Health
Benefit, how it can help you
N-acetylcysteine is an
excellent source of sulfhydryl groups and is converted in the body into
metabolites capable of stimulating glutathione synthesis, promoting
detoxification, and acting directly as a free radical scavenger.
Administration has historically been as a mucolytic
[mucus dissolving] agent in a variety of respiratory illnesses; however,
it appears to also have beneficial effects in conditions characterized by
decreased glutathione or oxidative stress, such as HIV infection, cancer,
heart disease, and cigarette smoking.
N-acetylcysteine (NAC) is pharmaceutically available either intravenously, orally, or by inhalation for reducing inflammation, fibrosis, invasion, cartilage erosion, acetaminophen detoxification, and transplant prolongation. It can be of benefit in improving the function of the endothelium.
Dosage, what is the right dose?
There are no accepted guidelines on the appropriate daily dosage. Some people may need none, others may
benefit from taking 500 mg a few days a week. If you
are taking other antioxidants, we suggest you reduce your dosage of n acetylcysteine. Some people think that the more antioxidants they take the
healthier they will be, but there is no proof of this.
Anti aging and longevity,
does it help you live longer?
Human studies are not available to determine whether regular intake,
and what daily or weekly dose, has an influence on lifespan.
Thiolic antioxidant supplementation of the diet reverses age-related
behavioural dysfunction in prematurely ageing mice.
Athletics and physical exertion, exercise
Pharmacol Biochemical Behav. 2005.
We have studied in a model of premature ageing in mice the effect of the
ingestion of thioproline plus N-acetylcysteine by female and male mice on
performance in two behavior tests. The antioxidant treatment (4 weeks in
two different periods of life, i.e., adult and old age) protected all
animals against early-age-associated behavioral impairment, but this
improvement was more evident in the prematurely ageing mice in comparison
to the control group or non-prematurely ageing mice.
These effects could be due to the glutathione precursor role of acetylcysteine and thioproline
that replenish the intracellular reduced glutathione levels despite advancing age.
N acetyl cysteine enhances muscle cysteine and glutathione availability
and attenuates fatigue during prolonged exercise in endurance-trained
individuals.
J Appl Physiology 2004.
The production of reactive oxygen species in skeletal muscle is linked with
muscle fatigue. This study investigated the effects of the antioxidant compound
acetylcysteine on muscle cysteine, cystine and glutathione, and on time to
fatigue during prolonged, submaximal exercise in endurance athletes. Eight males
completed a double-blind, crossover study, receiving acetylcysteine or placebo
before and during cycling. The nutrient was intravenously infused for 20 min
prior to and throughout exercise. This natural antioxidant improved performance
in well-trained individuals, with enhanced muscle cysteine and GSH availability
a likely mechanism.
Chemotherapy
benefit during cancer treatment
There is a condition called "chemo-brain," which effects a large
number of cancer patients receiving chemotherapy patients. Patients with
this condition suffer from memory loss and have difficulty with focus and
concentration. Dr. Gregory W. Konat at West Virginia University School of
Medicine in Morgantown first gave one group of rats to two drugs commonly
used to treat cancer, Adriamycin and Cytoxan. These drugs led to memory
problems.
However, memory loss was prevented when the rats were given n-acetylcysteine injections three times per week during chemotherapy. Metabolic Brain Disease, 2008.
J Laryngol Otol. 2016. Prevention of gentamicin ototoxicity with N-acetylcysteine and vitamin A. Gentamicin-induced hearing loss in rats may be prevented by the concomitant use of vitamin A and N-acetylcysteine. Specifically, N-acetylcysteine appeared to have a more protective effect than vitamin A for a greater range of noise frequencies.
N acetyl cysteine
prevents cisplatin induced ototoxicity in rats
Hearing Research 2004.
Animals were treated
with acetylcysteine or saline 15 or 30 minutes before receiving cisplatin
or 4 hours afterward. The treated rats showed no
significant change in auditory brainstem response with cisplatin therapy.
In contrast, the saline-treated animals displayed marked ototoxicity
(damage to hearing).
Would it also benefit those who have had radiation
to the brain?
I don't know for sure, but it is worth trying.
