A few years ago, I was asked: “If the supplement police came to your house and said you had to give up all but one of your supplements, which supplement would you keep, and why?”
My answer: N-Acetyl Cysteine (also known as NAC for short), because it has numerous benefits on multiple body systems!
Research has shown that NAC helps to reduce thyroid antibodies. It also supports our detoxification pathways (which are usually impaired in Hashimoto’s), as well as gut function.
Additionally, it can help asthma, osteoporosis, oxidative stress, chronic inflammation, and other concerns often seen in those with Hashimoto’s.
In this article, I’ll cover:
- What NAC is
- Why NAC is important for detoxification
- How NAC supports people with Hashimoto’s
- How NAC affects oxidative stress and chronic inflammation
- How to incorporate NAC into your routine
What is NAC?
N-acetyl cysteine (NAC) is a sulfur-based derivative of the amino acid L-cysteine. In the body, it acts as a potent antioxidant, and has been noted to be nearly 100 percent hepatoprotective — in other words, it has the ability to prevent liver damage.
In the 1970s, NAC was found to be an antidote for Tylenol (acetaminophen) overdoses; and later, in the 1980s, it was discovered that NAC can help prevent toxic reactions to chemotherapeutic agents. [1]
The Role of NAC in Hashimoto’s and Liver Support
Those with Hashimoto’s often have an impaired ability to clear toxins and may have an overload or accumulation of toxins. [2]
Toxins can accumulate due to intestinal permeability, or “leaky gut,” which can result in the absorption of problematic substances and lead to impaired detox abilities. (Studies have shown that everyone with an autoimmune disorder, including Hashimoto’s, has some degree of intestinal permeability. [3])
Additionally, there are several other factors associated with Hashimoto’s that can cause an impairment in the ability of the liver to properly eliminate toxins from the body.
These include:
- A decreased ability to sweat and eliminate toxins through the skin
- Nutrient absorption issues
- Food sensitivities that lead to accumulated antibodies
- The MTHFR gene variation that can impair the body’s ability to methylate (a key detox process)
Because so many people with thyroid conditions are dealing with a toxic load on their bodies, I consider NAC to be a super supplement for people with Hashimoto’s. In the body, NAC turns into glutathione, an antioxidant that not only supports liver function, but also helps the liver to clear out heavy metals and other toxins. [4]
NAC supports healthy levels of glutathione by providing the body with cysteine, the rate-limiting factor (or factor that prevents the process from happening more quickly) of glutathione production. [5] By supporting healthy glutathione levels, NAC in turn supports optimal levels of TSH and thyroid antibodies (more on that later).
Additionally, experimental research and previous clinical studies have found that glutathione can help recover oxidative stress-induced liver damage in alcoholic and non-alcoholic liver diseases. [6] In one study where 30 middle-aged participants with non-alcoholic fatty liver steatosis were randomly selected to receive either vitamin C or NAC, researchers found NAC could improve liver function in patients with non-alcoholic fatty liver disease (NAFLD). [7]
For this reason, NAC can be highly beneficial when you consider starting your health journey with a liver support protocol. You can read more about the importance of liver support for Hashimoto’s in this article.
NAC for Oxidative Stress and Chronic Inflammation
While research shows other benefits, here I’ll focus on two fundamental conditions that supplementing with NAC can affect: oxidative stress and chronic inflammation. [8] These two conditions are monumental drivers in almost every disease imaginable, including Hashimoto’s.
One caveat – while I discuss them separately, many times they overlap. In other words, if you have chronic inflammation, you probably also have oxidative stress, and vice versa.
NAC and Oxidative Stress
Oxidative stress results when an imbalance occurs and our cells produce too many free radicals, knocking oxidants and antioxidants out of balance. [9] Many factors can trigger or exacerbate oxidative stress, including:
- Chronic stress
- A lack of sleep
- A high-sugar, processed-foods-based diet
- Medications
- Environmental toxins and pesticides
When oxidative stress occurs, the process can adversely impact the DNA, proteins, and lipids (fats) within our cells.
Researchers have found that free radicals can damage multiple cellular organelles and processes, disrupting normal physiology. While the body has several antioxidant defense mechanisms, too many free radicals can overwhelm our body and (among other things) impact gene expression, which could lead to inflammation.
Oxidative stress can also become a key driver in Hashimoto’s and other thyroid disorders. In fact, researchers have found increased levels of oxidative stress among people with Hashimoto’s. [10]
When our thyroid gland makes thyroid hormones, it simultaneously creates free radicals. [11] Without sufficient glutathione to keep that oxidative stress in check, excess amounts can impact other tissues.
You can read more about this process in my article on iodine and Hashimoto’s.
As such, maintaining a minimal oxidative load is a fundamental piece in protecting thyroid cell function. NAC helps to reduce this oxidative stress by neutralizing the hydrogen peroxide (which can otherwise cause damage to the thyroid gland).
Studies have also correlated oxidative stress with various mood disorders common in people with Hashimoto’s, including depression and anxiety, because it causes nervous system impairment. [12] (Read more about depression and Hashimoto’s and anxiety and Hashimoto’s.)
NAC for Chronic Inflammation
Inflammation gets a bad rep, but in the right situation, it can benefit us. For example, if we cut our finger, the immune system rallies up its defenses and comes to the rescue. Swelling, redness, and other immediate signs often follow. This type of inflammation, called acute inflammation, works as a protective defense for the body, and then swiftly disappears when its job is done.
On the other hand, chronic inflammation is inflammation gone wild: while this low-grade inflammation quietly simmers and festers, all kinds of trouble can result.
The signs of chronic inflammation aren’t always obvious, but they can be harmful and even deadly. Studies connect chronic inflammation with many modern human diseases, including cardiovascular disease, type 2 diabetes, and cancer.
