ects have been reported with oral SAM supplementation other than
occasional nausea and gastrointestinal disturbances.5
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Accessory Nutrients and Essential Oils
Drug-Nutrient Interactions
No known drug-nutrient interactions have been reported. However, as with folic acid, vitamin B12 and choline, SAM is
a methyl donor, which may speed up the detoxification of various drugs in the liver.41 As well, SAM can af ect
neurotransmitter levels, caution should be exercised when using SAM in conjunction with anti-depressant and anti-
anxiety medications. Excess serotonin production, for example, can lead to serotonin syndrome, characterized by
myoclonus, rigidity, hyperreflexia, shivering, confusion, agitation, restlessness, coma, autonomic instability, low-grade
fever, nausea, diarrhea, diaphoresis, flushing and rarely, rhabdomyloysis and death. This is true for all natural health
products that can either increase the synthesis of serotonin or inhibit its degradation.42.43
1. Marks D, Marks A, Smith C, editors. Basic Medical Biochemistry: a Clinical Approach. Balitmore, MD: Williams & Wilkins. 1996. p. 614-