The Supplement Series: NAC - is this the antidote to modern life: pregnancy complications, developmental issues and infertility?!

This article is a look at the compound and supplement N-Acetyl Cysteine: what is increasingly being recognised as a powerful antioxidant to counteract a lot of the factors that seem to be increasingly present in our environment. Factors which are increasingly being suggested to contribute to a rise in autoimmunity and neurodevelopmental issues in children. We look at what it is, how it works and ultimately whether or not it makes sense for you to take as a supplement.

There is little doubt that modern life is seeing an increase in both autoimmune conditions and neurodevelopmental disorders in our kids. Think allergies, asthma, ADHD, Autism etc. Recent research is increasingly pointing to two culprits triggering our genes: oxidative stress and chronic inflammation (click the link for much more). Sources of which are sadly more and more prolific in our modern-day environment:

‘Maternal exposure to environmental stressors poses a risk to fetal development. Oxidative stress...and inflammation are tightly linked mechanisms that emerge as a causal factor of neurodevelopmental abnormalities.’ (1)

Translation: environmental factors are causing potential damage to our unborn babies by triggering oxidative stress and chronic inflammation which are damaging our cells and DNA. Particularly vulnerable is the rapidly developing baby and in particular the developing brain.

Click here for all you need to know about Oxidative Stress and Inflammation, but, the important question is:

What can you do about it?

The good news: there is a powerful defence within the body that can help with this.

The body’s ‘mop’ against oxidative stress = antioxidants. These effectively clear away the nasties that can cause cell damage. However, having enough of them is key:

Glutathione (GSH) is one of the most important molecules you have probably never heard of, it is also known as the ‘mother of all antioxidants’. Click here for much more on this wonder compound and how important it is for our ability to have healthy kids and for our bodies to defend themselves. It has been shown to not only scavenge for radical and reactive oxygen species (the very things that cause damage to our cells and DNA), but it is also crucial for the regeneration of other antioxidants that also help in the fight.

Modern research is increasingly suggesting that having an imbalance of this in the body is at the root cause of many modern diseases. (2)

‘Depletion of cellular GSH results in higher levels of pro-inflammatory factors compared to control factors...these pro-inflammatory cytokines can directly or indirectly cause neuronal death, dysfunction and impair spatial learning and memory function.’ (1)

Translation: there is an increasing link between modern disease and not having enough antioxidants, in particular Glutathione. This is even more important when you’re pregnant or are a small person.

Ok, so how do we get more of it?

Glutathione is made from three amino acids: glycine, cysteine and glutamic acid and is mainly produced within our bodies. The trouble is it is not something that can be taken in a supplement or oral form mainly due to an intestinal enzyme which breaks it down meaning essentially: even if we take it, we cannot absorb it. (2)

Bummer - however: all is not lost!

This is where N-Acetyl Cysteine (NAC) comes in.

Not exactly a slip off the tongue kind of name (!) but, this molecule has been used for several decades in clinical therapeutic practises, and has been shown to help the body’s own production of Glutathione.(3)

How does it do this?

Well, fundamentally, it is crucial to promoting the body to produce more of this super defender Glutathione: it is a precursor to one of the core building blocks: Cysteine which is one of the main factors that either helps (or limits) the body’s ability to produce it. As above, it is Glutathione that has been shown to have very powerful effects defending the body from these nasties:

‘The past decade has witnessed an explosion of data regarding the multifaceted biological activities of N-Acetylene Cysteine, including antioxidant, anti-inflammatory and anti carcinogenic activities.’ (3)

Unlike Glutathione however, the good news is that the body can absorb this well in supplement form. In fact, ‘several studies have shown that NAC is well absorbed by the intestine and that supplementation with NAC is effective for increasing Glutathione levels.’ (2) It has also been shown that taking it via tablet (oral) form is just as effective as taking it intravenously. Largely because it is rapidly and almost completely absorbed after being taken via mouth.

