Dr. Ruhoy is a board-certified neurologist practicing integrative pediatric and adult neurology in Seattle. She is the owner and founder of the Center for Healing Neurology, and received her M.D. from the University of Pittsburgh School of Medicine.
In my integrative neurology practice, I regularly recommend supplements and herbal formulations. At times, I recommend them to help minimize symptoms of necessary medications. Other times I recommend them for treatment in hopes of preventing progression of symptoms with the added optimism of avoiding medications in the future.
There are many different supplements and herbs I use, and it largely depends on the individual and their symptoms. I have a handful of favorites that are particularly efficacious and powerful in their effects. One of these favorites is N-acetylcysteine (NAC), an amino-acid-derived compound.
What does NAC do in the body?
NAC is technically classified as a mucolytic due to its effective adjunctive use in respiratory disorders that have excessive secretions. It is also hepatoprotective and used to protect the liver from damage due to overuse of acetaminophen. But as a neurologist, and not a hepatologist or a pulmonologist, I like it for its remarkable antioxidant and anti-inflammatory effects as well as actions on important neurotransmitters such as glutamate and dopamine.
NAC is a necessary precursor for the synthesis of glutathione, which is a powerful antioxidant in its own right. Both NAC and glutathione can scavenge free radicals that are formed when there is damage to the cells in the body. Free radicals can be particularly toxic to the walls of our blood vessels, our peripheral nerves, the neuronal cells of our brain, and our mitochondria. NAC can be effective adjunctive treatment for neuropathy, mild cognitive impairment, concussion, headaches, and autoimmune disorders. It may help to protect the brain from impaired blood flow and delivery by supporting vessel dilation and may modify the progression of some neurodegenerative diseases as well.
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How do you use this amino-acid-derived compound?
Due to its beneficial actions of glutamate and dopamine, NAC can be an effective part of treatment for behavioral disorders. I often see improvement in irritability and aggression as well as impulsivity and even depression in both children and adults with neurological or neurodegenerative concerns. It has been used in autism, OCD, and anxiety. In addition, it is useful in chronic pain syndromes as chronic pain often results in changes in neurotransmitter balances leading to behavioral effects that may be ameliorated by the use of NAC. Finally, it is an important part of detoxification and healing because it can protect the liver, brain, cells, and boost the natural healing powers within our bodies.
How do you take NAC?
Clearly, NAC is a useful supplement, and despite the fact that many people haven't heard of it before, I always consider treatment and preventive use. NAC is safe without significant toxicity when used appropriately. It is also non-sedating, as many of the medications prescribed for a variety of the diseases mentioned can be. When taken orally, glutathione is not as readily bioavailable as is NAC. Hence, I often recommend taking both NAC and glutathione as a double punch. For more power, NAC and glutathione can be given intravenously. Important food sources to boost the synthesis of NAC and glutathione include tomatoes, beets, cabbage, and asparagus. For dosing on supplement forms, please speak to a knowledgeable physician who can help you on your journey to optimal health.