N-acetyl cysteine, or NAC, is an antioxidant available in supplement form. Its major use is to act as a direct precursor in the body for the synthesis of glutathione, a major endogenous, or built-in antioxidant. In the liver, glutathione provides extensive detoxifying actions. A depletion of glutathione, which can occur with the ingestion of the amanita phalloides or "death cap" mushroom, or by ingesting an overdose of the common pain reliever, acetaminophen (Tylenol) can cause liver failure. In hospital settings, intravenous NAC is often used to treat liver glutathione depletion. Glutathione is also used to help degrade anabolic steroid drugs, and prevent the liver inflammation that would otherwise result from heavy steroid usage. Glutathione, which consists of three bonded amino acids, glutamic acid, glycine, and cysteine, is also available in supplement form, but it's useless when taken orally because it's degraded in the stomach into its constituent three amino acids. Cysteine is considered the major nutrient precursor for glutathione synthesis, and NAC is a more absorbable form of the amino acid.
From an exercise perspective, the findings about NAC supplementation are mixed. Some studies show that it helps prevent muscle fatigue, and may even block catabolic effects in muscle that can occur with intensive training.One study found that intravenous administration of NAC increased the time to exercise exhaustion by 26.3 percent. More recent studies, however, question the use of NAC just prior to or immediately following exercise because of an interference with the beneficial effects of reactive oxygen species or ROS, which are also produced during exercise. These are by-products of oxygen metabolism that were previously thought to have only negative health effects. Recent research suggests that ROS can produce some beneficial effects related to exercise adaptation processes. Taking NAC too close to exercise may negate these beneficial effects. Not all studies have found this, however, and it's still a matter of debate among scientists.
Other research has found a new role for NAC. This involves the treatment of mental illness and addictions. Most current psychiatric drugs work through interaction with brain neurotransmitters, which are amino acid-based substances that transmit nerve signals in the brain. Having too low or too high a level of these neurotransmitters can produce symptoms of mental illness, including schizophrenia, depression, and bipolar illness. The current drugs work by modulating the activity of these neurotransmitters, which may or may not relieve disease symptoms. One problem with the drugs is that they are replete with an extensive list of possible side effects.But it turns out that there is another pathway involved in mental illness. This involves an out-of-control level of both inflammation and oxidative stress in the brain.
Excess inflammation and oxidative stress in the brain produce damage by reducing proteins that stimulate neural growth, such as brain-derived neurotrophic factor. This proteins are involved in brain repair, and when in short supply, lead to brain damage. Extensive inflammation in the brain also promotes the death of neurons, leading to diseases such as Alzheimer's and Parkinson's diseases. Excess oxidation damages cellular mitochondria in the brain, leading to cell death, since the mitochondria are the sources of energy production in cells, including brain cells.
Preliminary studies with NAC show that it appears to relieve the symptoms of mental illness through a lowering of both excess inflammation and oxidation effects. It has been shown to reduce the depressive phase of bipolar illness. Other studies show that it reduces cravings for cocaine, marijuana, and even cigarette smoking. The only side effect thus far has been nausea when excessive doses of NAC are provided. Besides NAC, several other nutrients have also shown potential to treat most forms of mental illness because of their anti-inflammatory and anti-oxidant properties. These include omega-3 fatty acids, as found in fish oil. Aspirin and statin drugs also appear capable of reducing brain inflammation. Some studies show that intravenous glutathione appears to offer remarkable protective effects against the progression of Parkinson's disease.
The usual dose of oral NAC is 600 milligrams, taken twice daily. Besides its positive effects against mental illness, NAC may also alleviate another epidemic condition, non-alcoholic fatty liver, which is linked to insulin insensitivity, the onset of the metabolic syndrome and subsequent cardiovascular disease and diabetes.
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