An independent review of NAC based on personal experience and with the support of scientific studies

This story does not include professional or health advice. It is for information, inspiration, and awareness purposes.

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N-acetyl cysteine (NAC) has been a cornerstone of my wellness journey, offering remarkable benefits that have spanned over a decade. Unlike many hyped supplements, NAC stands out for its genuine efficacy and proven track record, supported by clinical studies, some of which are referenced in this article and more in my reference blog post to keep this story tidy.

NAC has been a critical health supplement in my toolbox for a long time. It made a substantial impact on my health transformation. Since starting to use NAC, I have not experienced a single flu or cold symptom.

I started with 600 mg, and now I use 1 gram daily, which my body tolerates the best. Giving a break is good. So, I usually stop using it a week at the end of each month, as my trusted health consultant advised me to reset my body's response.

For over a decade, I haven’t experienced any noticeable side effects. However, as I don’t use any medication, I cannot comment on the drug interactions. Therefore, discussing qualified healthcare professionals for NAC’s suitability is necessary. I provided a guiding entry from a published medical report in the final section.

I also investigated the cognitive aspect of NAC over a decade ago. For example, as pointed out in this 2012 paper, NAC has been shown to affect antioxidant status, glutamate transmission, inflammation, and neurogenesis.

“Adjunctive treatment with NAC improves the symptoms experienced by those with bipolar disorder, particularly depression, and it was hypothesized that cognition may also be improved following NAC treatment.”

Far from a hyped product, NAC has demonstrated its effectiveness in addressing various health conditions, rivaling prescription medications. Its multifaceted utility accentuates its importance beyond supplementation, making it a valuable asset in holistic health management strategies.

Many readers found my safe supplementation reviews helpful. Some readers particularly asked about NAC, as it has become popular during the pandemic. Therefore, I want to introduce this critical supplement to my readers, hoping it can be helpful for them in post-pandemic issues.

NAC is a readily accessible supplement, obtainable without a prescription from health stores, pharmacies, and reputable grocery outlets. Its widespread availability underscores its recognition as a valuable health aid. However, it might not suit everyone and might have side effects, so its use requires support from qualified healthcare professionals.

Notably, NAC garnered attention from the World Health Organization’s Expert Committee on the Selection and Use of Essential Medicines during a comprehensive review in 2008, further solidifying its status as a trusted supplement in the public domain.

When I reviewed the Government Clinical Trials by the US National Library of Medicine, I noticed that there were 648 clinical studies related to the term “N-acetylcysteine.” Pubmed has around 32000 medical or health research reports.

Purchasing this supplement from reliable sources is essential. I don’t particularly recommend a specific brand. However, discussing with your healthcare professionals and obtaining advice for choosing high-quality products is beneficial. This applies to any supplement. Unfortunately, supplements are not regulated in many countries.

I reviewed NAC as part of my personal transformation progress. I also covered NAC in my book titled “Powerful Life-Changing Hacks That Truly Transformed My Life,” published in 2019.

There are several use cases of NAC. People use it for various reasons. I use it every day for compelling reasons. My primary reason for using NAC is to boost glutathione naturally in my body. NAC is a building block for the creation of glutathione, which is a potent antioxidant.

To understand the importance of NAC, we need to know about the importance of glutathione first. I introduced glutathione in a previous article titled Three Steps to Maintain Healthy Glutathione Levels Naturally.

Glutathione is involved in many processes in the body, including tissue building and repair, making chemicals and proteins needed in tissues and the immune system.

Glutathione is made from three amino acids: glycine, cysteine, and glutamic acid. Our liver creates glutathione naturally. Even though we can supplement with glutathione directly, I don’t take glutathione supplements directly. Instead, I prefer my body to create glutathione naturally.

Insights from the Literature on Nine Use Cases for N-acetyl cysteine (NAC)

NAC stands out as one of the most extensively researched molecules in the health community. I summarize key findings from some scientific papers in this section, making the content easily understandable. These papers are freely accessible to the public. You can find more study links in my blog post for further reading.

