S-Adenosyl-L-methionine (SAMe) in ADNIVA exerts many key functions in the liver, including serving as a precursor for cysteine, 1 of 3 amino acids of Glutathione—the major physiologic defense mechanism against oxidative stress.

SAMe is important for the metabolism of nucleic acids and for the structure and function of membranes and many other cellular constituents.

SAMe is the principal methyl donor for methyltransferase reactions that regulate gene expression and facilitates the generation of the antioxidant GSH from Homocysteine.

SAMe is also a key metabolite that regulates hepatocyte growth, death, and differentiation.
Biosynthesis of SAMe occurs in cells as the first step in methionine catabolism in a reaction catalyzed by methionine adenosyltransferase (MAT).

Decreased hepatic SAMe biosynthesis is a consequence of all forms of chronic liver injury.