N-acetylcysteine, also referred to as NAC, has many applications and uses in our bodies. Derived from the amino acid L-cysteine, NAC has been promoted in natural health circles for decades for its support in liver detoxification and for its power in supporting the immune system. NAC also helps with healthy lung function and assists the body in healing from certain brain disorders. As a matter of fact, there are over 30 placebo-controlled studies on cellular glutathione (the body’s most powerful antioxidant) that show NAC as a favorable supplement for energy production, well-being, and quality of life. (1) But, how can one supplement do so many things? We are going to explore the many mechanisms at work with NAC in this article and how its ability to counteract the deleterious effects of stress on the body might be at the very crux of its success as such a multitarget drug. In doing so, I hope to also show how NAC may be used to help patients who have been exposed to mold and mycotoxins in their healing journeys.
NAC and Glutathione
We have discussed in previous articles how important glutathione is for liver detoxification; it is referred to as the “master antioxidant”. Perhaps, what needs more attention is the fact that NAC is one of the precursor amino acids which helps the body make glutathione. While glutathione is very necessary for treating acute toxicity (especially from mycotoxins) and may need to be used for some time depending on the severity of sickness and the individual response, adding NAC as part of treatment or even switching to it entirely can support the body’s ability to make its own glutathione. There is even some evidence to suggest that using glutathione long-term without other support may decrease the body’s ability to continue to make glutathione on its own. When supplementation decreases the body’s natural production, it is called a negative feedback loop. Sometimes the need for supplemental therapy outweighs the risk of creating a negative feedback loop, but, whenever possible, it is good to try to avoid it. I have also noted that MANY patients who complete the Organic Acids test show low to no levels of NAC. This could come from NAC simply being overutilized in so many functional demands–a sick body tends to deplete all available resources in an effort to stave off disease–or problems with absorption of all amino acids in general, or poor quality dietary protein. In any of these events, the use of NAC can accomplish a lot toward wellness in toxin-induced illness as well as maintenance of good liver detoxification in general.
NAC and Neuropsychiatric Issues
Are you one of those individuals who get headaches when you eat foods heavy in MSG (monosodium glutamate)? If so, then both avoiding MSG and using NAC may help you quite a bit. There is a genetic tendency in some to not metabolize the amino acid glutamate properly. From a neuropsychiatric point of view, however, it goes much further than that. An article published in January of 2020 reported positive findings in treating children with obsessive-compulsive disorder who had failed to fully respond favorably to traditional medications for this disorder with N-Acetylcysteine. (2) The theory is that a select group of the population cannot handle glutamates and break them down. Glutamates are amino acids found in many foods deemed as generally healthy and include meats, bone broth, soy, and others. If you happen to be one of these individuals, it would be difficult to pin down this cause as glutamates are so ubiquitous. Certainly, reducing the ingestion of high glutamate foods could help, but as they are generally healthy, adding NAC to ensure their proper processing could help quiet OCD and anxiety-driven conditions that can range from annoying to devastatingly disruptive in functioning. There have even been some articles suggesting that some cases of schizophrenia are likewise impacted by improper glutamate processing. In any event, NAC is a safe treatment and may yield some positive and behaviorally measured results. And, since NAC can increase glutathione production and calm inflammation, it is definitely a helpful treatment addition for those struggling with the anxiety and neuropsychological issues often brought on by mold and mycotoxin exposure.
For additional information, there is a wealth of articles about glutamate and its role in these disorders, and if OCD has impacted your life or that of a loved one, then it is certainly worth looking into more thoroughly. Lists of food alternatives are easily found as well, and I would encourage you to research this further. But again, the addition of NAC is not harmful and has the potential to be quite helpful.
NAC, Sulfur, and Mold-Related Illness
One of the details about N-acetylcysteine’s molecular makeup is that it contains a sulfur molecule. While it is beyond the scope of this article to go into the full biochemical description of why this molecule helps in lung problems, the big takeaway is that it is very important in causing mucus to become thinner and more easily expelled. The mucolytic property of NAC is the reason that is so helpful in the sinus and pulmonary problems from mold-related illness. (3) Expelling and ridding the mucous that contain spores and mycotoxins is, of course, desirable. There are also many articles about the use of NAC in the treatment of chronic bronchitis and COPD. It has shown benefits in reducing the episodes of severe symptoms and may even help in restoring lung function to some degree in affected patients. This is not just in thinning the mucous, which, of course, is very helpful, but also in reducing inflammation in the tissues. In acute episodes, the dose of NAC does have to be large, 1,200 mg per day, then reduced to 600 mg when exacerbation of symptoms has been reduced. These findings were some of the reasons that NAC was recommended both in the prevention and treatment of COVID 19, with its beneficial impacts on lung tissues and immunity in general. Remember the term “cytokine storm” in relation to COVID? Well, NAC has been shown to reduce the production of pro-inflammatory cytokines and modulate the symptoms of chronic inflammatory conditions, like mold-induced illness. Knowing this, NAC was actually quite hard to obtain due to its drastic increase in use. It has also become the subject of recent FDA scrutiny since NAC is a dietary supplement that cannot be sold with claims that it legitimately treats any disease. It has yet to be determined if its non-prescription availability will be impeded.
