Major interaction on record — check this product against your medications before combining. Check your meds →
Dietary supplement

SAM-e & TMG Natural Lemon Flavor Ingredients & Drug Interactions

by XYMOGEN

SAM-e & TMG Natural Lemon Flavor label
See full label image
Powder Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking SAM-e & TMG Natural Lemon Flavor against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

SAM-e & TMG Natural Lemon Flavor is a dietary supplement by XYMOGEN with 3 active ingredients. Its ingredients are commonly taken for high homocysteine levels, liver health (fatty liver), exercise performance and strength.Based on those ingredients, 356 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are S-Adenosyl-L-Methionine, Calcium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against SAM-e & TMG Natural Lemon Flavor by XYMOGEN

Ask about any prescription or over-the-counter medication and we check it for interactions with SAM-e & TMG Natural Lemon Flavor by XYMOGEN — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of SAM-e & TMG Natural Lemon Flavor by XYMOGEN

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 3 of its 3 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

This powder contains three active ingredients. Betaine anhydrous and S-Adenosyl-L-Methionine (SAMe) are compounds your body makes naturally; they support methylation, a key step in processing homocysteine and making mood chemicals and other molecules.

Calcium is a mineral essential for bone strength, muscle, and nerve function. The product also contains inactive ingredients — xylitol, citric acid, malic acid, stearic acid, silica, natural lemon flavor, and turmeric extract — that make it taste and mix well and help hold it together.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: Methyl donor support for biochemical processes.
  • We looked for evidence on: Depression, Osteoarthritis, Fibromyalgia, Hyperhomocysteinemia, Alcohol-related liver disease, Nonalcoholic steatohepatitis (NASH) — and 4 related terms.
  • The strongest evidence on file: Betaine Anhydrous is rated "Effective" for Homocystinuria (Natural Medicines).
  • Also on file: Same is rated "Likely Effective" for Osteoarthritis.
  • Also on file: Same is rated "Possibly Effective" for Depression.

Calcium in this product is likely effective for osteoporosis and effective for low blood calcium, weak bones in kidney disease, and heartburn. SAMe is likely effective for osteoarthritis and possibly effective for depression and a liver condition called cholestasis.

Betaine anhydrous is effective for a rare genetic condition (homocystinuria) and possibly effective for high homocysteine levels — a risk factor in heart disease — but the evidence for depression, GERD, liver disease, and colon health is too weak to rate. Because this is a combination product, what it does for you depends on why you're taking it and your own needs.

The evidence, ingredient by ingredient Betaine Anhydrous Same Calcium

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Calcium is generally safe at recommended doses during pregnancy and breastfeeding. SAMe is often well tolerated short-term but can cause stomach upset — nausea, diarrhea, constipation, headache, and dizziness are common — and may trigger mania in people with bipolar disorder; safety data are limited.

Betaine anhydrous is generally well tolerated but can cause body odor, nausea, vomiting, diarrhea, and general stomach trouble; there isn't enough safety data for pregnancy, and breastfeeding safety isn't well established. Very high calcium doses (over 1500–2000 mg daily from all sources) have raised theoretical concerns about kidney stones and a possible small increase in certain cancers, though the evidence is mixed and debated.

Side effects, ingredient by ingredient Betaine Anhydrous Same Calcium

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 2 of the 3 matched ingredients can interact with medications — Calcium, Same.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: heart-rhythm medications; lithium; Parkinson's medications.
  • For scale: 356 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your pharmacist if you take HIV integrase inhibitors (dolutegravir, elvitegravir, raltegravir) — calcium in this product can lower their blood levels significantly. Also flag serotonergic antidepressants (SSRIs, SNRIs, others), levothyroxine (Synthroid), sotalol, levodopa, diltiazem, and calcipotriene cream.

These interactions are mostly Moderate severity, but the HIV drugs carry Major risk and need careful scheduling.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

This product may help if you have osteoarthritis, osteoporosis, or high homocysteine — but only your doctor or pharmacist can tell if it's right for your situation. If you take any HIV medication, thyroid drug, heart medicine, antidepressant, or Parkinson's drug, talk to your pharmacist before adding this product; the timing and spacing of doses matter.

Check your exact medications using the tool on this page.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2025.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about SAM-e & TMG Natural Lemon Flavor, straight from the product label.

