N-acetyl Cysteine (NAC)

[David]

I have read where some people in here use NAC. I have never tried it but after my sister gave me a bottle and after reading this article I found on line, I have decides to add it tom arsenal of medicine.

The Overlooked Compound That Saves Lives.

N-acetyl Cysteine

www.lifeextension.com/magazine/2010/5/N-Acetyl-Cysteine/Page-01

In this article, you will discover the latest research on N-acetyl cysteine (NAC), a readily available, inexpensive amino-acid derivative with four decades of scientific validation. You will learn of its role in restoring intracellular levels of one of the body’s most powerful antioxidant defenses, glutathione (GSH). You will also find out how 600-1,800 mg of NAC daily may act as an effective intervention against a constellation of chronic, degenerative diseases, including impaired glucose control and cancer.

[jim]

Thanks for sharing David, I take NAC, it helps with my COPD and also helps to stabilise my moods.

[David]

I found this to be interesting.

Though most individuals gain benefits from 600-1,800 mg/day, clinical studies have found that doses of up to 2,000 mg/day are safe and effective. A recent study demonstrated the safety of 2,800 mg/day for 3 months in patients with COPD.

And this too.

NAC protects tissues from the effects of exercise-induced oxidative stress, adding value and safety to your workout.

It seems to be proven to be safe.

The recent explosion of scientific evidence for NAC’s multi-targeted health benefits is matched only by the willful ignorance of the mainstream medical community. Some even question its safety, despite nearly 40 years of use in a variety of clinical conditions, which have established the safety of this compound, even at very high doses and for long-term treatments.
One study demonstrated the safety of 1,800 mg per day for 142 days, while another study demonstrated the safety of 2,800 mg per day for 3 months.

[katepa]

I have used NAC in the past, but only when I've had a cold. That is the only time I produce mucus and then it is horrible stuff. The NAC seems to clear up the mucus really well.

[shelley]

I know many that use NAC on a regular basis and it seems to really help with either getting rid of or thinning mucus so that it can be coughed up easily. It's important to get it out of one's lungs because the mucus is usually what will get infected if it sits there too long. I tried it but it bothered my stomach, which is a known side effect for some.

New research points to it's ability actually slow down progression of the disease but that could be just because if the mucus gets out, additional scar tissue isn't formed. Either way, if I could take it, I would. It's a keeper.

[David]

I started taking one capsule (750 mg) every morning when I get up. So far I have felt no side effects.

[John]

David does it work for you ?

[David]

I am sure it is doing something.

I can't tell because I don't have bronchitis. My chest has been clear for many years. I have no cough and no mucus.

I am hoping it secretively helps me.

NAC protects tissues from the effects of exercise-induced oxidative stress, adding value and safety to your workout.

NAC replenishes levels of the intracellular antioxidant glutathione (GSH), which is often deficient with advancing age and in chronic illness.

NAC also regulates expression of scores of genes in the pathways that link oxidative stress to inflammation.

[gerald]

This 2013 study seems to indicate some benefits. However the only talk about 600 mg of NAC. I have sene some writeups that suggest benefits from 1000-1200 mg.

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High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study.

Abstract
BACKGROUND:

The mucolytic and antioxidant effects of N-acetylcysteine (NAC) may have great value in COPD treatment. However, beneficial effects have not been confirmed in clinical studies, possibly due to insufficient NAC doses and/or inadequate outcome parameters used. The objective of this study was to investigate high-dose NAC plus usual therapy in Chinese patients with stable COPD.
METHODS:

The 1-year HIACE (The Effect of High Dose N-acetylcysteine on Air Trapping and Airway Resistance of Chronic Obstructive Pulmonary Disease-a Double-blinded, Randomized, Placebo-controlled Trial) double-blind trial conducted in Kwong Wah Hospital, Hong Kong, randomized eligible patients aged 50 to 80 years with stable COPD to NAC 600 mg bid or placebo after 4-week run-in. Lung function parameters, symptoms, modified Medical Research Council (mMRC) dyspnea and St. George's Respiratory Questionnaire (SGRQ) scores, 6-min walking distance (6MWD), and exacerbation and admission rates were measured at baseline and every weeks for 1 year.
RESULTS:

Of 133 patients screened, 120 were eligible (93.2% men; mean age, 70.8±0.74 years; %FEV1 53.9±2.0%). Baseline characteristics were similar in the two groups. At 1 year, there was a significant improvement in forced expiratory flow 25% to 75% (P=.037) and forced oscillation technique, a significant reduction in exacerbation frequency (0.96 times/y vs 1.71 times/y, P=.019), and a tendency toward reduction in admission rate (0.5 times/y vs 0.8 times/y, P=.196) with NAC vs placebo. There were no significant between-group differences in mMRC dypsnea score, SGRQ score, and 6MWD. No major adverse effects were reported.
CONCLUSION:

