N-ACETYLCYSTEINE

Free Radical Protection

Free oxygen radicals can damage normal metabolic functions and result in many different disease processes. N-acetylcysteine works by protecting from such free-radical damage.

We have several different anti-oxidants to protect us from these free radicals. You can name a few pretty quickly - vitamin C, vitamin E, bioflavonoids. One you may not have heard of yet is glutathione. Your body produces this within each cell to protect the delicate intracellular machinery. N-acetylcysteine helps your body produce more glutathione.

Glutathione is composed of the three amino acids: cysteine, glutamine and glycine. Glutamine and glycine are fairly common in the body; sometimes we can run a little short of cysteine. You can find cysteine in onions, garlic, and in N-acetylcysteine.

When I was in training N-acetylcysteine was given by inhalation to help people with chronic lung disease. It's still used and effective for that purpose. We know that it works by helping the lung produce more glutathione, which helps the lung produce healthful mucous so that the unhealthful mucous can be expectorated. Nowadays, we will also use inhaled glutathione for the same purpose.

Although glutathione can be given by mouth, it is poorly absorbed. It is given by mouth in Europe as part of cancer treatments, and the high expense can be worth it in that situation. Generally, however, if you want to raise raise the levels of glutathione within the cell, you take lipoic acid or N-acetylcysteine by mouth. Although lipoic acid raises glutathione levels just as does N-acetylcysteine, we use the two agents in different situations.

Anti-viral effect

Many viruses, including the influenza virus and the virus that causes AIDS, require a special enzyme to multiply inside the cell. This enzyme is called reverse transcriptase, and is the target of several anti-viral drugs including AZT for HIV disease. N-acetylcysteine and vitamin C in combination are also powerful inhibitors of this enzyme, and dramatically reduce the ravages of this class of virus.

Uses of nac

Here are some of the clinical situations in which N-acetylcysteine has been shown to be useful.

Viral infections

For our patients with viral infections, we suggest 1000 milligrams of nac twice a day.

N-acetylcysteine for fluid in the ear

A European study was conducted of thirty-six children, about seven years old, with severe serous otitis media (glue ear). In such a situation surgery is often done and then sometimes the condition reoccurs after surgery. In this case some of the children were given N-acetylcysteine twice a day for a month following surgery. In the children so treated, hearing improved after one month and after one year. This was published in the European Journal of Respiratory Diseases Supplement 1980 (61:111).

Heart disease

In some people, heart disease is caused not by cholesterol but by elevated levels of homocysteine. N-acetylcysteine was shown in a study in Sweden to reduce levels of homocysteine by about 45%.

Sjogren's syndrome

In another Scandinavian study, patients with Sjogren's syndrome benefited from N-acetylcysteine 200 mg three times a day.

Type 2 diabetes

N-acetylcysteine improves insulin sensitivity.

Poisoning

Tylenol can damage the liver terribly, especially when taken with alcohol. When physicians treat acetaminophen (Tylenol) liver damage, the primary treatment is N-acetylcysteine.

N-acetylcysteine is recognized as an antidote to many poisons, not just Tylenol but mercury, pennyroyal, and others .

In the Journal of the American Board of Family Practice 1990 (3:293) a man is described who tried to commit suicide using an arsenic ant poison. After the usual measures including dimercaprol were not helpful, he was given N-acetylcysteine by vein, improved remarkably, and was later discharged.

Liver function support

When the intestinal bacteria become imbalanced, their toxins can overwhelm the liver and cause illness. The liver uses up cysteine to detoxify toxins. N-acetylcysteine provides cysteine to the liver and is effective in helping such patients.

COPD (or emphysema)

N-acetylcysteine 200 mg three times a day has been shown to reduce recurrence of bronchitis in people with chronic lung disease. This is addition to its helpful effect reducing the tenacity of pulmonary secretions so people can cough them up more easily, mentioned above.

One study looked at the ability of N-acetylcysteine to help people with chronic lung disease clear bacteria from their lungs without antibiotics. Of sixteen patients given

N-acetylcysteine, only three had positive cultures for bacteria. Of twenty-one patients who were not given N-acetylcysteine, fifteen had positive cultures. This was published in the European Respiratory Journal 1994 (7:94). A study in the journal Chest 1994 (105:806) showed that the white blood cells of patients given N-acetylcysteine were much more effective at eradicating Candida from the lung.

Kidney stones

N-acetylcysteine has been shown to inhibit calcium stone formation in people prone to production of kidney stones. This was published in the British Journal of Urology (1994, 74:288).

HIV

N-acetylcysteine in association with vitamin C inhibits growth of HIV in human cells.

Another published study showed that the CD4 lymphocytes, which tend to fall in patients with HIV, are increased in number when those people take N-acetylcysteine.

Side effects

N-acetylcysteine can cause a false positive reading for ketones on a urine test strip.

N-acetylcysteine can chelate zinc and copper. This means it combines with zinc and copper and can remove them from circulation. Anyone taking N-acetylcysteine for a long period of time should probably be taking extra zinc and copper.

Dose

For prevention, we usually suggest 500 milligrams twice a day. For treatment of illness, higher doses are used. Consult your physician.