The REAL Reasons to Use NAC (N-Acetyl Cysteine)

So we hear a lot about NAC or N-acetylcysteine in the supplement world, maybe in biochemistry, maybe in medicine, because it's both a drug and a supplement. And we get lots and lots of questions about it. So I want to break down some of the benefits of using NAC as potential support from a supplemental point of view. The first thing that I want to get to is what is it and why would I use that instead of another form of cysteine? Then I want to get into What does it do inside of my body, and why would it be used both medicinally as a drug product but also as a supplement? It's one of the more popular supplements in North America to be sold. Okay, so the first thing is NAC or N-acetylcysteine. What is it? There's an amino acid that your body uses called cysteine, and the form N-acetyl or N-acetylcysteine is a bioavailable form that is made that's pretty stable that can be given. Orally, you can inhale it like in a nebulizer, for example. It can be given intravenously. It's a very useful form of cysteine, and because of its stability, it can go in all of those different routes—respiratory, intravenous, oral—all that—and be stable until the cysteine can get into your body and do the job of cysteine. Now, cysteine, if you might remember, or if you ever smelled N-acetylcysteine, is a sulfur-bearing amino acid, also known as a thiol. So the Sulfur-bearing amino acids often will smell very sulfury. The other thing is that if you're sweating, you might smell sulfury and your urine will smell sulfury. So if you're taking N-acetylcysteine or you get injection of it or you're using it as a respiratory drug, you're going to potentially smell that out in your urine. And there's nothing wrong with that. Doesn't mean there's anything wrong with you. That is the way that your biochemistry takes care of the cysteine in your body because it has sulfur in it. So NAC is just a very bioavailable form of the amino acid cysteine. Now, what in the world would cysteine do and why would it be so important kind of across the board for health? Well, one of the first things, and this is often not thought about, is it's very supportive to the formation of your integument. And so that's like your skin, your hair, your nails, but also connective tissue inside. So for example, we had a chronic and acute viral supplement pack that our patients would use. And one of the supplements in there was N-acetylcysteine. And we had a number of people just report sort of anecdotally that they, well, they were taking it, you know, as a viral prevention or viral healing supplement, but also their hair was a lot shinier or whatever, and their nails were growing better and all of that. Well, that's because cysteine is required to help you grow hair, skin, nails, connective tissue, et cetera. So that's sort of a side benefit. But if you think about it beyond hair, skin, and nails, your integumentary system also is what kind of holds you together. And So that helps with the integumentary conformation of your skin and the way that your skin looks. It also helps with your connective tissue and holding you together or healing up from injuries, stuff like that. So that, that's one that doesn't usually get mentioned. I thought I'd throw that in there. Cysteine or N-acetylcysteine in high doses is used a lot in psychiatry. And that is a relatively new advent as far as using N-acetylcysteine in neuropsychiatry. Now we've known about mechanisms in the brain for a long time. But the last, I would say, 10 to 15 years especially, there's been more psychiatry papers published on higher dose N-acetylcysteine use. And so one of the big things that it does, and this is something that I've been teaching medical students and doctors for a long time about, is your blood-brain barrier, if it's working right, which it doesn't always work right, is supposed to be helping you keep your neurotransmitters kind of in and around your brain tissues and to keep bad things out. And also the blood-brain barrier has these little transporters that pump good stuff in and pump bad stuff out. Well, it turns out that cysteine, so N-acetylcysteine goes in and then eventually it dissociates into cysteine. Cysteine runs something called the antiporter. And what that means is it's an antiporter where the cysteine goes in towards your brain. And when it does that, it forces glutamate out. Now glutamate we need in our brain, but we get higher glutamate in inflammatory and some neuropsychiatric conditions. So if we can lower glutamate, We tend to lower things like anxiety, agitation. It's used in bipolar mania. It's used in all sorts of things. And we use it a lot for the anti-inflammatory or the glutamate lowering effect in people who have other neuroinflammatory disease. You could see it used in Parkinson's disease, multiple sclerosis, brain injuries, all sorts of things like that. The other upside is then it gives your brain some cysteine and it takes away the glutamate out to the body to be removed. And So that cysteine going into your brain can feed into whatever you need it for. Some of the things