I came across and reviewed many studies related to NAC’s biological, psychological, and psychiatric applications. For example, ADHD, schizophrenia, smoking cessation, addressing hangover symptoms, drug withdrawal, nephropathy, diabetes, liver disease, and helicobacter pylori eradication are a few.

Therefore, I provided relevant scientific papers in the reference section of this article to increase awareness of these studies.

This paper in The European Respiratory Journal informs that NAC, a glutathione derivative, has been used for over 30 years as a mucolytic drug and has been explored for treating respiratory and oxidative stress-related diseases.

Their new study aimed to assess NAC’s impact on influenza and influenza-like episodes among 262 participants. They concluded that while NAC didn’t prevent A/H1N1 virus influenza infection, it notably reduced the occurrence of symptomatic disease.

1 - Anticoagulant and Platelet-Inhibiting Properties

NAC is considered to protect the kidneys and liver during surgery, but its impact on blood clotting remains uncertain. To address this, the researchers investigated its effects during abdominal aortic reconstruction surgery.

In a randomized, double-blinded study in 2006, 20 patients undergoing this procedure received either NAC (a bolus of 150 mg/kg followed by a continuous 24-hour infusion of 150 mg/kg) or a placebo.

They monitored parameters including hematocrit, platelet count, prothrombin time, thromboelastometry, and platelet aggregation throughout and after surgery to assess the influence of NAC on blood coagulation.

They found that NAC has anticoagulant and platelet-inhibiting properties in patients undergoing major vascular surgery. It means that NAC has properties that prevent blood from clotting and inhibit platelets from sticking together in patients having major vascular surgery.

This may be good or bad, depending on the specific situation and the patient’s needs. In some cases, like during major vascular surgery, preventing blood from clotting excessively can be beneficial in reducing the risk of complications like blood clots or strokes. However, in other situations where clotting is necessary for wound healing or to prevent bleeding, these properties of NAC may not be desirable.

2 - Inhibiting Seasonal Human Influenza-A Virus Replication

This paper on Biochemical Pharmacology mentions that NAC, an antioxidant, inhibits seasonal human influenza A virus replication. In H5N1-infected lung epithelial cells, NAC (5–15 mM) reduced virus-induced effects, apoptosis, and viral yields 24 hours post-infection.

It also decreased pro-inflammatory molecule production and monocyte migration. NAC presents a potential treatment option during an influenza A virus pandemic.

In acetaminophen toxicity treatment, clinicians suspect NAC may raise prothrombin time (PT), but its impact on human blood coagulation is uncertain. Their previous study demonstrated NAC’s dose-dependent effect on PT, yet its mechanism remained unexplored.

3 - Antioxidant Effects

This 2018 paper informs that NAC’s antioxidant effect stems from its role as a precursor to reduced glutathione (GSH), a potent antioxidant and enzyme substrate.

Additionally, in conditions where endogenous cysteine (Cys) and GSH are depleted, NAC can directly combat oxidant species like NO2 and HOX.

Researchers explained that its ability to break thiolated proteins releases free thiols and reduced proteins, contributing to antioxidant activity, notably in proteins like mercapto albumin.

NAC’s disulfide-breaking action also underlies its mucolytic activity by reducing heavily cross-linked mucus glycoproteins.

4 - Reducing Oxidative Stress and Inflammation

This 2018 study in Medicine assessed the impact of adding N-acetylcysteine (NAC) to standard treatment versus standard treatment alone on oxidative stress, inflammatory markers, and radiological changes in patients with community-acquired pneumonia (CAP).

CAP patients at Weihai Municipal Hospital were randomly assigned to either receive conventional treatment plus NAC (1200 mg/d) or conventional treatment alone between August 2016 and March 2017. Parameters including malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAOC), tumor necrosis factor-α (TNF-α), and computed tomography (CT) images were assessed at baseline and post-treatment.

Before treatment, baseline levels of malondialdehyde (MDA), total antioxidant capacity (TAOC), superoxide dismutase (SOD), and tumor necrosis factor-alpha (TNF-α) were comparable between the two groups. Following treatment, plasma MDA and TNF-α levels decreased significantly more in the NAC group compared to the non-NAC group (p < 0.05 for MDA: p = 0.004, TNF-α: p < 0.001), while TAOC content showed a notable increase (p = 0.005).

