SAMe is a supplement based on a compound the body makes to attach chemical tags to hundreds of targets, used for liver, joint, and mood conditions. Support is strongest in liver disease, where bile and injury markers improve; mood and joint findings are split. Stomach upset is common; it can tip susceptible people into an elevated, driven mood state. Deficit repair is better supported than topping up a healthy system. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Alanine transaminase | 10–26 U/L men, 10–19 U/L women | Primary liver-injury marker and the endpoint SAMe is most credibly claimed to move |
| Aspartate transaminase | 10–26 U/L | The enzyme that fell significantly in pooled liver trials, making it the most responsive marker |
| Gamma-glutamyl transferase | Under 20 U/L | Sensitive marker of bile-flow obstruction and oxidative stress, the pathway SAMe acts on |
| Total bilirubin | 0.3–1.0 mg/dL | The other marker that fell significantly in pooled trials; tracks bile flow directly |
| Homocysteine | Under 8 µmol/L | Tracks the disposal route for the homocysteine that SAMe metabolism generates |
| Vitamin B12 (serum) | 500–1,000 pg/mL | Determines whether methionine can be regenerated, capping what supplementation can achieve |
| Folate (red-cell) | Above 400 ng/mL | Reflects tissue folate over months rather than the last meal, unlike serum folate |
| Plasma SAMe-to-S-adenosylhomocysteine ratio | No established target; track change from the individual's own baseline | The only direct read on methylation capacity rather than on substrate supply |
Cadence: Baseline panel before starting, repeated at 4 weeks, again at 12 weeks, then every 6–12 months on continued use. Liver enzymes are rechecked at 4 and 8 weeks for a liver indication; homocysteine gets a second look at 8 weeks where baseline B-vitamin status was marginal.