WORDS: Alyce Cimino | Naturopath + Owner of AHARA HEALTH
N-acetylcysteine (NAC) is a sulfur-based derivative of the amino acid L-cystine, it has grown wildly popular over the past few years due to the pandemic and its role there, however, NAC has been used clinically for a range of different conditions including but not limited to; chronic obstructive pulmonary disease, infertility and PCOS.
Medically NAC has been used since the ’70s as an antidote for paracetamol (acetaminophen) overdose.
As a naturopath, we are often prescribing NAC due to its impressive antioxidant role on the body, its ability to reduce the effects of long-term stress, as well as support liver detoxification and hormonal conditions including endometriosis, PCOS and unexplained fertility.
So how can NAC support hormonal health?
DETOXIFICATION
Possibly one of the most important roles of NAC is its ability to replenish Glutathione stores in the body. Glutathione is the most abundant antioxidant in the body and is essential for detoxifying an array of toxic substances from the body, including Xenobiotics – a class of chemicals that are foreign to the human body; these include pesticides, food additives, fragrances, environmental pollutants, and xenoestrogens found in plastics and beauty products.
We are exposed to xenobiotics daily and Long term, as xenobiotics increase within the body, they can start to take their toll on our long-term health, mimic our hormones such as oestrogen and worsen some conditions especially female hormonal conditions. Sadly, they are near unavoidable in the modern world, so it’s essential to support their elimination out of the body with ease and speed.
OXIDATIVE STRESS
Oxidative stress occurs when an imbalance occurs in our body, and as a result, alters the balance between oxidants (the bad guys) and antioxidants (the good guys). This imbalance can be caused by lack of sleep, chronic stress, high sugar diets, medications and environmental toxins as mentioned above.
From a hormonal and fertility perspective, we also know that high oxidative stress can reduce the quality of our egg and sperm health, as well as throw off hormonal balance which may further affect conception and fertility outcomes. This imbalance can also have a negative role on our thyroid health and immune system, together which can be a key driver for Hashimoto’s – explained further below.
THYROID BALANCE
We have already spoken about the role of Glutathione as an antioxidant and its protective role against chronic inflammation. It has also been suggested that lower glutathione levels may implicate higher thyroid antibodies levels in the body and even contribute to Hashimoto’s and hypothyroidism. Women with Hashimoto’s will often have symptoms such as poor weight management, issues with blood glucose regulation, mood conditions, sleep issues and fertility concerns. For women who are trying to conceive it is vital that the thyroid is supported, as when the thyroid is out of balance, as are our other hormones including our sex hormones (oestrogen + progesterone).
BLOOD GLUCOSE METABOLISM
If you have been following for some time, you know this naturopath is pretty obsessed with blood glucose balance. Research suggests that NAC may help improve insulin resistance in women, that is how the body is able to process blood glucose levels and how the body responds to the glucose in the first place. For women with PCOS, poor insulin metabolism is often a driver of the condition.
PCOS – POLY CYSTIC OVARIAN SYNDROME
In addition to improving insulin resistance in women, research has also suggested that it can improve fertility outcomes for women with PCOS. One study concluded that a daily dose of 1200mg of N-acetylcysteine had a clinical and significant increase in both ovulation and pregnancy. While this is only one study and a snapshot of its benefits, it is very promising when added alongside dietary and lifestyle changes for PCOS management.
ENDOMETRIOSIS
There is a lot we are only just learning about endometriosis; how the immune system, hormones and inflammation can affect and worsen the symptoms associated with endometriosis. One promising study found that the use of NAC for 3 months (600mg 3 x a day) had significant reduction in ovarian endometriomas, a reduction in pain and an increase in pregnancy outcomes. While this was only an observational study it is still very promising!
GUT HEALTH
Ok, so this isn’t technically a hormonal category however hear me out. Chronic inflammation can lead to a condition called intestinal permeability (commonly known as leaky gut), it also can contribute to an unbalance of good and bad bacteria. NAC has been found (mostly in animal studies) to improve intestinal tissue damage, there for improving how we absorb nutrients and our overall microbiome state. From there, our immune system, detoxification systems, mood and even hormonal health can benefit.
So, should everyone start taking NAC?
The short answer is no, you always want to speak to your health care professional as there is no one answer for everyone. NAC comes in both powder and capsule and the dosage prescribed changes based on your clinical needs, health history and symptom picture.
References:
1. PAUL J. MILLEA, MD, MA, Department of Integrative Medicine, Mid-Atlantic Permanente Medical Group, P.C., Falls Church, Virginia Am Fam Physician. 2009 Aug 1;80(3):265-269.
2. Rizk AY, Bedaiwy MA, Al-Inany HG. N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril. 2005;83(2):367–370.
3. Maria Grazia Porpora, et al, “A Promise in the Treatment of Endometriosis: An Observational Cohort Study on Ovarian Endometrioma Reduction by N-Acetylcysteine”, Evidence-Based Complementary and Alternative Medicine, vol. 2013, 7 pages. https://doi.org/10.1155/2013/240702