From the Guidelines
Ademetionine, also known as SAMe, should not be used as a primary treatment for liver disorders due to lack of consistent benefits on clinical endpoints, as shown in the most recent and highest quality study 1.
Introduction to Ademetionine
Ademetionine, or SAMe (S-adenosylmethionine), is a compound involved in various liver processes, including methylation reactions, glutathione production, and phospholipid synthesis. It has been studied for its potential benefits in improving liver function and reducing symptoms in patients with liver disorders.
Mechanism of Action
Ademetionine works by supporting key liver processes, which help reduce inflammation, protect liver cells from damage, and promote liver regeneration. However, despite its theoretical benefits, the evidence from recent studies does not support its use as a primary treatment for liver disorders.
Evidence from Recent Studies
A 2018 study published in the Journal of Hepatology found that several liver-specific therapies, including S-adenosyl-L-methionine, did not demonstrate consistent benefits on clinical endpoints in patients with alcoholic liver disease 1. Another study from 2013 found that SAMe exerted no statistically significant effects on overall mortality, liver-related mortality, complications, or liver transplantation results in patients with alcoholic liver disease 1. Even earlier studies, such as the 2010 study published in Hepatology, showed that SAMe did not demonstrate any significant benefit on total mortality, liver-related mortality, complications, or liver transplantation in patients with ALD 1.
Clinical Use and Side Effects
While Ademetionine may still be used in some cases under medical supervision, its use should be cautious, especially in patients with bipolar disorder, as it may affect mood. Side effects are generally mild and may include nausea, digestive discomfort, and headache.
Key Points to Consider
- Ademetionine should not be used as a primary treatment for liver disorders due to lack of consistent benefits on clinical endpoints.
- The most recent and highest quality study 1 does not support the use of Ademetionine as a primary treatment for liver disorders.
- Ademetionine may still be used in some cases under medical supervision, but its use should be cautious, especially in patients with bipolar disorder.
- Side effects are generally mild and may include nausea, digestive discomfort, and headache.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Ademetionine Uses in Liver Health
- Ademetionine, also known as S-adenosylmethionine (SAMe), has been implicated in the treatment of liver dysfunction 2.
- Studies have shown that SAMe is effective in improving liver-related parameters with few adverse events, which are primarily mild, transient gastrointestinal complaints 2.
- The most common doses of SAMe used in liver diseases are 1000 mg or 1200 mg per day, with or without another treatment or natural supplement 2.
Clinical Efficacy of S-Adenosylmethionine in Liver Diseases
- S-adenosylmethionine has been shown to possess powerful membrane-stabilizing properties, eliminating the manifestations of cytolysis, cholestasis, and mesenchymal-inflammatory syndrome in patients with non-alcoholic steatohepatitis (NASH) 3.
- Complex therapy with S-adenosylmethionine and Meldonium has been found to be superior to the correction of these syndromes in NASH and chronic kidney disease (CKD) 3.
- S-adenosylmethionine has also been found to increase the albumin-synthesizing function of the liver and prevent the loss of albumins in conditions of CKD 3.
Potential Use of S-Adenosyl-L-Methionine as a Hepatoprotector
- S-adenosyl-L-methionine has been proposed as a potential hepatoprotector for chronic liver diseases, including nonalcoholic fatty liver disease and intrahepatic cholestasis 4.
- Nutritional therapy, including the use of S-adenosyl-L-methionine as a dietary supplement, may have a positive influence on liver function and improve the clinical course of liver diseases 4.
Role of S-Adenosylmethionine in Liver Health and Disease
- S-adenosylmethionine is the principal biological methyl donor synthesized in all mammalian cells, but most abundantly in the liver 5.
- Patients with chronic liver disease have reduced S-adenosylmethionine levels, and mice lacking the enzyme methionine adenosyltransferase (MAT) have reduced hepatic S-adenosylmethionine levels and develop oxidative stress, steatohepatitis, and hepatocellular carcinoma (HCC) 5.
- A normal hepatic S-adenosylmethionine level is necessary to maintain liver health and prevent injury and HCC 5.
Therapeutic Effects of S-Adenosylmethionine
- S-adenosylmethionine has been found to have positive therapeutic effects in animal models with non-alcoholic fatty liver disease (NAFLD) and intrahepatic cholestasis, although these effects have not been confirmed in humans 6.
- S-adenosylmethionine has also been found to prevent hepatic cirrhosis, inhibit experimental tumor growth, and have proapoptotic effects on hepatocellular carcinoma and other cancer cells 6.