Chronic inflammation is a huge driver behind autoimmune diseases, like Hashimoto’s thyroiditis, as well. (As its name implies, anything ending with “itis” signals inflammation.)
In fact, researchers have found that several genes encoding different inflammatory cytokines can influence the severity of Hashimoto’s. [13]
NAC can help dial down that inflammation. In one study, researchers found this supplement provided anti-inflammatory benefits while increasing the enzymes superoxide dismutase (SOD) (which fights against reactive damaging oxidative molecules), glutathione, and glutathione S-transferase (GST). (These latter two enzymes also act against harmful oxidative molecules.) The researchers concluded that NAC has both anti-inflammatory and (bonus!) anti-ulcerative effects. [14]
NAC for Reducing Thyroid Antibodies
NAC is a precursor to the antioxidant glutathione. Glutathione is the most abundant antioxidant in your body, and is thus sometimes called the master antioxidant. It plays a role in many functions, including antioxidant defenses, nutrient metabolism, the regulation of cellular events (including gene expression and cell proliferation), and immune response.
Glutathione doubles as a heavyweight protector against oxidative stress that can also protect the body against chronic inflammation. [15] (Conversely, chronic inflammation can deplete glutathione levels.)
A depletion in glutathione levels has been implicated with higher levels of thyroid antibodies and may contribute to Hashimoto’s. One study conducted in 2012 found that Hashimoto’s patients had 62 percent lower levels of serum glutathione compared to age-matched controls. In this same study, a significant relationship was identified between serum glutathione levels, TPO antibodies, and TSH. The lower the glutathione, the higher the antibodies, and the higher the levels of TSH – suggesting hypothyroidism. [16]
As a precursor of glutathione, NAC can help to optimize glutathione levels and reduce thyroid antibodies.
NAC is an antioxidant in its own right. As a sulfur donor, it helps scavenge free radicals, and it does double duty, helping to boost glutathione levels by converting it into glutathione in the body. [17]
If you’re healthy, your body can make a solid supply of glutathione.
Unfortunately, many variables that overwhelm your body with oxidative stress and chronic inflammation, like stress, infections, and a poor diet, may result in your body making less than optimal amounts of this master antioxidant – which is not uncommon in those with Hashimoto’s.
NAC and Gut Health
Chronic inflammation underlies many gut conditions, including intestinal permeability, or leaky gut, which is one of the three factors that must be present in order for autoimmune diseases like Hashimoto’s to occur. Leaky gut involves damage to the body’s intestinal lining and causes tight junction malfunctions, which allow substances like bacteria and food particles that are not intended to go through your gut wall, to pass through.
Studies involving pigs have shown that NAC improves intestinal tissue damage, as is present with leaky gut, by creating signals that tighten the junctions (or “spaces”) within the intestinal wall. This, in turn, patches up the “leaks” in a leaky gut. [18]
When intestinal tissue damage is healed and leaky gut is reversed, many people may even be able to put their Hashimoto’s into remission!
NAC can also promote intestinal health by helping to detoxify intestinal bacteria and by breaking down biofilms. Biofilms are a collective of microorganisms that grow on biological surfaces and often house gut pathogens, which can, in turn, lead to infections. Today, many biofilms are becoming resistant to many clinical antibacterial treatments and host immune responses, so researchers are looking for new substances to combat these resistant biofilms.
A study in 2014 investigated NAC’s effectiveness in preventing the formation of biofilms, as well as in the destruction of existing ones. The study found that in combination with different antibiotics, NAC can significantly penetrate the deepest biofilm layers of bacteria that are becoming increasingly resistant to classical antibacterial treatments. [19]
This exciting discovery means that NAC can help us eradicate pathogens, which are commonly found in the gut and are often triggers of Hashimoto’s symptoms. (Read more about how pathogenic infections could be the root cause of your Hashimoto’s.)
NAC for Co-occurring Conditions
Incredibly well-researched studies support NAC’s efficacy for other conditions that often co-occur with Hashimoto’s. Let’s look more closely at some of the other benefits of NAC.
Respiratory Conditions
Those with autoimmune thyroid disease are more likely to develop, or already have, other autoimmune conditions, including asthma. [20] If you have a stubborn hacking cough and excessive mucus buildup due to asthma, NAC could help. This acetylated form of cysteine is also a mucolytic agent, which means it can break down and thin mucus, as its sulfur content can cleave the bonds in mucoproteins.
It may also benefit other respiratory-related conditions. [21] One meta-analysis of 12 randomized controlled trials, found that long-term (over six months) use of NAC reduced the risk of chronic obstructive pulmonary disease (which includes refractory asthma) becoming worse. [22]
Osteoporosis and Bone Health
Osteoporosis is more common in women with Hashimoto’s and thyroid conditions who take thyroid medications, as thyroid hormones speed up bone turnover. Researchers have found that inflammatory cytokines induce the expression of COX-2 (a chief driver of pain and inflammation among many chronic diseases) in the osteoblasts (cells responsible for the synthesis and mineralization of bones) of inflamed joints. This is followed by osteoclast activation, which breaks down bones. [23]
In one study, when NAC was added to rat bone marrow cultures, significant improvements were seen in the activity of alkaline phosphatase (levels of which increase when bones are growing) and osteoblastic cultures (cells that develop bone), as well as an upregulation of bone-related gene markers such as collagen. Another study found that NAC could inhibit the inflammatory process involved in bone resorption, by regulating COX-2 expression. [24]
Type 2 Diabetes
Inflammation (along with oxidative stress) plays a crucial role in the development of insulin resistance and type 2 diabetes. One study published in the medical journal Free Radical Research in 2018, compared a group of mice who were fed a high-fat diet for six months, with a group that was fed the same diet along with NAC. The group that was only fed a high-fat diet experienced a significant increase in body weight and body fat, a decrease in motor activity, and impaired glucose and insulin tolerance throughout the study. Meanwhile, the group that was fed NAC saw a significant increase in motor activity, improved glucose and insulin tolerance, as well as improvements to DNA, protein oxidative damage, and adipose (fat-storing) tissue inflammation. [25]
The results suggested that NAC can improve insulin resistance and chronic inflammation in obese mice, by providing anti-oxidative stress benefits.
