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3Medicinal

SAM-e

Also sold as S-adenosylmethionine

Used for osteoarthritis and mood; can trigger mania and serotonin excess.

TrustedSupp Tier System™ · Tier 3Take as a defined course
Check before you startThis one has documented interactions with medication classes where the consequences are serious. If you take any prescription medicine, run it past a pharmacist before starting.

Evidence strength

60/100Moderate
WEAKLIMITEDMODERATESTRONGVERY STRONG

What the evidence supports: osteoarthritis pain and depression.

This scores how well-supported the claim above is — not how much benefit you personally would get. A high score on a narrow claim does not extend to everything the product is marketed for.

How long to take it

Course-based, under medical supervision if you have any mood diagnosis.

Who it's actually for

Osteoarthritis and low mood — but not alongside psychiatric medication without oversight.

Safe upper limit

Unverified
No formal limit; 400–1,600 mg daily in trials
Serotonergic. Combined with antidepressants it risks serotonin syndrome, and it can precipitate mania in bipolar disorder.
No source or citation attached yet.

Interactions to know about

Other supplements:

Run your full list through the interaction check.

Practical notes

  • Never combine with SSRIs, SNRIs, tramadol, or St John's wort.
  • Can trigger mania — avoid in bipolar disorder unless a psychiatrist agrees.
  • Take on an empty stomach; enteric-coated tablets absorb better.