N-Acetyl Cysteine (NAC)

Potent Antioxidant, Glutathione Precursor and Mucolytic

NAC (N-acetyl cysteine) is a form of the amino acid cysteine which is found in food and is also made by the body. NAC is a:

• precursor to glutathione, a powerful antioxidant (1-8)
• potent free-radical scavenger (9-15)
• “mucolytic” (mucous-dissolving) agent (16-18)

NAC is used in conventional medicine to treat acetaminophen overdose, chronic bronchitis and COPD.

Uses of NAC include:

• Chronic bronchitis – NAC is a safe and effective treatment to reduce the thickness of mucous.(16-18) A review of 39 clinical trials found the number of aggravations of chronic bronchitis was reduced in 50% of people who took NAC at a dose of 400-600mg per day.(19)
• COPD – NAC supplies antioxidant protection to the lung and helps break down thick mucous, making it useful in Chronic Obstructive Pulmonary Disease (COPD). NAC was ineffective for COPD in patients taking steroids. (9,14-16)
• Parkinson’s disease – NAC decreases the negative side effects of Levodopa and also decreases free radical production. (7, 20)
• Infertility – as an adjuvant to clomiphene citrate in infertile patients with PCOS, NAC treatment results in higher ovulation and pregnancy rates, lower miscarriage rates and higher live birth rates. (21-24)
• Kidney failure / hemodialysis. NAC improved residual renal function in patients on dialysis in a pilot study. (25)
• IBS (Irritable Bowel Syndrome) – one study showed that NAC reduced inflammation and inflammatory cytokines in the small intestine. (26)
• Liver Protection. Studies have found that NAC prevents liver damage due to environmental toxins, anaesthesia and elevated cholesterol levels.(12, 27)
• Lupus – a pilot study shows that NAC may be helpful in lupus by blocking mTOR in T lymphocytes.(28)
• Melanoma prevention. NAC reduces oxidative stress caused by UV-radiation.(29)
• Schizophrenia and Bipolar Disorder. Both diseases are associated with glutathione depletion. Adding NAC to drug treatment improved depression in bipolar patients and overall symptoms in schizophrenic patients. (1-3,6)
• Sickle Cell Anemia – NAC may decrease sickle cell crisies. (10)
• Cancer Prevention. (30)

Typical doses used for COPD, bronchitis and respiratory mucous are 600mg per day. Other studies have used 600-4,800 mg per day in divided doses. Most studies use 600-1,200mg per day. Rare side effects include nausea, usually only seen at the highest doses.

Suggested dose:
1 cap, 1-2 times per day or as directed by a physician.

Each (one) capsule contains:
NAC (N-Acetyl L-Cysteine) …………………. 600 mg

Other ingredients:
gelatin capsule (gelatin and water) and rice flour.

Product #N359 (60 Capsules) $16.97

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References

1.) Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI.
N-acetyl cysteine for depressive symptoms in bipolar disorder–a double-blind randomized  placebo-controlled trial. Biol Psychiatry. 2008 Sep 15;64(6):468-75. Epub 2008 Jun 5.

2.) Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, et al. N-acetyl cysteine as a glutathione  precursor for schizophrenia–a double-blind, randomized, placebo-controlled trial. Biol Psychiatry.  2008 Sep 1;64(5):361-8. Epub 2008 Apr 23.

3.) Carmeli C, Knyazeva MG, Cuénod M, Do KQ. Glutathione precursor N-acetyl-cysteine modulates  EEG synchronization in schizophrenia patients: a double-blind, randomized, placebo-controlled trial. PLoS One. 2012;7(2):e29341. Epub 2012 Feb 22.

4.) Crinnion WJ. Do environmental toxicants contribute to allergy and asthma? Altern Med Rev. 2012 Mar;17(1):6-18.

5.) Krifka S, Hiller KA, Spagnuolo G, Jewett A, Schmalz G, Schweikl H. The influence of glutathione on  redox regulation by antioxidant proteins and apoptosis in macrophages exposed to 2-hydroxyethyl  methacrylate (HEMA). Biomaterials. 2012 Jul;33(21):5177-86. Epub 2012 Apr 24.

6.) Lavoie S, Murray MM, Deppen P, Knyazeva MG, et al. Glutathione precursor, N-acetyl-cysteine,  improves mismatch negativity in schizophrenia patients. Neuropsychopharmacology. 2008  Aug;33(9):2187-99. Epub 2007 Nov 14.

7.) Sun L, Gu L, Wang S, Yuan J, Yang H, Zhu J, Zhang H. N-acetylcysteine protects against apoptosis  through modulation of group I metabotropic glutamate receptor activity. PLoS One.  2012;7(3):e32503. Epub 2012 Mar 19.

8.) Fishman AI, Alexander B, Eshghi M, Choudhury M, Konno S. Nephrotoxin-induced renal cell injury  involving biochemical alterations and its prevention with antioxidant. J Clin Med Res. 2012  Apr;4(2):95-101. Epub 2012 Mar 23.

9.) Kao SJ, Wang D, Lin HI, Chen HI. N-acetylcysteine abrogates acute lung injury induced by endotoxin. Clin Exp Pharmacol Physiol. 2006 Jan-Feb;33(1-2):33-40.

