Acetylcysteine supplement side effect and benefit as antioxidant and for liver health, oral form tablet and capsule, often used for acetaminophen toxicity or overdose
March 23 2014

Acetylcysteine is made from the amino acid cysteine joined to an acetyl group. N-A-C, or NAC, is a strong antioxidant. It donates the amino acid cysteine to help form the antioxidant glutathione, a powerful antioxidant normally found in the body.

What exactly is the difference between cysteine and N Acetyl cysteine? Which one is better to take?
Most often, the latter is the one taken since it has stronger antioxidant potential, however it depends on the condition being treated. Acetylcysteine has an additional acetyl group which makes it more potent as an antioxidant.

Health benefit
N-acetylcysteine is an excellent source of sulfhydryl groups and is converted in the body into metabolites capable of stimulating glutathione synthesis, promoting detoxification, and acting directly as a free radical scavenger. Administration of this nutrient has historically been as a mucolytic (mucus dissolving) agent in a variety of respiratory illnesses; however, it appears to also have beneficial effects in conditions characterized by decreased glutathione or oxidative stress, such as HIV infection, cancer, heart disease, and cigarette smoking. NAC has liver protecting benefits and could protect from the toxic effects of acetaminophen use. In hospitals, acetylcysteine is often used intravenously for liver protection in cases of acetaminophen toxicity. In addition to its antioxidant properties, acetylcysteine is currently used in a variety of other ways: to lessen the symptoms of colds or the flu, and even to reduce the effects of hangovers.  This supplement certainly should be considered in protecting various cells from damage in the elderly and those with Parkinson’s disease.
   This nutrient may also be of benefit in men who infertility, those with cystic fibrosis, and for cocaine craving.

Buy N Acetyl Cysteine capsules, 500 mg
You can buy this product most often as a 250 mg, 500, or 600 mg capsule or tablet. Acetylcysteine capsules are significantly more effective than taking glutathione capsules.
The formation of glutathione synthesis is under feedback control. Administration with the resulting increase in glutathione levels may cause a feedback inhibition in glutathione synthesis. Thus, it may be best to take it every other day. If you are planning to take it along with other antioxidants, limit your daily dosage to 100 to 500 mg and don’t take it all the time. It is okay to break tablets in pieces or to open a capsule and take a portion.

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Dosage for daily use: There are no accepted guidelines on the appropriate n acetylcysteine daily dosage. Some people may need none, others may benefit from taking 500 mg two or three days a week. If you are taking other antioxidants, we suggest you reduce your dosage. Some people think that the more antioxidants they take the healthier they will be, but there is no proof of this.

Acute respiratory distress syndrome
Patients with ARDS are in a deficient oxidant-anti-oxidant balance and can get a significant benefit if supplemented with NAC.

Anti-aging research and studies
Effect of dietary restriction and n acetyl cysteine supplementation on intestinal mucosa and liver mitochondrial redox status and function in aged rats.
Exp Gerontol. 2004.
Ageing is characterized by a decrease of GSH concentrations, increased protein oxidation and decreased mitochondrial NO content. Hypocaloric diet ameliorated intestinal transport and, as well as acetylcysteine, was effective in enhancing GSH levels but at different extent according to the investigated districts. Both interventions reduced the age-associated increase of GSH-Px and protein carbonyls and improved mitochondrial respiration.

Benefit for cocaine craving
Dr. Peter W. Kalivas from the Medical University of South Carolina, Charleston evaluated the effects of N-Acetylcysteine on cue-induced cocaine craving of 15 people with cocaine dependence. Those who were taking the supplements had less cocaine craving and interest. The neurotransmitter system involved may be glutamate transmission. Dr. Peter W. Kalivas has started a double-blind study to evaluate the effects on nicotine and marijuana craving.

Is cocaine desire reduced by N-acetylcysteine?
Am J Psychiatry. 2007. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC,
In this trial, 15 volunteers received acetylcysteine or placebo during a 3-day hospitalization. Participants were crossed over to receive the opposite condition on a second, identical 3-day stay occurring 4 days later. During each hospital stay, participants completed a cue-reactivity procedure that involved collecting psychophysical and subjective data in response to slides depicting cocaine and cocaine use. While taking N-acetylcysteine, participants reported less desire to use and less interest in response to cocaine slides and watched cocaine slides for less time.

An open-label trial of N-acetylcysteine for the treatment of cocaine dependence: a pilot study.
Prog Neuropsychopharmacol Biol Psychiatry. 2007. Mardikian PN, LaRowe SD, Hedden S, Kalivas PW. Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC, USA.
Twenty three treatment-seeking cocaine-dependent patients participated in a 4-week medication trial and received N-acetylcysteine at doses of 1200 mg/day, 2400 mg/day or 3600 mg/day. Results suggested that the three doses were well tolerated. Overall, the retention rates appeared to favor higher doses of NAC (2400 mg/day and 3600 mg/day). The majority of subjects who completed the study either terminated use of cocaine completely or significantly reduced their use of cocaine during treatment.

Cystic fibrosis
Oral N-acetylcysteine, through its actions on glutathione, may reduce inflammation in cystic fibrosis.

Homocysteine level
Oral N acetylcysteine may lower homocysteine levels.

