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ingestible · for fibromyalgia

SAMe (S-Adenosylmethionine)

Reviewed by the Nimbera editorial team · Last updated May 2026

Jacobsen et al. 1991 (PMID 1925418; Scand J Rheumatol, 20(4):294-302) conducted a 6-week double-blind RCT in 44 fibromyalgia patients comparing oral SAMe 800 mg/day versus placebo. Active treatment showed statistically significant improvements in clinical disease activity (p=0.04), pain (p=0.002), fatigue (p=0.02), morning stiffness (p=0.03), and mood (p=0.006).$40-80/month

How to use

The dose used in positive fibromyalgia trials is 800 mg/day, typically taken as 400 mg twice daily on an empty stomach (30-60 minutes before meals) to maximize absorption. SAMe is unstable and must be stored in foil blister packs away from heat and light. Allow at least 4-6 weeks for effects to develop. Take with B vitamins (B6, B12, folate) to support the methionine cycle.

How it works

SAMe is the body's primary methyl donor, participating in synthesis of neurotransmitters (serotonin, dopamine, norepinephrine) and modulation of pain pathways. Its proposed benefit in fibromyalgia combines mild analgesic, antidepressant, and anti-inflammatory activity through methylation reactions in the central nervous system.

Where to buy

Pharmacies (Nature Made, Jarrow Formulas, NOW Foods) and health food stores. Buy enteric-coated tablets in foil blister packaging. Online through Amazon or iHerb. Choose products with independent third-party testing (USP, NSF).

Typical cost: $40-80/month

Safety notes

Contraindicated in bipolar disorder - SAMe can trigger hypomania or mania. Do not combine with antidepressants (SSRIs, SNRIs, MAOIs, tricyclics) without physician supervision due to risk of serotonin syndrome. May decrease effectiveness of levodopa in Parkinson's disease. Avoid if pregnant or breastfeeding. Side effects include nausea, digestive upset, and anxiety especially at higher doses. Consult your physician before starting, particularly if you take any psychiatric or neurological medications.

Drug & supplement interactions

  • Always tell your doctor or pharmacist about any supplements you take.
  • Interactions can occur with prescription medications, blood thinners, and immunosuppressants.
  • Herbal remedies can affect how the body absorbs or metabolises drugs.
  • Check drugs.com interactions checker before starting.

Clinical source

Jacobsen et al., Scand J Rheumatol 1991

This information is compiled from primary clinical literature and is for informational purposes only. It is not a substitute for professional medical advice. Read our full disclaimer.