N-Acetyl Cysteine, useless or useful?

[Twistofchaos]

Hi there,

a couple months ago there was some scam poster here trying to sell a drug having to do with Gluthation.
But while Gluthation can't be taken directly as it gets broken down before it ever reaches anything it still got me reading.
That led me to come across N-Acetyl Cysteine or NAC as a precursor to Gluthation. And which to my surprise the internet is full of. Also to my surprise is a mucus thinner/reducer even when taken orally and is even often mentioned with Cystic Fibrosis. Among many other purposes it's the main working ingredient of good old Mucomyst and Fluimicil.

http://en.wikipedia.org/wiki/Acetylcysteine

Why had I never heard of it?

Besides that it supposedly significantly reduces chances of getting colds and flu's and their symptoms (!!) and besides curing nearly everything it might even make me pregnant.
So..a miracle supplement if I ever saw one. Needless to say I'm very curious to find out people's experiences and expert opinions.

 

[Oboe]

I've done the PharmaNAC supplement for a month. It never really did much for me. I know I've read that some people have had positive results, though.

 

[Twistofchaos]

Thanks. Happen to have any links?

I'm trying it for a month now myself which is a bit short to say anything.
When I started however I was exposed to a cold and was comming down with it (why I started) getting first symptoms. However it didn't developed into a full cold and the times I escaped a cold like that in my life when already having symptoms like that I can count on one hand as well as having remarkably little sputum which was odd.
In this month I also had a ten day trip which went exceptionally well while being surrounded with people with colds and tiring days.

All that can easily be coincidence and there's sure to be some placebo effect, but even if it lessens sputum or other symptoms with 5 or 10% it's going to be well worth it to me.
So I hope there are more people with experience with it.

 

[triples15]

Hey Chaos,

I've been thinking of trying oral NAC for a long time now, not entirely sure what I'm waiting on. I'm one of the few who still neb mucomyst.

I do know of a few people who take NAC. From what I've heard, it needs to be the "fizzy" tablets (think alkaseltzer). It has something to do with oxidation, which I'm not quite smart enough to understand. Here is a link to the Bioadvantex NAC that I'm talking about:

http://www.bioadvantex.com/us/home-page-products/pharmanac.html

It was also sold on this site (medrise) for a while, but I don't see it anymore. Someone could correct me if I'm wrong.

Amy, who used to be an active member on this site has talked about oral NAC a lot. Here is the link to her blog posts specifically about NAC/glutathion. She has lots of good info.

http://noexcusesnoexcuses.blogspot.com/search/label/NAC

Well, I've gotta run. Keep us posted if you try it!

Take Care,

Autumn

 

[Twistofchaos]

Thanks! Very interesting readingmaterial.

Looks like that oxidationstory is something to look into. My first search to read about it however lands me at sites selling very expensive PharmaNAC so that's a bit fishy. (It makes a great selling point.)
Now to find a list of research or tests done on brands of NAC.. But I guess with NAC getting more known and popular more brands and higher quality will be available.

Great blog! Lots of reading to do and good to see it is indeed known in the CF community.

Why still Mucomyst? If anything hypertonic saline improves the housely aroma's and you no longer feel the need to get a farm of smelly dogs and cats to mask it with which saves a lot on petfood to buy NAC for or cards and stamps to invite your family back over with instead. Ohh but what if you didn't like your family all along..

Thanks again

 

[scarecrow]

I have been going down the progression of Glutathione myself. I took just the tablets for too long and then I found out that they don't get absorbed at all so now I'm taking the Pharmanac and a product called Cellgevity. The theory behind Glutathione is great. Everyone w/ CF is low. Not only does it help to thin mucus it also helps w/ the oxidation of the red cells and a bunch of other things that are all good. The problem is it is very hard to get it from outside of you to inside of you. I don't understand why you can't take it IV or even IM but doctors don't want to talk about it. I will say that it seems to make a difference if you can afford to take enough of it. But don't waste your money on the straight Glutathione.

 

[calebf]

I've done a bit of research on NAC. Links are below. I currently take 1800 mg of NAC 2x/day (http://www.amazon.com/Foods-Nac-Acetyl-Cysteine-600mg-Vcaps/dp/B0013OUQ3S/). Lower doses did not have much of an effect but up in the 2400+ mg/day range I saw improvements in FEV1 taken on a home spirometer within 2 weeks. I have been taking at least 2400 mg/day since June 2012 and now take 3600 mg/day. I notice a significant difference when I don't take them. I would highly recommend adding to your regimen and using a home spirometer daily to see how much of an effect it has on numbers.

http://www.ncbi.nlm.nih.gov/pubmed/8125859 - glutathione deficiency on CF patents
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1450222/ - confirms that high dose NAC is helpful
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=19557326 - Glutathione exhibits antibacterial characteristics against P. aeruginosa
http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=18499536 - improvement in FEV1, weight, and BMI
http://www.cff.org/treatments/Therapies/AlternativeTherapies/Antioxidants/ - quotes a stanford study that showed reductions in inflammation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352166/- phase II study showing that high dose NAC increases glutatione levels.

