NAC (N-Acetyl Cysteine)⁣- Choose Form

Note

N-acetylcysteine (NAC) has a strong, unpleasant taste and smell of rotten eggs. This is due to the presence of a thiol group in NAC. The taste and smell can cause nausea and vomiting, and make it difficult for patients to tolerate therapy. Capsules are more tolerable.

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BENEFITS⁣

Polycystic Ovary Syndrome (PCOS)

Reduces PCOS symptoms significantly like menstrual irregularities, high testosterone, weight gain, hair loss on scalp, hair growth on the face and chest, and infertility⁣.

NAC restores the hormonal balance in women with polycystic ovary syndrome (PCOS) Problems with PCOS include too high levels of androgens (male hormones) such as testosterone. This leads to menstrual disorders and hirsutism, i.e. excessive male hair growth. NAC helps in this case as well.

PCOS is often associated with an imbalance of reproductive hormones, and some studies suggest that NAC may help balance these hormones, which could reduce symptoms like hirsutism.

In a trial involving 100 women with PCOS, NAC was compared to Metformin, a blood sugar specific drug commonly prescribed in PCOS. In this trial women were given NAC or 500 mg metformin three times daily. What they found was that both treatments significantly reduced menstrual irregularities, free testosterone, and hirsutism.

The study showed that NAC helped to decrease:

• BMI
• Hirsutism (meaning there was less hair on the face, chest, and abdomen—a common complaint of women with PCOS)
• Fasting insulin (there was better blood sugar balance)
• Free testosterone (unusually high levels of testosterone can lead to acne, oily skin, and hair loss)
• Menstrual irregularities
• Total and LDL cholesterol (Metformin only led to a decrease in total cholesterol)

The study concluded that NAC was useful in the treatment of PCOS. 

Female Fertility 

In the last decade, many randomized controlled trials (RCTs) have been conducted on NAC as an adjuvant therapy for the management of female infertility treatment.

Certain studies revealed that NAC enhances the ovulation rates, pregnancy rates, and decreases miscarriage rates.

NAC helps to improve the body's insulin response, lower testosterone naturally and helps to protect egg quality

NAC is a safe and well-tolerated adjuvant for induction of ovulation, it can improve the ovulation and pregnancy rates in PCOS patients. It is also effective in long standing unexplained infertility patients undergoing intrauterine insemination (IUI). It improves pregnancy rate significantly in IUI cycles. The multiple biological effects of NAC may explain its ovulation induction properties.

In a case controlled study of women struggling with unexplained infertility and undergoing intrauterine insemination, it was shown that women given NAC had a higher number of follicles, as well as a higher pregnancy rate. 

Male Fertility

Oxidative stress can cause cell death and reduced fertility In some cases, NAC has been shown to improve male fertility. One condition that contributes to male infertility is varicocele — when veins inside the scrotum become enlarged due to free radical damage.

NAC orally daily produced a greater improvement in sperm concentration, ejaculate volume, sperm motility and normal morphology for idiopathic infertile men.

Three-month supplementation with NAC significantly improved sperm parameters (count, motility and normal morphology) from pre-treatment baseline.

Men with fertility issues have higher levels of semen reactive oxygen species (a form of oxidative damage) than fertile men. This can cause sperm damage and dysfunction. In a study of 50 infertile men, who were given NAC, it was shown that the men’s sperm count and motility increased. Abnormal structures and DNA fragmentation decreased. It was therefore concluded that oral NAC supplementation may improve sperm quality, as well as help with the balance between oxidative stress and antioxidants in men with fertility problems.

In another study with 35 infertile men with a varicocele, the participant underwent surgery to correct the varicocele and supplemented NAC for 3 months. The study found a 22% increase in pregnancy rates and improved sperm quality.  

⁣Asthma, COPD, Bronchitis etc

Decreases the risk of increased symptoms or worsening of conditions such as COPD, chronic bronchitis, and rhino-sinusitis⁣. N-acetylcystine (NAC) is a mucolytic medication, meaning that it breaks apart mucus. Investigators know that mucus is a factor in severe asthma attacks.

