How to Take Sam‐E

Administering Each Dose

Take SAM-e on an empty stomach. SAM-e absorbs better if you take it on an empty stomach. Consume each dose about 1 hour before a meal or 2 hours after a meal so that your stomach is empty. This will help you get the maximum benefit from the medication. For instance, take it as soon as you wake-up, then wait an hour before you eat breakfast.

Drink a full glass of water with SAM-e to possibly avoid heartburn. You might get heartburn or minor upset stomach while taking SAM-e. While you shouldn’t eat a snack with your supplement, it’s safe to drink water. Consume a full glass of water with SAM-e to help wash it down. This may prevent heartburn and stomach issues. If you’re still having heartburn, you might increase how much water you’re drinking. However, it may be best to talk to your doctor about other treatments. SAM-e does not interact with over-the-counter heartburn medications, so it's likely safe to take them together. However, it's best to check with your doctor first.

Use SAM-e early in the day so you're less likely to get insomnia. Since SAM-e boosts your serotonin, it might make it hard for you to fall asleep. To avoid insomnia, take your medication earlier in the day so the effects wear off before bed. Finish your last dose by dinner time for best results. If you’re taking 1 dose, take it in the morning. If you’re taking 2 doses, take them in the morning and an hour before lunch. If you’re taking 3 doses, take them in the morning, an hour before lunch, and in the late afternoon. If you're taking 4 doses, take 1 before breakfast, 1 mid-morning, 1 in early afternoon, and the last before dinner.

Choosing the Right Dose

Take 800 to 1600 mg daily in 2-4 divided doses for depression. SAM-e may help improve your depression, though you'll need to take a higher dose than with other conditions. Start out with a lower dose to see if your symptoms improve. Then, slowly increase your dosage up to 1600 mg daily until you find the right dose for you. For instance, if you’re taking 800 mg daily in 2 divided doses, you’d take 400 mg for each dose. SAM-e typically works faster than antidepressants with some people noticing an improvement in their symptoms within 10 days. However, for some people it can take up to 6 weeks to notice an improvement. If you still don’t notice an improvement at 1600 mg daily after 6 weeks, don’t keep increasing your dose. Instead, talk to your doctor about other treatment options that may work for you.Tip: It’s best to start with a low dose of 200 mg a day for the first week. Then, increase your dose to 400 mg a day after a week and then 800 mg daily during week 2. When you reach week 3, increase your dosage to 1600 mg daily unless you're experiencing side effects. This allows you to make sure SAM-e doesn’t negatively affect you.

Use 600 to 1200 mg daily in 3 divided doses for arthritis. SAM-e may relieve pain and stiffness from arthritis. Additionally, it might help improve your mobility. Start with a 600 mg daily dose to see if it helps you. If you don’t get the benefits you want, slowly increase your dose up to 1200 mg. As an example, you might take 200 mg 3 times a day for a 600 mg divided dose. If you're taking 900 mg daily, take 300 mg 3 times a day. For a 1200 mg daily dose, you'd take 400 mg 3 times a day. If you’re not getting the results you want at 1200 mg daily, see your doctor to discuss your treatment options.

Consume 400 to 1600 mg in 2 divided doses daily for fibromyalgia. Like with arthritis, SAM-e may improve pain and stiffness from fibromyalgia so you can move around better. Take 200 mg daily to see if it works for you. If you don’t see improvements, increase your dosage up to 800 mg daily. For example, take 200 mg in the morning and 200 mg an hour before lunch time. Alternatively, take 400 mg or 800 mg in the morning and an hour before lunch.

Take 600 to 1200 mg in 2 divided doses for 6 months for liver disease. While there’s no conclusive evidence it helps liver disease, SAM-e may help improve your liver function if you have chronic liver disease caused by alcoholism or medications. Talk to your doctor about taking 600 mg a day to support your liver. If you don’t improve, ask if it’s okay to increase your dose to 1200 mg a day. For instance, take 300 mg in the morning and 300 mg an hour before lunch time. As another option, take 400 mg in the morning and 400 mg before lunch. Similarly, you could take 600 mg before breakfast and then again an hour before lunch. If you’re taking SAM-e for liver disease, work with your doctor to make sure you’re using the supplement safely.

Using SAM-e Safely

Talk to your doctor if you have bipolar disorder. While SAM-e might help depression, it may also trigger a manic episode if you have bipolar disorder. Additionally, you may experience extreme anxiety. Don’t take SAM-e if you have bipolar disorder without checking with your doctor. They may recommend that you avoid taking it or they might recommend a medication to help stabilize your mood. You have other options for managing your bipolar disorder, so don’t worry. If SAM-e isn’t right for you, your doctor can help you find something that might work.

Don’t use SAM-e if you’re taking antidepressants or antipsychotics. SAM-e may interact with antidepressants and antipsychotics, so it’s not safe to take them together. Don’t start taking SAM-e while you’re on antidepressant or antipsychotic medications unless your doctor tells you to do so. Otherwise, your serotonin levels may get too high, which can cause serotonin syndrome. Serotonin syndrome can become dangerous. Symptoms of mild serotonin syndrome include agitation, restlessness, confusion, headache, rapid heart beat, high blood pressure, dilated pupils, loss of muscle coordination, twitching muscles, muscle rigidity, heavy sweating, shivering, goosebumps, and diarrhea. Severe serotonin syndrome may cause high fever, irregular heart beat, seizures, and unconsciousness.

Avoid taking other medications or supplements that may increase your serotonin levels. Like with antidepressants, taking other medications that raise your serotonin levels with SAM-e may lead to serotonin syndrome. Check with your doctor to make sure the medications and supplements you take don’t raise your serotonin. Additionally, don’t take any of the following medications while you’re using SAM-e unless your doctor says it's safe: St. John’s Wort Dextromethorphan, which is a cough suppressant Amphetamines NarcoticsTip: Some people can safely use St. John's Wort with SAM-e. However, it's important to check with your doctor to make sure you aren't at risk for serotonin syndrome.

Use caution if you have a weakened immune system. Unfortunately, SAM-e can boost microorganism growth in your body that can cause an infection. Since your weakened immune system can’t fight off infections very well, you might get sick while you’re taking it. Talk to your doctor to find out if SAM-e might be safe for you. However, it might be best to try a different treatment. If you take SAM-e and get sick, stop taking it immediately and go to the doctor for treatment.

When to Seek Medical Treatment

Check with your doctor before using SAM-e supplements. While SAM-e is generally safe, it’s not right for everyone. It may worsen certain medical conditions and may interact with medications you’re taking. Talk to your doctor to make sure SAM-e is safe for you to take. Tell your doctor why you want to take SAM-e. For instance, tell them you want to take SAM-e for depression.

Call your doctor if you experience any side effects. While it’s rare, you might have side effects while taking SAM-e. If you do have side effects, they’ll likely be mild and should go away. However, check with your doctor to make sure you’re okay. Watch for the following side effects: Nausea, constipation, diarrhea, or upset stomach Anxiety Irritability Mild insomnia Dizziness Sweating

Work with your doctor to manage the condition you’re treating. While SAM-e may be beneficial, it may not be the right treatment for you. Your doctor will help you monitor your symptoms to make sure you’re improving. Attend your regular doctor visits and tell your doctor how you’re doing. Additionally, undergo any diagnostic tests they might recommend. For instance, your doctor may test your liver levels to make sure your liver disease is improving. If you aren’t improving, your doctor might recommend you try other treatments.