Health and Medicine
Here’s Why N-Acetyl Cysteine Is a Vital Molecule for Health.
What if there’s hope to improve immunity: An independent review of N-Acetyl Cysteine (NAC) with support of recent scientific studies.
Introduction and Context
N-Acetyl Cysteine (NAC) has played a critical role in my personal transformation. I call it my “reentry” tool to a new world. I have been using NAC successfully for over a decade.
This powerful supplement is not hype. It is not a commercial pitch. And it is not a prescription drug. But it is as effective as medication for some health conditions, as proven by multiple clinical studies provided in the reference section of this article.
NAC is a valuable supplement available over the counter to the public. We can buy it from any health store, pharmacy, or even reputable grocery shop without needing a prescription. NAC was reviewed by the World Health Organization’s Expert Committee on the Selection and Use of Essential Medicines in 2008.
NAC has been a critical health supplement in my toolbox for a long time for good reasons. I reviewed NAC as part of my personal transformation progress in an article titled Impact of Supplements on Fitness and Health: What I learned from trying four unique molecules in my Euphoria publication.
I also covered NAC in my book titled “Powerful Life-Changing Hacks That Truly Transformed My Life,” published in 2019, which can be read on this platform via the publication ILLUMINATION Book Chapters.
NAC made a substantial impact on my health transformation. Apart from many benefits, as mentioned in my sensible bio-hacking articles in Euphoria, the most tangible benefit of NAC was preventing me from common cold and flu symptoms.
Since starting to use NAC, I have not experienced single flu or cold symptom.
Many readers found my safe supplementation reviews helpful. Some readers particularly asked about NAC, as it has become popular during the pandemic. Therefore, I want to introduce this critical supplement to my readers.
Please note that this article is not advice or a specific recommendation. I don’t provide medical advice in my articles.
I only share my personal experience and provide information so that my readers can gain awareness of valuable tools and discuss with their healthcare professionals whether these mentioned supplements could add value to improving their health conditions.
There are several use cases of NAC. People use it for various reasons. I use it every day for compelling reasons. My primary reason for using NAC is to boost glutathione naturally in my body.
To understand the importance of NAC, we need to know about the importance of glutathione first. Let me explain.
What is glutathione, and why is it important?
According to WebMD, Glutathione is involved in many processes in the body, including tissue building and repair, making chemicals and proteins needed in the body and the immune system.
Glutathione is made from three amino acids: glycine, cysteine, and glutamic acid. Our liver creates glutathione naturally.
Even though we can supplement with glutathione directly, I don’t take glutathione supplements directly. Instead, I prefer my body to create glutathione naturally.
NAC is a building block for the creation of glutathione which is a potent antioxidant.
Common use cases for NAC
The well-known contribution of NAC is Glutathione which is a significant antioxidant in our body. It protects our bodies.
According to a scientific paper titled “N-Acetylcysteine: Multiple Clinical Applications,” published by American Family Physician in 2009: “N-acetylcysteine is the acetylated variant of the amino acid L-cysteine and is widely used as the specific antidote for acetaminophen overdose.”
“Other applications for N-acetylcysteine supplementation supported by scientific evidence include:
Prevention of chronic obstructive pulmonary disease exacerbation
Prevention of contrast-induced kidney damage during imaging procedures
Attenuation of illness from the influenza virus when started before the infection
Treatment of pulmonary fibrosis, and
Treatment of infertility in patients with clomiphene-resistant polycystic ovary syndrome.
Preliminary studies suggest that N-acetylcysteine may also have a role as a cancer chemopreventive, an adjunct in the eradication of Helicobacter pylori, and prevention of gentamicin-induced hearing loss in patients on renal dialysis.”
I came across and reviewed many studies related to NAC’s biological, psychological, and psychiatric applications.
For example, ADHD, schizophrenia, smoking cessation, addressing hangover symptoms, drug withdrawal, nephropathy, diabetes, liver disease, and helicobacter pylori eradication are a few.
Therefore, I provided relevant scientific papers in the reference section of this article for awareness of these studies. You can read nine benefits of NAC from this Healthline article written in simple language.