 

[Jason Scala]

Acetylcysteine sulfur smell/taste

My daughter was prescribed Acetylcysteine. She had to drink it, I think it was about 2 fluid ounces. She complained about the sulfur smell/taste so we tried mixing it in EVERYTHING (Gatorade, juices, sodas, iced teas, lemonades, etc.) but nothing covered up the taste for her. Now she doesn't like Coke since that was what we tried the most to cover up the sulfur taste.

 

[erock77]

I've been looking into it too, can someone point us to why fizzy pharmaNAC is so superior to capsules? I don't quite understand why sealed capsules would oxidize more than fizzy tablets that you drop in water. I've tried both, probably more effect from the PharmaNAC but it's SO expensive. Like $60/month.

 

[triples15]

Why still Mucomyst? If anything hypertonic saline improves the housely aroma's and you no longer feel the need to get a farm of smelly dogs and cats to mask it with which saves a lot on petfood to buy NAC for or cards and stamps to invite your family back over with instead. Ohh but what if you didn't like your family all along..

Thanks again

Bwahahaha!! So true. So true. It is foul smelling stuff. The funniest to me is the respiratory therapists in the hospital who don't want to give it because of it. I think I've become desensitized to it, plus my sense of smell is shot from more sinus surgeries than I shake a stick at!

I have stuck with it because I feel like it works better than Hypertonic for me. I actually use it in addition to Hypertonic because the docs really pushed the hypertonic, so we compromised on using both.

You're welcome for the info! Hope it helped at all!

Take Care!

 

[triples15]

I've been looking into it too, can someone point us to why fizzy pharmaNAC is so superior to capsules? I don't quite understand why sealed capsules would oxidize more than fizzy tablets that you drop in water. I've tried both, probably more effect from the PharmaNAC but it's SO expensive. Like $60/month.

Hi erock,

I was just perusing some old threads on NAC, and came upon this thread:

http://forum.cysticfibrosis.com/threads/8568-First-night-on-PharmaNAC?highlight=Acetylcysteine

One of the posts shows Bioadvantex's claims as to why the fizzy tablets are superior. I just copied and pasted in case ppl don't have time to follow the link:


PharmaNAC:

* Certified European GMP grade NAC
* Effective way to help boost glutathione levels.*
* Effervescent, quick-dissolving tablets allow NAC to enter cells readily ensuring rapid absorption.
* Quality controlled according to pharmaceutical guidelines.
* Compliant to the standards of European Pharmacopoeia and United States Pharmacopoeia.
* High quality, extremely stable, great tasting and odorless NAC.
* Individually wrapped tablets in a special 4-layer (paper/plastic/foil plastic) air-tight material to prevent moisture and air from destabilizing and degrading the NAC; a major problem with most other over the counter (OTC) NAC products bottled in capsule form.

PharmaNAC delivers ThiolexTM, BioAdvantex Pharma's high-quality and trusted preparation of pure N-acetylcysteine (PATENT PROTECTED. Exclusive licensee of US patent # 6,566,401). Thiolex brand NAC has been trusted and used by various members of the academic community in clinical studies examining the role of NAC in supporting a healthy immune system and good respiratory function.*

PharmaNAC is an advanced NAC delivery system and the only effervescent preparation of its kind available in North America. The quality of PharmaNAC is controlled according to pharmaceutical guidelines. Thiolex, the brand of N-acetylcysteine (NAC) used in PharmaNAC, is certified compliant to the standards of European Phamacopoeia and United States Phamacopoeia (USP).

Quality Alert:

NAC is an antioxidant that must be processed in an extremely dry environment with extremely limited exposure to air. If it becomes oxidized to any degree, then it becomes destabilized and therapeutically ineffective. Unfortunately, some OTC NAC supplements sold on the market today are not manufactured under such strictly controlled environments due to the enormous associated control costs. As a result, these products often have little or no active NAC in them, despite labeling to the contrary.

This is precisely why BioAdvantex takes great care in diligently manufacturing PharmaNAC according to strict pharmaceutical standards. Special care is required to ensure that the components of each PharmaNAC tablet do not react during manufacture or within the compressed tablet following manufacture. In fact, each PharmaNAC tablet is individually wrapped in a special 4-layer (paper/plastic/foil plastic) air-tight material to prevent moisture and air from destabilizing and degrading the NAC (unlike other NAC products that loosely package numerous quantities of NAC capsules in a plastic bottle openly exposed to air). Our European GMP-compliant manufacturing process secures consistent quality, content uniformity, and stability in each and every 900mg effervescent tablet.

