N-ACETYL CYSTEINE (or NAC)
I first learned of NAC when I was a young pharmacy intern working at a hospital in Toronto. NAC was used intravenously to treat patients with acetaminophen overdose, and it was also prescribed via inhalation to help patients clear excess mucous from their lungs. As a result, I was quite surprised to learn that this drug has been available for decades as an over-the-counter dietary supplement. (1) In fact, NAC is a powerhouse supplement in the functional medicine world. NAC is a powerhouse supplement in functional medicine.
The body is under constant attack from free radicals, which are unstable molecules created through biochemical reactions in the body or from environmental insults. Free radicals can damage DNA and other components of cells, eventually leading to tissue aging and disease. NAC is an antioxidant that helps get rid of these free radicals. It does this by directly removing them, and more importantly, by boosting the production of glutathione. Glutathione is found in every cell of the body and is often referred to as the body’s “master antioxidant”. It is made up of 3 amino acids: glycine, glutamine, and cysteine, the last of which is often in limited supply. NAC provides a source of cysteine and thereby increases production of this powerful, disease-preventing antioxidant.In addition to its role as an antioxidant.
- Reduces inflammation through suppression of NF-kB activation
- Promotes growth and protection of nerve cells
- Supports removal of drugs, chemicals, and heavy metals from the body
- Breaks down excess mucous
- Modulates the activity of the neurotransmitters dopamine and glutamate, and
- Supports production of nitric oxide for blood vessel dilation (2-4)NAC shows promise for a variety of conditions
As a result of this myriad of actions in the body, NAC has shown promise in a wide-range of conditions either alone, or as an adjunct to conventional therapies.
- Male and female infertility
- COPD exacerbations
- Drug addiction relapse
- Parkinson’s Disease
- Traumatic brain injuries/concussion
- Chronic kidney disease
- Dry eye
- Retinitis pigmentosa, and more. (2-10)
Overall, it’s a very safe supplement with minimal side effects, the most common being nausea and vomiting. If you’re interested in trying it out, be sure to consult with a qualified practitioner as there are varying dosages and dosage forms, and a potential for drug interactions. (11)
The information contained in this article is intended for educational and entertainment purposes only. It is not to be construed as personalized nutritional advice nor intended to be a substitute for proper health and medical care. Please consult your physician or a qualified health care professional for support with your health.
Endnotes and References:
1. Although NAC has been available as a dietary supplement for quite some time, the FDA had recently considered banning its sale owing to its original status as a drug. However, as of August 2022 the FDA is considering a rule to allow ongoing sale of NAC, provided the products do not violate the Federal Food, Drug and Cosmetic Act. (2) I’ve got my fingers crossed that the FDA doesn’t ultimately decide to remove this valuable supplement from the OTC market.
2. Natural Medicines (online database). Monograph for N-Acetyl Cysteine, last updated 9/8/2022
3. NAC Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719286/
4. NAC Review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234027/
5. Female fertility & PCOS: https://pubmed.ncbi.nlm.nih.gov/15705376/
6. Male fertility: https://pubmed.ncbi.nlm.nih.gov/33167060/
8. Chronic Kidney Disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129408/
9. Acne & dermatology: https://pubmed.ncbi.nlm.nih.gov/30246706/
10. Neurological conditions: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967529/
11. NAC may potentiate the effects of nitroglycerin and anticoagulant/antiplatelet drugs, so it should be used with caution when used in combination with these medications.