that are coming up. Cysteine also is commonly used in the synthesis of proteins. So we talked about, you know, integumentary proteins and holding your body together and skin, hair, nails, and all of that. Well, cysteine is also used in a lot of other protein synthesis. So cysteine is an amino acid. And if we take some amino acids and put them in a string, that's called a peptide. And if we string enough peptides together, we call it an amino acid. So the formation of these longer peptide strings turning into an amino acid can be supported by the addition of cysteine into the diet and the body in general. Now, I mentioned that N-acetylcysteine is a drug that we will prescribe for respiratory problems, and it might be used in a nebulizer. Now, I also said it could be taken orally, it could be injected like intravenously, but in the respiratory world, Mucamist used to be a drug trade name. That was the original. It's just generic N-acetylcysteine now. Can be inhaled through a nebulizer, and that helps to break up mucus secretion. So they call it a mucolytic drug. This we use a lot in respiratory problems. So back with the earlier variants of COVID when people were having a lot of respiratory problems and sticky mucus, we were prescribing a lot of home nebulizer treatments. And one of the things we would use would be N-acetylcysteine. Acetylcysteine to help to break the mucus down, etc. So that can be a very useful purpose for N-acetylcysteine as well, and it is one of the reasons it's used as a drug. Now, what would be another reason it's used as a drug? Well, another drug reason for N-acetylcysteine, which this would just generally be injected like intravenously, is it is used in overdose of Tylenol. Tylenol overdose is very deadly. And it's also one of the most common over-the-counter drug overdoses in the world, and not just in the U.S., in the whole world. And the reason is that your body will take the Tylenol, acetaminophen, and it gets partway through the detox processes in the liver, and it can use up a lot of the components that help with its particular detox pathways, glucuronidation, etc. And so if that backs up, then you wind up with an acute liver Liver injury, and you could go into acute liver failure, which is obviously deadly. Well, it turns out that you can support those steps that get backed up from the acetaminophen drug by giving N-acetylcysteine. And in in those toxicology cases, it's given in quite high doses intravenously. Now we also use it intravenously in a little bit lower doses with people for some of the brain things that we're talking about: Parkinson's and MS and other things like that. We use it intravenously for people with other liver support needs, maybe a lower dose because they're not dying of acute liver injury, but we'll still use it intravenously as well. You also, of course, can take it orally. And anytime I have had occasion to give somebody N-acetylcysteine from a respiratory point of view, so they're breathing it through a nebulizer or IV, I always have them take it orally in between IV treatments or nebulizer treatments to keep their levels elevated. And then that helps a lot. Now, what's the other thing that N-acetylcysteine does that most people talk probably the most about. N-acetylcysteine, or NAC, provides cysteine, which is also the rate-limiting amino acid for a tripeptide, so 3-amino sequence called glutathione. Everybody's heard of glutathione. It's one of the primary 3 antioxidants that the body uses. Now, there's a ton of antioxidants, but at the level of just your cell, there is a base of 3 antioxidants that your cell uses, and those are vitamin C, vitamin E, and then glutathione. And they all help to recycle each other. And then all the other antioxidants work around them as the base. Your body naturally makes its own glutathione. We make most of it in our liver. It can be synthesized elsewhere as well. And if we don't have cysteine, cysteine's in the middle of those 3 amino acids, then we're not going to be able to make any glutathione because it's the rate-limiting step. The other 2 are glycine and glutamine, the 2 Gs. And they get together with cysteine and form glutathione. And normally we have lots of glutamine around. We often have glycine around, but cysteine is a very determinate part of your diet or supplementation to make the glutathione. So that's another reason why N-acetylcysteine can be very useful medically from a nutrient point of view, health point of view, et cetera. So what you're looking at then is if I don't have enough cysteine, among other things, whether it's my hair, skin, and nails, or my brain getting rid of glutamate, the inflammatory intermediate glutamate protein synthesis or whatever. I also am not going to be able to make as much glutathione, and that's critical for all of my antioxidant properties in the body. All right. Well, I hope this answers those questions that we got about NAC. We got a bunch of other NAC content as well. We'll put some other videos up here for you to look. Thank you, everyone. Please like, share, subscribe, and I'll see you all in the next video.