Obesity
Weight gain and metabolic disorders, including insulin resistance, often go hand-in-hand with thyroid conditions and inflammation. One 2016 study published in Pharmaceutical Research found that supplementing with NAC inhibited fat mass and obesity development in mice that were fed a high-fat diet. NAC also improved insulin resistance, suppressed fat from accumulating in the liver, and stimulated thermogenic (fat-burning) genes in the mice, suggesting that NAC may help protect against obesity and obesity-associated metabolic disorders. [26]
Supplementing with NAC
If you think NAC might be a good option for you, I recommend Rootcology’s Pure N-Acetyl Cysteine supplement.
If you are following the Liver Support Protocol as outlined in my Hashimoto’s Protocol book, I recommend that you continue taking NAC for three to six months after supporting your liver.
It is also safe to take on an ongoing basis. Daily doses of 1,800 mg are usually recommended. I would generally take this supplement with food to avoid stomach upset. As individual needs may vary, I highly recommend working with a healthcare practitioner to determine optimal dosages for your condition.
Here’s what one person had to say about Rootcology Pure N-Acetyl Cysteine:
“I’ve been taking it nightly for over a month. My thyroid levels improved, especially my T4 to T3 conversion levels. I was able to cut my medication by half!”
If you are already utilizing NAC, or are considering giving it a try, I wanted to provide a quick heads-up about a recent regulatory situation regarding NAC.
After a warning letter from the FDA was issued in July 2020, there was a subsequent debate on whether or not NAC should be sold as a supplement, because it had previously been approved for use as a drug in 1963.
In 2021, Amazon made the decision to remove all products containing NAC from their site, likely as a precautionary measure. In response, the Natural Products Association (NPA) reached out to Amazon to let them know that the issue was not closed with the FDA, and that NAC is a product that has dual uses as both a drug and a supplement, like many other products on the market (such as niacin, fish oil, and potassium, which can be sold as over-the-counter supplements, or prescribed by a medical professional). [27]
After a thorough review, the FDA denied two petitions filed by the Council for Responsible Nutrition (CRN) and the Natural Products Association (NPA), asking them to not remove products with NAC from the definition of a dietary supplement. [28]
Despite these denied petitions, I am happy to report that at this time, NAC-containing supplements are once again available on Amazon.
Most recently, the FDA released guidance that they did not find safety concerns in their initial review, but that they have not yet reached a final decision relating to an alternative request to allow the use of NAC in dietary supplements.
If you find NAC helpful or are considering trying it, you can stock up now (my Pure N-Acetyl Cysteine is available through the Rootcology website) to ensure you have extra on hand, no matter what additional changes regarding its status as a supplement may be in store for it in the future.
Precautions
While NAC is safe for most populations, it can interact with some medications. Do not take NAC if you are currently taking the following medications: ACE inhibitors, activated charcoal, antihypertensive drugs, anticoagulant/antiplatelet drugs, blood thinners, nitroglycerin (a vasodilator), chloroquine, metoclopramide, and/or anticancer agents.
Even at high doses, researchers have found NAC to be safe and well-tolerated. However, it’s important to note that NAC can cause stomach upset, nausea, vomiting, and diarrhea if taken on an empty stomach, so it should be taken with food to lessen the likelihood of these reactions.
Additionally, I don’t recommend NAC for those with an expressed CBS mutation or a sulfur sensitivity (you can read more about that here), or those who are prone to fainting.
Stop this supplement two weeks prior to surgery.
Consult with a physician prior to use if you have asthma, or if you are pregnant or breastfeeding. If you have any concerns about possible medication interactions, please speak with your functional medicine practitioner.
Please note that if you open a bottle of NAC supplements and notice a bad odor, you likely did not get a bad batch. NAC’s sulfurous compounds can often cause a “rotten-egg” smell — but that is normal! If you are concerned, however, I recommend contacting the supplement manufacturer.
The Takeaway
N-Acetyl Cysteine (NAC) is a multitasking supplement that can be especially beneficial for those with Hashimoto’s. I’ve created a graphic to sum up all the key benefits of NAC:
If you have Hashimoto’s or any other autoimmune disease — or if you have chronic inflammation and oxidative stress — you may wish to consider taking this supplement.
If you haven’t picked up a copy of my book Hashimoto’s Protocol already, I encourage you to do so and begin with the Liver Support Protocol. All of the supplements I recommend to support your liver can be found in the Rootcology store, including N-Acetyl Cysteine.
I wish you well on your journey to health and healing!
If you’ve used NAC, what did you use it for, and did you notice any significant benefits? Have you ever used NAC or another precursor to boost glutathione levels?
I’d love to hear your story below!
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References
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[2] Brent GA. Environmental exposures and autoimmune thyroid disease. Thyroid. 2010;20(7):755-761. doi:10.1089/thy.2010.163
[3] Fasano A. Leaky Gut and Autoimmune Diseases. Clinical Reviews in Allergy & Immunology. 2011;42(1):71-78. doi:10.1007/s12016-011-8291-x.
