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SAM-e is not considered an essential nutrient due to the fact that the body is able to manufacture it

Accessed 3 June 2024

Diarrhea is another commonly reported gastrointestinal side effect that may range from mild loose stools to more significant episodes that could lead to fluid and electrolyte imbalances if severe or prolonged

Bremer E, Calteau A, Danchin A, Harwood C, Helmann JD, Mdigue C, Palsson BO, Sekowska A, Vallenet D, Zuniga A, et al

Excessive production of reactive oxygen species (ROS) within the synovial environment contributes to mitochondrial dysfunction , lipid peroxidation, and chondrocyte apoptosis

However, real-world experience and the pharmacokinetic principles of volume of distribution suggest that lighter individuals benefit from a more conservative start, while heavier individuals may tolerate a slightly more aggressive approach