Cocaine
craving and addiction
Dr. Peter W. Kalivas from the Medical University of South Carolina,
Charleston evaluated the effects of N-Acetylcysteine on cue-induced cocaine
craving of 15 people with cocaine dependence. Those who were taking the
supplements had less cocaine craving and interest evoked by depictions of
cocaine use on photographic slides. The neurotransmitter system involved
may be glutamate transmission. Dr. Peter W. Kalivas is now starting a
double-blind study is being conducted to evaluate the effect of NAC
on relapse rates and also evaluating the effects on
nicotine and marijuana craving.
Am J Addiction 2013. A double-blind placebo-controlled trial of N-acetylcysteine in the treatment of cocaine dependence. The present report assessed the efficacy of NAC in the treatment of cocaine dependence. Cocaine-dependent volunteers were randomized to receive daily doses of 1,200 mg of NAC, 2,400 mg of NAC, or placebo. Participants were followed for 8 weeks (up to three visits weekly). At each of these visits, urine samples were collected, along with self-reports of cocaine use. Urine samples were assessed for quantitative levels of benzoylecognine (ie, cocaine metabolite). Overall, the primary results for the clinical trial were negative. However, when considering only subjects who entered the trial having already achieved abstinence, results favored the 2,400 mg NAC group relative to placebo, with the 2,400 mg group having longer times to relapse and lower craving ratings. While the present trial failed to demonstrate that NAC reduces cocaine use in cocaine-dependent individuals actively using, there was some evidence it prevented return to cocaine use in individuals who had already achieved abstinence from cocaine. N-acetylcysteine may be useful as a relapse prevention agent in abstinent cocaine-dependent individuals.
Is cocaine desire reduced by N-acetylcysteine?
Am J Psychiatry. 2007. LaRowe SD, Myrick H, Hedden
S, Mardikian P, Brady K, Kalivas PW, Malcolm R.
Department of Psychiatry and Behavioral Sciences, Medical University of
South Carolina, Charleston, SC,
In this double-blind, placebo-controlled trial, 15 volunteers received
acetylcysteine or placebo during a 3-day hospitalization. Participants
were crossed over to receive the opposite condition on a second, identical
3-day stay occurring 4 days later. During each hospital stay, participants
completed a cue-reactivity procedure that involved collecting
psychophysical and subjective data in response to slides depicting cocaine
and cocaine use. While taking N-acetylcysteine, participants reported less
desire to use and less interest in response to cocaine slides and watched
cocaine slides for less time.
An open-label trial of N-acetylcysteine for the
treatment of cocaine dependence: a pilot study.
Prog Neuropsychopharmacol Biol Psychiatry. 2007. Mardikian PN, LaRowe SD, Hedden
S. Center for Drug
and Alcohol Programs, Department of Psychiatry and Behavioral Sciences,
Medical University of South Carolina, Charleston, SC, USA.
Twenty three treatment-seeking cocaine-dependent patients participated in
a 4-week medication trial and received N-acetylcysteine
at doses of 1200 mg / day, 2400 mg/day or 3600 mg per day. The
majority of subjects who completed the study either terminated use of
cocaine completely or significantly reduced their use of cocaine during
treatment.
Fertility and infertility
I am not convinced yet that treatment with acetylcysteine NAC will help the
majority of men or women with infertility. There are many other causes for this
condition than would reduce the chances for NAC to be effective alone.
Reproductive Sci. 2015. N-Acetyl-Cysteine and l-Carnitine Prevent Meiotic Oocyte Damage Induced by Follicular Fluid From Infertile Women With Mild Endometriosis.
Mol Reprod Dev. 2014. Alpha-lipoic acid and N-acetylcysteine protects intensive swimming exercise-mediated germ-cell depletion, pro-oxidant generation, and alteration of steroidogenesis in rat testis. Prolonged and strenuous exercise has been proposed as a possible source of male-factor infertility. Forced intensive swimming has also been identified as one source of a dysfunctional male reproduction system. The present study evaluated the possible protective role of α-lipoic acid and N-acetylcysteine (NAC) on intensive swimming-induced germ-cell depletion in adult male rats.
Kidney disease and peritoneal
dialysis
In patients with chronic kidney disease,
inflammation and oxidative stress are cardiovascular risk factors. A
study looked at the effect of oral NAC on plasma levels of
inflammatory and oxidative stress markers in peritoneal dialysis
patients. The eight week, placebo-controlled study included 30 patients
on regular peritoneal dialysis. Twelve patients were treated twice daily with 600 mg of NAC
and the remaining ten patients received placebo. NAC significantly
decreased IL-6 levels without adverse side effects. Treatment reduced the
inflammatory response in peritoneal dialysis patients. Nascimento MM, Suliman ME. Effect of oral N-Acetylcysteine treatment on plasma inflammatory
and oxidative stress markers in peritoneal dialysis patients. Perit Dial Int. 2010.
