N-Acetyl-Cysteine: A Powerful Protector Banned From Amazon
N-Acetyl-Cysteine (NAC) is a supplement that increases the production of the most powerful antioxidant in the body. This antioxidant is called glutathione and it is a great anti-inflammatory and body protector. Glutathione is essential to the functioning of specific immune cells which fight infection.
It is well known that NAC supplements can increase the production of glutathione in the body. In times of a viral pandemic NAC should be easily available to those wanting a protective effect for their lungs. N-Acetyl-Cysteine (NAC) has made the news recently not because of its powerful health benefits, but because the U.S. Food and Drug Administration (FDA) suddenly decided after nearly 60 years of over-the-counter sales, NAC is now a “medication” or drug that requires a physician’s prescription.
Amazon suddenly bans all N-Acetyl-Cysteine products for sale
In July, 2020, the FDA sent warning letters to various NAC manufacturers that invoked the Drug Exclusion Provision in U.S. code Title 21 to ban the sale of n-acetylcysteine (NAC). In May 2021, almost a year later, Amazon pulled all NAC products from its virtual shelves, citing the warning letters from the FDA as the reason. The matter is far from settled, however, as Lawyers for the Council for Responsible Nutrition (CRN) has said this exclusion is “legally invalid”. Furthermore, the Natural Products Association (NPA) recently issued a statement advising manufacturers to continue making NAC products and for retailers to continue selling their NAC products on other websites besides Amazon.
Interestingly, NAC is currently being investigated for treatment of severe COVID and is showing promising results. This calls into question the timing of Amazon’s decision to pull NAC products from its catalogue. Is it merely co-incidental, or is Amazon siding with big pharma?
While we can no longer sell NAC on the Amazon platform, we will continue to sell NAC products on LiverDoctor under the advice of the NPA.
Why is NAC so vital to the body?
NAC has been used for over five decades in clinical medicine as a mucolytic agent (clearing up mucus), for respiratory infections, lung weakness and for lung diseases such as asthma, sinusitis, chronic obstructive airways disease (COPD), bronchiectasis, chronic bronchitis, cystic fibrosis and pulmonary fibrosis. Research has proven that NAC can be used alone, or in combination with antibiotics or other antimicrobial agents, to eradicate some chronic infections.
Health benefits of NAC
- Helps replenish glutathione (GSH) levels in the lungs and reduces inflammation in the lungs and bronchial tubes
- Strengthens the lungs
- Supports the body’s detoxification processes
- Inhibits inflammation in the whole body (systemic inflammation)
- Exerts antimicrobial properties
- Improves oral and dental health
- Exerts liver protective and reparative effects
- Can assist with rehabilitation and withdrawal therapy for drug addicted patients
NAC helps to prevent side effects of drugs, drug overdose and environmental toxins. Hospital emergency departments regularly give intravenous (IV) NAC to people with an acetaminophen (paracetamol) overdose to prevent kidney and liver damage or failure. NAC neutralizes toxins and pollutants including heavy metals that accumulate in the liver, kidneys and fatty parts of the body. Restoring glutathione levels with NAC supplements makes liver and kidney cells more able to protect themselves from damage caused by fatty accumulation, viral infections, toxic chemicals, drug induced damage, alcohol excess or autoimmune inflammation.
Considering the poor oral absorption of dietary or supplemental glutathione (GSH), orally administered NAC has been found to be more efficient than glutathione tablets or capsules. NAC has a long-established safety record in adults and children and has been approved by the US Food and Drug Administration since 1963.
Biofilms and infections
Infections persist and become chronic in the body because microorganisms (viruses, bacteria and fungi) make themselves a protective external layer called a biofilm. These microorganisms survive and hide in body cavities and surfaces through the formation of biofilms. Biofilms are microbial communities surrounded by a layer of mucus like material, which makes it hard for the immune system to fight them. Biofilms are resistant to antiviral and antibacterial treatments and to the immune defenses of the person infected.
Some viruses are capable of forming complex biofilm-like structures, similar to bacterial biofilms. These biofilm structures protect viruses from the immune system and enable them to spread more easily from cell to cell. Viral biofilms are likely to be a major method of propagation for many types of viruses.
