I read with interest a recent article discussing the potential benefits of N- acetylcysteine, an amino acid that has been used in treatment primarily of tylenol toxicity. The effects are based on its ability to act as a potent antioxidant which may support the body’s ability to fight infections or stress. It appears to protect cells from toxins by detoxification of various toxic substances.
The most interesting clinical application is in the treatment and prevention of influenza. With more and more threat of the pandemic H1/N1 swine flu, N-acetylcysteine may be a useful adjunct to current therapy. Compared to placebo pills, N-acetylcysteine users were less likely to have clinical influenza (or at least symptoms of it). Secondly, when those patients actually did develop influenza, it was a much less severe case. It appeared that immunity at a cellular level improved significantly. Though not part of any official CDC recommendations, it may be an option for those who are at higher risk of developing the H1/N1 strain, or any influenza strain for that matter.
A second use of N-acetylcysteine is for patients with chronic lung disease (COPD or emphysema). A study of over 1300 patients found there was a reduction in cough severity and amount of phlegm produced. Those same patients had less likelihood of developing shortness of breath and associated heart failure. Furthermore, based on actual lung testing, they had improvement in their overall lung function. It was shown that in the N-acetylcysteine group, there was nearly 50% less loss of lung function when compared to those not on the supplement. This may be exciting news for patients with chronic lung disease. Many of the available inhaled treatments do not provide total relief. Addition of N-acetylcysteine may be useful in preventing future attacks of acute bronchitis.
Dosing is generally 1200 mg twice per day. Generally at lower doses, the drug is well-tolerated. Side effects may include nausea, vomiting, diarrhea, skin rash, flushing and abdominal pain. Larger doses are used to treat acetaminophen toxicity (tylenol poisoning). At these doses, side effects may include headache, itching, fever and severe allergic reactions. Any patient on nitroglycerin for heart disease should use caution as this combination may result in significant drops in blood pressure. N-acetylcysteine is available over the counter in doses of 600 mg. As noted, standard dosing is two capsules twice per day.
In short, N-acetylcysteine, by acting as a potent antioxidant, may improve symptoms of chronic lung disease and may also be a useful adjunctive medication in the prevention and treatment of viral influenza. It may also protect against kidney damage when given prior to certain imaging procedures (i.e. CT scans that use intravenous contrast). I did not expand on this fact in a deliberate attempt to not bore my readers to tears. There you have it.
The most interesting clinical application is in the treatment and prevention of influenza. With more and more threat of the pandemic H1/N1 swine flu, N-acetylcysteine may be a useful adjunct to current therapy. Compared to placebo pills, N-acetylcysteine users were less likely to have clinical influenza (or at least symptoms of it). Secondly, when those patients actually did develop influenza, it was a much less severe case. It appeared that immunity at a cellular level improved significantly. Though not part of any official CDC recommendations, it may be an option for those who are at higher risk of developing the H1/N1 strain, or any influenza strain for that matter.
A second use of N-acetylcysteine is for patients with chronic lung disease (COPD or emphysema). A study of over 1300 patients found there was a reduction in cough severity and amount of phlegm produced. Those same patients had less likelihood of developing shortness of breath and associated heart failure. Furthermore, based on actual lung testing, they had improvement in their overall lung function. It was shown that in the N-acetylcysteine group, there was nearly 50% less loss of lung function when compared to those not on the supplement. This may be exciting news for patients with chronic lung disease. Many of the available inhaled treatments do not provide total relief. Addition of N-acetylcysteine may be useful in preventing future attacks of acute bronchitis.
Dosing is generally 1200 mg twice per day. Generally at lower doses, the drug is well-tolerated. Side effects may include nausea, vomiting, diarrhea, skin rash, flushing and abdominal pain. Larger doses are used to treat acetaminophen toxicity (tylenol poisoning). At these doses, side effects may include headache, itching, fever and severe allergic reactions. Any patient on nitroglycerin for heart disease should use caution as this combination may result in significant drops in blood pressure. N-acetylcysteine is available over the counter in doses of 600 mg. As noted, standard dosing is two capsules twice per day.
In short, N-acetylcysteine, by acting as a potent antioxidant, may improve symptoms of chronic lung disease and may also be a useful adjunctive medication in the prevention and treatment of viral influenza. It may also protect against kidney damage when given prior to certain imaging procedures (i.e. CT scans that use intravenous contrast). I did not expand on this fact in a deliberate attempt to not bore my readers to tears. There you have it.
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