[4] Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A Review on Various Uses of N-Acetyl Cysteine. Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872
[5] Tenório MCDS, Graciliano NG, Moura FA, Oliveira ACM, Goulart MOF. N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants (Basel). 2021;10(6):967. Published 2021 Jun 16. doi:10.3390/antiox10060967
[6] Sacco R, Eggenhoffner R, Giacomelli L. Glutathione in the treatment of liver diseases: insights from clinical practice. Minerva Gastroenterol Dietol. 2016;62(4):316-324.
[7] Khoshbaten M, Aliasgarzadeh A, Masnadi K, Tarzamani MK, Farhang S, Babaei H, et al. N-acetylcysteine improves liver function in patients with non-alcoholic Fatty liver disease. Hepatitis Monthly. 2010;10(1):12-6.
[8] Steele ML, Fuller S, Maczurek AE, Kersaitis C, Ooi L, Münch G. Chronic inflammation alters production and release of glutathione and related thiols in human U373 astroglial cells. Cellular and Molecular Neurobiology. 2013;33(1):19-30. doi: 10.1007/s10571-012-9867-6.
[9] Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A Review on Various Uses of N-Acetyl Cysteine. Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872
[10] Mikulska AA, Karaźniewicz-Łada M, Filipowicz D, Ruchała M, Główka FK. Metabolic Characteristics of Hashimoto’s Thyroiditis Patients and the Role of Microelements and Diet in the Disease Management-An Overview. Int J Mol Sci. 2022;23(12):6580. Published 2022 Jun 13. doi:10.3390/ijms23126580
[11] Thannickal VJ, Fanburg BL. Reactive oxygen species in cell signaling. Am J Physiol Lung Cell Mol Physiol. 2000;279(6):L1005-L1028. doi:10.1152/ajplung.2000.279.6.L1005
[12] Bouayed J, Rammal H, Soulimani R. Oxidative stress and anxiety: Relationship and cellular pathways. Oxidative Medicine and Cellular Longevity. 2009;2(2):63-67.
[13] Zaletel K, Gaberšček S. Hashimoto’s Thyroiditis: From Genes to the Disease. Current Genomics. 2011;12(8):576-88. doi: 10.2174/138920211798120763.
[14] Atalay F, Odabasoglu F, Halici M, et al. N-Acetyl Cysteine Has Both Gastro-Protective and Anti-Inflammatory Effects in Experimental Rat Models: Its Gastro-Protective Effect Is Related to Its In Vivo and In Vitro Antioxidant Properties. J Cell Biochem. 2016;117(2):308-319. doi:10.1002/jcb.25193; Younus H. Therapeutic potentials of superoxide dismutase. Int J Health Sci (Qassim). 2018;12(3):88-93.
[15] Pizzorno J. Glutathione!. Integr Med (Encinitas). 2014;13(1):8-12.
[16] Rostami R., Aghasi M.R., Mohammadi A., Nourooz-Zadeh J. Enhanced Oxidative Stress in Hashimoto’s Thyroiditis: Inter-Relationships to Biomarkers of Thyroid Function. Clin. Biochem. 2013;46:308–312.
[17] Nimni ME, Han B, Cordoba F. Are we getting enough sulfur in our diet?. Nutrition & Metabolism (London). 2007;4:24.
[18] Hou Y, Wang L, Yi D, Wu G. N-acetylcysteine and intestinal health: a focus on its mechanism of action. Frontiers in Bioscience (Landmark Ed). 2015 Jan 1;20:872-91; Yi D, Hou Y, Xiao H, et al. N-Acetylcysteine improves intestinal function in lipopolysaccharides-challenged piglets through multiple signaling pathways. Amino Acids. 2017;49(12):1915-1929. doi:10.1007/s00726-017-2389-2
[19] Dinicola S, De Grazia S, Carlomagno G, Pintucci JP.N-acetylcysteine as powerful molecule to destroy bacterial biofilms. A systematic review. Eur Rev Med Pharmacol Sci. 2014 Oct;18(19):2942-8.
[20] Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A Review on Various Uses of N-Acetyl Cysteine. Cell J. 2017;19(1):11-17. doi:10.22074/cellj.2016.4872
[21] Barreiro E, Sánchez D, Gáldiz JB, Hussain SN, Gea J; ENIGMA in COPD project. N-acetylcysteine increases manganese superoxide dismutase activity in septic rat diaphragms. Eur Respir J. 2005;26(6):1032-1039. doi:10.1183/09031936.05.00003705
[22] Fowdar K, Chen H, He Z, et al. The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review. Heart Lung. 2017;46(2):120-128. doi:10.1016/j.hrtlng.2016.12.004
[23] Origuchi T, Migita K, Nakashima T, Honda S, Yamasaki S, Hida A, et al. Regulation of cyclooxygenase-2 expression in human osteoblastic cells by N-acetylcysteine. Journal of Laboratory and Clinical Medicine. 2000;136(5):390-4.
[24] Yamada M, Tsukimura N, Ikeda T, Sugita Y, Att W, Kojima N, et al. N-acetyl cysteine as an osteogenesis-enhancing molecule for bone regeneration. Biomaterials. 2013;34(26):6147-56. doi: 10.1016/j.biomaterials.2013.04.064.
[25] Shen F-C, Weng S-W, Tsao C-F, Lin H-Y, Chang C-S, Lin C-Y, et al. Early intervention of N-acetylcysteine better improves insulin resistance in diet-induced obesity mice. Free Radical Research. 2018. DOI: 10.1080/10715762.2018.1447670
[26] Ma Y, Gao M, Liu D. N-acetylcysteine Protects Mice from High Fat Diet-induced Metabolic Disorders. Pharm Res. 2016;33(8):2033-2042. doi:10.1007/s11095-016-1941-1
[27] Long J. Amazon reportedly removes NAC-containing dietary supplements. Natural Products Insider website. https://www.naturalproductsinsider.com/regulatory/amazon-reportedly-removes-nac-containing-dietary-supplements. Published April 22, 2021. Accessed May 3, 2021; 15 JL| M. DOJ: FDA response on NAC petition is ‘forthcoming’. Natural Products INSIDER. https://www.naturalproductsinsider.com/regulatory/doj-fda-response-nac-petition-forthcoming. Published March 15, 2022. Accessed March 18, 2022.