NAC is a robust treatment for COPD that reduces phlegm and cough, thins mucus, and eases expectoration. 

Oxidative stress and free radicals play a role in COPD, which makes anti-inflammatory substances and antioxidants a logical choice for helping to treat and manage the condition. NAC has been shown to reduce COPD and chronic bronchitis flares. 

In a 2016 review in the Journal of Respiratory Medicine it was concluded that NAC either alone or with antibiotics can decrease the risk of increased symptoms or worsening of conditions such as COPD, chronic bronchitis, and rhinosinusitis.   

As with most studies regarding NAC, there is a dose dependent effect. Or in other words, if you aren’t taking enough and doing it consistently then you’re unlikely to see a benefit.

NAC is also a common prescription to be used with a nebulizer (drug is acetylcysteine) for those with COPD. This is because it also helps with the clearance of mucus from the lungs.

 Lumbar Spondylitis with Sciatica

NAC can help in managing these conditions by 

Reduces Inflammation:

• NAC works as an anti-inflammatory agent by replenishing glutathione, a key antioxidant in the body that helps reduce inflammation. In lumbar spondylitis, inflammation in the spinal joints can lead to pain and stiffness, while in sciatica, inflammation of the sciatic nerve is a major cause of pain. By reducing inflammation, NAC can help alleviate symptoms in both conditions.

Promotes Nerve Health:

• Sciatica involves the irritation or compression of the sciatic nerve, leading to pain that radiates down the leg. NAC has been shown to support nerve health by protecting nerve cells from oxidative damage, which can reduce nerve pain and promote healing of damaged nerves.

Pain Relief:

• NAC’s anti-inflammatory and antioxidant properties may help reduce pain in both the lumbar spine and the sciatic nerve. By decreasing oxidative stress and inflammation, NAC can address the underlying causes of chronic pain in lumbar spondylitis and sciatica.

 Improves Tissue Healing:

• NAC plays a role in tissue repair by promoting the production of glutathione, which supports the body’s natural healing processes. This can be particularly beneficial for repairing damaged tissues in the lumbar spine and improving recovery after flare-ups of sciatica or spondylitis symptoms.

Detoxification and Immune Support:

• NAC is commonly used to support the liver’s detoxification processes, which can indirectly benefit individuals with chronic inflammation and autoimmune conditions like lumbar spondylitis. A healthier immune response can reduce the frequency and severity of inflammation and pain episodes.

May Improve Brain Health

NAC has been shown to ameliorate the symptoms of Alzheimer’s Disease and Parkinson’s Disease, two diseases that affect the brain (as well as other systems in the body). 

NAC for Alzheimer’s Disease

In Alzheimer’s Disease, mitochondrial dysfunction, metal accumulation, and inflammation all play a role…as well as oxidative damage. Different studies have shown that lipoic acid and NAC decreased levels of oxidative damage, while also helping to protect mitochondrial function. 

Because lipoic acid and NAC can act on our mitochondria, they have a lot of potential in the treatment of Alzheimer’s. Mitochondria are a huge source of oxidative stress in neurodegeneration, so protecting them is key. 

NAC for Parkinson’s Disease

Parkinson’s Disease is also caused by deterioration of neurons in the brain and nervous system. It has been found that most patients with Parkinson’s have oxidative damage. In animal models, treatment with NAC has led to improvements in: increased levels of glutathione in the brain, reduction of oxidative damage, and increased brain mitochondrial activities.  

COVID 19

This study shows that N-acetylcysteine (NAC), has very low toxicity, has been FDA approved for many years, and has the potential to improve therapeutic strategies for COVID-19.

 It is noted that RNA viruses need active NF-κB pathway support within host cells in order to replicate. For human coronaviruses (HCoV-229E), suppression of NF-κB significantly reduced the replication rate. Therefore, taking NAC - (a drug that inhibit NF-κB activation) could potentially reduce viral replication.

