Why NAC Should Be On Your Shelf

On July 29, 2020, the Food and Drug Administration (FDA) issued a letter[1] to seven companies who were selling a product containing N-Acteyl Cysteine (NAC) to prevent and treat hangovers. The FDA warned these companies that they must cease to advertise since the supplements are not approved by the FDA for such treatment. Moreover, the FDA stated it approved NAC as a drug in 1963, and it cannot be sold as a supplement. But there is only a hand-written note from that date with no signature, and it was only for an inhaled drug. Besides, the FDA has referred to NAC as a supplement for over 30 years. In spite of this, many companies have taken NAC out of their products. Amazon stopped selling most brands of NAC, making it difficult to get.

Nobody is sure where the actual controversy comes from, but several have noted that NAC is effective in the treatment of COVID-19 infection.[2] The elderly who have low levels of glutathione, a very important antioxidant and immune modulator, are especially helped by this supplement.

N-acetyl cysteine (NAC) comes from the amino acid L-cysteine. Amino acids are building blocks of proteins and provide many functions for the body. NAC is especially important as a source of sulfur that provides many important benefits to the body, such as making hair strong, detoxifying drugs and other toxins, and thinning mucous secretions. Thus, it makes sense that this amino acid has many benefits.

Benefits of NAC

NAC has been studied in many different illnesses, and has shown incredible results:

• Protects against scarring of the cornea (used in eye drops)
• Protects against heart disease
• Improves hair strength
• Improves stomach acid production
• Acts as an antioxidant
• Prevents cancer of stomach and pancreas
• Improves photosensitivity
• Improves insulin sensitivity
• Decreases vascular inflammation
• Thins mucous secretions
• Prevents aging
• Detoxifies acetaminophen (Tylenol) and many other toxins.
• Increases rates of ovulation and pregnancy in polycystic ovary disease
• Increase male infertility
• Decreases sleep apnea
• Reduces influenza symptoms
• Increases dopamine transport in Parkinson’s
• Improves cognitive function in those with multiple sclerosis
• Weakens peripheral neuropathy
• Improves stroke outcomes
• Prevents noise-induced hearing loss
• Treats diabetic neuropathy
• Treats Crohn’s disease and ulcerative colitis
• Reduces negative symptoms of schizophrenia
• Prevents further bipolar illness episodes
• Controls obsessive compulsive disorder
• Acts as a chelator for heavy metals and nanoparticles[3][4]

Who would take NAC?

• People exposed to toxins such as painters, smokers, dry cleaners, lead, iron, chlorine, or any oxidizers.[5]
• Anyone who wants to prevent flu symptoms (including COVID-19)[6]
• Those aiming to improve hair and nail growth.
• Those with any inflammatory condition or chronic illness.
• Any who choose radiation or chemotherapy
• Those with immune dysfunction, including HIV
• People who have lung and breathing problems[7]

Why is NAC so effective at so many different problems?

NAC Produces Glutathione

The primary reason is that it is one of the three amino acids that make glutathione. [8] Glutathione is the primary antioxidant in the body, protecting all your mitochondria that produce the energy for your cells. Glutathione is also a primary detoxifier in the liver. Even a small dose of acetaminophen (Tylenol) is highly toxic to the liver, but glutathione quickly detoxifies it. We can only get toxic from acetaminophen when we run out of glutathione. It also protects the kidneys from the toxicity of contrast dye and normal cells from chemotherapy toxins.

Some of the chemicals that glutathione is known to detoxify include:

• acetaminophen (Tylenol) and other pharmaceuticals
• acetone, solvents, paint removers
• fuels and fuel by-products
• heavy metals (mercury (dental amalgams, vaccines, tattoos), lead, cadmium, copper, etc.)
• pesticides, herbicides
• nitrates and other chemical food preservatives
• artificial sweetener aspartame
• synthetic food dyes
• benzopyrenes (tobacco smoke, barbequed foods, fuel exhaust)
• alcohol
• household chemicals (synthetically scented and colored detergents and fabric softeners, air fresheners, mothballs, mildew removers, cleaners and bleach, lawn and plant fertilizers, etc.)
• housewares chemicals (non-stick coating of pans and skillets, plastic containers and linings of tin cans and other food packaging)
• formaldehyde and styrene (photocopiers and toner printers)
• chlorine in treated water
• medical X-rays
• UV radiation
• electromagnetic fields (EMF)
• industrial pollutants[9]

Glutathione decreases with age.[10] From about age 20 there is a gradual decline in this essential antioxidant. For this reason, many believe glutathione production is the key to preventing aging. I believe it’s only part of the picture, but an important part.

