PCOS and NAC supplements #37
What does the evidence say about NAC supplementation for PCOS?
Hello everyone,
We are officially returning to the UK after a lovely time in Malta. I am the happiest next to the sea, so I look forward to moving there one day.
This week, we discuss NAC supplementation. Thank you to the reader who submitted this question 🙏🏼. I am sure others will benefit from knowing the answer.
This week’s question:
What does the evidence say about NAC supplementation for PCOS?
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What is NAC?
N-acetylcysteine is a compound derived from the amino acid cysteine, commonly abbreviated as NAC. It has a long history of medical use, initially developed as an agent to treat respiratory conditions such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis. NAC has also found its place in emergency medicine as an antidote for paracetamol overdose due to its ability to restore glutathione, an essential antioxidant in the liver.
What does research say about its use in PCOS?
The use of NAC in PCOS treatment has gained momentum due to its potential to address multiple aspects of the condition. Whilst research exists, I wouldn’t say it’s extremely robust.
How does it work?
It’s important to note that the main mechanism of action with NAC supplementation is increased glutathione - our most powerful antioxidant.
Antioxidants are crucial for our body because they counteract oxidative stress. Oxidative stress is caused by many of the body’s mechanisms, including the creation of energy (ATP). But most importantly, inflammation creates oxidative stress on the body. Having a good bank of antioxidants means that oxidate stress can be controlled. Excess insulin, obesity, high cholesterol, a bad diet and lack of exercise raise our inflammation markers and oxidative stress.
As a result, NAC supplementation can help our antioxidants bank and fight inflammation.
Research has shown NAC can help:
Increased pregnancy rate
A study on 60 women found that the odds of live birth with NAC were nearly three times higher than placebo. In addition, studies done on 377 women showed a three-and-a-half higher chance of getting pregnant. This seems to be because NAC supplementation can increase the chance of ovulation and the egg quality.
It may improve insulin sensitivity.
Studies found that NAC supplementation may aid in lowering fasting glucose but didn’t show improvements in fasting insulin. This might be due to the limited time it was supplemented, but NAC doesn't have robust research to prove this compared to other supplementations such as berberine and inositol.
Lower inflammation
This is the most interesting application of NAC. Due to its ability to replenish glutathione (our most powerful antioxidant), it can help with inflammation. I would consider it if your CRP levels (see my article on PCOS and Inflammation here) are high, and you might think that inflammation is driving some of the symptoms.
May lower testosterone levels
Some studies reported lowering testosterone levels by potentially inhibiting the conversion of cholesterol to testosterone.
The above results show potential, but more studies are needed to confirm its universal use for PCOS.
Is NAC safe to take?
NAC supplementation seems to have a safe profile if taken at advised dosages. Most studies above supplemented participants with about 1800mg/day of NAC, usually divided into three dosages throughout the day.
Overall, it’s associated with minimal side effects. The most common adverse effects are gastrointestinal, such as nausea and vomiting. More rare side effects include itching and abnormal redness of the skin.
Sorry, but I need to give you the spiel:
Individual responses to NAC may vary, and it should be considered part of a comprehensive treatment plan under the guidance of a healthcare professional.
Conclusion
In conclusion, NAC seems to have potential in the management of PCOS. I would consider it for higher levels of inflammation rather than a universal supplement for PCOS.
If you have more curiosities about PCOS, please don’t hesitate to submit them here. I will aim to answer them in an article like this one.
See you next Sunday,
Francesca
1 Sources
Fulghesu, A. M., Ciampelli, M., Muzj, G., Belosi, C., Selvaggi, L., Ayala, G. F., & Lanzone, A. (2002). N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertility and Sterility, 77(6), 1128–1135. https://doi.org/10.1016/s0015-0282(02)03133-3
Sandhu, J. K., Waqar, A., Jain, A., Joseph, C., Srivastava, K., Ochuba, O., Alkayyali, T., Ruo, S. W., & Poudel, S. (2021). Oxidative stress in polycystic ovarian syndrome and the effect of antioxidant N-acetylcysteine on ovulation and pregnancy rate. Cureus, 13(9). https://doi.org/10.7759/cureus.17887
Tenório, M. C. dos S., Graciliano, N. G., Moura, F. A., Oliveira, A. C. M. de, & Goulart, M. O. F. (2021). N-acetylcysteine (NAC): Impacts on human health. Antioxidants (Basel, Switzerland), 10(6), 967. https://doi.org/10.3390/antiox10060967
Thakker, D., Raval, A., Patel, I., & Walia, R. (2015). N-acetylcysteine for polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled clinical trials. Obstetrics and Gynecology International, 2015, 1–13. https://doi.org/10.1155/2015/817849
Disclaimer: We are all unique in our ways, so this information is for educational purposes only. In my communications, I summarise research data and bring my experience. This shouldn’t be viewed as medical advice at any point. Please further consult your healthcare provider about your health needs.