Everything You NEED to KNOW About NAC (N-Acetylcysteine)

Dr. Stengler: N-acetylcysteine is a powerful supplement, but most people don't know what to use it for or how to use it. In this video, I'm going to cover all the important facts you need to know about N-acetylcysteine — also referred to as NAC.

NAC is a very potent antioxidant that neutralizes harmful free radicals that can damage your cells. It's also important because it increases the body's glutathione levels — possibly the most powerful antioxidant in the body. NAC is used to support liver and kidney detoxification and to support immunity.

Hospitals actually use NAC for very specific purposes, which speaks to the strength of the science behind it. It's given to patients who have overdosed on acetaminophen to prevent liver damage. It's also used orally and by nebulization — breathing it in — to reduce mucus thickness and promote drainage in the respiratory system.

In holistic medicine, we use NAC for many different reasons.

Respiratory health. NAC has a unique ability to break up and thin mucus so the body can drain it more effectively — out of the sinuses and out of the lungs. It's also anti-inflammatory. I use it frequently for patients with sinusitis, bronchitis, pneumonia, COPD, and post-nasal drip. Most people use between 600 and 1,200 milligrams per day, but you can go up to 4,000 milligrams for chronic bronchitis or COPD to achieve a stronger effect. I also use it as a nebulized breathing treatment for these conditions, though that form requires a doctor's prescription.

Immune function. As we head into fall and winter, NAC is excellent for immune support. It has been shown to improve natural killer cells — the immune system's equivalent of special forces, circulating through the bloodstream to eliminate viruses, bacteria, fungi, and even cancer cells. In one study, only 25% of people taking NAC for six months got the flu, compared to 79% in the placebo group.

Liver health. NAC is anti-inflammatory, antioxidant, and enhances glutathione — all of which support the liver's detoxification pathways. It can help with fatty liver and liver accumulation, which is so common in Americans.

Kidney protection. NAC is one of the few agents shown to protect against kidney injury from contrast dyes used in medical imaging, likely due to its antioxidant and vasodilating effects that improve blood flow through the kidneys. A study published in the Journal of the American Heart Association reported that NAC supplementation was associated with a significant decrease in contrast dye-induced kidney injury. I typically have patients take 600 to 1,000 milligrams a few hours before a contrast dye study, and another 600 to 1,000 milligrams afterwards.

Mood and neurological disorders. A review published in Neuroscience & Biobehavioral Reviews found favorable evidence for the use of NAC in several psychiatric and neurological conditions, including autism, Alzheimer's disease, cocaine and cannabis addiction, bipolar disorder, depression, trichotillomania — compulsive hair pulling — nail biting, skin picking, OCD, schizophrenia, drug-induced neuropathy, and progressive myoclonic epilepsy. NAC also has a balancing effect on glutamate, an excitatory neurotransmitter, and has been shown to help with dopamine balance — dopamine dysregulation being a contributor to low motivation and depression.

For most people, a typical dose is 1,000 to 1,200 milligrams once or twice daily, best taken on an empty stomach. Those on psychiatric medications should check with their doctor before using it. Overall, NAC is a very safe supplement and the average person will do very well with it.

Now you know how to use NAC for different conditions and the appropriate doses. For more videos on detoxification, immune support, and the best evidence-based supplements, look for more videos on my YouTube channel.

‍