NAC Breaks up Mucous

Since the early 1960’, NAC has been used for lung problems. People with cystic fibrosis have thickened secretions and often get mucous plugging and pneumonia. NAC can be inhaled into the lungs to thin the secretions allowing faster clearing and preventing pneumonia and collapse of the lungs. Since it is not specific, it can be used for any illness that causes thick secretions or mucous plugging. It can be used orally instead of mucolytics like Mucinex.

NAC Strengthens Protein

Collagen is a protein made of cysteine which forms disulfide bonds for strength. The connective tissues including skin, tendons, and ligaments all need this protein. It also helps the elasticity of these connective proteins. Hair is made up of a protein called keratin, which has a lot of cysteine in it. The cysteine forms the bonds between the amino acid chains, making hair thick and strong.  It also works for nails.

NAC Regulates the Immune System

NAC lowers inflammation. Besides making glutathione, it is also an antioxidant. It also decreases autoimmunity by lowering interleukins, such as IL-17, which cause inflammation, clotting, and atherosclerosis.[11] However, there are many more effects. NAC has been shown to lower many other chemicals that cause inflammation; besides IL-17, it also decreases TNF-α, IL-1β, IL-6, IL-8, and IL-10 serum levels in those with inflammation.[12]

NAC Protects the Digestive System

NAC decreases acetaldehyde production and lowers the risk of cancer of the stomach and pancreas that is created by alcohol. Anyone who drinks even small amounts of alcohol will benefit from NAC supplementation. Also, NAC is rapidly made into glutathione in the small intestine which can lower inflammation in a number of digestive problems such as ulcerative colitis, celiac disease, and toxicity.[13]

NAC Decreases Vascular Disease

NAC can decrease atherosclerosis, blood pressure, and risks of heart disease.[14] NAC was thought to increase homocysteine because homocysteine is a product of cysteine. However, in-vivo studies showed homocysteine levels actually normalized in those who had high homocysteine.[15] In other words, they got better, with lower homocysteine, and lower risk of atherosclerosis.

NAC Improves Brain Function

NAC seems to improve irritability in children with autism. But it doesn’t seem to help other autism symptoms. It has also been shown to be helpful with many neurological problems including schizophrenia, psychosis, Parkinson’s disease, and Alzheimer’s disease.[16]

NAC Reduces Flu (influenza) Symptoms

Taking N-acetyl cysteine by mouth seems to reduce flu symptoms.[17] The studies indicate that it doesn’t prevent infection, but rather when people get the flu, they don’t get symptoms. This is especially important now with a coronavirus pandemic because the coronavirus infection doesn’t kill people, the immune response is the culprit. NAC prevents the excessive immune response and could potentially save many lives and keep people out of the hospital.

 Are There Any Problems with NAC?

• Because of the sulfur, NAC has an unpleasant odor that some people find hard to tolerate.
• NAC might slow clotting which could cause excess bleeding in people with bleeding disorders, or those having surgery.
• NAC also inhibits GABA in the brain and may increase anxiety in some people.
• It has been tested up to 10,000 mg per day given in the veins, with no ill effects. The general recommendation is to maintain the balance of amino acids by using 2,000mg per day or less.[18]

NAC Recommendations

Just because there are so many benefits to having an amino acid doesn’t mean everyone should be taking it. Remember, the chemistry of the body is based on balance, and not so much on amount. It is uncommon to have a deficiency of cysteine in young people so most will have no benefit from taking more. I have tested thousands of people and have found about 20% (my guess) with low glutathione, and low cysteine. Having said that, the reason I have listed all the things that can be helped by NAC is so you would know if it might help you. You can get tested, or you could just try NAC supplements.

Remember that it is an amino acid and should be taken on an empty stomach. 

