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Antioxidant Booster
Cost: 
Time: 
$200
60 min

N-Acetylcysteine, commonly abbreviated as NAC;NAC is a precursor to glutathione production, one of the body's most important antioxidants.  You have probably heard of antioxidants, but few people understand how they work.  Antioxidants are naturally found in foods that we eat, such as fruits and vegetables, and also available through supplements and medications.


Antioxidants fight free radicals in our body.  Free radicals are important for certain functions, such as fighting infection; however, they are also linked to multiple illnesses including diabetes, heart disease, and cancer.  Without antioxidants, free radicals would grow to high levels and quickly cause significant harm and eventually death.  Free radical production is increased by things such as air pollution, alcohol use, high blood sugar, viral infections, and more. When free radicals outnumber antioxidants it can lead to a state called oxidative stress, and prolonged oxidative stress has negative consequences to our health. 


NAC replenishes glutathione, the master antioxidant, our body is better able to regulate free radicals and promote overall health.  In fact, reducing oxidative stress can improve gut health, muscle performance, and even slow the progression of Parkinson's and Alzheimer's diseases.


In addition to these major benefits, NAC has also shown to detoxify our liver and it is commonly used in hospitals to prevent liver damage with patients who have taken toxic levels of Tylenol.  It may improve mood health by regulating glutamate, a neurotransmitter that is responsible for sending signals between our brain and the nerves in our body, AND it has been shown to improve infertility, improve testosterone utilization, and even help improve symptoms of Polycystic Ovary Syndrome (PCOS).


Ingredients:

B12 : 5,000 mcg

Acetylcysteine (NAC) 600 mg


Administration:

Can be administered with a bag of IV fluids for hydration or given as a quick high dose IV push additive for a lower fee (does not include hydration)


WORKUP AND MONITORING RECOMMENDATIONS

-Required - Vital signs before and after

-A basic workup on file is a general recommendation for ongoing injections or infusions (baseline CBC/CMP/GP6)


FREQUENCY: 

  • Maximum 1-2 per week

Acetylcysteine (NAC): Patient Information

Basic Information: NAC is the supplemental form of  the amino acid l-cysteine ( a critical amino acid for our health ) NAC aids in replenishing glutathione, which is the most important antioxidant in the body. Antioxidants help neutralize free radicals which damage cells and body tissues.  NAC is the supplemental form of  the amino acid l-cysteine ( a critical amino acid for our health ) NAC aids in replenishing glutathione, which is the most important antioxidant in the body. Antioxidants help neutralize free radicals which damage cells and body tissues.  

N-acetyl-cysteine, or NAC, is derived from the amino acid L-cysteine. Consuming adequate amounts of cysteine is critical to our health. One of the body’s most important antioxidants, glutathione, helps neutralize free radicals that can damage cells and tissues within the body. It is essential for immune health and for fighting off damage at the cellular level. NAC helps to replenish the glutathione in our bodies. It acts as a hepatoprotective agent by restoring hepatic glutathione, serving as a glutathione substitute. Cysteine is an antioxidant found in high-protein foods, such as chicken, turkey, yogurt, cheese, eggs, and legumes. NAC is the supplement form of cysteine. It is used to help many conditions, such as flu, dry eye, and kidney disease. It is used for cough and other lung conditions due to its antioxidant and expectorant properties of loosening the mucus in your airways and reducing the inflammation in your bronchial tubes and lung tissue. It is also used in emergency rooms to treat Tylenol® overdose. NAC helps in the regulation of glutamate, a neurotransmitter responsible for sending signals between the brain and nerves in the body. In conditions such as addiction, NAC may help with withdrawal symptoms and relapse.


Uses : Endocrine ( infertility, androgen support, adrenal support ) Immune health (  liver detoxification, replenishes glutathione levels ) Mood Health ( addictive behavior, psychiatric diseases such as depression, bipolar disorder, schizophrenia and OCD ) Respiratory health ( mucolytic agent


Benefits

Endocrine/Thyroid/Energy:

NAC can promote/improve androgen production (i.e. testosterone), accelerates antioxidant activity in the thyroid gland which helps support thyroid conversion/utilization and supports adrenal function. Improves PCOS symptoms and can improve androgen hormone utilization. NAC has also been found to help improve fertility as it plays an important role in germ cell survival.

Immune Health: 

NAC is a precursor to glutathione production, glutathione is the body's master antioxidant. It also supports liver detoxification

Mood Health:

It is also thought that N-acetyl cysteine may improve psychiatric disorders such as depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder and addictive behaviors as well. NAC helps in the regulation of glutamate, a neurotransmitter responsible for sending signals between the brain and nerves in the body. In conditions, such as addiction, NAC can help decrease withdrawal symptoms and relapse

Respiratory Health:

NAC can help treat respiratory conditions as well. N-acetylcysteine acts as an antioxidant and expectorant by loosening the mucus in your airways and reducing the inflammation in your bronchial tubes and lung tissue.

