SAM-e for Fibromyalgia & Chronic Fatigue Syndrome

The Possible Benefits

SAM-e (S-adenosylmethionine) and Energy, Pain, Neurotransmitter Balance:

SAM-e is a co-enzyme your body makes and uses to build a variety of important molecules. It's also important in the production of the neurotransmitters serotonin and dopamine, which can be low in people with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS).

Some studies suggest that SAM-e is effective at relieving FMS symptoms such as pain, morning stiffness and tender-point count, as well as mood disorders and depression symptoms.

It's not as well researched in connection with ME/CFS, but many experts say anecdotal evidence supports its use.

SAM-e Dosage:

Many doctors recommend starting with 400 mg a day of SAM-e and increasing the dosage if you tolerate it well, possibly to as high as 800 mg a day.

SAM-e should be taken on an empty stomach. t can be stimulating, so it's best to take it early in the day so it doesn't disrupt your sleep.

SAM-e in Your Diet:

You can't get SAM-e through your diet -- it's produced naturally by your body. Supplements are one way to increase the available amount.

Side Effects of SAM-e:

Possible side effects of SAM-e include:

  • Digestive problems, especially nausea
  • Skin rash
  • Lowered blood sugar
  • Dry mouth
  • Bloody stool
  • Thirst
  • Increased urination
  • Headache
  • Hyperactivity
  • Anxiety
  • Insomnia

People with Parkinson's disease shouldn't take SAM-e. Because of an association with mania and hypomania, those with bipolar disorder, anxiety disorders or other psychiatric conditions should be under the close supervision of a healthcare provider when taking SAM-e.

We don't have safety data on SAM-e use during pregnancy or breastfeeding.

More Supplement, Serotonin & Dopamine Information:


American Journal of Medicine. 1987 Nov 20;83(5A):107-10. "Evaluation of S-adenosylmethionine in primary fibromyalgia. A double-blind crossover study."

Scandinavian Journal of Rheumatology. 1991;20(4):294-301. "Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation."

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