Possible side effects Once SAM-e donates its methyl group to the hill in the formation of creatine, carnitine, DNA, tRNA, noradrenaline, and other compounds, is transformed into S-adenosyl-homocysteine (SAH). Normally, homocysteine, in the presence of vitamin B6, vitamin B12 and folic acid (the main co-factors of SAM-e), in the end it enters again into methionine, SAM-e, or cysteine, glutathione and other useful substances. However, if enough is not present in these vitamins, SAM-e is not metabolized in a proper way. As a result, all the benefits of SAM-e is not obtained, and homocysteine may increase to unsafe levels. Elevated levels of homocysteine have been associated with atherosclerosis (hardening and narrowing of the arteries) as well as an increased risk of heart attacks, strokes, liver damage, and possibly Alzheimer’s disease. Because of this, vitamin B supplements are taken with the SAM-e.These vitamins help metabolize homocysteine into other useful compounds. Another side effect of SAMe is insomnia, so that the supplement is usually taken in the morning often. Other side effects reported include lack of appetite, constipation, nausea, dry mouth, sweating, and anxiety / nervousness, but in placebo-controlled studies, these side effects occur with approximately the same rate as in the placebo groups. Some users reported increased anxiety with only 50 mg / day. The range of therapeutic doses from 400mg/d a stands up 1600mg/d a, although higher doses can be used in some cases. 24 Some doctors recommend even lower dose placed in the range of 50 to 200mg/day to treat depression without triggering some severe side effects. Consult your doctor before and while using it.