Addiction:

NAC is thought to improve symptoms and addiction in patients with cannabis use disorder/cannabinoid hyperemesis syndrome

Gut Health:

Ulcerative colitis is a chronic inflammatory disorder which multiple casual factors can affect it. Human colitis has many similar characteristics to acetic acid (AA)-induced colitis, as a reproducible and simple model. Studies have indicated that some signaling pathways contributing in cell apoptosis and growth, angiogenesis, redoxregulated gene expression, and inflammatory response can be affected by NAC. Therefore, NAC may not only protect against the direct detrimental impacts of oxidants, but also advantageously modify inflammatory events in colitis (34). The beneficial influences of NAC were related to the changes including: Softened colonic injury,. Decreased oxidative stress,  Lowered cell apoptosis, Increased recovery of the injured colon, and increased formation of the tight junction..

Muscle Performance:

Investigations showed no effect of NAC on non fatigued muscle, although after three minutes of repetitive contractions, it caused a considerably enhanced force output, up to approximately 15%. This means that NAC can improve muscle performance. This result originated from the fact that oxidative stress plays a causal role in the fatigue process, since NAC is a scavenger of free radicals causing oxidative stress. It has been well reported that infusion of NAC can be effective in enhancing the overall redox status in vivo. It has also been shown that NAC infusion could minimize muscle fatigue..

Parkinson Parkinson disease (PD) 

Is a very prevalent neurodegenerative disorder caused by unknown deterioration of cells which generate dopamine in the pars compacta, a part of the substantial nigra located in the midbrain . In terms of pathogenesis, PD appears to be a multifactorial disorder, including environmental factors, acting on genetically vulnerable individuals when they are older. A wide range of both genetic and environmental factors have been proposed as contributing to the initiation and progression of PD, but aging is the single most important risk factor for this disorder and undoubtedly interferes in PD progression through its accumulative oxidative damage, decrease in antioxidant ability and impairment of mitochondrial bioenergetic capacity in the brain . Taking into account that most PD patients experience accumulative oxidative damage, some clinical studies have demonstrated the controversial effect of some antioxidant administrations -such as NAC- on treatment of PD. Some improvements have been reported for systemic administration of NAC in animal models, such as: i. Enhancement of brain level of glutathione, ii. Reduction of oxidative damage-markers, iii. Enhancement of brain synaptic and non-synaptic brain mitochondrial complex I activities, and iv. Protection against dopamine-induced cell death.

Alzheimer disease (AD) 

Is known as a multifactorial disease with many abnormalities in physiological, biochemical, and neurochemical point of view. Aging is the major risk factor for AD that coexists with other causes of cognitive decline, particularly vascular dementia. Some factors, such as mitochondrial dysfunction, abnormal protein aggregation, metal accumulation, inflammation and excitotoxicity play important roles in AD pathology. Although the relationship between these factors and development of AD is multidirectional, oxidative damage is considered as a common thread linking some of these factors . Results of different studies showed that lipoic acid (LA) and NAC decreased levels of oxidative and apoptotic markers via protection of mitochondrial function. Combination of both LA and NAC maximizes this protective effect suggesting that this may prevent mitochondrial decay associated with aging and age-related disorders such as AD. Antioxidant therapies based on LA and NAC seem promising since they can act on mitochondria, one key source of oxidative stress in aging and neurodegeneration .

Asthma 

Is a chronic disorder associated with inflammation and immune cell infiltration of airways. Airway hyper-responsiveness (AHR) can be originated from the consistent presence of inflammatory mediators and immune cells in airways. AHR is clinically determined with breathlessness, coughing and wheezing symptoms. Studies showed the preventive effect of NAC antioxidant on the AHR and steroid resistant accumulation of inflammatory cells in the airways of the animal model with acute exacerbation of asthma 


Recommended for the following Client Complaints:

  1. Depleted glutathione stores/Immunity

  2. Low testosterone/PCOS/ Infertility 

  3. Muscle Health/Performance

  4. Thyroid dysfunction

  5. Liver Detoxification/hepatoprotective

  6. Flu/cold/respiratory symptoms/asthma/acute illness

  7. Low energy/  oxidative stress 

  8. Alzheimers, Parkinsons

Side Effects/Precautions: NAC is generally safe for most adults. Women who are pregnant or breastfeeding are also typically safe when taking NAC, but should always speak with their healthcare provider before taking. Some drugs may interact with NAC. One major interaction is with nitroglycerin. Nitroglycerin dilates the blood vessels and increases blood flow. NAC tends to increase the effects of nitroglycerin, possibly causing increased side effects, such as headache, dizziness, and lightheadedness. Another drug that moderately interacts with NAC is activated charcoal. 


