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
- 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]
- Other
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
Asthma Management When Society Collapses
Acute and Chronic Liver Failure in Armageddon
Medicinal Uses of Activated Charcoal
[1] https://www.healthline.com/nutrition/nac-benefits
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[3] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[5] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[6] https://drbrighten.com/nac-benefits/
[7] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[9] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[10] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[11] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[12] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[13] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[14] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[17] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[19] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[20] https://www.hindawi.com/journals/bmri/2018/2469486/
[21] https://www.hindawi.com/journals/bmri/2018/2469486/
[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[23] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[24] https://www.sciencedirect.com/science/article/pii/S095461111630141X
[25] https://drbrighten.com/nac-benefits/
[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10390689/
[27] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[28] https://www.sciencedirect.com/science/article/abs/pii/S000629520900728X
[29] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[30] https://drbrighten.com/nac-benefits/
[32] https://drbrighten.com/nac-benefits/
[33] https://drbrighten.com/nac-benefits/
[34] https://drbrighten.com/nac-benefits/
[35] https://pubmed.ncbi.nlm.nih.gov/21831508/
[36] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306416/
[37] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[38] https://pubmed.ncbi.nlm.nih.gov/21831508/
[39] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306416/
[40] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[41] https://drbrighten.com/nac-benefits/
[42] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[43] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
[44] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[45] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[46] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[47] https://www.ncbi.nlm.nih.gov/books/NBK537183/
[48] https://www.sciencedirect.com/science/article/pii/S095461111630141X
[49] https://www.europeanreview.org/wp/wp-content/uploads/2942-2948.pdf
[50] https://www.europeanreview.org/wp/wp-content/uploads/2942-2948.pdf
[51] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/
