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N-acetylcysteine (also known as NAC, acetylcysteine, N-acetyl-L-cysteine) is a supplement and drug used to increase levels of glutathione (GSH), the most common natural antioxidant in the body.[1] For this reason, NAC itself is sometimes referred to as an antioxidant. NAC is a pro-drug for cysteine, which is the rate-limiting ingredient in the biosynthesis of glutathione. It is thought that NAC is better than cysteine at increasing GSH in the brain since most cysteine will be consumed by the liver during first-pass metabolism, and NAC may bypass first-pass metabolism. Since orally consumed GSH will be broken down in the stomach, NAC is a more efficient means of enhancing GSH in cells.[2] NAC was originally approved as a medicine to breakdown excess mucus in the lungs.

Evidence[edit | edit source]

In a presentation to the 2016 IACFS/ME conference Dr Dikoma Shungu of Cornell University gave a presentation on a trial of NAC in ME/CFS patients. [3] Previously his team had found a 36% deficit of the tissue anti-oxidant occipital cortex glutathione (GSH) in the cortical areas of the brains ofME/CFS patients.[4]

The trial supplemented patients (meeting the CDC criteria for CFS} with 1800mg daily of GSH precursor n-acetylcysteine for 4 weeks and looked at levels of cortical GSH. The study found that cortical GSH had increased in patients and that CFS symptoms (as assessed with the CDC CFS symptom inventory) were significantly reduced.[5]

In 2020, a double-blind placebo controlled clinical trial of NAC was registered, and is due to take place at Cornell University in conjunction with NINDS, to measure the effects of 900mg and 3600mg of NAC compared to a placebo in ME/CFS patients.[6] The trial will take part in two different locations, with the principle investigator is Dikoma Shungu.[6] The trial aims to measure the effect of NAC on patients with ME/CFS who have low GSH levels.[6]

Clinical use[edit | edit source]

NAC is still clinically used as a mucolytic agent.

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

chronic fatigue syndrome (CFS) - A fatigue-based illness. The term CFS was invented invented by the U.S. Centers for Disease Control as an replacement for myalgic encephalomyelitis (ME). Some view CFS as a neurological disease, others use the term for any unexplained long-term fatigue (idiopathic chronic fatigue) without additional symptoms. Sometimes used as a the term as a synonym of myalgic encephalomyelitis, despite the different diagnostic criteria.

double blinded trial - A clinical trial is double blinded if neither the participants nor the researchers know which treatment group they are allocated to until after the results are interpreted. This reduces bias. (Learn more: www.nottingham.ac.uk)

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.