Infertility
Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study.
J Urol. 2009. Urology and Nephrology Research Center, Shahid Beheshti University, MC, Tehran, Islamic Republic of Iran.
The study included 468 infertile men with low sperm counts of unknown reason who were randomized to receive 200 microg selenium orally daily, 600 mg NAC orally daily, 200 microg selenium plus 600 mg N-acetyl-cysteine orally daily  or similar regimen of placebo for 26 weeks. These patients provided blood samples for the measurement of serum testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin, inhibin B, selenium and N-acetyl-cysteine. Semen samples were also obtained for routine semen analysis. In response to treatment, serum follicle-stimulating hormone decreased but serum testosterone and inhibin B increased. All semen parameters significantly improved with treatment. We advocate their use for male infertility treatment.

Kidney protection
Acetylcyteine prevents toxicity to the kidneys during x-ray testing after injection with a contrast material in the bloodstream.
Patients with a heart attack undergoing primary angioplasty are at high risk for contrast-medium–induced kidney damage. We randomly assigned 354 consecutive patients undergoing primary angioplasty to one of three groups: 116 patients were assigned to a standard dose of N-acetylcysteine (a 600-mg intravenous bolus before primary angioplasty and 600 mg orally twice daily for the 48 hours after angioplasty), 119 patients to a double dose of N-acetylcysteine (a 1200-mg intravenous bolus and 1200 mg orally twice daily for the 48 hours after intervention), and 119 patients to placebo. The serum creatinine concentration increased 25 percent or more from baseline after primary angioplasty in 33 percent of the control patients, 15 percent of the patients receiving standard-dose N-acetylcysteine, and 10 patients receiving high-dose. Overall in-hospital mortality was higher in patients with contrast-medium–induced nephropathy than in those without such nephropathy. Thirteen patients (11 percent) in the control group died, as did five (4 percent) in the standard-dose N-acetylcysteine group and three (3 percent) in the high-dose N-acetylcysteine group. Intravenous and oral N-acetylcysteine may prevent contrast-medium–induced nephropathy with a dose-dependent effect in patients treated with primary angioplasty and may improve hospital outcome.

Saudi J Kidney Dis Transpl. 2014 January. The effect of treatment with N-acetylcysteine on the serum levels of C-reactive protein and interleukin-6 in patients on hemodialysis. Our study found that short-term oral NAC treatment might result in the reduction of IL-6 and hs-CRP in patients who are on regular HD. This suggests that patients with ESRD may benefit from the anti-inflammatory effects of NAC.

Counteracting Tylenol toxicity
Regular use of the painkiller acetaminophen is associated with higher rates of liver and kidney toxicity, asthma, and chronic obstructive pulmonary disease and reduced lung function. Animal experiments have suggested that acetaminophen might lower antioxidant activity in the lungs, and causes harm to the liver and kidneys.
   Those who need to take acetaminophen for a health condition should consider Acetylcysteine, a nutrient that protects the liver from this drug's toxicity. The antidote for acetaminophen poisoning is N acetyl cysteine. It is thought to work through a number of protective mechanisms. Acetylcysteine is a precursor of glutathione and increases glutathione availability. Acetylcysteine also functions as an anti-inflammatory and antioxidant and has positive inotropic effects. Acetylcysteine increases local nitric oxide concentrations, and this vasodilatory effect on microcirculatory blood flow enhances local oxygen delivery to peripheral tissues. These vasodilating effects decrease morbidity and mortality even in the setting of established liver damage.
   Doctors prescribe intravenous or IV acetylcysteine to patients with liver damage due to acetaminophen (Tylenol) overdose. Acetylcysteine IV protects the liver quite well.
   Comments: If your doctor approves, it may be a good idea to take a small daily amount or a few times a week of a n acetylcysteine supplement, although there is little research to guide us on how much is needed and how often one should take this nutrient, however a dose of 100 mg a day would seem reasonable.

Which is more potent for liver detoxification, silymarin or NAC?
    It's difficult to say, We think NAC is more potent but they work in different ways.

Ulcerative colitis
N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis: randomized, placebo-controlled pilot study.
World J Gastroenterol. 2008.
To evaluate the effectiveness and safety of oral NAC co-administration with mesalamine in ulcerative colitis patients. Thirty seven patients with mild to moderate ulcerative colitis were randomized to receive a four-wk course of oral mesalamine (2.4 g/d) plus N-acetyl-L-cysteine (0.8 g/d) (group A) or mesalamine plus placebo (group B). Clinical remission rates were 63% and 50% after 4 wk treatment in group A and group B respectively. In group A, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.

N Acetylcysteine side effects, danger, is it safe? Overdosage
Other than large doses causing nausea, acetylcysteine does not have any significant side effects and appears to be a safe nutrient as long as the dosage is kept to less than 500 mg. Nausea can occur for a few minutes within an hour of taking two or three 600 mg pills on an empty stomach.
   One possible acetylcysteine side effect that should be kept in mind (it could also be a benefit) is that this supplement has anticoagulant and platelet-inhibiting properties. Oral overdosage could result in side effects such as nausea, vomiting and other gastrointestinal symptoms. Rare side effects could include bronchospasm, which is much more likely when used by the intravenous route.