N Acetyl cysteine in nephrology; contrast nephropathy
and beyond.
Curr Opin Nephrol Hypertension. 2004.
At least 19 randomized trials evaluating acetylcysteine
for the prevention of radiocontrast-induced nephropathy, at least five
meta-analyses, and several reviews on that topic have been published
within the past few years. One study indicated that long-term antioxidative treatment with acetylcysteine significantly reduced
cardiovascular events in patients with end-stage renal failure.
Although there are controversies on dosing and timing, its use together with hydration should be considered to protect
patients from radiographic contrast media-induced nephropathy.
Nephropathy
prevention
Researchers randomly assigned 354 consecutive patients undergoing primary
angioplasty to one of three groups: 116 patients were assigned to a
standard dose of N-acetylcysteine (a 600-mg intravenous bolus before
primary angioplasty and 600 mg orally twice daily for the 48 hours after
angioplasty), 119 patients to a double dose (a 1200-mg
intravenous bolus and 1200 mg orally twice daily for the 48 hours after
intervention), and 119 patients to placebo.
Intravenous and oral N-acetylcysteine may prevent
contrast-medium�induced nephropathy with a dose-dependent effect in
patients treated with primary angioplasty and may improve hospital
outcome.
MDMA, Ecstasy neurotoxicity
A rodent study showed potential reduction in neural damage from
MDMA use.
Sickle cell disease
Annals Hematology. 2012. N-acetylcysteine reduces oxidative stress in
sickle cell patients.
Trichotillomania or hair pulling
treatment
N-acetylcysteine, a glutamate modulator, in the treatment of
trichotillomania:
a double-blind, placebo-controlled study.
Arch Gen Psychiatry. 2009. Grant JE, Odlaug BL. Department of
Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN,
USA.
Trichotillomania is characterized by repetitive hair pulling that causes
noticeable hair loss. N-acetylcysteine seems to restore the extracellular glutamate concentration in the
nucleus accumbens. Fifty individuals with trichotillomania (45 women and 5 men)
were tested. Half received 1200 to 2400 mg/d of the supplement, and the other half
placebo for 12 weeks. The treated patients had
significantly greater reductions in hair-pulling symptoms as measured using the
Massachusetts General Hospital Hair Pulling Scale and the Psychiatric Institute
Trichotillomania Scale.
Tylenol toxicity, overdose,
acetaminophen excess
In addition to its antioxidant properties,
acetylcysteine is currently used to counteract
the effects of an overdose of
acetaminophen
(i.e., Tylenol). Regular use of the painkiller acetaminophen is
associated with higher rates of liver and kidney toxicity, asthma, and
chronic obstructive pulmonary disease and reduced lung function. Animal experiments have suggested that
acetaminophen might lower antioxidant activity in the lungs, and causes
harm to the liver and kidneys.
With hundreds of people each year dying
from acetaminophen overdose, thousands more with liver damage or other
health problems, why is
acetaminophen still available for sale without a prescription whereas
regulators have tried to pull away certain nutritional supplements that
are far less toxic? Those who need to take the painkiller for a health
condition should consider regular use of acetylcysteine, a nutrient that protects the
liver from this drug's toxicity. As a resident, I prescribed intravenous
N-acetylcyteine to patients with liver damage due to acetaminophen
(Tylenol) overdose. It protected the liver quite well.
A patient-tailored N-acetylcysteine protocol for acute acetaminophen
intoxication.
Clin Ther. 2005.
Liver toxicity as a result of acetaminophen (APAP) intoxication has
become an important problem, but early intervention with N-acetylcysteine is effective in preventing hepatic injury.
I would like to use acetylcysteine to protect my
liver from the amount of acetaminophin I am required to take on a daily
basis due to my injuries. How much would I need to take?
We have not seen any studies regarding the long term
use of acetaminophen and acetylcysteine, however a dose of 100 mg a day or
250 mg a few times a week would seem reasonable.
Acetylcysteine side effects,
safety and risk
Other than large doses causing nausea, acetylcysteine does not have
any significant side effects and appears to be a safe nutrient as long as
the dosage is kept to less than 500 mg. I experienced nausea for a few minutes within an hour
of taking three 600 mg pills on an empty stomach.
