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Home > Health Library > N-Acetyl Cysteine (NAC)
N-Acetyl Cysteine (NAC)

NAC ( ) is a more stable and bioavailable form of cysteine. Cysteine, when ingested as a supplement, is oxidized, which means it is "burned up" rather quickly by the body, rendering it useless. NAC is much more stable and does not suffer this fate as NAC is one powerhouse of a supplement with potent antioxidant activity. The antioxidant properties of NAC have been shown to combat exercise-induced damage to muscle tissue, which is important for post-exercise recovery. It has been used successfully to detoxify the body, with emphasis on detoxifying the liver in cases of acetaminophen poisoning, and exerts the same properties to counter the effects of alcohol on the body. As cysteine, it is an integral part of the development and maintenance of strong connective tissue and the formation of skin and hair. NAC is coveted for its anti-aging properties, most likely connected to its role in the substantial release of glutathione in the body, which fights the cellular damage of oxidative stress, a key to fighting against aging. Its ability to inhibit viral replication may be useful in fighting viral infections from HIV to the flu. And these are just the highlights on this potent antioxidant.

What is NAC?
Acetylcysteine (rINN;) also known as N-acetylcysteine or N-acetyl-L-cysteine (abbreviated NAC), is a pharmaceutical drug used mainly as a mucolytic agent and in the management of paracetamol (acetaminophen) overdose.

Where is it Found?
NAC is the more stable supplement form of the amino acid cysteine. Food sources for cysteine include poultry, yogurt, oats, wheat germ, egg yolks, red peppers, garlic, onions, broccoli, and Brussels sprouts.

See NAC related videos:
video icon THE FORGOTTEN ANTIOXIDANT - NAC - N-acetyl cysteine   (video module – 3.03 minutes)
video icon NAC  (video module – 5.51 minutes)
Product related PDF file

N-Acetyl Cysteine - Powerful Protection for Our Cells

Benefits / Uses
During recent years, nutritionists and other health care professionals have begun to identify some key healing properties and advantages of taking N-acetylcysteine as a supplement. In The Essential Guide to Vitamins, Minerals and Herbal Supplements, Brewer (2010) highlights health benefits associated with NAC, to include the following:

arw boosts levels of glutathione (powerful antioxidant)

arw helps disperse mucus

arw significantly reduces mucus production

arw decreases coughs associated with bronchitis, emphysema, sinusitis

arw helps treat ear infection, glue ear

arw may prevent some smoke-related lung damage

arw interferes with viral replication - may help virus sufferers, e.g. HIV

arw reduces trichotillomania or chronic hair-pulling

arw affects neurotransmitter to reduce compulsive behavior

arw lowers risk of post-operative abnormal heart rhythm in cardiac patients

arw improves chronic obstructive pulmonary disease

Why athletes use NAC
NAC is one of the most important antioxidants for an athlete. Its effect on muscle trauma caused by lifting weights or intense cardio training is exciting. Its importance is paramount in detoxifying the body and helping keep the liver in "like-new" condition. Its anti-aging benefits and ability to aid in joint health are great value add-ons.

Post-exercise recovery
Supplementation with NAC (and other antioxidants) has been shown to illicit a protective effect on muscle and other related tissues after intense exercise. Much of this is due to its ability to increase (and preserve) glutathione levels. In a nutshell, this seems to combat the oxidative damage of exercise and help preserve muscle on a cellular level. This is a complex process (as is pretty much everything in our bodies), but the positive view is that in addition to aiding in recovery, consistent use may help maintain and even add muscle.

Detoxifying properties
As a premier anti-toxin and cell-membrane stabilizer, NAC helps neutralize the byproducts of ingested fats and alcohol metabolism and protect the body from the damaging effects of chemotherapy, cigarette smoke, heavy metals, and various other substances. Its liver-protecting benefits may make it useful for other liver conditions.

Connective tissue
NAC (as cysteine, which it becomes once in the body) is an integral component of connective tissue — tendons, ligaments, and the soft tissues that support our joints. Along with a number of other nutrients (like Vitamin C), it is actually part of the material that comprises the connective tissue. NAC is used by elite athletes who have suffered tears and partial tears of connective tissue as part of a post-surgery recovery strategy. In more mild cases, it can help reduce joint inflammation and the pain that goes with it.

The battle against time
Unchecked free radicals are also believed by researchers to be a major factor in the process of aging because they cause both cellular and DNA damage. Couple this with the fact that glutathione levels can drop by up to 35% as we age, and NAC, which both fights free radicals and increases glutathione levels, may help slow this "natural" process. It also has an impact in the formation of skin tissue.