In this study, 1-year treatment with high-dose NAC resulted in significantly improved small airways function and decreased exacerbation frequency in patients with stable COPD.
TRIAL REGISTRY:

ClinicalTrials.gov; No.: NCT01136239; URL: www.clinicaltrials.gov.

www.ncbi.nlm.nih.gov/pubmed/23348146

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This study covers higher doses  www.medscape.com/viewarticle/508001

[susan]

Good quality N.A.C. (N-acetyl cysteine) is one of the supplements my Naturopathic Doctor has me take.  I discussed it with my Pulmonologist and he was aware of the studies and said it was a natural supplement and in his opinion, it wouldn't do any harm for me to take it. The following is the information I've found regarding N.A.C.:


N.A.C. may also be able to help those with chronic degenerative diseases, including liver disease, kidney disease, lung disease and impaired glucose control.

liver-health
Attachment Deleted
N.A.C. (N-acetyl cysteine) may be able to reduce a large range of chronic, degenerative problems, including liver inflammation and impaired glucose control.

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

N.A.C. is given intravenously. in hospital emergency departments as a life saving treatment for acute poisoning with paracetamol (also known as acetaminophen also known as Tylenol).


Here are a few recently published trials:
Published in the November 2006 journal Apoptosis, one trial investigated if N.A.C. could inhibit liver cell death in acute severe liver failure. Based on an animal model, the researchers concluded that N.A.C. 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 N.A.C. for acute liver failure had a better outcome than matched controls not treated with N.A.C.

With over more than 40 years of use in a wide range of medical disorders, N.A.C. has been proven to be safe even at very high doses and for long-term treatments.

Cautions with N.A.C.
There are no known contraindications to N.A.C. Diabetics should check with their healthcare provider regarding interference with insulin efficacy.


What You Need to Know: N-Acetyl Cysteine’s Broad-Spectrum Benefits

• Long relegated to infrequent use in unusual circumstances, the amino acid-derived compound N-acetyl cysteine (NAC) has drawn increased scientific attention.
• NAC replenishes levels of the intracellular antioxidant glutathione (GSH), which is often deficient with advancing age and in chronic illness.
• NAC also regulates expression of scores of genes in the pathways that link oxidative stress to inflammation.
• These dual effects give NAC a unique role in the prevention and treatment of many common diseases, both acute and chronic.
• NAC can protect against avian influenza and more common seasonal flu symptoms.
• NAC reduces the frequency and duration of attacks of chronic obstructive pulmonary disease (COPD) and may slow the clinical course of idiopathic pulmonary fibrosis (IPF).
• NAC protects tissues from the effects of exercise-induced oxidative stress, adding value and safety to your workout.
• NAC improves insulin sensitivity in people with some of the most difficult-to-treat metabolic disorders.
• NAC blocks cancer development at virtually every step in the process, and through multiple mechanisms, making it an important cancer chemopreventive agent.
• NAC fights the stomach infection Helicobacter pylori on two fronts, inhibiting the organism’s growth while reducing production of inflammatory cytokines that can lead to gastritis and cancer.
  
  Though most individuals gain benefits from 600-1,800 mg/day, clinical studies have found that doses of up to 2,000 mg/day are safe and effective. A recent study demonstrated the safety of 2,800 mg/day for 3 months in patients with COPD 
  

www.lifeextension.com/magazine/2010/5/N-Acetyl-Cysteine/Page-01

[gerald]

There have been a couple of studies against NAC, stating it can assist in spreading Cancers etc.
However, when I talked with my Pulminary Specialist about the studies he discounted them.
He said as NAC does occur naturally in the body there was not yet a way to identify levels that would be come problematic.

He thought that it offered enough potential to include it in ones diet. I use 1500 mg/day.
Of course it rules out using tylenol etc, but I never used much of that anyways.

[gerald]

Another update study on NAC titled: "N-acetylcysteine in COPD: why, how, and when?". Some of the studies referred were over a year in length. The article is quite long but worth a read if you have time. I have key some key phrases from the conclusions and posted them below.

Full Article: mrmjournal.biomedcentral.com/articles/10.1186/s40248-016-0039-2

The conclusion is strong:

Thus, the antioxidant and mucolytics properties of NAC have the potential for being a useful adjunct in COPD therapy. Even because a recent investigation has demonstrated that NAC is also able to enhance the effectiveness of antimuscarinic bronchodilators generally used in COPD patients.

The daily dosage of the drug raised some perplexities in the past, but it is well established by now that to achieve some benefit in terms of prevention from COPD exacerbations or possibly of respiratory function and symptoms improvement, high-dose NAC (1200 mg/day on average) must be administered for a long period of time.

