The Medicinal Uses of N-Acetyl Cysteine

Disclaimer. 
I am not a licensed health practitioner.  This is just another post on an
item you might wish to have available if needed so that a physician can treat
you and your family as best as possible.  No medication, including those available
over the counter, should be taken without consulting a physician. 
Information shared here is for educational and entertainment purposes
only.  It is not medical advice nor a substitute for licensed medical
care.  A qualified, licensed physician or other medical provider should be
consulted before beginning any herbal or conventional treatment, especially
anything related to poisoning or overdose.

Earlier this year,
I ordered some N-acetyl cysteine (NAC) from Amazon.  It arrived with the rest of the items in that
order and then sat by my bedside since then to remind me to write a post about
it.  Of course, in the intervening seven
months, I completely forgot why I ordered it. 
But I knew I had a good reason or reasons.

But before getting
into those reasons, let’s first take a look at what exactly NAC is.  N-acetyl cysteine is the supplement form of
cysteine, a ‘conditionally essential’ amino acid because the body can make it
from other amino acids.  It becomes an
‘essential’ amino acid when the body’s intake of methionine and serine is low.[1]  Cysteine is found in high protein foods like
yogurt, cheese, eggs, chicken, turkey, garlic, and legumes.[2]  A balanced diet will provide all the cysteine
a healthy body needs and supplementation with NAC isn’t necessary. 

For those times
when the body is challenged, however, supplementation with NAC may be quite
beneficial.  Beyond that, especially for
medicinal uses, there are actually several good reasons for all families to
stock a bottle or two of NAC, as listed below. 

The most important
reasons for us likely lie in its utility in treating acetaminophen overdoses
and respiratory illnesses.  NAC is FDA
approved for treating potentially toxic doses of acetaminophen and is almost
100% effective when therapy is initiated within 8 hours of the overdose.[3]  [4]  Of course, activated charcoal is also
effective, but it must be administered within 4 hours of the overdose.  NAC treatment has a wider window of efficacy.  In addition, NAC is a mucolytic (breaks up
mucus) and as such is also approved for use in respiratory diseases where the
mucus is very thick, like asthma, COPD, COVID, and pneumonia.[5] 

USAGE

• Endocrine
• Blood sugar support 600 mg/day[6]

• Gastrointestinal

• Helicobacter pylori infections[7]

• Ulcerative
  colitis[8]

• Hepatic

• Acetaminophen
  overdose

• Acute
  hepatic failure[9]

• Acute
  pennyroyal or clove oil ingestion[10] 

• Carbon
  monoxide poisoning[11]

• Carbon
  tetrachloride poisoning[12]

• Mushroom
  poisoning[13]

• “The dosing schedule for the 72-hour oral NAC protocol [in
  treating acetaminophen overdose] is as follows: 

• 140
  mg/kg loading dose orally.
• After
  4 hours of the loading dose, 70 mg/kg should be given every 4
  hours for an additional 17 doses, which is a total dose of 1330 mg/kg. The
  solution should be diluted to 5% and preferably mixed with a
  soft drink or juice to enhance palatability. 
• Any
  vomited doses should be readministered.”[14]

• It is recommended
  prior to and throughout the course of treatment to monitor acetaminophen and
  transaminase levels in the blood, which is not likely to be an option if
  medical facilities are not available.

• Musculoskeletal

• Muscle
  performance.  NAC has been demonstrated to
  minimize muscle fatigue.[15]

• Neurological

• Alzheimer’s[16]

• Depression[17]

• Parkinson’s[18]

• Schizophrenia[19]
  [20] 

• Substance
  abuse

• Reduces
  cravings, especially for cannabis, and somewhat so for nicotine[21]

• Respiratory

• Asthma[22]

• Chronic
  bronchitis (commonly prescribed in Europe)[23]

• COPD[24]

• 1200-1800 mg/day[25]

• COVID-19
• 1200-1800 mg/day[26]

• Cystic
  fibrosis[27]

• Influenza
  A[28]

• Pneumonia[29]

• Viral illness

• 600 mg/day[30]

• Urogenital

• Female
  infertility
• 1,200
  mg/day[32]
• Immune
  function post-menopause
• 600
  mg/day[33]
• Male
  infertility
• 600
  mg/day[34]
• Polycystic
  ovary syndrome (PCOS)[35] [36]
  [37]

• Increasing pregnancy rates in women with
  PCOS[38]
  [39]
  [40]

• 600-1200
  mg/day[41]

• Other

•   Cancer[42],
  particularly liver cancer[43]
•   Sepsis[44]

SIDE EFFECTS

NAC comes in
intravenous solutions as well as capsules; both are equally effective.  Oral NAC may cause nausea, vomiting (in up to
33% of patients), diarrhea, gas, and gastroesophageal reflux.  It may also induce gastrointestinal bleeding
in patients with pre-existing ulcers or varices.[45]  In these cases, intravenous NAC is preferred.[46] 

Intravenous NAC
may cause anaphylactoid reactions in up to 18% of patients; this is not an
issue with oral NAC.  If this occurs,
discontinue NAC therapy immediately and administer an antihistamine like
Benadryl and intravenous fluids to prevent hypotension.  (Interestingly, this reaction is more common
with lower levels of acetaminophen toxicity.) 
Severe reactions like bronchospasms (1% of patients) are more likely to
occur in asthma patients, and bronchodilators are the recommended treatment.[47]

SYNERGISMS

NAC works
synergistically with many antibiotics to defeat gram-positive and –negative
bacteria, and combines particularly well with ciprofloxacin.[48]  Numerous studies have demonstrated that NAC
helps to inhibit or destroy bacterial biofilms as it increases the permeability
of antibiotics to overcome drug resistant bacteria.[49] 

TOXICITY

The most common
problem is iatrogenic (hospital or doctor) error, where the dosage is
miscalculated and the patient is overdosed (by a factor of 10 or more), which
may be fatal. 

As with all
medications and supplies recommended on this blog, you are only storing these
items to have on hand for licensed medical personnel to use to treat your
family.  You need to be familiar with
this product and its uses, if you choose to acquire it for your family, so that
in the event someone in your group experiences an acetaminophen overdose or other
situation where NAC would be used, you can offer it to the attending
physician.  It’s not a common item to
store and not something a physician would likely inquire about.

When used as prescribed,
NAC is safe for pregnant women and their babies.[50]
[51]

Links to related posts:

Preparing for and Preventing Unintentional Acetaminophen Overdose

Alternative Uses of Benadryl

Asthma Management When Society Collapses  

Acute and Chronic Liver Failure in Armageddon  

Medicinal Uses of
Activated Charcoal