NAC, Athletic Performance, and Weight Loss
Muscles contain glutamates, and under heavy exercise, these can become inflammatory. NAC can reduce this inflammation and can enhance performance naturally. As stated before, NAC also reduces inflammation and oxidative stress in lung tissues following heavy exercise. Taking NAC about an hour before workouts seems to be the best strategy. For professional athletes, it is not a controlled substance or what is typically thought of as “performance-enhancing” so is legal and safe to use.
A German study published in the Journal of Molecular Medicine reported that NAC aids in fat burning and weight loss. Indirectly, NAC helps improve workouts as mentioned above, but, more directly, the study demonstrated a 5% reduction in body fat in eight weeks without any change in dietary habits. The theory is that NAC interferes with insulin thus preventing fat storage and allowing fat to be mobilized out of storage to be burned for energy at an accelerated rate.
Another study conducted by researchers at the Baylor College of Medicine with lab mice concluded that low levels of glutathione inhibit our ability to break down fat but supplementing with NAC increased the ability to break down fat and increased metabolic rates even in older mice. (4) Using this mechanism we can see also why NAC may be helpful in improving fertility in patients with Polycystic Ovarian Syndrome (PCOS) since the condition can be linked to insulin resistance and metabolism. It seems that as NAC mobilizes the metabolism and insulin, it also prevents the build-up of hormones in the body that can lead to PCOS.
More Positive Press for NAC
Kidneys also benefit from N-Acetylcysteine. While some of these mechanisms are not fully known, it has been shown to help reduce the damage from radioactive nucleotides injected for some radiological procedures. While it would not reverse renal failure, it can help to mitigate renal damage from some medications and exposures, including acetaminophen. As a matter of fact, NAC has been used for decades to treat patients hospitalized for acetaminophen overdoses. The antioxidant properties in NAC counteract the liver damage that can be caused by such an overdose. And, since detoxification of toxins such as mycotoxins produced by molds put such a heavy burden on the liver, the use of NAC can be in much the same way to mitigate that damage. A consistent intake of high-quality NAC (with that sulfur molecule we discussed earlier) aids in sulfation. Sulfation is involved in a variety of biological processes, including detoxification, hormone regulation, molecular recognition, cell signaling, and viral entry into cells. It is among the reactions in phase II detoxification. Aiding the body with that little boost and sulfur transfer from the NAC can render some mycotoxins less active and toxic and make them easier for the body to excrete.
While there is no such thing as a one-size-fits-all supplement, I will say that N-Acetylcysteine comes as close as most anything I can recommend. A caveat here, the quality of any supplement matters! You must ensure that the sources are pure and the label is truthful in how much is actually contained in each pill. Make sure you are purchasing from a certified and trusted source that is 3rd-party tested for purity and efficacy. One that I can recommend is the N-Acetyl Cysteine recently released by Micro Balance Health Products. Pure Encapsulations and Thorne also make high-quality products. As far as dosing, I usually recommend 600-1200 mg, generally before a meal, empty stomach best. Once-daily dosing is okay. If you are taking NAC for exercise recovery, take it 30 to 60 minutes prior to exercising, if possible.
Susan Tanner has practiced medicine for over 33 years, concentrating primarily on chronic illness and the impacts on the individual, the family and the community. Her driving curiosity into why people are made ill caused her to pursue education in Environmental Medicine, completing coursework, exams, and necessary practice years to earn board certification in this area in 2009. Her own struggles with mold-related illness drove her desire to teach those similarly affected. While in clinical practice, Dr. Tanner wrote and contributed to a number of publications on environmental health, prepared narratives for understanding in legal matters, and researched new techniques for modulating the body’s ability to clear toxins and infections. She now has a fitness and health website www.thebodynexus.com, where she writes articles and shares education on utilizing the various body systems into improve overall health.
This is a great article on NAC, however NAC is known to release mercury from the body so if you have silver amalgams you need to be cautious as the mercury can be re absorbed into the organs.
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This is a great article on NAC, however NAC is known to release mercury from the body so if you have silver amalgams you need to be cautious as the mercury can be re absorbed into the organs.