Prevent Heart Disease

Oxidative damage can destroy heart tissue and lead to head attack, stroke, and other cardiovascular issues.

Because NAC is helpful in reducing oxidative stress, it can be useful in preventing oxidative damage to tissues of the heart. This gives it great potential to help in the treatment and prevention of heart disease. 

NAC also improves blood flow and circulation by increasing nitric oxide production and acting as an anti-aggregate. An anti-aggregate prevents platelets from clumping together to form a clot in your blood vessels. 

As stated in the PCOS section of this article, NAC has also been shown to have benefits on healthy cholesterol levels. 

Respiratory Aid, Smokers, Lung Cleanse 

Studies have found that supplementing with 3 grams of NAC daily reduces number of cigarettes smoked in current smokers, significantly reduces cravings in those trying to stop and increases the number of people who are able to stop smoking completely

N-Acetylcysteine helps flush out irritants, infectious agents or environmental pollutants to facilitate lung detox and clear lungs for healthy breathing.

SARS-Cov-2.

NAC administered intravenously, orally, or inhaled, may suppress SARS-CoV-2 replication and may improve outcomes if used timely. 

Influenza and Viral Illness

In cell models, NAC has been shown to inhibit replication of RNA viruses like the kind responsible for influenza A, B and RSV. It has also been shown in both cell models and human studies to inhibit inflammatory molecules. 

Because of its ability to support healthy immune function, antioxidant status and support the body in modulating inflammation, NAC is an important consideration in the treatment of viral illness. 

In a randomized placebo-controlled study of 262 elderly individuals without any pre-existing respiratory illness receiving NAC daily for six months, it was found that the group taking NAC experienced a significant decrease in frequency of influenza-like episodes, length of time confined to a bed, and a reduction in severity of symptoms. 

What may be most compelling about this study is that they found that in those using NAC, only 25% of those infected developed symptoms. In the placebo group (those not taking NAC), 79% developed symptoms. While this study does show promise, it is important to note it has not been replicated, which is important in determining the efficacy of this treatment. 

The antioxidant N-acetyl-L-cysteine (NAC) had been shown to inhibit replication of seasonal human influenza A viruses. Slows down the multiplication of viruses like the kind responsible for Influenza and Viral Illness.

Oral supplementing of NAC significantly decreased the frequency and severity of influenza.

More human trials are needed to understand the potential of NAC in this capacity and examine the synergistic effect of NAC alongside pharmaceutical treatment. Some studies have shown that NAC’s effectiveness is strain dependent, which means while it may help with inflammation, immune system modulation, and mucus breakdown, it may not elicit a direct effect on viral replication in all cases. Remember to always talk with your doctor before beginning new supplements.

⁣Immune Booster 

Increased Glutathione Production -Glutathione is our body’s antioxidant powerhouse. Antioxidants protect our cells from free radical damage.Free radicals defend against viruses, bacteria, and other pathogens. Oral administration of NAC significantly reduced oxidative bursts from neutrophils induced by the stimulants C. albicans, fMLP, and PMA.

Improved Immune in Menopausal Women

As we age, immune function declines, which is in part due to oxidative damage and inflammation.

In a small study assassing the benefits of NAC in supporting postmenopausal women’s immune health it was concluded that:

“The present finding suggest that a short period of NAC supply (i.e., 2-4 months) at the dose used may lead to prolonged strengthening of immune defense in postmenopausal women, likely by increasing the leukocyte glutathione pool. Thus, NAC could contribute to maintenance of good health and quality of life in postmenopausal women by decreasing the probability of immune system-related diseases, such as infections, in aging.” 

These conclusions were drawn because NAC supplementation led to the test group’s studied immune system parameters becoming closer to that of the control group (young, healthy females). It was concluded that NAC might exert a modulating effect on the immune system, helping it to find balance. 