Adverse reactions and interactions with medications
Even though NAC is publicly available, NAC may have some side effects for some people, like any supplement. It can also have reactions and interactions with medications.
Therefore, we need to know about the side effects, reactions, and medication interactions and discuss the risks with our healthcare professionals.
According to this medical paper, [N-Acetylcysteine: Multiple Clinical Applications]:
“At dosages of 1,200 mg twice daily or lower, N-acetylcysteine is well tolerated. At these dosages, side effects are unusual but may include nausea, vomiting, diarrhea, transient skin rash, flushing, epigastric pain, and constipation.
At the much larger dosages used to treat acetaminophen overdose, N-acetylcysteine is often poorly tolerated, with side effects such as headache, tinnitus, urticaria, rash, chills, fever, and anaphylactoid reactions (pseudoanaphylaxis).
N-acetylcysteine strongly potentiates the effect of nitroglycerin and related medications, and caution should be used in patients receiving these agents in whom it may cause hypotension.”
I use 600 mg daily, which my body tolerates the best.
For over a decade, I haven’t experienced any noticeable side effects. However, as I don’t use any medication, I cannot comment on the drug interactions.
Purchasing this supplement from reliable sources is essential.
I don’t particularly recommend a specific brand. However, it is beneficial to discuss with your healthcare professionals and obtain advice for choosing high-quality products. This applies to any supplement.
Unfortunately, supplements are not regulated in many countries.
We are lucky in Australia as TGA (Therapeutic Good Administration), as part of the Australian Department of Health, has reasonable control and does not allow the entry of dangerous supplements into our country.
A Condensed Literature Review on Benefits of N-Acetyl Cysteine
NAC is one of the most researched and reviewed molecules in the medical community for valid and compelling reasons.
I provide an overview of ten prominent scientific papers from my recent reviews in this section, including crucial points in these studies. I also include DOI (digital object identifier) which is a unique alphanumeric string to identify content and provide a persistent link to its location on the Internet.
These papers are accessible to the public for free.
You can find links to more peer-reviewed scientific papers at the end of this article as essential references.
1 — Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment
[DOI: 10.1183/09031936.97.10071535]
“N-acetylcysteine (NAC), an analogue and precursor of reduced glutathione, has been in clinical use for more than 30 yrs as a mucolytic drug. It has also been proposed for and/or used in the therapy and/or prevention of several respiratory diseases and of diseases involving an oxidative stress, in general. The objective of the present study was to evaluate the effect of long-term treatment with NAC on influenza and influenza-like episodes. A total of 262 subjects of both sexes (78% > or = 65 yrs, and 62% suffering from nonrespiratory chronic degenerative diseases) were enrolled in a randomized, double-blind trial involving 20 Italian Centres. N-acetylcysteine did not prevent A/H1N1 virus influenza infection but significantly reduced the incidence of clinically apparent disease.”
2 — N-acetyl-L-cysteine (NAC) inhibits virus replication and expression of pro-inflammatory molecules in A549 cells infected with highly pathogenic H5N1 influenza A virus
[ DOI: 10.1016/j.bcp.2009.08.025]
“The antioxidant N-acetyl-L-cysteine (NAC) had been shown to inhibit replication of seasonal human influenza A viruses. Here, the effects of NAC on virus replication, virus-induced pro-inflammatory responses and virus-induced apoptosis were investigated in H5N1-infected lung epithelial (A549) cells. NAC at concentrations ranging from 5 to 15 mM reduced H5N1-induced cytopathogenic effects (CPEs), virus-induced apoptosis and infectious viral yields 24 h post-infection. NAC also decreased the production of pro-inflammatory molecules (CXCL8, CXCL10, CCL5 and interleukin-6 (IL-6)) in H5N1-infected A549 cells and reduced monocyte migration towards supernatants of H5N1-infected A549 cells. Therefore, antioxidants like NAC represent a potential additional treatment option that could be considered in the case of an influenza A virus pandemic.”
