Early hepatoprotection with same in patients with chronic liver disease

S-adenosyl-L-methionine (SAMe) plays a crucial role in liver health by influencing various biochemical pathways involved in hepatic function. Early intervention with SAMe has been shown to reduce the progression rate of cirrhosis. A comprehensive literature search was performed to identify studies highlighting the benefits of early treatment with SAMe in conditions such as intrahepatic cholestasis (IHC), intrahepatic cholestasis of pregnancy (ICP), viral hepatitis, drug-induced liver injury (DILI), alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), hepatocellular carcinoma (HCC) and chemotherapy-induced liver injury (CILI). The mechanism of action of SAMe and its associated pathways were also detailed. Significant improvements in liver enzymes such as AST, ALT, GGT and ALP have been reported in the literature with treatment durations as short as 2 weeks. Reduction in symptoms such as pruritus, fatigue and jaundice has also been observed. The data suggest that SAMe has beneficial effects on liver biochemistry and clinical symptoms. It can act as an important clinical asset in the management of liver conditions alongside etiology-specific management. Further studies can be done to evaluate the benefits of SAMe as a hepatoprotective agent for the early treatment of liver dysfunction.