Immune Function in HIV Patients

Research has shown improved immune function in those supplementing with NAC. In the research, many studies have focused on human immunodeficiency virus (HIV). 

In one study it was stated: 

“Two randomized placebo-controlled trials have shown that treatment of HIV-infected patients with N-acetyl-cysteine caused in both cases a significant increase in all immunological functions under test, including an almost complete restoration of natural killer cell activity.” 

Autoimmune Disease

Many autoimmune diseases (e.g. Hashimoto’s, multiple sclerosis, inflammatory bowel disease, etc.) stem from inflammation in the body. Often, finding ways to reduce the inflammation (such as eating more vegetables, eliminating or reducing refined sugar, and limiting intake of vegetable oil) can have positive outcomes for those who suffer with autoimmune diseases. 

Supplementation can also be helpful. And that’s where NAC comes in. As a precursor to glutathione that helps to reduce inflammation, it is a great choice for those with autoimmune conditions who want to support their health. 

Additionally, NAC was shown in a study to inhibit inflammatory cytokines, making it a potential treatment for Th1-mediated autoimmune diseases. 

Remember, autoimmunity is complex, which is why it generally requires a holistic approach, which sometimes also includes pharmaceuticals. 

Detoxification

There has been a significant amount of research into the efficacy of NAC in helping with detoxification. NAC is protective of both the kidneys and liver.

Acetaminophen (commonly recognized as Tylenol) toxicity is the common cause of medication-induced hepatotoxicity. NAC is the antidote given in cases of acetaminophen toxicity. 

Hepatotoxicity refers to damage to the liver caused by medications, supplements, or chemicals. NAC has been used for years as a counter-poison for acetaminophen toxicity. If a person is administered NAC within eight hours of acetaminophen overdose, their chances of recovery are great, and the danger to their liver is minimal.

Acetaminophen metabolism produces a toxin known as N-acetyl-pbenzoquinonimine, which rapidly depletes the body’s glutathione. NAC is thought to be hepatoprotective due to its antioxidant properties, is known to replenish glutathione, and can directly aid the body in metabolising N-acetyl-pbenzoquinonimine. 

You know what else depletes glutathione? Alcohol. Which is why popping a Tylenol after a night of binge drinking can be a big disaster for some people. 

NAC is important for phase 2 liver detoxification, which is a crucial step in neutralizing potential toxins created during phase 1 detoxification. Yes, your body sometimes makes toxic intermediates during this process, which is why phase 2 is so important.

Another example of how NAC can help with detoxification is in dentistry. Poly-methyl methacrylate (PMMA) resin is one of the most commonly used materials in dental practices (e.g. to make dentures). However, it has been shown to be a cytotoxin, meaning that it can result in cell damage or cell death. In a study of the dental pulp cells of rats, the addition of NAC to the PMMA resin helped improve the cytotoxicity to the dental pulp cells. 

Anti Inflammatory 
NAC is an effective anti inflammatory for autoimmune diseases (e.g. Hashimoto’s, multiple sclerosis, inflammatory bowel disease, etc.)⁣

May Stabilize Blood Sugar

A study of high-fat diet-fed mice (who are glucose intolerant and insulin resistant because of their diet) was conducted. These mice presented with elevated fasting glucose levels, as well as impaired glucose disposal.  

After being given NAC at specific doses, NAC improved both glucose tolerance and insulin sensitivity. 

In human clinical trials NAC has been studied as a short-term (2 week intervention) with no benefit to blood sugar. It’s important to note that the majority of studies showing benefit of NAC have had participants supplementing for longer periods of time (generally around 3 months). So it may be that while no benefit is seen after 2 weeks, there may be benefits with a longer duration of use.

Other studies have noted that with regards to PCOS, NAC may be beneficial in supporting healthy insulin levels. Insulin is the hormone that helps glucose (blood sugar) enter the cell
Supports a Healthy Microbiome

Your gut is where the majority of your immune system resides. So to have a healthy immune system, we need to have a healthy gut. In fact, to be healthy at all we need to have a healthy gut. After all, you are what you eat, digest, and absorb.