3- In vitro study of N-acetylcysteine on coagulation factors in plasma samples from healthy subjects
[DOI: 10.1007/s13181–012–0242–2]
“In the treatment of acetaminophen toxicity, clinicians believe that N-acetylcysteine (NAC) artificially elevates prothrombin time (PT). However, the effect of NAC on human blood coagulation remains unverified. In a previous study, we show that NAC had a dose-dependent effect on PT. To our knowledge, there are no studies that specifically examine the mechanism by which NAC affects PT. This study evaluates the effect from a therapeutic NAC dose on the activity of coagulation factors II, VII, IX, and X in human plasma.”
4 — N-Acetylcysteine as an antioxidant and disulphide breaking agent: the reasons why
“The antioxidant effect is due to the ability of NAC to act as a reduced glutathione (GSH) precursor; GSH is a well-known direct antioxidant and a substrate of several antioxidant enzymes. Moreover, in some conditions where a significant depletion of endogenous Cys and GSH occurs, NAC can act as a direct antioxidant for some oxidant species such as NO2 and HOX. The antioxidant activity of NAC could also be due to its effect in breaking thiolated proteins, thus releasing free thiols as well as reduced proteins, which in some cases, such as for mercaptoalbumin, have important direct antioxidant activity. As well as being involved in the antioxidant mechanism, the disulphide breaking activity of NAC also explains its mucolytic activity which is due to its effect in reducing heavily cross-linked mucus glycoproteins.”
5 — N-acetylcysteine improves oxidative stress and inflammatory response in patients with community-acquired pneumonia: A randomized controlled trial
“The aim of the study was to compare the effect of adding N-acetylcysteine (NAC) to conventional treatment versus conventional treatment on oxidative stress, inflammatory factors, and radiological changes in CAP patients. Eligible CAP patients at Weihai Municipal Hospital were stratified and randomly assigned to either NAC group or non-NAC group between August 2016 and March 2017. The NAC group received conventional treatment for pneumonia and NAC (1200 mg/d). Thenon-NAC group received conventional therapy. malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAOC), tumor necrosis factor-α (TNF-α), and computed tomography (CT) images were evaluated at baseline and after treatment.”
6 — N-acetylcysteine attenuates systemic platelet activation and cerebral vessel thrombosis in diabetes
[DOI: 10.1016/j.redox.2017.09.005]
“We previously demonstrated that diabetes exacerbates stroke-induced brain injury, and that this correlates with brain methylglyoxal (MG)-to-glutathione (GSH) status. Cerebral injury was reversed by N-acetylcysteine (NAC). Here we tested if the pro-thrombotic phenotype seen in the systemic circulation and brain during diabetes was associated with increased MG-glycation of proteins, and if NAC could reverse this. Collectively, these results show that the diabetic blood and brain become progressively more susceptible to platelet activation and thrombosis. NAC, given after the establishment of diabetes, may offer protection against the risk for stroke by altering both systemic and vascular prothrombotic responses via enhancing platelet GSH, and GSH-dependent MG elimination, as well as correcting levels of antioxidants such as SOD1 and GPx-1.”
7- The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm
[DOI: 10.1097/01.mbc.0000195922.26950.89
“N-acetylcysteine (NAC) may offer renal and hepatic protection during surgery, but in experimental studies it has been shown to impair coagulation. Since very little is known about the effects of NAC on blood coagulation in surgical patients, we studied its effects during abdominal aortic reconstruction. NAC (a bolus of 150 mg/kg followed by a continuous 24-h infusion of 150 mg/kg) or the same volume of placebo was given intravenously, in a randomized double-blinded fashion, to 20 patients undergoing abdominal aortic aneurysm repair. The haematocrit, platelet count, prothrombin time, thromboelastometry, and platelet aggregation were studied during and after surgery.”
8 — Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis
[ DOI: 10.1080/10715762.2018.1468564]
“Acute respiratory distress syndrome (ARDS) is a serious complication of acute lung injury. Severe systemic inflammation is the main cause of multiple organ dysfunction and high mortality. Removal of reactive oxygen species by anti-oxidants has been applied in clinical practice. N-acetylcysteine (NAC) is the most commonly used anti-oxidant. However, the benefit of anti-oxidant therapy was not consistently demonstrated by previous studies. In the present study, a meta-analysis was performed to evaluate the effects of NAC for adult patients with ARDS.”