Hope that helps at all!

Take Care,

Autumn

 

[Twistofchaos]

Thanks everyone for additional links. Thanks Calebf!

Triples15 the problem with that story is that it's from PharmaNAC itself and the only real reason anyone would buy PharmaNAC ofcourse. While it's probably true to some extent I can't find much other information about this oxidized and degraded NAC of other supplements. Infact as I understand it it's L-Cysteine itself that's very prone to oxidation but the n-acetyl cysteine, acetyl compound already makes it more stable and less prone to oxidation correct me if I'm wrong. So it's fishy.

So far I bought two other brands to try (Now Foods and Jarrow Formulas) because I hadn't yet heard of PharmaNAC but I'll give that a try too in the future. Opened up a Now Foods capsule and dissolved it in a cup of water and it sure has the good old Mucomyst smell and taste.. Though that doesn't mean it's of any quality it can atleast function as a strong chemical weapon. *stares at crappy neighbours house*
Let's keep us updated on info and experiences.

 

[Epona]

Oral supplementation with NAC is actually effective, as several studies have shown (a previous reply listed a few of them). One study showed that NAC from 600mg to 1g per day) taken orally significantly increased neutrophil glutathione levels in the lungs - and that's a really good thing since glutathione is our most important endogenous antioxidant. Oral NAC at a dose of 300mg 3x day is regularly prescribed to people with interstitial lung disease, and high-dose NAC is given to people with acetaminophen (tylenol) overdoses.

I asked my CF doc to give me a rx for NAC at 300mg 3x day, citing the relevant research, and she said fine. I've been on it for a week now, so I can't say if it's changed anything yet. There is currently a later-phase clinical trial being done on NAC in CF, I think with PharmNAC. I look forward to the results. Regardless, it's harmless stuff and you can ask your doc for an rx and get your insurance to pay for it. There's really no reason at all that your doc should deny you it. Don't pay for an over-the-counter if you don't have to, make your insurance company pay for it!

One reason why my doc said NAC supplementation and Mucomyst went out of fashion is that Mucomyst smells bad, and when pulmozyme hit the market they target similar disease pathways (to reduce neutrophil elastase) so docs just went for the ease of prescribing pulmozyme instead. Oral NAC hasn't been thoroughly studied until now. But it's promising, plus it targets the causes of infection at the fundamental level (faulty neutrophil activity) which appeals to me very much. I'm tired of the palliative emphasis in allopathic medicine.

 

[Richard of OZ]

Regarding those whose experience with the tablets having a Sulphur smell. This actually means the acetyl cysteine is inactive, as the thiol group has been reduced by oxidation. PharmaNAC is the product being trialled by Stanford in their study, which is now in Phase III, for action against damage caused by CF. Taking this is only half the solution. I have been taking PharmaNAC (900mg twice daily) and another product called Ultra Thistle (phytosomal sylibin from Milk thistle) since diagnosis last year (at the age of 63, now 64). These together help limit the damage done by the oxidative inflammation caused by the breakdown of neutrophils in attempting to attack the chronic infections. I notice if I misjudge the deliveries (I live in Australia, but order from US), it takes about 3 days before I begin to suffer respiratory and pancreatic distress. So, no, it is not a curative, but it does help in allowing you to keep active. I also need Creon 40000 each time I eat, Lantus and NovaRapid for the CFRD, regular ultrasounds for the liver (value of 12 on Fibra Scan - 12.5 is cirrhosis, 17.5 transplant) and levodopa/codeine for RLS caused by fibromyalgia and Augmentin Duo Forte antibiotics for chest flare ups - which are now quite rare.

 

[MGrossan]

N-Acetyl Cysteine is currently used as a special amino acid that helps to protect hearing and other cells.
Products known to lower the viscosity of mucus include papain - an enzyme from papaya and bromelain - an enzyme from pineapple.
These are commonly available to swallow as an aid to digestion. However, if swallowed, very little gets into the body as it is inactivated by stomach acid.

For scuba divers, there is a product Clear.ease that is papain and bromelain. It is melted in the mouth so it doesn't reach the stomach. It is used to thin the mucus and reduce swelling for divers. Should work well for CF too.These are proteolytic enzymes. If you would like to try this let me know and I can send you some to try. see www.hydromedonline.com

 

[Twistofchaos]

PharmaNAC is the product being trialled by Stanford in their study, which is now in Phase III, for action against damage caused by CF.

Let's hope it'll soon see approval and become part of everyone's CF treatment then.

3/4th of a year later I can give something of an update too.
Combined with lifting weights I've been having great results in health, bodyweight and strength that combined are hard to explain other than that NAC is effective. I've made no other significant changes to diet, supplementation or lifestyle.