[28] FDA Releases Final Guidance on Enforcement Discretion for Certain NAC Products. US Food and Drug Administration. August 1, 2022. https://www.fda.gov/food/cfsan-constituent-updates/fda-releases-final-guidance-enforcement-discretion-certain-nac-products
Note: Originally published in December 2018, this article has been revised and updated for accuracy and thoroughness.
Is NAC safe if GAD 65 antibodies are present. I do not have diabetes, but my functional doctor wanted to test for GAD 65 antibodies. I’m understanding that GAD 65 has something to do with conversion of glutamate to GABA.
Jane – thank you for reaching out. That’s a great question and unfortunately I don’t have any information to share with you at this time but, I will add this to my list of future article possibilities. I would recommend that you to discuss this with your clinician. <3
Dear Izabelle, I rely on your book and blog posts so much. I’m in the care of a naturopathic doctor, mainly so I could get prescribed natural desiccated thyroid and LDN. How does the NAC react with LDN, and is it better for reducing thyroid antibodies? Or not?
Jacki – thank you for reaching out. I am happy to hear you have found a practitioner. <3 I don't have any information to share with you at this time, but will add this to my research list. I recommend you discuss this with your clinician.
Is it possible to have a worsening of symtoms initially, like a dye off effect?
Alba – thank you for reaching out. I am so sorry you are not feeling well. <3 Even at high doses, researchers have found NAC to be safe and well tolerated. However, it’s important to note that NAC can cause stomach upset, nausea, vomiting and diarrhea if taken on an empty stomach, so it should be taken with food. Moreover, NAC is not recommended if you have an expressed CBS mutation or a sulfur sensitivity. I recommend that you reach out to your practitioner who is familiar with your health history.
My mother is 95 and I have been giving her one NAC pill daily entire year. She’s complains of lack of appetite more lately and has Heartburn but she is taking it with food. She’s also complains of weakness but then again she had since Covid injections. Nac cause any of these problems and she’s also taking blood pressure medication? And also taking drops for glaucoma? is this a problem. Should she continue or stop? Thank you
Sarah – thank you for sharing your moms journey. ❤️ I would recommend stopping this supplement to see if her symptoms subside and discuss her symptoms with her practitioner. Please keep me posted on her progress
How can we understand that we have sulphur sensitivity?
Hello – Thank you for following! Here is an article with some information on sulfur sensitivity. I hope you find it helpful.
WHAT ARE GOITROGENS?
https://thyroidpharmacist.com/articles/what-are-goitrogens-and-do-they-matter-with-hashimotos/
Dr. Went,
I appreciate all the good information presented here on NAC. Since it is a precursor to glutathione, would IV glutathione be even better? I have had it a couple of times with IV vitamin C, but may consider a more regular dosing if so.
Thank you!!
Penney – thank you for reaching out and sharing your journey. <3 I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. Please discuss the use of supplements with your personal doctor.
Since NAC is a precursor to Glutathione, why not just take that?
Daryl – thank you for reaching out. Hashimoto’s patients are deficient in the antioxidant glutathione. It helps prevent free radical damage to the thyroid but isn’t well-absorbed if taken orally. N-acetyl cysteine (NAC) is a precursor to glutathione and can be taken orally. You can find more information about this here:
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
It seems liposomal glutathione is all the rage now. Would that be more effective than NAC? I currently have glutathione tablets. Wish I would have read your article before I bought them:/
Gina – thank you for reaching out. <3 Glutathione can be taken orally as well, and NAC is a supplement that can help with increasing glutathione levels. As a precursor of glutathione, NAC can help to optimize glutathione levels and reduce thyroid antibodies. NAC is an antioxidant in its own right. As a sulfur donator, it helps scavenge free radicals, and it does double duty, helping to boost glutathione levels by converting into glutathione in the body. I hope that helps.
Please send me link, or phone number to order supplement NAC
Carol – thank you for reaching out. I recommend Rootcology’s Pure N-Acetyl Cysteine supplement. Here is a link: https://rootcology.com/collections/supplements/products/nac-n-acetyl-cysteine
Hi! Can I take NAC during pregnancy?
And can you make an article of which supplements did you use during pregnancy and postpartum?
Thanks!!!
Susana – thank you for reaching out. I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your practitioner. I appreciate your feedback and I will add pregnancy/postpartum supplements to my list of future articles. <3
Thank you very much for this very informative material on NAC. I’ve been taking it for some time and appreciate the details of your report together with the fact I should take it with food. It was said that I had osteopenia (sp), (yeah, I’ve been on thyroid meds about 60 years) but now I’m not even in the alert stage for bone density!!! I have been told I have liver toxins buildup (whatever the proper name for it is), but now with both NAC and milk thistle, the toxins are gone. Thanks to all your past info as well as all the docs on chronic disease documentaries, I have felt much more well than for a long time, though because we can’t get proper testing here, we have to work at it mostly alone. Thanks again, Dr. Wentz; I have your first book and still check back into its help.
Helen – you are very welcome! That’s amazing! I appreciate you sharing your journey with me! Please keep me posted on your progress. <3
Can I take NAV if I’m allergic to Sulfa medications?
Bonnie – thank you for reaching out. I recommend that you discuss this supplements with your personal doctor who is familiar with your health history. NAC is not recommended if you have a sulfur sensitivity. You can read more about that, here:
HOW SUPPORTING THE LIVER IS KEY TO RECOVERING FROM THYROID DISEASE
https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/
Thank you just one question
For those of us who have a sulphur intolerance, would we be able to take this product.