Furthermore, these results could assign to NAC a broader role than previously recognized, that is that of a drug able to be used as add on therapy to decrease the exacerbation rate and symptoms score, represented by cough and phlegm, in COPD patients, also without the moderate to severe airways obstruction.

[gerald]

This is one of the first control studies on NAC and it provides some fairly conclusive evidence that NAC does make a difference.
Unfortunately it does not identify the types of COPD that were involved so we do not know if it applies across all COPD


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Effect of N-acetylcysteine on the pulmonary function and serum inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease

YUAN Xiao-mei;LI Hua-xu;SUN Zhi-yuan;GAO Xin-yuan;YANG Xiao-hua;Department of Respiratory Medicine,the First Affiliated Hospital of Xinxiang Medical University;Medical College of Nanchang University;School of International Education,Xinxiang Medical University;

Objective To investigate the effect of N-acetylcysteine(NAC) on the pulmonary function and serum inflammatory factors in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).

Methods A total of150 patients with acute exacerbation of COPD treated in the First Affiliated Hospital of Xinxiang Medical University from January 2014 to June 2017 were selected and randomly divided into control group and observation group,75 cases in each group.The patients in the control group were treated with methylprednisolone sodium succinate and doxofylline by intravenously guttae,and terbutaline sulphate and budesonide inhalation,and anti-infective agents according to the patient's condition. The patients in the observation group were treated with NAC orally on the basis of routine treatment.

Results There was no significant difference in the percentages of forced expiratory volume in 1 second(FEV1) to predicted value(FEV1% pred),forced vital capacity(FVC) to predicted value(FVC% pred) and FEV1 to FVC(FEV1/FVC) between the two groups before treatment(P 0. 05). The FEV1% pred,FVC% pred and FEV1/FVC after treatment for 14 days were significantly higher than those before treatment(P 0. 05). The FEV1% pred,FVC% pred and FEV1/FVC of the patients in the observation group were all higher than those in the control group after treatment for 14 days(P 0. 05). There was no significant difference in serum SAA,TNF-α,and IL-6 levels between the two groups before treatment(P 0. 05). The serum SAA,TNF-αand IL-6 levels after the treatment for 14 days were significantly lower than those before treatment in the two groups(P 0. 05). The levels of serum SAA,TNF-α and IL-6 in the observation group were significantly lower than those in the control group after treatment for 14 days(P 0. 05).

Conclusion  NAC combined with routine treatment can effectively improve the pulmonary function,reduce the release of inflammatory factors and the inflammatory response in patients with acute exacerbation of COPD.

en.cnki.com.cn/Article_en/CJFDTotal-XXYX201804014.htm

[gerald]

A new updated study, still proving the benefits but further identifying the doses required

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High-dose N-acetylcysteine in patients with exacerbations of chronic obstructive pulmonary disease.
Zuin R1, Palamidese A, Negrin R, Catozzo L, Scarda A, Balbinot M.

Abstract
OBJECTIVE:
To investigate the efficacy and tolerability of high-dose N-acetylcysteine (NAC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (COPD).

DESIGN AND PATIENTS:

Randomised, double-blind, double-dummy, placebo-controlled study in 123 patients experiencing an acute exacerbation of COPD.

INTERVENTIONS:

NAC 1200 mg/day, 600 mg/day or placebo administered once daily for 10 days.

MAIN OUTCOME MEASURES:

The primary objective was to assess the proportion of patients with normalised C-reactive protein (CRP) levels. Also assessed were effects on interleukin (IL)-8 levels, lung function and symptoms.

RESULTS:

Both NAC 600 and 1200 mg/day were associated with a significantly higher proportion of patients achieving normalised CRP levels compared with placebo (52% and 90% vs 19% of patients; p </= 0.01); however, NAC 1200 mg/day was superior to NAC 600 mg/day (p = 0.002). Furthermore, treatment with NAC 1200 mg/day was more efficacious than NAC 600 mg/day in reducing IL-8 levels and difficulty of expectoration, while the two active regimens had similar beneficial effects on lung function and other clinical outcomes (cough intensity and frequency, and lung auscultation). Treatments were well tolerated with one adverse event reported in NAC 1200 mg/day recipients and two reported in placebo recipients.
CONCLUSION:

Treatment with NAC 1200 mg/day improved biological markers and clinical outcomes in patients with COPD exacerbations. It is speculated that the effect of NAC on inflammatory markers may be due to both mucolytic and antioxidant properties.

www.ncbi.nlm.nih.gov/pubmed/17532680

[gerald]

A new write up on NAC. There is quite a bit of repetitive information so rather than post it again I have just included the link.

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Top 9 Benefits of NAC (N-Acetyl Cysteine)

www.healthline.com/nutrition/nac-benefits