Gut Microbiome

Prevotella, as well as other organisms are known to create biofilms to protect themselves from the body’s immune system and antibiotic therapy. Healthy levels of Lactobacillus brevis can help lower the biofilm defense in order for the immune system to naturally eradicate unhealthy overgrowth of these organisms. However, when overgrowth of normal flora occurs (commonly referred to as dysbiosis), there may not be sufficient Lactobacilli available to inhibit biofilm production. 

This is where NAC can be of benefit!

It is a known biofilm disruptor that can be used alongside antibiotics or antimicrobial herbs in treating the gut. Clinically, I have found great benefit from using NAC alongside an antimicrobial prescription in order to eradicate unhealthy levels of bacteria. 

In a systematic review it was stated, “NAC, in combination with different antibiotics, significantly promoted their permeability to the deepest layers of the biofilm, overcoming the problem of the resistance to the classic antibacterial therapeutic approach.”

Or in other words, NAC helps the medication get to the organisms in order to elicit its effect. 

The study went on to state that because NAC is effective and safe, NAC should be considered for more widespread clinical use.

Biofilm disruptors, like NAC, can also be useful in the treatment of Small Intestinal Bacterial Overgrowth or SIBO.

Biofilms can be present in the gut, vagina, mouth, and in the respiratory tract. 

Respiratory Tract Microbiome

Biofilms have been cited as being associated with recurrent respiratory infections. 

In fact, Prevotella (as the example we are using here) is one of the more predominant organisms in the respiratory tract. Interestingly, some studieshave shown however, that this not the case in those who suffer from asthma. 

Oral Microbiome

In the Journal of Microbial Physiology and Biochemistry it was stated that NAC has been shown to decrease inflammation in gum tissue and has the potential to disrupt biofilms, as well as elicit and antimicrobial effect. 

More research is needed, specifically clinical trials, to understand how NAC can best be utilized as part of dental care.

May Reduce Psychiatric and Addictive Disorders

Research has shown that NAC has the potential to help with the treatment of psychiatric and addictive disorders, such as nicotine addiction, OCD, trichotillomania (TTM: the compulsion to pull out body hair), schizophrenia, bipolar disorder, and more. 

Reduction of Trichotillomania Symptoms

In a double-blind, placebo-controlled trial of NAC for the treatment of TTM, 50 people were given NAC or a placebo for six weeks, followed by another six weeks of NAC or a placebo. Half the people were also taking medication at the time, and a few were undergoing psychotherapy. It was found that NAC decreased the symptoms of TTM. 

Hair Loss 

Recent studies have suggested that a diet poor in cysteine, or health problems resulting in deficient cysteine absorption in the body, are among the main causes of hair loss. This article discusses treatment with N-acetylcysteine (NAC) as a therapeutic option for patients with trichoteiromania. It resulted in complete hair regrowth within 16 weeks.

NAC for Schizophrenia

It has been found that, in people with schizophrenia, there is dysfunctional glutamate metabolism, as well as decreased levels of glutamate in the prefrontal cortex. Additionally, there is evidence showing that individuals with schizophrenia have oxidative stress. NAC might be helpful in the treatment of schizophrenia because it can decrease oxidative stress, as well as alleviate glutamatergic dysfunction. 

NAC for OCD, Bipolar, and Depression

There have been studies showing benefits of using NAC in moderate to severe OCD. In one randomized, double-blind, placebo-controlled trialNAC was used in addition to fluvoxamine, a common SSRI, in one treatment group. The other group received fluvoxamine and placebo. The group receiving NAC in addition to their medication experienced more improvement in symptoms compared to the placebo group.

NAC has also been found to decrease symptoms of depression and bipolar disorder. In one analysis, it was found that NAC reduced depressive symptoms and resulted in an overall increase in functionality. 

While NAC does show promise in supporting mental health, you should not use NAC to replace your medication or make changes to your regimen without talking to your doctor

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