Even wine, unless it us organic, the sulphur in it makes me cough.
Anne – thank you for reaching out. NAC is not recommended if you have a sulfur sensitivity. You can read more about that, here:
HOW SUPPORTING THE LIVER IS KEY TO RECOVERING FROM THYROID DISEASE
https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/
I am allergic to both Sulpha based drugs and coconut. Any suggestions on how to work on my leaky gut other than monitoring my diet? Thanks!
Tina – thank you for reaching out and sharing! <3 We know that intestinal permeability (aka leaky gut) is present in every case of autoimmunity and often precedes the development of Hashimoto’s. Symptoms of leaky gut may include bloating, diarrhea, constipation, stomach aches, acid reflux and irritable bowel syndrome. According to the Institute of Functional Medicine, many people develop IBS 5-10 years before an autoimmune diagnosis. I was one of them and didn’t take my gut health as seriously as I should have. Gut problems are often caused by infections like H. pylori, parasites like Blasto, SIBO, an imbalance of bacteria, and enzyme deficiencies or food sensitivities (especially to gluten, dairy, and/or soy). Even stress can be a factor in gut permeability. Here are some articles you might find interesting.
6 DIFFERENT ROOT CAUSES
https://thyroidpharmacist.com/articles/6-different-hashimotos-root-causes/
WHAT’S CAUSING YOUR LEAKY GUT
https://thyroidpharmacist.com/articles/whats-causing-your-leaky-gut/
Thank you for providing this information concerning the supplement NAC. My functional medicine dr perscribed high dose for me as I had been dealing with constant dry, non productive cough for quite awhile and then recurring acute bronchitis and acute sinusitis earlier this year. I took a two week dose of antibiotics but a couple days later the symptoms came back full force so my functional medicine dr perscribed a month long course of antibiotics and probiotics, along with me taking two 900mg in the morning and two 900mg in evening while taking the antibiotics. To support my liver function during the couse of antibiotics as I have had non alcoholic fatty liver for many years. My concern is that I did not realize I was supposed to stop taking all that NAC once my course of antibiotics ended. Also I am sensitive to sulfer. I was experiencing very dry sinus and inside of my nose was very painful. Anyway I fortunately contacted the dr and she told me to just take one NAC per day. I stopped taking it completely till I see her in January. My sinus symptoms have cleared and nose feels normal again but what a painful experience that was! After reading your info concerning the benefits of NAC I will try taking just one per day and see how I feel. Seems I may have over done a good thing!
Deanna – thank you so much for sharing your journey! <3 I hope you will keep me posted on your progress.
Such an informative article. Thank you. Would this detoxification pathway help the liver clear unwanted estrogens from the body? It seems we’re all affected to some extent by unwanted estrogens in the environment, etc.
Vivien – you are very welcome! Toxins and chemicals are established environmental triggers for developing Hashimoto’s in people who are genetically predisposed. These include iodine intake, bacterial and viral infections, hormonal imbalances, toxins, as well as therapy with certain types of medications and mercury!
In people with Hashimoto’s, only 50% of their identical twins presented with thyroid antibodies, meaning that genes alone are not everything and that environmental triggers are extremely important. Here are some articles which you may find interesting:
LIVER SUPPORT
https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/
THYROID AND SKIN
https://thyroidpharmacist.com/articles/the-thyroid-and-skin/
FLUORIDE
https://thyroidpharmacist.com/articles/fluoride-and-your-thyroid/
Dear Dr.,
Since NAC is Sulphur based product, will it be harmful for G6PD carrier?
Thanks and Regards
Thuzaru – thank you for reaching out. NAC is not recommended if you have a sulfur sensitivity. You can read more about that, here:
HOW SUPPORTING THE LIVER IS KEY TO RECOVERING FROM THYROID DISEASE
https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/
Dear Dr. Izabella,
First of all I want to thank you for all of the incredible work you have done to support all the women out there with Hashimoto’s. I have read both of your books, and have received so much benefit from changing my diet and adding in the supplements. I am still struggling with some of my root causes, and healing my gut, but know that healing is a continuous process, and am trying to be more loving to myself throughout (another big benefit I got from your book- addressing the emotional healing side of living with autoimmunity!) I wanted to ask you- were you able to eventually get your Hashis in remission and get off of the thyroid hormone drugs? I have had Hashis, and have been taking thyroid hormone (first Synthroid and then NDT) for 10 years now. I am seeing a functional medicine doctor who has been great overall, but says the chances of me ever getting my thyroid function back/getting off of the drugs are very slim considering it’s been so long… Have you seen any of your patients go into remission after such a long period on hormone replacement? Thank you so much. With love and thanks!
Gabriella – thank you so much for reaching out and sharing your journey. <3 Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I'm currently working on some protocols to help with tissue regeneration. Reversing Hashimoto's means different things to different people. For some, it means a reduction in symptoms, and for others, it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you:
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO'S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
https://thyroidpharmacist.com/articles/hashimotos-self-care
In case you want to learn more, here are the links to my books:
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Thank you so much for your reply, and for these great articles! It’s truly special how you respond to each of us. I am so grateful…
I would love to hear more about the protocols on tissue regeneration. I remember reading about the laser therapy in your last book. Have you heard of development of stem cell injections? Very open to try anything at this point!
Thanks again!
Gabriella – you are very welcome! I appreciate your support. Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m
currently working on some protocols to help with tissue regeneration. Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms, and for others, it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you:
LASERS FOR THYROID TISSUE REGENERATION
https://thyroidpharmacist.com/articles/lasers-thyroid-tissue-regeneration/
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
Oh, and I had one more question- my Free T3 is quite high/out of range. Do you have any info on what this might mean? my endocrinologist thinks it’s just from taking NDT but my functional medicine doctor thinks it could be pointing to the meds not functioning properly/ possible adrenal issues. Curious if you have come across High Free T3 with Hashi in your practice and have any thoughts! Thanks so much!