For those over 50, the anti-aging dose to increase glutathione includes glycine and NAC together for a week, then off for a week. This should be done for at least 6 months but could be continued for life to keep the glutathione elevated.

• Glycine 1,000mg per day
• NAC 600mg per day

For acute inflammatory conditions take NAC 600mg twice per day. When symptoms resolve, you can stop it, or decrease to the standard dose. If you don’t notice any improvement within a couple weeks, you need to search for a different cause.

Standard dose for all other issues: Take NAC 600mg five days per week.

Clearly the controversy surrounding NAC is not about effectiveness or toxicity; it is simply about politics and money. This nutrient has a proven track-record, and thousands of studies. It has been sold as a supplement for decades with no evidence of toxicity. NAC is not needed for everyone, but if you have any of the issues listed above, it can be a life saver! Review them to see if you should be taking this vital nutrient.

 

 

 

 

Sources:

[1] https://www.fda.gov/news-events/press-announcements/fda-warns-companies-illegally-selling-hangover-remedies
[2] Ther Clin Risk Manag. 2020 Nov 2;16:1047-1055. doi: 10.2147/TCRM.S273700. eCollection 2020.
N-Acetylcysteine to Combat COVID-19: An Evidence Review
Zhongcheng Shi 1 2, Carlos A Puyo 3
[3] J Nutr Metab. 2021; 2021: 9949453.
N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks)
Gerry K. Schwalfenberg
[4] Int J Audiol. 2019 Mar;58(3):151-157. doi: 10.1080/14992027.2018.1543961. Epub 2019 Jan 17.
Treatment of military acoustic accidents with N-Acetyl-L-cysteine (NAC)
Ulf Rosenhall 1 2, Björn Skoog 3, Per Muhr 1
[5] https://pubmed.ncbi.nlm.nih.gov/25731901/
[6] Eur Respir J. 1997 Jul;10(7):1535-41. doi: 10.1183/09031936.97.10071535.
Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment; S De Flora 1, C Grassi, L Carati
[7] https://wholefoodsmagazine.com/columns/legal-tips/nac-the-latest-health-success-story-to-become-an-fda-target/
[8] Molecules. 2018 Mar; 23(3): 575.
Published online 2018 Mar 3. doi: 10.3390/molecules23030575
Effects of the Usage of l-Cysteine (l-Cys) on Human Health
Noelia Clemente Plaza, Manuel Reig García-Galbis, and Rosa María Martínez-Espinosa
[9] http://www.immunehealthscience.com/what-depletes-glutathione.html
[10] Exp Gerontol. 2004 Feb;39(2):203-10. doi: 10.1016/j.exger.2003.10.014.
Age-related changes in glutathione availability and skeletal muscle carbonyl content in healthy rats
Laurent Mosoni 1, Denis Breuillé, Caroline Buffière, Christiane Obled, Philippe Patureau Mirand
[11] Autoimmun Rev. 2017 Sep;16(9):984-991.
Effects of Interleukin 17 on the cardiovascular system
Marie Robert 1, Pierre Miossec 2
[12] Curr Pharm Biotechnol. 2021;22(12):1584-1590.
The Potential Mechanism of N-acetylcysteine in Treating COVID-19
Nan Zhou 1, Xiaofan Yang 1, Aie Huang 2, Zhenbing Chen 1
[13] Front Biosci. 2015 Jan 1;20:872-91. doi: 10.2741/4342.
N-acetylcysteine and intestinal health: a focus on its mechanism of action
Yongqing Hou 1, Lei Wang 1, Dan Yi 1, Guoyao Wu 1
[14] https://www.openaccessjournals.com/articles/potential-role-of-nacetylcysteine-in-cardiovascular-disorders.pdf
[15] https://pubmed.ncbi.nlm.nih.gov/25731901/
[16] Nihon Shinkei Seishin Yakurigaku Zasshi. 2016 Apr;36(2):29-35.
[Effectiveness of N-acetylcysteine in the treatment of schizophrenia] Nobumi Miyake, Seiya Miyamoto
[17] Eur Respir J. 1997 Jul;10(7):1535-41. doi: 10.1183/09031936.97.10071535.
Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment; S De Flora 1, C Grassi, L Carati
[18] https://pubmed.ncbi.nlm.nih.gov/18161828/