There was no significant difference in increased plasma SOD activity between the groups (p = 0.368), and the NAC group did not exhibit greater improvement in CT scores. Moreover, no adverse effects related to NAC were observed.

Researchers concluded that overall, NAC therapy in CAP patients resulted in reduced MDA and TNF-α levels and increased TAOC, suggesting its potential to mitigate oxidative and inflammatory damage associated with pneumonia treatment.

5 - Reducing Stroke Risk

In previous studies, these researchers found that diabetes worsens brain injury after a stroke, linked to altered levels of methylglyoxal (MG) and glutathione (GSH) in the brain. Treatment with N-acetylcysteine (NAC) reversed this injury.

Their new study published in Redox Biology investigated whether diabetes-induced blood clotting in the systemic circulation and brain was due to increased MG-glycation of proteins and if NAC could counteract this effect.

Their findings suggest that diabetes increases susceptibility to blood clotting in both the blood and brain. Administering NAC post-diabetes onset may reduce stroke risk by modulating systemic and vascular clotting responses, enhancing platelet GSH, eliminating MG, and restoring antioxidant levels such as SOD1 and GPx-1.

6 - Lowering Oxidative stressors

ARDS is a severe lung problem caused by inflammation, which can lead to organ failure and a high risk of death. Doctors often use antioxidants like N-acetylcysteine (NAC) to fight the harmful effects of inflammation.

However, past studies didn’t always show clear benefits from using antioxidants. In this 2018 study, researchers did a meta-analysis to see how NAC affects adults with ARDS.

They concluded that NAC)exhibits antioxidant properties through multiple mechanisms. While it doesn’t directly combat all types of oxidative stressors, it acts as a precursor to glutathione. It replenishes depleted glutathione levels, scavenges oxidants like NO2 and HOX, and breaks down thiolated proteins to release free thiols with enhanced antioxidant activity.

NAC’s mucolytic activity also stems from its ability to reduce heavily cross-linked mucus glycoproteins. These findings underscore NAC’s multifaceted role in combating oxidative stress.

7 - Alternative to Current Antithrombotic Treatments

This 2017 study on Circulation demonstrates that NAC is a safe and effective alternative to current antithrombotic treatments for restoring vessel patency post-arterial occlusion. NAC administration intravenously facilitates arterial thrombi lysis, even in cases resistant to conventional therapies like recombinant tissue-type plasminogen activators and antiplatelet treatments.

Through both in vitro and in vivo experiments, the research highlights the von Willebrand Factor as the principal target of NAC’s thrombolytic effects, particularly in arterial thrombi.

Furthermore, combining NAC with a nonpeptidic GpIIb/IIIa inhibitor enhances thrombus dissolution. It prevents rethrombosis, ultimately improving outcomes in a large-vessel thromboembolic stroke model without exacerbating hemorrhagic stroke effects, thus suggesting NAC’s ability to exert thrombolytic effects without majorly impacting normal balance.

8 - Potential Antithrombotic Benefits in MPN Management

This 2020 study in Blood Advances addresses the urgent need for effective antithrombotic therapies in myeloproliferative neoplasms (MPNs), where conventional treatments like aspirin and hydroxyurea offer limited primary prevention.

Thrombosis, a leading cause of mortality in MPN patients, involves complex cellular mechanisms like platelet activation and neutrophil-extracellular trap formation.

Seeking to target these processes, the research explores NAC treatment in a JAK2V617F mouse model of polycythemia vera.

Remarkably, NAC administration prolonged the lifespan of JAK2V617F mice without altering blood counts or splenomegaly, indicating potential antithrombotic benefits in MPN management.

This study on Medical Toxicology assesses the impact of therapeutic NAC doses on coagulation factors II, VII, IX, and X activity in human plasma. They demonstrated a significant decrease in the activity of coagulation factors II, VII, IX, and X with the addition of NAC. This may be the mechanism by which PT increased in their previous study.

Essentially, the study highlights that NAC may impact blood clotting factors, potentially influencing coagulation processes in the body.

