Many people are aware of the use of N-acetyl cysteine (NAC) as an over the counter remedy to thin mucus secretions that often occur with colds, flus, sinusitis, or seasonal allergies. However, did you know that NAC is a powerhouse natural remedy that can be useful in a variety of diseases and conditions?

N-acetyl cysteine is a readily available and inexpensive amino acid with years of validated scientific research behind it. NAC is a slightly modified version of the sulfur-containing amino acid cysteine. When taken internally, NAC replenishes intracellular levels of the natural antioxidant glutathione (GSH), helping to restore cells’ ability to fight damage from reactive oxygen species (ROS). It is such an effective mucolytic, the term used for substances that are able to thin mucus secretions, that it has been patented into various pharmaceutical interventions. It has become a favorite treatment intervention for many naturopathic physicians because it is an inexpensive and effective treatment for a variety of complaints and conditions.

In the area of women’s health, NAC is receiving increased attention in its role in the treatment of polycystic ovarian syndrome (PCOS) and endometriosis. PCOS is a syndrome characterized by higher than normal circulating levels of testosterone (hyperandrogensim) and insulin (hyperinsulinaemia). PCOS leads to menstrual irregularities, anovulation, and is a major contributor to female infertility. NAC has been shown to improve insulin sensitivity, restore normal menstrual cycles, normalize ovulatory cycles in women and improve fertility. It was also shown to work similarly to the conventional drug Metformin, which is impressive, as both treatments resulted in weight loss, a decrease in the excess body hair that often comes with PCOS, and improvements in cholesterol numbers.

Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside or lining the tissue of the uterus, but in a location outside of the uterus. It is a leading cause of pelvic pain and is estimated to contribute to approximately 20 – 50% of infertility cases. Animal models have shown significant decreases in the number of endometrial implants and anti-inflammatory processes associated with endometriosis with supplementation of NAC. Observational studies in humans have found increased pregnancy rates, reductions in endometriosis cyst size, and relevant pain reduction in NAC treatment groups vs. placebo.

Complementary alternative medicine is an emerging field in the area of mental health and neuropsychiatry. NAC modulates several key neurotransmitters known to be involved in a range of mental health disorders and is also the precursor to glutathione, the major antioxidant molecule of the central nervous system. NAC may be a useful adjunct in the treatment of schizophrenia, bipolar disorder, addiction, and obsessive-compulsive disorder (OCD).

Several studies have shown positive effect utilizing NAC in the treatment of bipolar depression. Significant reduction in bipolar depression and improvements in manic symptoms have been reported. Reductions in negative symptoms of schizophrenia have also been reported with supplementation of 1gram of NAC twice daily. NAC may also help curb addiction related cravings with both marijuana and cocaine. Reductions in gambling behaviors have been studied with pathological gambling addictions. NAC has also been studied in the treatment of OCD, with improvements seen in hair pulling (trichotillomania) and reductions in skin picking associated with Prader-Willis syndrome. Extrapolating positive findings for specific compulsions in OCD studies have led practitioners to begin using NAC in the treatment of generalized OCD symptoms.

Historically, NAC has been used as a mucolytic in a variety of respiratory illnesses. Emerging data now indicates that NAC may also be a useful adjunct in the treatment of chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. This is particularly exciting as COPD has very few treatment options available apart from daily steroid inhaler use. Increased oxidative stress and inflammation has a role in the pathogenesis of COPD and the antioxidant and anti-inflammatory effects of NAC may provide a useful therapeutic approach for COPD. New research has shown that supplementation with 600 mg NAC twice daily can prevent COPD exacerbations and improve small airway function.

NAC may play a role in the treatment of diabetes mellitus due to its ability to improve insulin sensitivity and reduce fasting blood insulin levels. Emerging data also shows promise in the treatment of diabetic nephropathy (kidney disease induced by diabetes). Diabetic nephropathy often results in abnormally high levels of protein in the urine, a result of high levels of circulating blood sugar damaging the kidney’s normal filtration abilities. A 2013 study of type II diabetics showed a reduction in urine protein levels with NAC supplementation, suggesting improvements in kidney function.

NAC is a promising natural remedy useful for the treatment of a variety of conditions. It is also safe, effective, inexpensive, and widely available, making it a superstar natural medicine.