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N-Acetyl Cysteine – NAC

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N-acetyl cysteine (NAC) is a small protein with over 40 years of scientific research to back up its clinical effectiveness. NAC’s powerful health benefits derive from its ability to restore intracellular levels of glutathione. Glutathione is a very important compound because it’s your body’s own powerful antioxidant and detoxifier.

Glutathione helps your liver to protect you against toxicity, and it is most needed by people with an inflamed liver or fatty liver. Chronic liver inflammation depletes your body of glutathione, and in fact so do many different diseases. Immune system problems and autoimmune diseases cause chronically low levels of glutathione. This is not good for your liver and it can worsen the inflammation and symptoms of autoimmune disease.

NAC is the precursor of glutathione and is the most effective way of raising levels in your body. NAC is also very beneficial for the kidneys and lungs and can help to protect them from damage.

 

 liver-health lung-health

NAC may be able to reduce a large range of chronic, degenerative problems, including liver inflammation and impaired glucose control.

Today researchers are now realizing just how vital glutathione’s actions in the body are, and how many chronic disease conditions are associated with glutathione deficiency. According to Stanford University’s Dr. Kondala R. Atkuri, “NAC has been used successfully to treat glutathione deficiency in a wide range of infections, genetic defects and metabolic disorders, including HIV infection and Chronic Obstructive Pulmonary Disease. Over two-thirds of 46 placebo-controlled clinical trials with orally administered NAC have indicated beneficial effects of NAC measured either as trial endpoints or as general measures of improvement in quality of life and well-being of the patients.”

NAC has been shown to increase blood glutathione in HIV-infected patients with low levels of glutathione due to their chronically damaged immune system.
NAC’s ability to replenish intracellular glutathione and reduce free radical damage provides significant protection against DNA damage and thus cancer development.

NAC neutralizes toxins and pollutants including heavy metals that accumulate in the liver, kidneys and fatty parts of the body.

Restoring glutathione levels with NAC supplements makes liver cells more able to protect themselves from ongoing damage caused by fatty accumulation, viral infections, drug induced damage, alcohol excess or autoimmune inflammation etc.

How can we get more glutathione in our body?

Oral glutathione supplements are available in some health food stores and pharmacies and do not require a prescription. The main problem is that glutathione is not well absorbed from the gut, as it is broken down by digestive enzymes before it has a chance to be absorbed. For this reason it is far more effective to take its precursor (building block). NAC is the most important precursor to glutathione synthesis. NAC is easily absorbed from the gut and is rapidly turned into glutathione.

Approximately 150 milligrams daily of glutathione is obtained from the average diet, mainly from fruits and vegetables. However the majority of glutathione is manufactured within the cells of the body, especially within liver cells. It is interesting to know that around 80% of the glutathione produced in the liver is transported to the blood stream to be used by the kidneys for detoxification. Thus increasing glutathione levels is good for the liver and the kidneys.

For people with very depleted levels of glutathione in their body, taking glutathione intravenously would be best, but this is impractical. The practical solution is to take NAC, the main precursor to glutathione – a component the body’s cells need to make their own glutathione.

How is NAC taken?

NAC does not require a prescription and is taken as an oral supplement in doses of 600 to1800 mg daily. NAC is taken one to three times per daily, or as recommended by your healthcare provider. NAC can be taken with or without food.

NAC is given intravenously in hospital emergency departments as a life saving treatment for acute poisoning with paracetamol (also known as acetaminophen). Overdoses with paracetamol are the number one cause of acute liver failure in the United States. Large doses of paracetamol overwhelm the body’s glutathione stores, which causes irreversible damage to liver cells. Treatment with NAC quickly restores protective levels of glutathione, thus preventing irreversible liver failure. In paracetamol (acetaminophen) overdose, NAC is administered intravenously to detoxify the drug before it destroys large numbers of liver cells and causes fatal liver failure.

