N-acetylcysteine (NAC) At-a-glance
- N-acetylcysteine (NAC) boosts production of glutathione, an important antioxidant that helps reduce free radical damage and plays a role in the detoxification of heavy metals and other harmful substances.
- In emergency medicine, NAC is used as an antidote for acetaminophen toxicity resulting from an overdose. Mortality due to acetaminophen toxicity is largely eliminated when NAC is promptly administered.
- The most common use of NAC is for liver support, but it’s also showing tremendous promise in the treatment of neurodegenerative disorders such as Parkinson’s disease.
- NAC also shows particular promise in the treatment of mental health disorders, including PTSD, depression and drug abuse, and appears to improve fertility in both men and women.
- NAC is safe and inexpensive, and has been commercially available for a long time. It’s also generally well-tolerated and has no known serious side effects.
N-acetylcysteine (NAC) — a precursor which is needed for glutathione biosynthesis — is an incredibly useful supplement that few people have even heard of. Many of its benefits relate back to the fact that it helps boost production of glutathione, an important antioxidant your body produces naturally that helps reduce free radical damage and plays a role in the detoxification of heavy metals and other harmful substances.
NAC is both safe and inexpensive, and has been commercially available for a long time. It’s also generally well-tolerated and has no known serious side effects. Considering its wide array of health benefits, it’s a supplement worthy of consideration for many. As noted in a recent medical review of NAC’s many clinical uses, it is a:1
“… Potential treatment option for diseases characterised by the generation of free oxygen radicals. Studies have shown no maternal or fetal harmful effects of NAC treatment … NAC prevents apoptosis [editor’s note: programmed cell death] and oxygen related genotoxicity in endothelial cells by increasing intracellular levels of glutathione and decreasing mitochondrial membrane depolarisation.”
N-acetylcysteine (NAC) Helps Counter Toxic Effects of Alcohol
N-acetylcysteine (NAC) supplementation can also help “pre-tox” your body when taken before alcohol, thereby minimising the damage associated with alcohol consumption — a tidbit that may be useful to know in light of the approaching holidays. NAC is a form of the amino acid cysteine, which in addition to increasing glutathione also reduces acetaldehyde toxicity that causes many hangover symptoms.
Taking NAC (at least 200 milligrams) 30 minutes before you drink can help lessen the alcohol’s toxic effects. NAC is thought to work even better when combined with vitamin B1 (thiamine) Vitamin B6 may also help to lessen hangover symptoms.
Since alcohol depletes B vitamins, and B vitamins are required to help eliminate alcohol from your body, a B vitamin supplement taken beforehand, as well as the next day, can be helpful. All of that said, it’s important to realise that this protocol will not reduce your susceptibility to alcohol poisoning or other acute adverse events associated with binge drinking, so please use common sense and drink responsibly.
N-acetylcysteine (NAC) Is a Potent Antidote to Acetaminophen Toxicity
N-acetylcysteine (NAC) is also used in medicine as an antidote for acetaminophen toxicity. Like alcohol, one way that acetaminophen causes liver damage is by depleting glutathione. If you keep your glutathione levels up, the damage from the acetaminophen may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room — to increase glutathione.
Mortality due to acetaminophen toxicity has actually been shown to be virtually eliminated when NAC is promptly administered in cases of acetaminophen overdose. While I generally do not recommend using acetaminophen-containing drugs for minor aches and pains, they are sometimes necessary to temporarily suppress severe pain, such as post-surgical pain. So, if you ever use acetaminophen I strongly recommend taking it along with NAC.
And, if you have children and keep acetaminophen in your home, I strongly recommend keeping a bottle of NAC as well in case of accidental overdose. NAC therapy should be initiated within eight hours of an acute overdose for best results. If you suspect an overdose has occurred, seek medical help right away. If this isn’t an option, the World Health Organisation (WHO) recommends the following protocol:
“Oral administration is the preferred route for NAC therapy unless contraindications exist (e.g aspiration, persistent vomiting). The usual recommended loading dose is 140 mg/kg followed in 4 hours by a maintenance dose of 70 mg/kg orally given every 4 hours. This dosing is commonly recommended to be continued for 72 hours; however more recent clinical experience supports tailoring the duration of therapy to the patient’s clinical condition.”
N-acetylcysteine (NAC) Offers Important Liver Support
The most common use of NAC is for liver support in general. A 2010 study — in which it was noted that the antioxidant resveratrol has been found to enhance replication of the hepatitis C virus and hence is not a suitable supplement for those with hepatitis C — suggests NAC may be a better alternative for this and other chronic liver diseases.
“Consistently, we found that [NAC] modulates the expression of iNOS [editor’s note: iNOS is an inducible and calcium-dependent isoform of the enzyme nitric oxide synthase or NOS, which helps synthesise nitric oxide] in human hepatocytes stimulated by pro-inflammatory cytokines,” the authors write.
“The effect occurs by blocking the activation of the iNOS promoter, and is associated with modulation of NF-κB activity, a central transcription factor for induction of iNOS expression. The biological phenomenon might well be the basis of the therapeutic effects of NAC on chronic liver diseases different from those caused by acetaminophen intoxication.”