I was wondering if I could overdose on NAC. What is the safest maximum per-day
dosage?
Each person has a different threshold for N acetyl cysteine, but as with most supplements, more is not better, there could be
a feedback loop, or tolerance, or displacement of other crucial nutrients,
etc. I personally prefer not to exceed 250 mg a few
times a week, but a different doctor may have a different opinion.
Review and Recommendations
Acetyl cysteine is sold in dosages ranging from 250 to 600 mg.
It can help form the powerful antioxidant glutathione but the
formation of glutathione synthesis is under feedback control.
Administration with the resulting increase in
glutathione levels may cause a feedback inhibition in glutathione
synthesis. Thus, it may be best to take it every other day.
Its use certainly
should be considered as an additional supplement in protecting various
cells from damage in the elderly and those with Parkinson�s disease. If
you are planning to use acetylcysteine along with other antioxidants,
limit your daily dosage to 100 to 500 mg and don�t take it all the time.
What exactly is the difference between cysteine and the N Acetyl
form? Which one is better to take?
The latter has an additional acetyl group which makes
it more potent as an antioxidant.
Review article for benefits
Neurosci Biobehav Rev. 2015. Clinical trials of N-acetylcysteine in
psychiatry and neurology: A systematic review. N-acetylcysteine (NAC) is
recognized for its role in acetaminophen overdose and as a mucolytic.
Over the past decade, there has been growing evidence for the use of NAC
in treating psychiatric and neurological disorders, considering its role
in attenuating pathophysiological processes associated with these
disorders, including oxidative stress, apoptosis, mitochondrial
dysfunction, neuroinflammation and glutamate and dopamine dysregulation.
In this systematic review we find favorable evidence for the use of NAC
in several psychiatric and neurological disorders, particularly autism,
Alzheimer's disease, cocaine and cannabis addiction, bipolar disorder,
depression, trichotillomania, nail biting, skin picking,
obsessive-compulsive disorder, schizophrenia, drug-induced neuropathy
and progressive myoclonic epilepsy. Disorders such as anxiety, attention
deficit hyperactivity disorder and mild traumatic brain injury have
preliminary evidence and require larger confirmatory studies while
current evidence does not support the use of NAC in gambling,
methamphetamine and nicotine addictions and amyotrophic lateral
sclerosis. Overall, NAC treatment appears to be safe and tolerable.
Testimonials
I wanted to let you know that my teenage son participated in a
clinical trial at Yale for OCD with very good results. They used an
effervescent formula (PharmaNAC) of 900 mg a day for the first two
weeks, 1800 mg a day the second two, then 2700 mg per day after that. I
have also tried it to reduce cigarette cravings and had significantly
reduced cravings, although it irritated my bladder too much to continue.
I wanted to share our experiences with you.
I am a mild asthmatic, adult onset, female, age 54. I have been taking 500 mg of N Acetyl cysteine daily for about six months. It has helped me manage my symptoms and reduce inhaled corticosteroids ICS required by reducing the amount and thickness of both chest and sinus mucus/phlegm.
I have been taking NAC for a couple of years now with great results -- 1200mg a day in a drink that I make that includes other vitamins and herbals just before breakfast. I have some interesting autoimmune issues: autoimmune thyroiditis, Raynaud's and erythromalalgia. For about 20 years I had consistent, elevated liver enzymes although for the last 4 years or so they have been normal. I added NAC after reading one of Sherri Roger's books on detoxification and found that I noticed a clearer head, less pain and overall improved energy. However, I have been taking many other nutritional supplements and have made some dramatic changes in my diet over the years.
Q. I have been searching on internet both scholarly
articles and patient forums on whether NAC and SAM-e would combine or
not? But except very few physicians, patients none had such experience.
Do you have some experience to shed light?
Additional products sold online
A. Any combination of supplements depends on the dosage,
medications taken and a host of variables including diet, activity
level, etc.
Jarrow Formulas, N-Acetyl-L-Cysteine, 500 mg, 200 Capsules
Natural Factors, N-Acetyl-L Cysteine, 500 mg, 90 Veggie Caps
Buy N Acetyl Cysteine, 500 mg
per pill,
90 Capsules
| Supplement Facts | ||
| Serving Size: 1 Capsule | ||
| Amount Per Serving | %Daily Value | |
| N-Acetyl-L-Cysteine (Pharmaceutical Grade) | 500 mg | ** |
| ** Daily Value not established. | ||