Ademetionine, also known as SAMe (pronounced ‘‘sammy’’), is a specific form of the amino acid methionine (S-adenosyl-methionine). The body manufactures it, and it is found in most tissues of the body. Ademetionine is essential for the formation of glutathione, a water-soluble peptide that helps the body fight free radicals.

SAMe also helps the liver to process fats (protecting against a fatty liver) and is believed to play a role in protecting the body from heart disease. SAMe is a methyl donor, which means that it provides other molecules with methyl groups that are critical to their metabolism.

In general, ademetionine raises the level of functioning of other amino acids in the body. Severe deficiencies of SAMe can cause problems with other important body functions, such as secretion of important hormones such as melatonin, which plays a key role in regulating sleep and circadian rhythms.

It is believed to increase levels of serotonin and dopamine, and a synthetic version of SAMe may be useful in treating some conditions, including osteoarthritis and depression.

The United States Food and Drug Administration does not regulate supplements such as ademetionine, which means that supplements have not proven to be safe or effective. The safety of ademetionine for use by children, pregnant women, and nursing mothers has not been established.

In addition, ingredients are not standardized to comply with federal regulations. SAMe is not suitable for patients with bipolar disorder, as it may amplify the manic phase of the condition. People should consult their doctor or practitioner before taking SAMe.

This is especially important for people with pre-existing conditions such as those previously mentioned. One possible drawback to ademetionine treatment is its cost. One company in 2008 offered a bottle containing 30 200-mg tablets for about $40. Another vendor sold 30 400-mg tablets for that price.

Since daily dosages vary by condition, it could cost up to $100 or more for a month’s supply of ademetionine. In addition, SAMe is not likely to be covered by medical insurance.

Side effects of ademetionine could include gastrointestinal conditions such as nausea, vomiting, constipation, and diarrhea. Other side effects include increased thirst, heartburn, skin rash, anxiety, dizziness, headaches, insomnia, and sweating.

In patients who are deficient in the B vitamins, notably B6 and B12, there is a danger that SAMe may break down to form homocysteine, an amino acid that has been linked to heart disease and stroke.

If the patient’s levels of B vitamins are maintained, then, the body will be able to convert the homocysteine back into methionine and glutathione. As a result, use of SAMe will supposedly not increase the risk of heart disease. Ademetionine should not be used in conjunction with prescription medications such as anti-depressants and MAO inhibitors.