Brand XYMOGEN
Barcode (UPC) 871149002046
Net contents 30 Stick Pack(s); 2.75 Ounce(s); 78 Gram(s)
Market status On market
Date entered into DSLD Sep 25, 2025
DSLD ID 335565
Product type Other Combinations
Supplement form Powder
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Vegan, Vegetarian, Adult (18 - 50 Years), No Allergies, Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for SAM-e & TMG Natural Lemon Flavor by XYMOGEN, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2.6 Gram(s)
Maximum serving Sizes:
2.6 Gram(s)
Servings per container
30
UPC/BARCODE
871149002046
IngredientAmount% DV
Calories5 Calorie(s)--
Total Carbohydrate1 Gram(s)1%
Betaine Anhydrous600 mg--
S-Adenosyl-L-Methionine400 mg--
Calcium75 mg6%

Other ingredients: Xylitol, Citric Acid, Malic Acid, Stearic Acid, Silica, Lemon Flavor, Natural, Turmeric Extract

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols

GMP compliant third-party verified

ePV (ePedigree Verification)

Brand IP Statement(s)

Copyright 2023 XYMOGEN

XYMOGEN Exclusive Professional Formulas

General Statements

This packaged is completely recyclable

30 - 0.09 oz (2.6 g) stick packs Scan this code to learn more!

Clean seas Turn the tide on plastic #CleanSeas XYMOGEN is committed to reducing the amount of plastics used throughout our business, particularly in the packaging of our products. With our participation in the United Nations Environment Programme Clean Seas initiative, we strive to positively decrease our environmental footprint, providing results that can ultimately: - Help free the ocean of litter, making it safer for millions of marine animals. - Reduce the use of non-renewable resources. - Keep wild-caught seafood healthy and safe to eat. - Protect maritime economies such as organic fishing, tourism, and recreation.

Suggested/Recommended/Usage/Directions

Directions: Consume the contents of one stick pack daily away from meals, or as directed by your healthcare professional. Preferably pour a small amount of the contents of a stick pack directly into the mouth and allow contents to dissolve. Then repeat process until contents of the entire stick pack have dissolved in the mouth. Alternatively, contents may be added to 2-4 oz of water or preferred liquid; stir and drink within 15 minutes.

Precautions

Consult your healthcare professional prior to use.

Individuals taking medication should discuss potential interactions with their healthcare professional.

Use special caution in individuals with bipolar disorder. Do not use if stick pack is damaged.

Storage: Keep closed in a cool, dry place out of reach of children.

Formula

SAM-e & TMG is a sweet, yet slightly tart lemon-flavored powder. SAM-e (S-adenosyl-L-methionine) and TMG (trimethylglycine) are naturally occurring substances that act as methyl donors during vital biochemical processes in the body. Methylation is essential to normal cell health and function. It can decline with age or chronic alcohol consumption, and it can be limited in some individuals due to their genetic makeup. SAM-e donates methyl groups, which are needed for the synthesis of neurotransmitters, proteins, nucleic acids, and phospholipids. It supports glutathione production, liver health, joint comfort, and a healthy mood. TMG is an especially important methyl donor involved in the metabolism of homocysteine and the formation of SAM-e. TMG ultimately supports cardiovascular and neurological health, as well as normal cell-life regulation. XYMOGEN’s SAM-e & TMG formulation contains a minimum of 70% of the SS isomer of SAM-e, the active form the body can use most readily. This concentration makes SAM-e & TMG cost effective as most SAM-e formulations on the market contain less than 44% active SS isomer.

Methyl donors

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Storage

Storage: Keep closed in a cool, dry place out of reach of children.

Formulation

Formulated to exclude: Wheat, gluten, yeast, soy, animal and dairy products, fish, shellfish, peanuts, tree nuts, egg, sesame, ingredients derived from genetically modified organisms (GMOs), artificial colors, and artificial sweeteners.

FDA Statement of Identity

Dietary Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

SAM-e & TMG Natural Lemon Flavor by XYMOGEN label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

SAM-e & TMG Natural Lemon Flavor label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in SAM-e & TMG Natural Lemon Flavor by XYMOGEN

These are the 3 active ingredients this product is made of. Select any to open its full monograph.

Serving size2.6 Gram(s) Dosage formPowder Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Betaine Anhydrous

No known
interactions
600 mg per serving Form: Trimethylglycine

Betaine anhydrous (also called trimethylglycine) is a compound found in foods like beets, spinach, and whole grains, and is sold as a supplement and a...

Betaine Anhydrous monograph & interactions

S-Adenosyl-L-Methionine

Interacts with
189 drugs
400 mg per serving Form: S-Adenosyl-L-Methionine 1,4 Betandisulfonate

SAM-e is a compound your body makes naturally that is sold as a supplement, most often for depression and osteoarthritis. Some research suggests it ma...

S-Adenosyl-L-Methionine monograph & interactions

Calcium

Interacts with
168 drugs
75 mg per serving Form: Calcium Carbonate, Calcium Chloride Anhydrous, Calcium Oxide

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...

