PCOS and NAC

Women who have polycystic ovary syndrome (PCOS) and use the nutritional supplement NAC (n-acetyl-cysteine) may benefit in several ways, according to medical studies:

  • Reduction of undesirable insulin resistance.
  • Reduction of undesirable homcystieine.
  • Increase effectiveness of fertility drug.
  • As an antioxidant, it may provide reproductive support and improve egg quality.

What is NAC?

NAC (n-acetyl-cysteine) is a stable derivative of the amino acid cysteine, which has antioxidant properties and is required for the body's production of glutathione. Glutathione, along with NAC, are powerful antioxidants. Adequate antioxidants are essential for protecting your cells from damage. NAC is also very good at helping you get rid of toxins in your body.

NAC is not found in the diet but is available as a nutritional supplement. It is also available as a FDA-approved prescription drug.

NAC is commonly used for these health problems: liver toxicity, acetaminophen poisoning, chemotherapy, detoxification, respiratory problems, heart disease, gallstones, and excess mucus production.

However, NAC also has some value for polycystic ovarian syndrome.

NAC Improves Insulin Sensitivity in Women with PCOS

Insulin resistance, the inability to efficiently utilize the hormone insulin, is thought to be a primary cause of polycystic ovary syndrome. Although not every woman with PCOS has an insulin problem, the majority probably do. Therefore, anything that helps to normalize insulin is worth considering.

A recent study(1) evaluated the effect of NAC on insulin secretion and insulin resistance in 6 lean and 31 obese women women with polycystic ovary syndrome. They took 1.8 grams of NAC daily for 5-6 weeks. A dose of 3 grams per day was arbitrarily chosen for the massively obese. Six of the 31 obese patients were treated with placebo.

Those treated with NAC had a reduction of their insulin resistance and a significant fall in testosterone levels.

Although this is a small study, it suggests that NAC can play a role in improving your insulin sensitivity. Many of you are taking metformin for the same purpose. Improved insulin sensitivity is crucial to reversing PCOS.

Homocysteine and NAC

Women with polycystic ovarian syndrome are often prescribed the drug metformin (Glucophage) to deal with their insulin problems. One of the problems with metformin is that it has a tendency to increase homocysteine levels. And, in general, PCOS women have higher homocysteine levels than normal women.

Homocysteine is an amino acid in the blood. A normal amount is OK. But an elevated level means that your metabolic processes are not working properly. Elevated homocysteine is associated with coronary artery disease, heart attack, chronic fatigue, fibromyalgia, cognitive impairment, and cervical cancer.

Another medical study (2) showed that people taking NAC for two months had a significant decrease in homocysteine levels. Higher doses were more effective than lower doses.

NAC May Improve Fertility

If you are having fertility problems, your doctor may have prescribed a the drug clomiphene or "Clomid" in order to induce ovulation. However, some women are "resistant" to Clomid and it does not work.

A very interesting study(3) of 150 Clomid-resistant women with PCOS has shown that NAC appears to make Clomid more effective. The women were dividied into two groups. One group took Clomid and NAC. The other group took Clomid and a placebo.

In the NAC group, 49.3% ovulated and 1.3% became pregnant. In contrast, in the placebo group, only 21.% ovulated and there were no pregnancies.

In another study of 573 women with polycystic ovary syndrome, Clomid plus NAC was used in one group, and Clomid alone was used in another group.(4)

The ovulation rate improved significantly after the addition of NAC. In the group taking Clomid plus NAC, 52% ovulated whereas in the Clomid alone group 18% ovulated.

The study's authors concluded: "N-Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovary patients."

NAC Provides Antioxidant Protection

NAC is a well-known antioxidant, meaning it protects cells from being damaged by free radical molecules.

An increasing body of evidence indicates that women with polycystic ovarian syndrome have greater oxidant stress and lower antioxidant levels, thus reducing their ability to control inflammation and prevent cell damage.

Chronic inflammation and oxidant stress make PCOS symptoms worse and tend to reduce fertility. We discuss this problem extensively in our book, The Natural Diet Solution for PCOS and Infertility.

NAC and Pregnancy Problems

We hope you are not exposed to second hand cigarette smoke or other pollutants that could harm your unborn child. If you think you may be exposed to any kind of environmental toxins or pollution, consider taking NAC.

The are a number of animal studies showing the NAC protects the unborn fetus from damage from toxins. For example, a study from Kocaeli University in Turkey exposed pregnant rats to cigarette smoke.(5) One group was given NAC and one group was not. In the mother rats not protected by NAC, the fetuses had significant lung damage whereas much of this damage was prevented in the fetuses of the NAC-treated rats.

We also hope that you do not take unnecessary drugs or take excessive dosages of drugs during pregnancy. For example, acetaminophen (Tylenol) is the most common drug overdose in pregnancy. NAC has been shown to reduce the toxicity of such overdoses.(6)

Safety

NAC is considered safe.

Although NAC has not been shown to have any adverse effect on the fetus, you should check with your doctor before taking NAC if you are pregnant. Do not take NAC while also taking nitroglycerin.

Before taking NAC in combination with metformin, check with your doctor. If you are taking a substantial dose of NAC, you may need to reduce the dosage of metformin.

Very high doses of NAC may cause some nausea or gastrointestinal problems in a few people.

How Much Should You Take?

We do not recommend that you start using NAC at the 1.8-3 gram (1,800 - 3,000 milligrams) dose range cited in one of the studies above. However, up to 600 milligrams per day would be a starting point.

Consult with a qualified physician as to whether a higher dose is appropriate for you, especially if you are taking metformin.

Where Can You Get It?

NAC may be relevant for PCOS

NAC may be relevant for PCOS, insulin resistance and fertility

A high quality NAC is available from our PCOS Supplements Store.

Click here for article footnotes.

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