Gabriella – most people feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Here is a research article which might help further:
TOP 10 THYROID TESTS FOR DIAGNOSIS
https://thyroidpharmacist.com/articles/top-6-thyroid-tests/
Hello,Izabella. I was diagnosed with hashimoto’s 10 years before. No doctor said me “it can be heal”. Do I have a chance to get my health back after so many years?
Nel – thank you for reaching out and sharing your journey. Thyroid tissue can regenerate, but the rate at which it does is not always predictable. Thus, some are able to stop the autoimmune attack on their thyroid and regain normal thyroid function. Others can reduce the dose of medications, and others will need to stay on the medications indefinitely. I’m currently working on some protocols to help with tissue regeneration. Reversing Hashimoto’s means different things to different people. For some, it means a reduction in symptoms, and for others, it means a reduction in your antibodies. I had both. Here a few articles that might be helpful for you:
IS IT POSSIBLE TO RECOVER THYROID FUNCTION IN HASHIMOTO’S
https://thyroidpharmacist.com/articles/is-it-possible-to-recover-thyroid-function-in-hashimotos
REVERSING AUTOIMMUNITY? AND THE PERFECT STORM
https://thyroidpharmacist.com/articles/reversing-autoimmunity-and-the-perfect-storm/
HASHIMOTO’S SELF CARE, GETTING AND STAYING IN REMISSION
https://thyroidpharmacist.com/articles/hashimotos-self-care
In case you want to learn more, here are the links to my books:
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
I have been taking curcumin since 2014 to help in my fight of thyroid cancer. Is NAC better than curcumin for this purpose? If so, in what ways?
David – thank you for reaching out and sharing. <3 I am not able to advise on whether this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor.
Hi Dr. Izabella, I like many others thank you for your work. I’ve been taking NAC for close to 5 months along with a protocol involving PectaSol-C, provided by my practitioner, to help bind toxins to promote their elimination from my body. I believe this is helping. My question concerns the testing of my microbiome, perhaps through a company called Viome, which claims to be able to test my particular microbiome for the types of food my body needs at this time in addition to recommending foods my body does not need at this time. Could you share your thoughts on testing the microbiome?
Dianne – thank you for reaching out. I am not familiar with that test. The gold standard, most accurate test for food sensitivities is going to be an elimination diet, but if you are someone that is not quite ready to do one, or needs to see things in black and white, you may want to look into food sensitivity testing. I recommend the 184 Food Allergy IgG test from Alletess or their 96 Food version. Here are some resources you may find helpful.
Elimination Diet
https://thyroidpharmacist.com/articles/elimination-diet-for-hashimotos
https://thyroidrx.mymedlab.com/locations?return_to=https%3A%2F%2Fthyroidrx.mymedlab.com%2Fproducts%2Fdr-wentz.184-food-allergy-igg-alletess-trx
https://thyroidrx.mymedlab.com/locations?return_to=https%3A%2F%2Fthyroidrx.mymedlab.com%2Fproducts%2Fdr-wentz.96-food-allergy-igg-alletess-trx
I was on NAC 3 x a week for a week. I found that I was on top of the world day of. Then the next day I was a bit tired and somewhat depressed and then the next day I was exhausted and not getting over my depression or mood swing. Took NAC and again on top of the world. My doctor said she never heard of this and end of discussion. I stopped until I get further info.
Also is it true if you have silver fillings you shouldn’t use this?
I hope you can answer this.
Lisa – thank you for reaching out and sharing! <3 I wish I could give you more direct advice but, each person will react differently. I would advise you to ask your trusted clinician who’s care you are under.
Hi, I can’t get Rootcology in the UK. I can get a hypoallergenic product suitable for me but it’s only 500mg per capsule. If the required dose is 1800mg per day as you’ve said then I can only take either 1500mg or 2000mg. Will this matter? I wouldn’t want to take too much, nor would I want to take too little and not have enough effect.
Also, you mention a rotten egg smell which I know is well known for sulphur. My concern is, would I end up smelling like rotten eggs if I take it?! Like can sometimes happen with garlic capsules etc.
Thanks
Vanessa – thank you for reaching out. For questions about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
I started 900mg NAC, within 2 days my sleep is worse, trouble falling asleep and staying asleep. I didn’t make any other changes. I’m taking it at 10am. Would there be any point in trying a lower dose? Or any other suggestions for me?
Thanks!
Kay – thank you for reaching out. For questions about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
I am allergic to Sulfa. Can I take NAC
Mary – thank you for reaching out. NAC is not recommended if you have a sulfur sensitivity. You can read more about that, here:
HOW SUPPORTING THE LIVER IS KEY TO RECOVERING FROM THYROID DISEASE
https://thyroidpharmacist.com/articles/support-liver-recover-from-thyroid-disease/
Can I take this supplement while also using an ashwaghanda/probiotic supplement?
Molly – thank you for reaching out. NAC is an FDA approved supplement and considered safe for most populations, it can interact with some medications. Using NAC with an active peptic ulcer is contraindicated, and this supplement can also interact with anticancer agents. Furthermore, it is not recommended while taking nitroglycerin or metoclopramide. If you have any concerns about possible medication or supplement interactions, please speak with your practitioner.
So grateful for your library of information, and your supplement shopping page.z
I added 3 additional supplements: NAC, Alpha Lipoid Acid, and S-Acetyl L-Glutathione. I read about increased bioavailability of the S-Acetyl L Glu. Crossing fingers.