9 — Potent Thrombolytic Effect of N-Acetylcysteine on Arterial Thrombi
[DOI: 10.1161/CIRCULATIONAH]
“We provide evidence that NAC is an effective and safe alternative to currently available antithrombotic agents to restore vessel patency after arterial occlusion. We demonstrated that intravenous NAC administration promotes lysis of arterial thrombi that are resistant to conventional approaches such as recombinant tissue-type plasminogen activator, direct thrombin inhibitors, and antiplatelet treatments. Through in vitro and in vivo experiments, we provide evidence that the molecular target underlying the thrombolytic effects of NAC is principally the VWF that cross-link platelets in arterial thrombi. Coadministration of NAC and a nonpeptidic GpIIb/IIIa inhibitor further improved its thrombolytic efficacy, essentially by accelerating thrombus dissolution and preventing rethrombosis. Thus, in a new large-vessel thromboembolic stroke model in mice, this cotreatment significantly improved ischemic lesion size and neurological outcome. It is important to note that NAC did not worsen hemorrhagic stroke outcome, suggesting that it exerts thrombolytic effects without significantly impairing normal hemostasis.”
10 — N-acetylcysteine inhibits thrombosis in a murine model of myeloproliferative neoplasm
“Thrombosis is a major cause of mortality in patients with myeloproliferative neoplasms (MPNs), though there is currently little to offer patients with MPN beyond aspirin and cytoreductive therapies such as hydroxyurea for primary prevention. Thrombogenesis in MPN involves multiple cellular mechanisms, including platelet activation and neutrophil-extracellular trap formation; therefore, an antithrombotic agent that targets one or more of these processes would be of therapeutic benefit in MPN. Here, we treated the JAK2V617F knockin mouse model of polycythemia vera with N-acetylcysteine (NAC), a sulfhydryl-containing compound with broad effects on glutathione replenishment, free radical scavenging, and reducing disulfide bonds, to investigate its antithrombotic effects in the context of MPN. Strikingly, NAC treatment extended the lifespan of JAK2V617F mice without impacting blood counts or splenomegaly.”
Government Clinical Trials of NAC
When I reviewed the Government Clinical Trials by the US National Library of Medicine, I noticed that there were 555 clinical studies related to the term “N-acetylcysteine”.
There is currently a compelling research study that NAC may reduce the severity of viral infections.
The recent clinical study is titled “Effect of N-acetylcysteine on Oxidative Stress in COVID-19 Patients”.
Medical Doctor Roger Seheult presents whether NAC could be effective in COVID-19. Dr. Roger Seheult is an American Board of Internal Medicine certified in Pulmonary Diseases, Critical Care Medicine, and Sleep Medicine.
Dr. Seheult articulates these ideas and discusses the peer-reviewed data involved. The presentation also mentions the clinical trial by the US government.
Here is the outstanding presentation by Dr. Seheult on his popular YouTube channel, also part of his Medcram courses.
My understanding of Dr. Seheult’s conclusion on using NAC for COVID-19 is that we don’t have full evidence yet; however, if we connect the dots, there is potential. We need to be open-minded. I hope there will be more research on this promising molecule for our health and well-being.
Further education on NAC molecule
For scientifically minded readers, I recommend watching this medical lecture to learn more about the biochemical details of this important molecule posted by Drbeen Medical Lectures.
The presentation shows how N-Acetylcysteine functions in our body to help against infections and oxidative stresses.
Conclusions
N-Acetyl Cysteine (NAC) has played a critical role in my personal transformation as my “re-entry” tool to a transformed world. Likewise, I hope it can serve as a “re-entry” to society during this pandemic.
Using NAC successfully for over a decade has provided many immune-boosting benefits to me. The research on NAC is solid and continuing as it has promising results. It has the potential to address immunity issues related to the COVID-19 situation too.
Many research institutes, including government organizations, are working on the possibilities. We hope some good results will be produced soon.
This supplement is not just for individual self-improvement purposes but also as a hope to ease the pain of a debilitating pandemic.