With over more than 40 years of use in a wide range of medical disorders, NAC has been proven to be safe even at very high doses and for long-term treatments. Studies have demonstrated the safety of 1,800 mg per day for 142 days, and 2,800 mg per day for 3 months. The most commonly used doses range from 600-1,800 mg daily and clinical studies have found that doses of up to 2,000 mg/day are safe.

Many researchers have come to the conclusion that a deficiency of liver glutathione is one of the leading factors that allow liver disease to progress. The liver cells of people with chronic liver disease are continually overworked as they fight toxins and free radicals and it is mainly glutathione which can protect them from severe damage or cell death. Researchers proved that glutathione given in high doses intravenously to patients with severe fatty livers resulted in marked improvement in their liver blood test results.

Here are a few recently published trials:
Published in the November 2006 journal Apoptosis, one trial investigated if NAC could inhibit liver cell death in acute severe liver failure. Based on an animal model, the researchers concluded that NAC shows a liver-protective role for this type of liver failure.
Published in the January 2008 journal Liver Transplantation, a retrospective study found that children treated with NAC for acute liver failure had a better outcome than matched controls not treated with NAC.

The evidence linking glutathione depletion with a poor prognosis in those with liver disease is now clear-cut.

Cautions with NAC

There are no known contraindications to NAC. Diabetics should check with their healthcare provider regarding interference with insulin efficacy

39 comments

  1. Greetings ~ This may not be up your alley, but I have a horse that has elevated liver enzymes, which my Vet says he probably got from toxic plant ingestion. He is presenting with lethargy, weakness & other manifestations, so it did not happen overnite. I purchased milk thistle powder, which is a common supplement to give to horses with liver function issues. I just got it today & started him on 900mg 3 times a day. My local health food store guru told me to look up NAC (N-acetyl cysteine) to give him to detox his liver. I am currently giving him about 2 cups of mineral oil in his mash, per my Vet, which is supposed to slow down the absorption of ammonia in the liver so his liver can heal. I am wondering if you have any helpful info regarding giving NAC to my poor horse….like how much to give him & how long he should take it. I appreciate any info you can give me…..& Skippy thanks you too! Vera

    • Hi Vera,

      Unfortunately you are quite correct that your concerns are not really up our alley, so we suggest you err on the safe side and speak to as many horse people or websites as possible.

      It is important to detox as quickly as possible and bile is the key substance to help here. Again we recommend a wide search and many questions, on the use of the active compound of turmeric, and Dr Cabot prescribes

      Curcumin Advanced formula – this is far better absorbed than whole turmeric and we suggest you crush the number of tablets required and mix the powder in the oil you are adding to your horses feed mix.

      Kind Regards,
      Victoria Taylor
      Naturopath for Liverdoctor.com

  2. Hi! I started taking NAC 1 month ago at 500mg now I have increased to 1500mg. However I have such itching and crawling sensation around my skin especially my vulva area and around my butt. I’ve been to the doctor, no yeast infection or skin condition. Could this be from side effects of the NAC?? It’s driving me crazy .

    • Hi Sahar,

      Dr Cabot’s NAC capsules contain 600mg so we presume you are using another product, and we recommend you contact the company to determine if their product contains anything but NAC that you may be sensitive to.

      We suggest you stop taking the supplement you now have until all itching stops and drink lots of water to rid your body of it quickly.

      When all itchiness has ceased, begin taking Dr Cabot’s NAC, 1 capsule daily.

      If this is tolerated, please increase to 1 capsule twice daily.

      Depending on the reason you are supplementing with NAC, you may need to increase the dosage to 2 capsules twice daily.

      Kind Regards,
      Victoria Taylor
      Naturopath for Liverdoctor.com

      • Hi Victoria,
        I take the AOR brand of NAC -each capsule contains 500mg NAC and non medical ingredients as sodium stearyl fumarate, microcrystalline cellulose. Capsule: hypromellose. I contacted the company about any allergic reactions. The reason I am taking it is because I have endometriosis and it will reduce inflammation in my body. Once the itchiness stops I will purchase Dr. Cabot’s NAC.

