it's in her oct 7 blog here is what is says about NAC/GSH.
"AN ALTERNATIVE WAY TO USE n-ACETYLECYSTEINE (MUCOMYST)
"The benefits of Mucomyst aerosols are sometimes offset by the odor of the aerosol which resembles rotten eggs, the stickiness of the not inhaled Mucomyst, which can interfere with function of table top computeres, television sets and other electronic equipment, and the risk of bacterial infection if the nebulizer is not carefully sterilized daily. Some of my patients have substituted three times a day of oral n-acetylcysteine as NAC capsules size 600 to 1000mg or, two or more teaspoons of 10% solution of Mucomyst or one or more teaspoons of 20% solution of Mucomyst.
"Some of these patients still benefit from the use of Intal and occasional bronchodilator inhalations by means of metered dose inhalers. Some of these patients do not use any; aerosols except antibiotics.
GLUTATHIONE AND HYPERTONIC SALINE AEROSOLS
"Glutathione is a combination of three amino acids: glutamate, cysteine, and glycine. Cysteine is the active amino acid in this molecule. NAC is a more stable form of cysteine because it has only an acetic acid group attached. NAC is more water soluble and is the most cost effective way to increase glutathione levels in the body. N-acetylecysteine in solution is sourer than glutathione but NAC comes in capsules.
"I recommend oral or aerosol n-acetylecysteine over oral of aerosol glutathione. I have used Mucomyst for aerosols for many years. I have been encouraging patients to expiment with oral NAC capsules. The cysteine amino acid part to both molecules provides the antioxident, antiinflammatory and mucolytic actions of both molecules.
"Hypertonic saline increases the water in the periciliary fluid. It does this by attracting water to reduce the hypertonic saline to normal saline concentration. This extra water floats the mucus high enough that the cilia can beat and move the mucus out of the lungs. This activity lasts until the hypertonic saline is diluted to normal. I do not know how long it takes for this to happen.
"A balancing consideration is that our studies have showed that the regular twice a day use of HFCC with either the square or triangle waveform machines will increase the water content of water in the sputum for at least 12 hours after the last regular twice a day treatment. While the published studies show the immediate effectiveness of the hypertonic saline aerosols I prefer the HFCC method since it couples the increase of water on the mucus membranes with the removal of that mucus as well as round the clock effectiveness.
"I have been so very satisfied with our Mucomyst aerosols taht I have been slow to experiment with hypertonic saline. However I have one patient who had an unusual problems with airway clearance after a shelf full of supplies fell on her and broke her back. After 3 years of poor response to surgery and other treatments (her back was too painful that she could not tolerate even low pressure sine waveform HFCC therapy) show a very significant improvement of all her pulmonary function tests. Based on this observation and the good resports in the literature I regard hypertonic saline aersol as a therapy worth of physician and patient experiment as an addition to, but as a replacement for Mucomyst. My current appproach would be to recommend only 3% saline. "
