N-acetylcysteine

an extremely potent and important antioxidant

The hot potato team

You know already that vitamin C, vitamin E and many other substances protect the body from damage from free radicals. A free radical is a molecule that wants to give an electron to other molecules. As it does this, it alters them and damages the system. Vitamin E, for example, can take an electron from a free radical to neutralize it. Once vitamin E has done that, we describe that as an oxidized vitamin E and it can no longer work as a free-radical scavenger.

In other words, the antioxidant vitamin E is used up whenever it quenches a free-radical.

Nature, however, has a cunning plan. She uses vitamin C can regenerate the vitamin E and make it ready to go again. And then she uses lipoic acid to regenerate the vitamin C, and something else to regenerate the lipoic acid. This hot potato method allows rapid quenching of the free radical with more leisurely disposal of the free radical.

Team Specialists

Another reason to have several members of the team is that each member has different areas of the body in which it works.

Vitamin E is soluble in membranes. Vitamin C is soluble in the cell fluids between the membranes. Lipoic acid is unique in that it can move easily from the fatty part of the body to the watery part. Glutathione is especially suited to reduce free-radical damage inside the nucleus of the cell.

Glutathione

Glutathione is a word that you'll no doubt learn over the ensuing few years as it hits the mainstream media. Glutathione is present in the interior of all our cells. Higher levels are correlated with lower levels of cancer. Glutathion glutathion you can remember this word.

Gene p53

Now think about genetics, and the genetic codes in our DNA that determine our eye color, and height, and all the details of our makeup and metabolism. A gene is one particular genetic code with a particular function. We all have a gene called p53. When is active, our body is active at suppressing cancer. If p53 is low then we are more likely to develop cancer. Viruses that predispose to cancer often work by inactivating gene p53. Radiation or carcinogens sometimes cause cancer by damaging the p53 gene so that it cannot work properly. To quote one cancer researcher, "Mutations in the p53 tumor-suppressor gene are common in diverse types of cancer.[i]" High levels of intracellular free-radicals impair the function of p53. Glutathione (remember this word) is important in keeping p53 levels high. And thereby reducing the risk of cancer. (Gene p53, by the way, recently made it onto the cover of Newsweek. Don't ever think that the "little guy" doesn't get recognition, because the role of gene p53 in prevention of cancer finally made the national news!)

And, the final piece of the puzzle, lipoic acid is intimately involved with recycling glutathione which protects gene p53.

So lipoic acid is important in that it recycles and regenerates many of the antioxidants in the cell as well as being a powerful antioxidant itself. In my opinion, lipoic acid will come to be recognized as more effective than vitamin C or E in prevention of cancer in the average healthy person. (I still suggest vitamin C as well.)

Therapeutic use of lipoic acid for liver diseases

Deadly mushrooms and the liver

Lipoic acid was first used in clinical medicine to treat people with Amanita mushroom poisoning. This can destroy the liver in a matter of days. Generally only 10-50 % of people with amanita mushroom poisoning survive.

Now lipoic acid is used for people poisoned with amanita mushrooms. One group of 75 patients was treated with lipoic acid. Of them, 67 survived, almost 90%.

Hepatitis C

The hepatitis C virus uses an enzyme called reverse transcriptase to copy itself into the gene of the cells it infects. Lipoic acid is a potent inhibitor of reverse transcriptase, as is ascorbic acid. My patients with hepatitis C show lower levels of liver inflammation when they take lipoic acid.

Therapeutic use of lipoic acid for other conditions

Prevention of cancer

Healthy adults who wish to decrease risk of cancer will benefit from lipoic acid 100 milligrams two to four times a day. See discussion above

Diabetes

Lipoic acid is used in people with diabetes for two purposes.

  1. One is that it reduces levels of blood glucose.
  2. The second is that it prevents some of the complications of high blood sugar. The tissue damage in people with diabetes is due to the high levels of glucose, causing glucose to attach to proteins in the body and make them work less well. Lipoic acid interferes with the attachment of sugar to proteins in the body. Glucose, although is an important fuel for us, is regulated in a fairly tight range. Too little and our brain stops functioning and we will faint with hypoglycemia. Too much and the sugar molecules will start reacting chemically with other proteins in the body and cause them to lose their capacity to function. In the case of the nerves this can result in nerve damage; in the case of the kidneys they function less well; in the case of the eye vision is impaired; in the case of blood vessels they develop arteriosclerosis. So, if we can keep the blood glucose normal, we can prevent these complications.
  3. Lipoic acid has been used in Germany for over 20 years to treat the nerve damage from diabetes.
  4. Diabetics are also prone to cataract formation. A cataract is a condition in which the transparent lens of the eye becomes less transparent, something like fog on your bathroom window when you take a hot shower. Evidence from animals in the laboratory indicates that lipoic acid prevents this.

Glaucoma

In one study of 45 patients with stage I and II open angle glaucoma, 150 mg of lipoic acid a day resulted in greater improvement in visual function compared to patients taking placebo.

Stroke and Heart Attack

Stroke and heart attack are both illnesses in which occlusion of a blood vessel results in damage to the tissue nourished by that blood vessel. Animal studies show that lipoic acid greatly diminishes the area of tissue thas injured when the blood supply is cut off. Animals given lipoic acid had only 1/3 the death rate from stroke compared to those not so treated.

Safety of Lipoic acid

No serious side effects from lipoic acid have appeared in over thirty years of scientific research and therapeutic use

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Some people with diabetes have developed hypoglycemia because the lipoic acid improved their glucose handling. Any person with diabetes should take supplements only under supervision of their physician.

Other people have developed allergic skin conditions. If a person is deficient in thiamine (vitamin B1) they should not take lipoic acid until their thiamine deficiency is treated. Thiamine deficiency can cause loss of appetite, confusion, constipation, depression, digestive disturbances, fatigue, irritability, memory loss, weakness, nervousness, loss of sensation, pain, shortness of breath, and sensitivity to sound.

Dose of lipoic acid

Lipoic acid tends to wash out of the blood stream quickly, so you benefit more by spreading out the dose to two to four times a day. I suggest a total daily dose of at least 500 milligrams. Eight hundred would certainly be safe and more beneficial.

[i] Borek C. "Molecular mechanisms in cancer induction and prevention." Environmental Health Perspectives. 1993 Oct;101 Suppl 3:237-45.