        However, Is it normal for NAC to cause itchiness/crawling sensation? If I start NAC again will it start again? Will it ever stop as my body adjusts? Also, I have asthma is taking NAC safe? Thanks again.

        • Hi Sahar,

          I am not aware of any side effects with the binders/fillers used in the AOR brand of NAC.

          Please follow the wash out and challenge procedure I outlined for you yesterday.

          There is a university trial conducted by University of California on the use of NAC with mucus producing asthma. Unfortunately there was not a final post available, but it certainly indicates that it is not contraindicated.

          Kind Regards,
          Victoria Taylor
          Naturopath for Liverdoctor.com

  3. Is NAC safe to take for those with cancer? I am reading conflicting info. Some studies say that it helps metestatic cancerous cells evade destruction leading to liklier metastisis. Another very small study says that it stops spread and metastisis of breast cancer. Very confused.

  4. I don’t have a question. I just get really nervous taking new stuff. Ever since I had my gallbladder removed last year I get terrible pains near my liver. I know NAC is good for me. I just don’t want to have a reaction or be in any worse pain than I am already in. What are the chances of a bad reaction occurring? Does it happen to a lot of people?

    • Hi Matthew,

      Please read the article at the following link, and keep for future reference, https://www.liverdoctor.com/things-you-must-know-you-dont-have-gallbladder/.

      As you have had you gallbladder removed, Dr Cabot prescribes

      Ox Bile capsules – 1 – 2 capsules at the beginning of each meal to replace the bile that can no longer be delivered from your gallbladder to help essential fat and fat-soluble vitamin absorption.

      To improve your liver function and your vitality, Dr Cabot prescribes

      15 Day Cleanse. Two weeks to begin your journey toward improved liver health and function, utilising both supplements and a tasty, easy to prepare dietary regimen. Go to http://www.drcabotcleanse.com to place an order.

      Livatone Plus – 1 to 2 capsules twice daily, to improve liver function.

      N-Acetyl-Cysteine (NAC 600mg) – 1 to 2 capsules twice daily at the beginning of your meals. This supplement works well with Livatone Plus to get your liver better faster.

      You may purchase these supplements and Dr Cabot’s books at https://shop.liverdoctor.com/

      Kind Regards,
      Jessah Robinson
      Nutritionist for Liverdoctor.com

  5. can i take NAC ? i have been diagnosed with liver cirrhosis since 2006, non-alcoholic fatty liver. i just found out about this product. i have never tried anything because my provider tells me that cirrhosis is not reversible. i am scared because my aunt had cirrhosis and now about 6 yrs later has been diagnosed with liver cancer. i want to thank you in advance for your assistance to this matter. i am greatly appreciated for your response.

    • Hi Martha,

      Please read this article: https://www.liverdoctor.com/cirrhosis-how-can-we-help-it/.

      Dr Cabot recommends you take

      Livatone Plus – 1 cap twice daily for the first week, then 2 caps twice daily after that to repair liver cells, promote fat burning and increase bile flow.

      N-Acetyl-Cysteine (NAC 600mg) – 1 to 2 capsules twice daily well away from food, if any upset occurs take at the beginning of your meals. As you will see from the attached pamphlet this supplement works well with Livatone Plus to get your liver better faster.

      Serrapeptase – begin with 1 capsule daily for 3 days, increase to 1 capsule twice daily for 4 days and if it well tolerated you may increase the dose to 2 capsules twice daily and always to be taken on an empty stomach. This supplement is contraindicated if you have liver related bleeding problems or if you are taking blood thinners.

      These can be purchased here: https://shop.liverdoctor.com

      Kind Regards,
      Jessah Robinson
      Nutritionist for Liverdoctor.com

  6. I started taking nac 600 mg and after 120 mg for ocd and I notice its helping me a lot but I feel very very tiredand exhausted what should I do I don’t want to stop taking it since its helping me !! pls help

    • Hi Carmen,

      We would recommend you go back to one a day and wait another 1 -2 weeks before increasing the dose to 2 a day
      to let your body adjust to the supplement as you may be detoxing too fast and that is what is making you tired.
      Also make sure you are drinking plenty of water.
      Let us know how you get on.