Calcium monograph & interactions

Other (inactive) ingredients: Xylitol, Citric Acid, Malic Acid, Stearic Acid, Silica, Lemon Flavor, Natural, Turmeric Extract. These complete the product’s ingredient list but are not active constituents.

Interaction report

SAM-e & TMG Natural Lemon Flavor by XYMOGEN Drug Interactions

Want to check YOUR meds against SAM-e & TMG Natural Lemon Flavor?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
356Drugs
7 Major 331 Moderate 18 Minor

Ingredients driving the most interactions

S-Adenosyl-L-Methionine 189
Calcium 168

Individual Drug Interactions

The ingredients in SAM-e & TMG Natural Lemon Flavor interact with 356 drugs. Click any drug to see the details.

2 of the 3 ingredients in SAM-e & TMG Natural Lemon Flavor interact with drugs. Each result below shows which ingredient is responsible. S-Adenosyl-L-Methionine Calcium

Each ingredient & the kinds of drugs it affects

For each ingredient in SAM-e & TMG Natural Lemon Flavor with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

S-Adenosyl-L-Methionine2 drug types · 189 drugs

Levodopa

SAMe might reduce the effectiveness of levodopa.
SAMe methylates levodopa, which might reduce its effectiveness for treating Parkinson disease.

Likelihood Possible Evidence D
Serotonergic Drugs

Taking SAMe with serotonergic drugs might increase the risk of serotonin syndrome and other serotonergic side effects.
SAMe has serotonergic effects. Theoretically, combining serotonergic drugs with SAMe might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. In one case report, SAMe 100 mg intramuscularly was given daily with clomipramine (Anafranil) 25 mg per day. When the clomipramine dose was increased to 75 mg per day the patient experienced serotonin syndrome about 48-72 hours later, requiring hospitalization.

Likelihood Possible Evidence D
S-Adenosyl-L-Methionine full monograph & interactions

Calcium18 drug types · 168 drugs

Ceftriaxone (Rocephin)

Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.

Likelihood Probable Evidence D
Dolutegravir (Tivicay)

Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.

Likelihood Probable Evidence B
Elvitegravir (Vitekta)

Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.

Likelihood Probable Evidence B
Aluminum

Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.

Likelihood Possible Evidence B
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.

Likelihood Probable Evidence D
Bisphosphonates

Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.

Likelihood Probable Evidence C
Calcipotriene (Dovonex)

Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.

Likelihood Possible Evidence B
Digoxin (Lanoxin)

Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.

Likelihood Possible Evidence B
Diltiazem (Cardizem, Others)

Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.

Likelihood Probable Evidence D
Levothyroxine (Synthroid, Others)

Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.

Likelihood Probable Evidence B
Lithium

Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.

Likelihood Possible Evidence B
Quinolone Antibiotics

Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.

Likelihood Probable Evidence B
Raltegravir (Isentress)

Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.

Likelihood Possible Evidence B
Sotalol (Betapace)

Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.

Likelihood Possible Evidence B
Tetracycline Antibiotics

Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.

Likelihood Probable Evidence C
Thiazide Diuretics

Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.

Likelihood Probable Evidence C
Verapamil (Calan, Others)

Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.

Likelihood Probable Evidence D
Calcium Channel Blockers

Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.

Likelihood Unlikely Evidence D
Calcium full monograph & interactions
The maker

Brand information

Manufacturer and brand details for SAM-e & TMG Natural Lemon Flavor, from the product label.

XYMOGEN

See all XYMOGEN products
Name
XYMOGEN
Street Address
6900 Kingspointe Pkwy.
City
Orlando
State
FL
ZipCode
32819
Phone Number
800-647-6100
Web Address
www.xymogen.com
Pharmacist Counseling Corner

