NAC (N-Acetyl-L-Cysteine)

NAC is a precursor molecule used by the body to manufacture glutathione (GSH). GSH is a potent anti-oxidant that is used by the body in a variety of ways. It seems to play a role in the prevention and treatment of infection, cancer and heart disease and in the detoxification of environmental toxins, such as through environmental exposure or cigarette smoking.

In addition to it\'s role as an anti-oxidant, NAC plays a role in the liver detoxification processes. Liver detoxification is carried out through two independent pathways, referred to as Phase I and Phase II. Phase I is an enzyme-dependent pathway that can be effected by certain types of toxins (such as alcohol) or certain drugs (such as dilantin). After completing Phase I detoxification, substances are shuttled through Phase II detoxification, which has many subcategories. It is through Phase II that NAC, and its constituent compound GSH, is involved in the modulation of free radical expression and enhancement of energy production. Through some of these actions, NAC has been shown to lower levels of lipoprotein A and homocystein. These two components, when elevated, tend to increase the rate of heart and circulatory disease.

NAC also seems to play a favorable role in the respiratory system, especially in those who have respiratory disabilities, such as emphysema, chronic obstructive lung disease or underlying significant allergies or asthma.

NAC has been shown to play a favorable role in the treatment of infectious complications as well. A great deal of research has recently looked at the role of NAC in the treatment of HIV-positive individuals. In clinical studies, it has been shown that those with HIV and other types of chronic infections exhibit low GSH levels and low cysteine levels. Supplementation of NAC has been shown to normalize these levels and evidence suggests that NAC enhances immune response of peripheral blood T-cells.

The role of NAC as it relates to treatment of various infections also applies to viral illnesses, such as influenza, where administration of NAC appears to reduce symptomatology associated with influenza or influenza-like episodes. The usual dose used in this study was 600 mg, twice daily, for a period of up to six months.

NAC may play a role in the prevention and treatment of various forms of cancer. However, this information is still preliminary. Experimentally-induced DNA damage can be completely blocked in some situations by supplementation of NAC. Evidence also indicates that NAC can protect bone marrow cells from the growth inhibitory effects of certain drugs, such as Chloramphenicol. NAC has been shown to have anti-mutagenic activity toward a variety of toxic agents.

NAC may play a role in the removal of heavy metals from the body, such as lead, cadmium, aluminum and similar toxins. Because of its sulfur-containing components, the molecules can easily bind to these very toxic compounds and assist in their elimination through bile, feces and urine.

NAC appears to be a relatively non-toxic compound. In very high doses given to animals in certain studies, no adverse effects were noted. Larger doses, especially intravenously, have rarely been shown to cause nausea and gastrointestinal disturbance. Occasionally, a dermatologic rash has developed, but this has occurred in instances where NAC was being used in large doses to treat Tylenol toxicity. It is recommended that supplementation with NAC be accompanied by supplementation of higher dose ascorbic acid or vitamin C. The vitamin C tends to prevent the accumulation of potentially pro-oxidant amino acid metabolic compounds derived from normal NAC metabolism.

If you have further questions, please contact the Advanced Medical Center.

Dale Guyer, M.D.