It doesn't stop there:

Whether NAC’s power is simply as it builds up Glutathione or whether or not it is powerful in its own right is debated, however, one aspect that it has all on its own is its ability to act as a detoxifying agent for heavy metals - once again something that is prolific in our environment and causes all sorts of health issues, particularly around neurodevelopment and cell/DNA damage:

‘NAC possesses therapeutic effects over a wide range of disorders [including] heavy metal toxicity, Acetaminophen poisoning, and psychiatric/neurological disorders.’ (3)

One study (4) looked at its ability to detoxify lead. Lead is persistent in our environment, it is also pervasive and is and has been in everything from petrol to batteries, water pipelines and even cosmetics. It is also used in various industrial activities such as mining, smelting etc. The trouble is lead exposure can have a number of negatives for our health and can ‘cause neurotoxicity and brain damage, affect cognitive, neurobehavioral and neuropsychological development especially in young children.’ (4)

Once again, the way in which it is thought to have potential benefit is the fact that lead exposure creates oxidative stress in the body. It does this in part by reducing antioxidant reserves (ie. Glutathione) as well as interfering with antioxidant related enzymes that allow them to function and mop up the waste within our bodies(4). NAC has been shown to play a role not only rebuilding Glutathione but also blocking the negative effect that lead can have on allowing antioxidants to do their job. It has also shown to have benefit detoxifying mercury and cadmium two other environmental culprits and known neurotoxins.

When should we focus on this?

It is always good to avoid these things/boost our defences, no matter what stage of life you’re in, as both have been shown to damage our cells and also to impact how our genes express themselves, also known as epigenetics. However, when you’re trying to have good quality eggs and sperm (sperm in particular is very susceptible to oxidative stress damage) you’re pregnant or have a rapidly growing small person it is even more important.

Click here for more on how this can affect sperm but, it is also very important during pregnancy (inflammation in particular is linked to preterm birth) and in the rapid early years of development:

‘Anomalies arise because fetal brain growth and plasticity is highly susceptible to neurochemical perturbations caused by prenatal factors such as inflammation and environmental stressors.’ (1)

Translation: a baby’s brain (of course) is particularly vulnerable as it is developing to external environmental stressors.

The third trimester is particularly vulnerable for the brain as this is when we typically see a big growth spurt - a period known as Synaptogenesis. Research is showing that the defences against the damage caused by oxidative stress and inflammation (ie. level of antioxidants) of the mother has ‘direct consequences’ for fetal brain development. (1)

Damage from excess alcohol consumption is an obvious example of this, although there are many more subtle environmental factors that are now playing a role.

We also know that babies are particularly vulnerable, particularly during pregnancy:

‘Inadequately developed fetal antioxidant system in early-mid gestation stages is highly vulnerable to oxidative stress.’ (1)  

How to take it:

Well the good news is that NAC has a long-established safety record in both adults and children and has been approved by the FDA since 1963. Most supplements recommend between 600-800mg/day however higher doses have been shown to be safe. That being said - as always it is crucial to consult with your doctor before taking any supplement especially if you are pregnant or breastfeeding. Do not take without talking to your doctor and always follow the manufacturer’s guidelines.

Side bar: one of the reasons that meat stock (which we obsess a bit about here) is also good is because it also contains some of the key amino acids that are needed for Glutathione production by the body. Click here for more.

References:

(1) AKHTAR F, ROUSE CA, CATANO G: Acute maternal oxidant exposure causes susceptibility of the fetal brain to inflammation and oxidative stress: Journal of Neuroinflammation: 2017 Sept 30: 14 (1).

(2) SCHMITT B, VICENZI M, DENIS F: Effects of N-acetylcysteine, oral glutathione (GSH) and a Novak sublingual form of GSH on oxidative stress markers: A comparative crossover study: Redox Biology: 2015 Dec 6: 198-205.

(3) PEI Y, LUI H, CHEN J: Biological Activities and Potential Oral Applications of N-Acetylcysteine: Progress and Prospects: Oxidative Medicine and Cellular Longevity: 2018.

(4) SISOMBATH NS, JALIEHVAND F: Similarities between N-Acetylcysteine and Glutathione in Binding to Lead(II) Ions: Clinical Research in Toxicology.

(5) SHAHRIPOUR RB, HARRIGAN MR, ALEXANDROV A: N-Acetylcysteine (NAC) in neurological disorders: mechanisms of action and therapeutic opportunities: Brain and Behaviour: 2014: Mar: 4 (2): 108-122
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This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.