9 - Promising in the Treatment of Pulmonary Fibrosis and Infertility

According to this paper by American Family Physician, N-acetylcysteine is the acetylated variant of the amino acid L-cysteine. It is widely used as the specific antidote for acetaminophen overdose.

NAC demonstrates multifaceted benefits across various health domains, serving as a potent intervention in diverse medical scenarios. Its efficacy extends to preventing chronic obstructive pulmonary disease exacerbations and contrast-induced kidney damage during imaging procedures.

Moreover, when administered before influenza virus infection, NAC exhibits the potential to reduce illness severity.

Additionally, it holds promise in the treatment of pulmonary fibrosis and infertility among patients with clomiphene-resistant polycystic ovary syndrome, offering a comprehensive spectrum of therapeutic applications.

How About Side Effects, Adverse Reactions, or Interactions with Medications

Even though NAC is publicly available, NAC may have some side effects for some people, like any supplement. It can also have reactions and interactions with medications. Therefore, we must know about the side effects, reactions, and medication interactions and discuss the risks with our healthcare professionals.

According to this medical paper, [N-Acetylcysteine: Multiple Clinical Applications]:

“At dosages of 1,200 mg twice daily or lower, N-acetylcysteine is well tolerated. At these dosages, side effects are unusual but may include nausea, vomiting, diarrhea, transient skin rash, flushing, epigastric pain, and constipation.

At the much larger dosages used to treat acetaminophen overdose, N-acetylcysteine is often poorly tolerated, with side effects such as headache, tinnitus, urticaria, rash, chills, fever, and anaphylactoid reactions (pseudoanaphylaxis).

N-acetylcysteine strongly potentiates the effect of nitroglycerin and related medications, and caution should be used in patients receiving these agents in whom it may cause hypotension.”

Conclusions and Takeaways

Using NAC successfully for over a decade has provided me with many immune-boosting benefits. The research on NAC is solid and continuing as it has promising results. It can potentially address immunity issues related to the COVID-19 situation, too. In 2022, I got the COVID-19 virus, but NAC and a high dose of Vitamin D3 helped me recover quickly.

Many research institutes, including government organizations, are working on the possibilities. We hope some good results will be produced soon. This supplement is not just for individual self-improvement purposes but also as a hope to ease the post-pain of a debilitating pandemic.

Some studies suggested that NAC may also be a cancer chemopreventive, an adjunct in eradicating Helicobacter pylori and preventing gentamicin-induced hearing loss in patients on renal dialysis. I will cover them in another story as they are comprehensive and require discussions with caveats.

NAC is a simple over-the-counter product. However, paradoxically and as history shows, sometimes big problems are solved by minimal tools. We need an open mind and collaboration to research this possibility further.

Further education on NAC molecule

Medical Doctor Roger Seheult presents whether NAC could be effective in COVID-19. Dr. Roger Seheult is an American Board of Internal Medicine certified in Pulmonary Diseases, Critical Care Medicine, and Sleep Medicine.

Dr. Seheult articulates these ideas and discusses the peer-reviewed data involved. The presentation also mentions the clinical trial by the US government. Here is the outstanding presentation by Dr. Seheult on his popular YouTube channel, as well as part of his Medcram courses.

My understanding of Dr. Seheult’s conclusion on using NAC for COVID-19 is that we don’t have full evidence yet; however, if we connect the dots, there is potential. We need to be open-minded. I hope there will be more research on this promising molecule for our health and well-being.

For scientifically minded readers, you may watch this medical lecture to learn more about the biochemical details of this important molecule posted by Drbeen Medical Lectures. The presentation shows how N-acetylcysteine functions in our body to help against infections and oxidative stresses.

You can read nine benefits of NAC from this Healthline article, which is written in simple language.

My goal and fervent aspiration are to contribute to the ongoing research by inspiring practitioners and innovative researchers while promoting public visibility and awareness.

Thank you for reading my perspectives. I wish you a healthy and happy life.

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If you found these stories helpful, you may also check out my other articles on NewsBreak. As a postdoctoral researcher and executive consultant, I write about important life lessons based on my decades of research and experience in cognitive, metabolic, and mental health.