SAM-e & TMG Natural Lemon Flavor by XYMOGEN: Common Questions

Does SAM-e & TMG Natural Lemon Flavor by XYMOGEN interact with any medications?
Yes. Based on its ingredients, SAM-e & TMG Natural Lemon Flavor has a known interaction with 356 medications, including 7 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
SAM-e & TMG Natural Lemon Flavor contains 3 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this with my antidepressant?
That depends on which one you take. SAMe in this product can interact with serotonergic antidepressants — SSRIs, SNRIs, and some others — and raise the risk of serotonin syndrome, a serious condition where serotonin levels get too high. Tell your pharmacist which antidepressant you're on before you start this product.
Will this product help my osteoarthritis?
SAMe in this product is likely effective for osteoarthritis pain and stiffness. But effectiveness is individual, and you should talk with your doctor about whether it's the right choice for you and how long to take it before assessing whether it helps.
Is there enough calcium in this powder to replace a calcium supplement?
We don't have the amount of calcium per serving in our data, so you'll need to check the nutrition label to see if it matches your daily needs. A typical adult needs 1000–1300 mg of calcium daily, and too much — over 1500–2000 mg from all sources — can cause side effects.
What are the most common side effects?
SAMe often causes stomach upset — nausea, diarrhea, constipation, headache, and dizziness — especially at higher doses. Betaine can cause body odor, nausea, vomiting, and GI trouble. Calcium typically causes bloating, gas, and constipation. Most people tolerate all three well at studied doses.
Is this safe if I'm pregnant or breastfeeding?
Calcium is safe during pregnancy and breastfeeding at recommended amounts. Data on SAMe and betaine anhydrous during pregnancy and breastfeeding are limited, so talk with your doctor before using this product if you're pregnant or nursing.
Why can't I take this at the same time as my thyroid pill?
Calcium binds to levothyroxine (Synthroid) in your stomach and stops your body from absorbing it, which makes your medication less effective. Take this powder at least 4 hours away from your thyroid pill — your pharmacist can help you plan a dosing schedule.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

SAM-e & TMG Natural Lemon Flavor label
Go deeper

The Full Monographs Behind SAM-e & TMG Natural Lemon Flavor’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Betaine Anhydrous

Betaine anhydrous (also called trimethylglycine) is a compound found in foods like beets, spinach, and whole grains, and is sold as a supplement and as a prescription medicine for a rare gen...

Read the full Betaine Anhydrous monograph → Herb & supplement monograph

Same

Interacts with 189 drugs

SAM-e is a compound your body makes naturally that is sold as a supplement, most often for depression and osteoarthritis. Some research suggests it may help with these conditions, but the qu...

Read the full Same monograph → Herb & supplement monograph

Calcium

Interacts with 168 drugs

Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...

Read the full Calcium monograph →
Sources

Sources & How We Checked

SAM-e & TMG Natural Lemon Flavor's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 104 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Betaine Anhydrous 11 references
  1. Cystadane (betaine anhydrous for oral solution) Package insert. Orphan Medical, Inc. Minnetonka, MN. November 2005.
  2. Abdelmalek MF, Angulo P, Jorgensen RA, et al. Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroenterol 2001;96:2711-7.. PubMed
  3. Schwab U, Torronen A, Toppinen L, et al. Betaine supplementation decreases plasma homocysteine concentrations but does not affect body weight, body composition, or resting energy expenditure in human subjects. Am J Clin Nutr 2002;76:961-7. PubMed
  4. McGregor DO, Dellow WJ, Robson RA, et al. Betaine supplementation decreases post-methionine hyperhomocysteinemia in chronic renal failure. Kidney Int 2002;61:1040-6. PubMed
  5. Olthof MR, van Vliet T, Verhoef P, et al. Effect of homocysteine-lowering nutrients on blood lipids: results from four randomised, placebo-controlled studies in healthy humans. PloS Med 2005;2:e135. PubMed
  6. Knopman, D. and Patterson, M. An open-label, 24-week pilot study of the methyl donor betaine in Alzheimer disease patients. Alzheimer Dis.Assoc.Disord. 2001;15(3):162-165. PubMed
  7. Moat, S. J., Madhavan, A., Taylor, S. Y., Payne, N., Allen, R. H., Stabler, S. P., Goodfellow, J., McDowell, I. F., Lewis, M. J., and Lang, D. High- but not low-dose folic acid improves endothelial function in coronary artery disease. Eur J Clin Invest 2 PubMed
  8. Abdelmalek, M. F., Sanderson, S. O., Angulo, P., Soldevila-Pico, C., Liu, C., Peter, J., Keach, J., Cave, M., Chen, T., McClain, C. J., and Lindor, K. D. Betaine for nonalcoholic fatty liver disease: results of a randomized placebo-controlled trial. Hepa PubMed
  9. Ashtary-Larky D, Bagheri R, Ghanavati M, et al. Effects of betaine supplementation on cardiovascular markers: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2021 Mar 25:1-18. PubMed
  10. Zawieja EE, Zawieja B, Chmurzynska A. Betaine supplementation moderately increases total cholesterol levels: a systematic review and meta-analysis. J Diet Suppl. 2021;18(1):105-117. PubMed
  11. Imbard A, Toumazi A, Magréault S, et al. Efficacy and pharmacokinetics of betaine in CBS and cblC deficiencies: a cross-over randomized controlled trial. Orphanet J Rare Dis 2022;17(1):417. PubMed

See these in context on the Betaine Anhydrous monograph →

Same 31 references
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