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Thoughts on NAC Supplements (N-Acetyl Cysteine)

N-acetylcysteine structure
N-acetylcysteine structure

This medication was and is mainly used to treat overdoses on other pharmaceuticals such as acetaminophen or working to break down mucus build-up. In cases like Cystic Fibrosis, this mucus buildup is a major concern as it inhibits proper digestion and absorption (1).


Looking into the Phycatric or therapeutic aspect of this it was seen to have beneficial effects for multiple mental disorders such as BPD and schizophrenia. changes in lipid peroxidation and protein carbonylation markers have a relation to mania (where oxidative stress is seen). (3) That is to be said that with the addition of NAC, there is a reasonable thought that it can help reduce the stress which in turn reduces the mania in these conditions.


In regards to blood sugars a small study of T2DM patients were provided a glucose tolerance test at baseline and again 2 weeks after 600mg of NAC supplementation which doubled to 1200mg in the next 2 weeks. The results showed no change in "Glycemic control, glucose tolerance, and insulin release" (4). This is also a very small study with limited data. In a preliminary study done on mice, similar methods were used. Treatments of 600, 1200, and 1800 mg/kg/day resulted in a wide range of concentrations that can improve B-cell function with increased insulin sensitivity presented only in the 1200mg/kg/day group (5). What all this means is that it is likely not something to be used at the moment until more data is present and more studies have been completed.


The "better" brands that would be a possible recommendation start with Wholesome Story. They are very aware that not all products are for everyone and are transparent. When looking at the bottle the only ingredient is the NAC. For a cheaper version using Target or Walmart brands may be better. For continued transparency supplements are not regulated and what is written about or on the bottles may not be true.


If someone is interested in these types of medication speak with your personal care team and PCP/GP. There is plenty more information to be learned about these medications and it should not be the first line of defense. More research should be done on its use and possible benefits.



 

1. Tenório, M. C. D. S., Graciliano, N. G., Moura, F. A., Oliveira, A. C. M., & Goulart, M. O. F. (2021). N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants (Basel, Switzerland), 10(6), 967. https://doi.org/10.3390/antiox10060967

2. Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A Review on Various Uses of N-Acetyl Cysteine. Cell journal, 19(1), 11–17. https://doi.org/10.22074/cellj.2016.4872

3. Dean, O., Giorlando, F., & Berk, M. (2011). N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action. Journal of psychiatry & neuroscience : JPN, 36(2), 78–86. https://doi.org/10.1503/jpn.100057

4. Szkudlinska, M. A., von Frankenberg, A. D., & Utzschneider, K. M. (2016). The antioxidant N-Acetylcysteine does not improve glucose tolerance or β-cell function in type 2 diabetes. Journal of diabetes and its complications, 30(4), 618–622. https://doi.org/10.1016/j.jdiacomp.2016.02.003

5. Falach-Malik, A., Rozenfeld, H., Chetboun, M., Rozenberg, K., Elyasiyan, U., Sampson, S. R., & Rosenzweig, T. (2016). N-Acetyl-L-Cysteine inhibits the development of glucose intolerance and hepatic steatosis in diabetes-prone mice. American journal of translational research, 8(9), 3744–3756.


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