      Kind Regards,
      Jessah Robinson
      Nutrition Consultant for Liverdoctor.com

  7. Can you confirm that taking NAC is likely to reduce my GGT levels which have been consistently high (150-350) for years? I have had all the tests and scans and my liver appears normal other than the GGT levels, I am told I have nothing to be concerned about but I am not happy when I read about the effects of raised GGT levels. I changed my diet completely in May removing carbohydrates such as potatoes, flour, pasta, rice, cereal other than oats, I now eat everything you have suggested and lost 25lbs with no effort and now back to normal weight for my height etc. I would be very interested in any suggestions that might also improve GGT. Thanks, Tom

    • Hi Tom,

      We recommend you read this article for more information on liver function tests: https://www.liverdoctor.com/liver-function-tests/
      We also recommend you eliminate or reduce sugar and processed foods.
      There is an anti-inflammatory diet plan in Dr Cabot’s book ‘I Can’t Lose Weight and I Don’t Know Why’.
      As well as NAC we recommend you take
      Livatone Plus 2 caps twice daily to protect liver cells and improve liver function.
      Let us know how you get on.

      Kind Regards,
      Jessah Robinson
      Nutrition Consultant for Liverdoctor.com

      • Thanks for your reply Jessah. I do not eat any sugar only that naturally occurring in fruit and vegetables and I eat no processed food or refined carbohydrates. Thank you for pointing me to the article which I had read but this does not answer why my GGT levels are high and yet the consultant specialist says everything is ok and normal and I do not need to do anything, he mentioned no change in diet, no supplements or medication which incidentally I take none of. Just a strange place to be in. I will look at the Livertone plus supplements and consider these along with my current diet. I would be interested in knowing why my high GGT is reconsidered normal if you have an answer that would be great.
        Best regards Tom

        • Hi Tom,

          High GGT is liver specific and like it says in the article may indicate using alcohol or other liver toxic substances to excess.
          We recommend you see your healthcare practitioner for further information.

          Kind Regards,
          Jessah Robinson
          Nutrition Consultant for Liverdoctor.com

        • I am in the same situation as you Tom. Why are ggt levels high? I do not drink in excess at all.

          • Hi Tom,

            We suggest you read this article for further information: https://www.liverdoctor.com/liver-function-tests/
            GGT can be elevated in those who use alcohol or other liver toxic substances to excess.
            There is some dietary information in this article: https://www.liverdoctor.com/what-should-you-eat-if-you-have-fatty-liver/
            You would benefit from taking
            Livatone Plus 2 caps twice daily to protect liver cells and optimise liver function.
            N-Acetyl Cysteine (NAC) 2 caps twice daily at least 2 hours away from food, if any upset occurs please take with meals. NAC is the precursor to glutathione; the body’s most potent antioxidant. This supplement works well with Livatone Plus to get the liver better faster.
            These supplements can be purchased here: https://shop.liverdoctor.com/
            Let us know how you get on.

            Kind Regards,
            Jessah Robinson
            Nutrition Consultant for Liverdoctor.com

  8. Hi, question. Is it normal or expected to feel any type of reactions from taking NAC? When I took it I mixed it with about 8 ounces of water and drank it right down. (As I do with L-Glutamine with no problems) About an hour later I ate and started getting what I thought was heartburn but noticed an ache coming from my liver and around back near what I believe to be my kidneys. Kind of felt like when I had gall stones.. Is it possible that my liver and kidneys are just working extra from the NAC as kind of a “good” bad reaction or is this just a bad reaction all together? Id like to be able to take this stuff as Im doing a detox for heavy metals. I also don’t have a gallbladder and am wondering what effect if any that has on the situation. Any thoughts would be much appreciated. Thanks!

