NAC Improves Insulin Sensitivity in Women with PCOS

ARTICLE: N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome, Fulghesu AM, et al, Fertil Steril 2002 Jun;77(6):1128-35

ARTICLE SUMMARY: This study evaluated the effect of N-acetyl-cysteine (NAC) on insulin secretion and peripheral insulin resistance in subjects with polycystic ovary syndrome (PCOS). Six lean and 31 obese subjects, aged 19-33 years, were treated for 5-6 weeks with NAC at a dose of 1.8 g/day orally. A dose of 3 g/day was arbitrarily chosen for massively obese subjects. Six of 31 obese patients with PCOS were treated with placebo and served as controls.

Before and after the treatment period, the hormonal and lipid blood profile and insulin sensitivity, assessed by an hyperinsulinemic euglycemic clamp, were evaluated and an oral glucose tolerance test (OGTT) was performed.

Study results: Fasting glucose, fasting insulin, and glucose area under curve (AUC) were unchanged after treatment. Insulin AUC after OGTT was significantly reduced, and the peripheral insulin sensitivity increased after NAC administration, whereas the hepatic insulin extraction was unaffected. The NAC treatment induced a significant fall in T levels and in free androgen index values. In analyzing patients according to their insulinemic response to OGTT, normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters, whereas a significant improvement was observed in hyperinsulinemic subjects.

Study conclustions: NAC may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.

DOCTOR’S COMMENTS: N-acetyl cysteine (NAC) is an altered form of the amino acid cysteine, which is commonly found in food and synthesized by the body. NAC supports your antioxidant system and thus helps prevent cell damage. It’s available as a dietary supplement.

I do NOT recommend that you start using NAC at the 1.8 – 3 gram (that’s 1,800 – 3,000 milligrams) dose used in this study. A qualified physician should assist you with this, especially if you are taking metformin. However, 250-500 milligrams daily should be OK for a start.

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.

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