Therapeutic uses
As with other nutrients that are believed to help boost immunity, NAC has been studied to see if it may help reduce the number of flu viruses or at least their severity. One study performed in Italy indicates that it may do just that. In this 6-month study, 25% of the people supplementing with NAC reported flu symptoms versus 79% in the placebo group.

NAC has been used since the 1960's to help treat respiratory conditions by helping thin mucus and increase immunity and may be especially useful for people with chronic bronchitis, which is often associated with smoking. Preliminary studies indicate that NAC may also help increase levels of a type of immune cell called CD4+ in both healthy people and people with HIV.

NAC is commonly found in 500-mg capsules with daily supplement levels ranging from 1 to 3 capsules daily. Optimal levels are dependent on many variables, including amount of exercise and other specific situations when its ability to protect liver health may be important (like when you're going to drink a few alcoholic beverages).

Some reports have indicated the upper limit for effective NAC supplementation is 2,000 mg daily. Amounts greater than this are not considered beneficial to use for extended periods.

NAC may be taken effectively with meals. There may be added benefits from taking NAC with other antioxidants, including Vitamin C and Vitamin E.

Synergists of NAC
Synergistic antioxidant benefits may be realized by supplementing NAC with Vitamin C in a 1 to 3 ratio. (For example, if you were to use 500 mg of NAC, you would supplement with 1,500 mg of Vitamin C.)

Anyone suffering from ulcers or similar conditions affecting the lining of the stomach may want to avoid NAC supplementation.

Toxicity of NAC
No known toxicity, although the benefits for extended use may peak at 2,000 mg daily.

Possible Side-Effects / Precautions / Possible Interactions:
N-acetyl cysteine is likely safe for most adults, when used as a prescription medication. It can cause nausea, vomiting, and diarrhea or constipation. Rarely, it can cause rashes, fever, headache, drowsiness, low blood pressure, and liver problems. When inhaled (breathed into the lungs), it can also cause swelling in the mouth, runny nose, drowsiness, clamminess, and chest tightness. N-acetyl cysteine has an unpleasant odor that may make it hard to take.

Special Precautions & Warnings:
Pregnancy or breast-feeding: N-acetyl cysteine is POSSIBLY SAFE when taken by mouth, delivered through a hole in the windpipe, or breathed in. N-acetyl cysteine crosses the placenta, but there is no evidence so far linking it with harm to the unborn child or mother. However, N-acetyl cysteine should only be used in pregnant women when clearly needed, such as in cases of acetaminophen toxicity.

If you are pregnant or lactating, NAC is not recommended.
Asthma: There is a concern that N-acetyl cysteine might cause bronchospasm in people with asthma if inhaled or taken by mouth or through a tube in the windpipe. If you take N-acetyl cysteine and have asthma, you should be monitored by your healthcare provider.

Possible Interactions:
Nitroglycerin interacts with N-ACETYL CYSTEINE
Nitroglycerin can dilate blood vessels and increase blood flow. Taking N-acetyl cysteine seems to increase the effects of nitroglycerin. This could cause increased chance of side effects including headache, dizziness, and lightheadedness.

Activated charcoal interacts with N-ACETYL CYSTEINE
Activated charcoal is sometimes used to prevent poisoning in people who take too much acetaminophen and other medications. Activated charcoal can bind up these medications in the stomach and prevent them from being absorbed by the body. Taking N-acetyl cysteine at the same time as activated charcoal might decrease how well it works for preventing poisoning.

Research Studies / References

arw Horowitz, J.D., et al., "Combined Use of Nitroglycerin and N-acetylcysteine in the Management of Unstable Angina Pectoris," Circulation 77.4 (1988) : 787-94.

arw Kinscherf, R., et al., "Low Plasma Glutamine in Combination with High Glutamate Levels Indicate Risk for Loss of Body Cell Mass in Healthy Individuals: the Effect of N-Acetyle-Cysteine," J Mol Med 74.7 (1996) : 393-400.

arw Marchetti, G., et al., "Use of N-Acetylcysteine in the Management of Coronary Artery Diseases," Cardiologia 44.7 (1999) : 633-7.

arw Mold'eus, P., et al., "Lung Protection by a Thiol-Containing Antioxidant: N-Acetylcysteine," Respiration 50 suppl 1 (1986) : 31-42.

arw Rasmussen, J.B., Glennow C., "Reduction in Days of Illness After Long-Term Treatment with N-acetylcysteine Controlled-Release Tablets in Patients with Chronic Bronchitis," Eur Respir J 1.4 (1988) 351-5.

arw Sen, C.K., et al., "Oxidative Stress After Human Exercise: Effect of N-Acetylcysteine Supplementation," J Appl Physiol 76.6 (1994) : 25707.