NAC has been extensively researched for its effectiveness in inhibiting biofilm formation and in destroying developed biofilms. Studies show a role for NAC in the treatment of biofilms, with excellent safety and effectiveness. NAC has shown good properties in combating persistent antibiotic resistant bacterial infections and inhibiting bacterial adhesion and dissolving the biofilm matrix. NAC has been shown to help the body fight viral infections and inhibited the replication of seasonal human influenza A viruses.
Drug resistant infections such as Helicobactor pylori, sinusitis, cystic fibrosis, bronchiectasis and gastrointestinal infections usually have well developed biofilms. Biofilm protected bacteria can be up to a thousand times more resistant to treatment and the host’s own immune defenses and 80% of refractory infections (i.e. unresponsive to medical treatment) are attributable to biofilm colonies. Biofilm may spread into uninfected areas and the cycle repeats thus worsening the infection.
Dental plaque is a form of biofilm and NAC is a therapy used as an antiplaque and bacteriostatic agent for managing chronic dental decay.
NAC is very underutilized as a therapeutic agent in chronic persistent infections which have previously resisted standard antimicrobial treatments.
NAC and selenium work together
Selenium acts in the body as a cleaning up agent and antioxidant, which neutralizes toxic substances. Selenium is required for antioxidant enzymes in the body called seleno-proteins to work efficiently. The most important seleno-protein is glutathione. Glutathione and Selenium are continually to protect your cells. To learn about the medical properties of NAC do a quick search on PubMed and you will find thousands of good scientific studies. NAC is worth keeping in your medicine chest and a bottle of NAC will stay fresh in your refrigerator for several years in case you need it one day.
The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.
1. K. R. Atkuri, et al, “N-Acetylcysteine–a safe antidote for cysteine/glutathione deficiency,” Current Opinion in Pharmacology, vol. 7, no. 4, pp. 355–359, 2007.
2. M. Berk, et al, “The promise of N-acetylcysteine in neuropsychiatry,” Trends in Pharmacological Sciences, vol. 34, no. 3, pp. 167–177, 2013.
3. G. F. Rushworth and I. L. Megson, “Existing and potential therapeutic uses for N-acetylcysteine: the need for conversion to intracellular glutathione for antioxidant benefits,” Pharmacology & Therapeutics, vol. 141, no. 2, pp. 150–159, 2014.
4. S. Dinicola et al, “N-acetylcysteine as powerful molecule to destroy bacterial biofilms: a systematic review,” European Review for Medical and Pharmacological Sciences, vol. 18, no. 19, pp. 2942–2948, 2014.
5. T. Akca, et al, “The effect of N-acetylcysteine on pulmonary lipid peroxidation and tissue damage,” The Journal of Surgical Research, vol. 129, no. 1, pp. 38–45, 2005.
6. A. S. Koh, T. A. et al, “Identification of a mechanism by which the methylmercury antidotes N-acetylcysteine and dimercaptopropanesulfonate enhance urinary metal excretion: transport by the renal organic anion transporter-1,” Molecular Pharmacology, vol. 62, no. 4, pp. 921–926, 2002.
7. H. Sies, “Glutathione and its role in cellular functions,” Free Radical Biology & Medicine, vol. 27, no. 9-10, pp. 916–921, 1999
8. K. R. Gibson et al, “Evaluation of antioxidant properties of N-acetylcysteine in human platelets: prerequisite for bioconversion to glutathione for antioxidant & antiplatelet activity,” Journal of Cardiovascular Pharmacology, vol. 54, no. 4, pp. 319–326, 2009.
9. G. Spagnuolo, V. D’Antò et al, “Effect of N-acetyl-L-cysteine on ROS production and cell death caused by HEMA in human primary gingival fibroblasts,” Biomaterials, vol. 27, no. 9, pp. 1803–9, 2006.
10. Y. Jiao, S. Ma, J. Li et al., “N-Acetyl cysteine (NAC)-directed detoxification of methacryloxylethyl cetyl ammonium chloride (DMAE-CB),” PLoS One, vol. 10, no. 8, article e0135815, 2015.