I seem to need slightly less food to maintain same weight or in other words it seems my digestion is better which could mean it dissolves some mucus in my digestion or some other positive effect. I have the feeling I'm absorbing more protein and other nutrients which lead to.:
I've gotten a lot stronger. I've been lifting dedicated for a long time so one doesn't expect improvement at this point but I've made big progress.
That resulted in adding 2kg's/4 pounds of muscle mass. That is a lot.
And the big one for me.: All that has resulted in my resting sats having gone up from their usual 91-92% to their current 93-94%'s. My lungfunction hasn't improved though but my fev1's have been stuck at <35% for some 8 years now and I don't see that changing upward without rigorous means.

So yeah I can see people not being immediately impressed with it if they're not lifting. (They should) Results would not be so obvious off the bat then but by all means.. in the long run this stuff might preserve some decent lungfunction %'s for most everyone.

 

[politicaljules]

sorry to veer off subject...

I have been taking PharmaNAC (900mg twice daily) and another product called Ultra Thistle (phytosomal sylibin from Milk thistle) since diagnosis last year (at the age of 63, now 64).

Wow! I do not mean to get off subject, or get all personal, but WOW! How did they diagnose Cf at age 63? Was it a blood test where they found the mutations?

I've often wondered why people diagnosed with Cf late in life typically live much longer.

It seems once we bring in a child diagnosed with Cf at birth, and mega dose them with all the Cf pharma drugs for years and years and years, along with exposing them to hospital clinics 7-30+ times a year, their infections, complications and cultures are so much worse. And for at least 50% of them, their lifespan is much shorter. And I know people who were diagnosed in their 60's who had DDF508. I just got to wonder if there is a correlation with being undiagnosed later in life to living longer.

Tracing our own lineage of those in our family who had active Cf or were carriers is equally as shocking. We believe my paternal grandmother had active Cf, and chronic lung issues along with chronic digestive issues. She almost died in childhood because of the weight gain issues, but her mom was vigilant in giving her the sweetbread, and extremely high fat meals. My Nana lived well into her 80s but never made it over 100lbs. She smoked unfiltered camels on and off during her lifetime.

I have crazy hair brained ideas all the time,(VEST) and this may be one of them. But it does make me wonder.

 

[Richard of OZ]

@politicaljules. Diagnosed last year by a medical geneticist (after spending $2000 for the test). After spending that much, and asking what difference does it make, I never bothered to find the actual mutation. I think what is going on, is that I come from two ancient Celtic families - 1 side Scottish, the other Irish. Looking back over the family histories, a lot of them died from "emphysema". A study done a couple of years ago on emphysema sufferers (47 I think), all over 45 yo, it was found that 26 of them actually had CF, though only being treated for E. I must admit that my journey was no bed of roses, health wise, with lots of pneumonia, never putting on weight, unable to play footy at school, and not developing the same physique as my father. At the age of 20 I was 5ft. 11ins. and weighed in at 8st. 6lb. At least since starting on my own treatment, I have managed to push that up. Of course, the Creon helps, for without it I WILL end up back in hospital. A few attacks of pancreatitis, one nearly taking you out, certainly concentrates the mind. For the first six months of last year, I was put on chemo for liver fibrosis, which was grueling. It was this treatment that brought the chest complaints to the fore, and set me on the road for diagnosis. The lungs are pretty well stuffed - Pulmonary Fibrosis, COPD, interstitial lung disease, bullae, emphysema (there it is again) and damage from chronic infection, though last CT scan showed signs of repair, for which I was stoked. As for your granny, yes, my family are all long lived, even those who had the "emphysema". I think it might be the Scottish belligerence that does it.
One thing I found out in my travels through the Net, apparently CF sufferers have dodgy neutrophils, which tend to break down to inflammatory oxidising agents, which trigger more neutrophils, which break down, and there you have it. The NAC is converted to glutathione, which is used to build stronger neutrophils. Also, should watch out for Vitamin D. CF people have trouble absorbing it. My results were woeful, and my bone density is -2.4. -2.5 is osteoporosis. Unfortunately, just taking the tabs only helps for a couple of months, then it all goes pear shaped again. I guess, we just make sure we don't expose ourselves to extreme sports, eh?

 

[Twistofchaos]

Also, should watch out for Vitamin D. CF people have trouble absorbing it. My results were woeful, and my bone density is -2.4. -2.5 is osteoporosis. Unfortunately, just taking the tabs only helps for a couple of months, then it all goes pear shaped again. I guess, we just make sure we don't expose ourselves to extreme sports, eh?

You can incorporate resistance training (like any adult should CF or not) and see bone density increase a lot and in relatively short time even or especially at advanced age.
The body adapts and when our bones are never exposed to decent load they quickly atrophe just like muscles and most everything else in the body. That's neither complicated nor surprising. Sickness and CF makes this (much) worse and we have to be as proactive as possible about this.