NAC is a simple over-the-counter product. However, paradoxically and as history shows, sometimes big problems are solved by minimal tools. We need an open mind and collaboration to further research this possibility.
My aim and fervent wish are to contribute to this ongoing research by inspiring practitioners and innovative researchers and creating visibility and awareness for the public.
Thank you for reading my perspectives. I wish you a happy and healthy life.
I also wrote about other valuable nutrients. Here are the links for easy access:
Lutein/Zeaxanthin, Phosphatidylserine, Boron, Urolithin, taurine, citrulline malate, biotin, lithium orotate, alpha-lipoic acid, n-acetyl-cysteine, acetyl-l-carnitine, CoQ10, PQQ, NADH, TMG, creatine, choline, digestive enzymes, magnesium, zinc, hydrolyzed collagen, nootropics, pure nicotine, activated charcoal, Vitamin B12, Vitamin B1, Vitamin D, Vitamin K2, Omega-3 Fatty Acids, N-Acetyl L-Tyrosine, and other nutrients to improve metabolism and mental health.
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I write about various hormones and neurotransmitters such as dopamine, serotonin, oxytocin, GABA, acetylcholine, norepinephrine, adrenaline, glutamate, and histamine.
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Noteworthy References on NAC from Credible Sources
Many studies have been conducted on using NAC by scientists and medical researchers. I only provide a minimal amount from my recent reviews as part of my interest in the potential of this remarkable molecule.
N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19
A Study of N-acetylcysteine in Patients With COVID-19 Infection
N-acetylcysteine reduces the size and activity of von Willebrand factor in human plasma and mice
Overview on the Effects of N-Acetylcysteine in Neurodegenerative Diseases.
Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review.
N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review.
N-acetylcysteine for antioxidant therapy: pharmacology and clinical utility.
N-Acetylcysteine for the Treatment of Psychiatric Disorders: A Review of Current Evidence.
An update of N-acetylcysteine treatment for acute acetaminophen toxicity in children.
Effects of N-acetylcysteine amide on anxiety and stress behavior in zebrafish.
Nebulized N-Acetylcysteine for Management of Plastic Bronchitis.
N-Acetylcysteine amide: a derivative to fulfill the promises of N-Acetylcysteine.
N-Acetylcysteine augmentation in refractory obsessive-compulsive disorder.
Impact of N-Acetylcysteine on Autologous Fat Graft: The Consideration of Blood Concentration.
Topical N-acetylcysteine in ichthyosis: Experience in 18 patients.
N-acetylcysteine use to prevent contrast medium-induced nephropathy: premature phase III trials.
N-acetylcysteine and intestinal health: a focus on its mechanism of action.
S-Nitroso-N-acetylcysteine Generates Less Carcinogenic N-Nitrosamines in Meat Products than Nitrite.
Therapeutic effect of N-acetylcysteine on chemotherapy-induced liver injury.
N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects.
N-Acetylcysteine Use in Non-Acetaminophen-Induced Acute Liver Failure.
The chemistry and biological activities of N-acetylcysteine.
Biological Activities and Potential Oral Applications of N-Acetylcysteine: Progress and Prospects.
N-acetylcysteine as an adjunctive treatment for smoking cessation: a randomized clinical trial.
Antioxidant effects of N-acetylcysteine on the male reproductive system: A systematic review.
N-acetylcysteine as powerful molecule to destroy bacterial biofilms. A systematic review.
A minireview on N-acetylcysteine: An old drug with new approaches.
Effect of N-acetylcysteine on mucosal immunity of respiratory tract.
N-Acetylcysteine for Pediatric Obsessive-Compulsive Disorder: A Small Pilot Study.
N-acetylcysteine as an adjuvant therapy for Helicobacter pylori eradication.
N-acetylcysteine for non-paracetamol (acetaminophen)-related acute liver failure.
[Effectiveness of N-acetylcysteine in the treatment of schizophrenia].
N-Acetylcysteine: Antioxidant, Aldehyde Scavenger, and More.
Intravenous N-acetylcysteine in the prevention of contrast media-induced nephropathy.
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