    • Hi Matthew,

      Mild reactions are typically signs of increased detoxification. Not having a gallbladder places extra strain on your liver, therefore NAC should be particularly beneficial for you.

      Kind Regards,
      Jessah Robinson
      Nutrition Consultant for Liverdoctor.com

  9. Can we take NAC with food , or it is better on empty stomach ?

    • Hi Yosed,

      Thank you for your enquiry.
      For better absorption, we recommend having the NAC at least 2 hours away from meals.
      If any upset occurs please take with meals.

      Kind Regards,
      Jessah Robinson
      Nutritional Consultant for Liverdoctor.com

  10. I am going to give my son who its autistic nac to try and help manage his ocd, from the studies I’ve read, the amount administered for ocd was in the range of 2400 to 3000 daily.
    My question is, is a person’s weight important in trying to determine a therapeutic dose?
    My son weighs about 290lbs.
    I’m thinking therefore I should give him a higher dose (around 2800 or so?) I’m giving him 1800 now, (for about a week) haven’t seen much in results yet, (haven’t noticed any side effects either)
    Thanks for your help

    • Hi Jimi,

      We recommend you see your healthcare practitioner for further information.

      Kind Regards,
      Jessah Robinson
      Nutritional Consultant for Liverdoctor.com

  11. I only just started taking nac supplement of 1200 to 1800mg a day for about a week now. Do I stop taking them To get an accurate reading on a liver functioning blood test and if I should stop taking, how long before the test should I stop taking them?

    • Hi Kim,

      Please refer to your healthcare practitioner for further instruction.

      Kind Regards,
      Jessah Robinson
      Nutritional Consultant for Liverdoctor.com

  12. I have been diagnosed with a fatty liver, I don’t drink alcohol and cholesterol is good.
    Question is can I take livertone plus and NAC together. Or is there enough NAC in the livertone. Just a bit confused before I purchase.
    Thanku

    • Hi Melissa,

      There is no NAC in the Livatone Plus. NAC works well with Livatone Plus to get the liver better faster.
      Please take Livatone Plus 2 caps twice daily and NAC 2 caps twice daily at least 2 hours away from food, if any upset occurs please take with meals.
      Fatty liver can also be caused by excessive carbohydrate intake, build up of toxins or polypharmacy.
      We recommend you eliminate grains sugar, processed food and takeout meals from your diet.
      There is some dietary information in this article: https://www.liverdoctor.com/what-should-you-eat-if-you-have-fatty-liver/
      There is an excellent eating plan in Dr Cabot’s book: ‘Fatty Liver: You Can Reverse It’.
      Let us know how you get on.

      Kind Regards,
      Jessah Robinson
      Nutritional Consultant for Liverdoctor.com

      • Thankyou I will purchase livatone plus and NAC and eliminate sugar and grains. I will be retested in 6 weeks and will let you know.
        Much appreciated your time and advice

      • Hi Jessah, Livatone Plus label shows it has NAC in it, under proprietary blend.

      • Hi Jessah,

        I am going to start taking the NAC with the Livatone Plus for better results. In your comment I am replying to, you are saying there is no NAC in the Livatone Plus; however, the ingredients on the Livatone Plus bottle shows the Proprietary Blend has NAC listed as the 2nd ingredient. If that is the case, how much actual NAC is in Livatone Plus?

        • Hi Karen,

          The amount of NAC in Livatone Plus per 4 capsules is 80mgs. ( so not a lot )

          Kind Regards,
          Jessah Robinson
          Nutrition Consultant for Liverdoctor.com

  13. I feel amazing since are started taking this supplement three weeks ago, no phlegm after eating, loads of energy n my ast alp levels r both dropping

  14. Is it normal to have a reaction to NAC? Since taking for a month I’ve felt unwell, lots of fatigue and general ‘yucky’ feeling.

    • Hi Emma,

      Some people experience a detox reaction from NAC. Reduce the dose and drink plenty of water and make sure you have regular bowel motions.

      Kind Regards,
      Jessah Robinson
      Nutritional Consultant for Liverdoctor.com

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