11. M. Yamada, N. Tsukimura, T. Ikeda et al., “N-Acetyl cysteine as an osteogenesis-enhancing molecule for bone regeneration,” Biomaterials, vol. 34, no. 26, pp. 6147–6156, 2013
12. M. Zafarullah, et al, “Molecular mechanisms of N-acetylcysteine actions,” Cellular and Molecular Life Sciences, vol. 60, no. 1, pp. 6–20, 2003.
13. H. Toker, H. et al, “N-Acetylcysteine, a thiol antioxidant, decreases alveolar bone loss in experimental periodontitis in rats,” Journal of Periodontology, vol. 80, no. 4, pp. 672–678, 2009.
14. C. Pérez-Giraldo, et al, “Influence of N-acetylcysteine on the formation of biofilm by Staphylococcus epidermidis,” The Journal of Antimicrobial Chemotherapy, vol. 39, no. 5, pp. 643–646, 1997.
15. S. Y. Quah, S. et al, “N-Acetylcysteine inhibits growth and eradicates biofilm of Enterococcus faecalis,” Journal of Endodontics, vol. 38, no. 1, pp. 81–85, 2012.
16. Stuart, S. Schwartz, T. Beeson, et al, “Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment,” Journal of Endodontics, vol. 32, no. 2, pp. 93–98, 2006.
17. J. H. Moon, Y. et al, “Antibacterial effects of N-acetylcysteine against endodontic pathogens,” Journal of Microbiology, vol. 54, no. 4, pp. 322–329, 2016.
18. L. F. M. Silveira, et al, “Antimicrobial activity of alexidine alone and associated with N-acetylcysteine against Enterococcus faecalis biofilm,” International Journal of Oral Science, vol. 5, no. 3, pp. 146–149, 2013.
19. U. Palaniswamy, et al, “Effectiveness of N-acetyl cysteine, 2% chlorhexidine, and their combination as intracanal medicaments on Enterococcus faecalis biofilm,” Journal of Conservative Dentistry, vol. 19, no. 1, pp. 17–20, 2016.
20. A. T. Ulusoy, et al, “Antibacterial effect of N-acetylcysteine and taurolidine on planktonic and biofilm forms of Enterococcus faecalis,” Dental Traumatology, vol. 32, no. 3, pp. 212–218, 2016.
21. J. H. Moon et al, “In vitro effects of N-acetyl cysteine alone and in combination with antibiotics on Prevotella intermedia,” Journal of Microbiology, vol. 53, no. 5, pp. 321–329, 2015.
22. J. Alam et al, “N-acetylcysteine and the human serum components that inhibit bacterial invasion of gingival epithelial cells prevent experimental periodontitis in mice,” Journal of Periodontal & Implant Science, vol. 44, no. 6, pp. 266–273, 2014.
23. F. Blasi, C. Page, G. M. Rossolini et al., “The effect of N-acetylcysteine on biofilms: implications for the treatment of respiratory tract infections,” Respiratory Medicine, vol. 117, pp. 190–197, 2016.
24. A. C. Olofsson et al, “N-Acetyl-L-cysteine affects growth, extracellular polysaccharide production, and bacterial biofilm formation on solid surfaces,” Applied and Environmental Microbiology, vol. 69, no. 8, pp. 4814–4822, 2003.
25. M. Yamada et al, “The inhibition of infection by wound pathogens on scaffold in tissue-forming process using N-acetyl cysteine,” Biomaterials, vol. 32, no. 33, pp. 8474–8485, 2011.
26. M. AlMatar, T. et al, “Therapeutic potential of N-acetylcysteine for wound healing, acute bronchiolitis, and congenital heart defects,” Current Drug Metabolism, vol. 17, no. 2, pp. 156–167, 2016.
27. M. Deniz et al, “An effective antioxidant drug on prevention of the necrosis of zone of stasis: N-acetylcysteine,” Burns, vol. 39, no. 2, pp. 320–325, 2013.
28. B. Yilmaz et al, “Efficacy of N-acetylcysteine on wound healing of nasal mucosa,” The Journal of Craniofacial Surgery, vol. 26, no. 5, pp. e422–e426, 2015.