10.) Nur E, Brandjes DP, Teerlink T, Otten HM, Oude Elferink RP, Muskiet F, Evers LM, Ten Cate H,  Biemond BJ, Duits AJ, Schnog JJ. N-acetylcysteine reduces oxidative stress in sickle cell patients. Ann Hematol. 2012 Feb 10. [Epub ahead of print]

11.) Faruqi RM, Poptic EJ, Faruqi TR, De La Motte C, DiCorleto PE. Distinct mechanisms for  N-acetylcysteine inhibition of cytokine-induced E-selectin and VCAM-1 expression.  Am J Physiol.1997 Aug;273 (2 Pt ):H817-26.

12.) Galicia-Moreno M, Favari L, Muriel P. Antifibrotic and antioxidant effects of N-acetylcysteine in an  experimental cholestatic model. Eur J Gastroenterol Hepatol. 2012 Feb;24(2):179-85.

13.) Koksel O, Ozdulger A, Ercil M, Tamer L, Ercan B, Atik U, Cinel L, Cinel I, Kanik A.
Effects of N-acetylcysteine on oxidant-antioxidant balance in oleic acid-induced lung injury.
Exp Lung Res. 2004 Sep;30(6):431-46.

14.) Akca T, Canbaz H, Tataroglu C, Caglikulekci M, Tamer L, Colak T, Kanik A, Bilgin O, Aydin S.
The effect of N-acetylcysteine on pulmonary lipid peroxidation and tissue damage. J Surg Res. 2005  Nov;129(1):38-45.

15.) Foschino Barbaro MP, Serviddio G, Resta O, Rollo T, Tamborra R, Elisiana Carpagnano G,  Vendemiale G, Altomare E. Oxygen therapy at low flow causes oxidative stress in chronic  obstructive pulmonary disease: Prevention by N-acetyl cysteine. Free Radic Res. 2005  Oct;39(10):1111-8.

16.) Sadowska AM. N-Acetylcysteine mucolysis in the management of chronic obstructive pulmonary disease. Ther Adv Respir Dis. 2012 Jun;6(3):127-35. Epub 2012 Feb 23.

17.) Jackson IM, Barnes J, Cooksey P. Efficacy and tolerability of oral acetylcysteine (Fabrol) in chronic bronchitis: a double-blind placebo controlled study. J Int Med Res 1984;12:198–206.

18.) Tattersall AB, Bridgman KM, Huitson A. Acetylcysteine (Fabrol) in chronic bronchitis—a study in general practice. J Int Med Res 1983;11:279–84.

19.) Stey C, Steurer J, Bachmann S, et al. The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review. Eur Respir J 2000;16:253–62 [review].

20.) Martínez-Banaclocha MA. N-acetyl-cysteine in the treatment of Parkinson’s disease. What are we  waiting for? Med Hypotheses. 2012 Apr 28. [Epub ahead of print]

21.) Badawy A, State O, Abdelgawad S.N-Acetyl cysteine and clomiphene citrate for induction of  ovulation in polycystic ovary syndrome: a cross-over trial. Acta Obstet Gynecol Scand.  2007;86(2):218-22.

22.) Nasr A. Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS  women: a pilot study. Reprod Biomed Online. 2010 Mar;20(3):403-9. Epub 2009 Dec 14.

23.) Rizk AY, Bedaiwy MA, Al-Inany HG. N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in  clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril. 2005  Feb;83(2):367-70.

24.) Salehpour S, Akbari Sene A, Saharkhiz N, Sohrabi MR, Moghimian F. N-acetylcysteine as an  adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic  ovary syndrome. J Obstet Gynaecol Res. 2012 Apr 30. doi: 10.1111/j.1447-0756.2012.01844.x.  [Epub ahead of print]

25.) Feldman L, Shani M, Sinuani I, Beberashvili I, Weissgarten J. N-acetylcysteine may improve residual  renal function in hemodialysis patients: A pilot study. Hemodial Int. 2012 Apr 30. doi:  10.1111/j.1542-4758.2012.00702.x. [Epub ahead of print]

26.) Hou Y, Wang L, Yi D, Ding B, Yang Z, Li J, Chen X, Qiu Y, Wu G. N-acetylcysteine reduces  inflammation in the small intestine by regulating redox, EGF and TLR4 signaling. Amino Acids. 2012 Apr 25. [Epub ahead of print]

27.) Beyaz SG, Yelken B, Kanbak G. The effects of N-acetylcysteine on hepatic function during  isoflurane anaesthesia for laparoscopic surgery patients. Indian J Anaesth. 2011 Nov;55(6):567-72.

28.) Lai ZW, Hanczko R, Bonilla E, Caza TN, Clair B, Bartos A, et al. N-acetylcysteine reduces disease  activity by blocking mTOR in T cells of lupus patients. Arthritis Rheum. 2012 May 1. doi:  10.1002/art.34502. [Epub ahead of print]

29.) Goodson AG, Cotter MA, Cassidy P, Wade M, Florell SR, Liu T, Boucher KM, Grossman D.
Use of oral N-acetylcysteine for protection of melanocytic nevi against UV-induced oxidative stress:  towards a novel paradigm for melanoma chemoprevention. Clin Cancer Res. 2009 Dec  1;15(23):7434-40. Epub 2009 Nov 17.

30.) Mates JM, Segura JA, Alonso FJ, Marquez J. Sulphur-containing non enzymatic antioxidants:  therapeutic tools against cancer. Front Biosci (Schol Ed). 2012 Jan 1;4:722-48