N-Acetylcysteine Studies

N-acetylcysteine (NAC) is an anti-inflammatory nutrient that is a precursor to glutathione. Glutathione is a very powerful antioxidant that is important for reducing oxidative stress in the body, something that PCOS patients often experience at increased levels. Increased oxidative stress can lead to increased androgens and inflammation. In PCOS patients, NAC is can be used to increase insulin secretion from pancreas and improve insulin receptor sensitivity to glucose by increasing cellular levels of glutathione2. Studies have shown that by decreasing insulin, we can decrease testosterone and androgen levels. This can help to improve symptoms of hyperandrogenism such as acne and hirsutism (coarse hair growth in areas such as the chin, between the breasts, abdomen and thighs).

In some studies, it was found that NAC improved insulin resistance and lipid profiles more effectively or was comparable to Metformin 3,6. Metformin is a commonly prescribed pharmaceutical for blood sugar regulation in diabetic or PCOS patients. Metformin works by decreasing the glucose output from the liver and lowering fasting insulin. However, it also affects the absorption of vitamin B12 and may have adverse side effects such as nausea, diarrhea or bloating. Additionally, NAC is comparable to Metformin at improving symptoms of hyperandrogenism and anovulation. Therefore, it can be used to ameliorate acne, male pattern hair growth on the body, hair loss on the scalp and regulate the menstrual cycle.

NAC has also been shown to protect cells from oxidative damage which provides long term benefits for insulin secretion, sensitivity and metabolism.  By increasing intracellular glutathione, NAC can be used to improve egg and embryo quality1 which is beneficial for PCOS patients who are looking to conceive in the future.

It is important to note that although NAC can improve insulin receptor sensitivity and blood glucose levels, diet and lifestyle are the most fundamental factors when it comes to PCOS. Consuming a low glycemic index diet will ensure blood glucose levels are more stable, which decreases the amount of insulin required to be secreted to shuttle that glucose out of the blood and into the cells. Therefore, no supplement will be able to effectively improve insulin resistance while consuming a high glycemic diet. Supplements are often used as an added benefit after the fundamentals  of health are put into place.


References

  1. Cheraghi, E., Mehranjani, M. S., Shariatzadeh, M. A., Esfahani, M. H., & Ebrahimi, Z. (2016). N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin. Reproduction, Fertility and Development, 28(6), 723

  2. Fulghesu, A. (2002). N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertility and Sterility, 77(6), 1128-113

  3. Javanmanesh, F. et al. (2015) A comparison between the effects of metformin And N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. Gynecological Endocrinology, 32(4), pp. 285–289

  4. Kanthi, Bansal. Dimri, Pooja Sharma. Reddy, Apoorva Pallam. Decoding Polycystic Ovarian Syndrome. Jaypee Brothers Medical p, 2017

  5.  Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: Purposes and pitfalls. Obstet Gynecol Surv 2004;59:141–15

  6. Oner, G., & Muderris, I. I. (2011). Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 159(1), 127-131

  7. Wu, S., Divall, S., Nwaopara, A., Radovick, S., Wondisford, F., Ko, C., & Wolfe, A. (2013). Obesity-Induced Infertility and Hyperandrogenism Are Corrected by Deletion of the Insulin Receptor in the Ovarian Theca Cell. Diabetes, 63(4), 1270-1282. doi:10.2337/db13-1514

Cannabis use disorder — N-acetylcysteine (NAC) and topiramate have been evaluated for efficacy in adolescents with cannabis use disorder:

N-acetylcysteine — NAC is an antioxidant precursor to glutathione that modulates glutamatergic, neurotropic, and inflammatory pathways. Its use, as an adjunct to psychosocial treatment, is supported by a clinical trial in adolescents.

The trial randomly assigned 116 adolescents with DSM-IV cannabis dependence to either NAC or placebo [15]. Dosing of NAC was 1200 mg twice daily with no titration needed or contraindications reported. Participants assigned to receive NAC had more than twice the odds, compared with those receiving placebo, of having negative urine cannabinoid test results during treatment (odds ratio 2.4, 95% CI 1.1-5.2). NAC was well tolerated with minimal adverse events, although a few subjects reported vivid dreams.

We conclude that NAC, which is an antioxidant, plays an important role in germ cell survival in the human seminiferous tubules in vitro. We also suggest NAC as a possible new therapeutic factor for some men with idiopathic oligospermia. (J Clin Endocrinol Metab 83: 2523– 2531, 1998)


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