29. A. Oguz et al, “Topical N-acetylcysteine improves wound healing comparable to dexpanthenol: an experimental study,” International Surgery, vol. 100, no. 4, pp. 656–661, 2015.
30. S. C. De Rosa, M. D. Zaretsky, J. G. Dubs et al., “N-Acetylcysteine replenishes glutathione in HIV infection,” European Journal of Clinical Investigation, vol. 30, no. 10, pp. 915–929, 2000.
31. A. Witschi, S. Reddy, B. Stofer, and B. H. Lauterburg, “The systemic availability of oral glutathione,” European Journal of Clinical Pharmacology, vol. 43, no. 6, pp. 667–669, 1992.
32. L. Bonanomi and A. Gazzaniga, “Toxicological, pharmacokinetic and metabolic studies on acetylcysteine,” European Journal of Respiratory Diseases Supplement, vol. 111, pp. 45–51, 1980.
33. L. Borgstrom, B. Kagedal, and O. Paulsen, “Pharmacokinetics of N-acetylcysteine in man,” European Journal of Clinical Pharmacology, vol. 31, no. 2, pp. 217–222, 1986.
34. E. M. Grandjean et al, “Cost-effectiveness analysis of oral N-acetylcysteine as a preventive treatment in chronic bronchitis,” Pharmacological Research, vol. 42, no. 1, pp. 39–50, 2000
35. M. Benrahmoune, P. Therond, and Z. Abedinzadeh, “The reaction of superoxide radical with N-acetylcysteine,” Free Radical Biology & Medicine, vol. 29, no. 8, pp. 775–782, 2000
36. K. Pawlowska-Goral, E. Kurzeja, and M. Stec, “N-Acetylcysteine protects against fluoride-induced oxidative damage in primary rat hepatocytes,” Toxicology In Vitro, vol. 27, no. 8, pp. 2279–2282, 2013.
37. A. Mohsen et al,, “Antibacterial, anti-biofilm activity of some non-steroidal anti-inflammatory drugs and N-acetyl cysteine against some biofilm producing uropathogens,” American Journal of Epidemiology and Infectious Disease, vol. 3, no. 1, pp. 1–9, 2015.
38. L. Drago et al, “Activity of N-acetyl-L-cysteine against biofilm of Staphylococcus aureus and Pseudomonas aeruginosa on orthopedic prosthetic materials,” The International Journal of Artificial Organs, vol. 36, no. 1, pp. 39–46, 2018.
39. B. Leite et al, “Combined effect of linezolid and N-acetylcysteine against Staphylococcus epidermidis biofilms,” Enfermedades Infecciosas y Microbiología Clínica, vol. 31, no. 10, pp. 655–659, 2013.
40. S. Kirmusaoǧlu et al, “The effect of N-acetylcysteine on growth and biofilm formation in Staphylococcus epidermidis strains,” Turkish Journal of Medical Sciences, vol. 42, no. 4, pp. 689–694, 2012
41. F. Gomes et al, “Farnesol in combination with N-acetylcysteine against Staphylococcus epidermidis planktonic and biofilm cells,” Brazilian Journal of Microbiology, vol. 43, no. 1, pp. 235–242, 2012.
42. A. Marchese et al, “Effect of fosfomycin alone and in combination with N-acetylcysteine on E. coli biofilms,” International Journal of Antimicrobial Agents, vol. 22, pp. 95–100, 2003.
43. J. Lea, A. Conlin et al, “In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media,” Journal of Otolaryngology – Head & Neck Surgery, vol. 43, no. 1, p. 20, 2014.
44. T. Zhao and Y. Liu, “N-acetylcysteine inhibit biofilms produced by Pseudomonas aeruginosa,” BMC Microbiology, vol. 10, no. 1, p. 140, 2010.
45. R. M. A. el-Baky, D. M. M. A. el Ela, and G. F. M. Gad, “N-acetylcysteine inhibits and eradicates candida albicans biofilms,” American Journal of Infectious Diseases and Microbiology, vol. 2, no. 5, pp. 122–130, 2014