Grateful for your info on gut biome. After reading your info, I added the Pure Encapsulations brand of Enzymes, the Pure Encapsulations probiotic, & Pepsin HCL.
Multi Vitamin- Today I am switching to an iodine free formula of the Pure Encapsulations Nutrient 950.
Fortunately, my physician will test my antibody level, as often as I want. He warned me, that the insurance company may not pay for it. So that might be a reason why some physicians ‘hold back’ on testing frequently. Glad you provided us a link to self-refer to get our own testing done.
Mack – thank you so much for sharing your journey! I am happy to hear you are taking charge of your health and have found a practitioner. I hope you will keep me posted on your progress. <3
Hi Izabella,
I just read your book “Hashimotos protocol” and ordered some supplements including the Rootcology NAC. Is it best to take 1 capsule twice a day with food, or two at once in the morning? Thank you for your incredible work and service to those of us suffering from Hashimotos. ?❤️
Danielle – thank you for reaching out. You should start with the directions on the bottle and adjust your dosage from there. If you have more specific questions on how and when to take particular supplements under normal circumstances, please do reach out to my team by email, at info@thyroidpharmacist.com and they will be more than happy to help ?
Thank you for this informative article. Does NAC react to low dose naltrexone (up to a max dose of 4.5 mg)?
Kind regards,
Denise
Denise – you are very welcome! <3 I wish I could give you more direct advice but, each person will react differently. I recommend that you to ask your personal pharmacist or a trusted clinician who’s care you are under.
I’ve tried taking NAC but it always seems to cause this deep burning/pain in my gut. I wonder if this is inflammation as a negative response, but I also wonder if this is a healing reaction….? I did develop some sort of gut inflammation/leaky gut issues that turned into mcas/hit symptoms. I’m on a low histamine low lectin diet now but still have gut issues. Anyway I read NAC can lower DAO but I don’t seem to have an increase in histamine taking NAC just pain. But haven’t taken it long enough to see if the pain goes away and gut symptoms improve.
Michael – thank you for sharing your journey! I’m sorry you are having trouble with the NAC supplement. Please understand, I am not able to advise on whether NAC is an appropriate supplement for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor. <3
I have been using NAC earlier for my dry eyes (I hav Hashimoto as well) but then I stopped 3 months ago as I am trying to conceive was not sure if I could take it in pregnancy. I got pregnant at once but got an early miscarriage (w 6-7) and now today I got positive pregnancy test again (thankful about that!). My question would be if it would be safe to start NAC again as I felt it was helping my dry eyes and making me feel better in general? I only took 150 mg 2-3 times a day together with Vit C. I asked around with my doctors but nobody can answer (they don’t know anything about NAC) and reading paper online it even seems like it’s good for preventing miscarriages. But I am really not sure what to do as I only want the best for this pregnancy. I really hope you can answer as you seem to be one of the most knowledgeable pharmacist out there 🙂
Isabella – thank you so much for sharing your journey with me. Congratulations! <3 Please understand, I am not able to advise on whether NAC would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your OB.
Hi Izabella
Thx for your info on thyroid health. I’m 65yo female dx with Toxic nodular goiter (non-cancerous) for the last 27 years. Otherwise healthy, no other disease and on no other medications than for the thyroid and hormone treatment for my menopause, Activelle 1 mg/0.5 mg (estradiol/norethisteronacetate) and going to continue with that one :).
Started on Levaxin 30y to suppress goiter, but, ~12y ago diagnosed with hyperactive thyroid and a larger goiter, on scan with a downward growth into the thorax, deviating my bronchus. Been using medication for ~5y, first Carbimazole, TSH/T4/T3 stabilized, but last 6 months changed to Thiamazole 2×1 first; take now 1 tabl daily, and have a plan for surgery, thyroidectomy, on dec 9th.
My question is, been taking NAC for 4 months, now 1200 mg daily. Feels like my goiter has reduced somewhat (subjective) and the thyroidea hormones have been lowering, well, could be because of a better response to the Thiamazole treatment, but, also taking NAC. Now the Q, should I suspend or delay the operation, total thyroidectomy. Any reason or data supporting that NAC could be involved to reducing the goiter and therefore wait. The docs are more putting the responsibility upon my shoulders wether to be operated or not, like it were some cosmetic one! Thx in advance for your answer
/LG
Laufey – thank yo for reaching out and sharing your journey with me. <3 I'm happy to hear you are seeing some progress. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Here is an article you may find helpful.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
I took NAC in the past (when in treatment for SIBO), and now I am learning about glutathione. From your article, it sounds like NAC is a precursor to glutathione. Can someone supplement with only glutathione or glutathione reduced?
Mariel – thank you for reaching out. I use NAC and recommend, as a precursor of glutathione, NAC can help to optimize glutathione levels and reduce thyroid antibodies. It is an antioxidant in its own right. As a sulfur donator, it helps scavenge free radicals, and it does double duty, helping to boost glutathione levels by converting into glutathione in the body. As always I recommend that you discuss the addition of any supplement with your practitioner whose familiar with your health history.
Thanks Izabella for this info. I found the section on co-occurring conditions particularly interesting. You always provide such valuable info.
I took NAC, glutathione, MSM, milk thistle, vitamin C, etc for about 3 years while having my amalgam fillings replaced gradually over a period of about 14 months. I didn’t notice any health improvements but my hair tissue mineral analysis showed a significant improvement in toxic metal levels while taking these supplements. However, I don’t set a lot of store by HTMA results, as low levels of toxic metals can simply mean the metals are not being excreted.
Nevertheless, your article has inspired me to try another course of NAC.
Tanya – thank you so much for sharing your journey! <3 I hope you will keep me posted on your progress.
Hello Dr Wentz,
What is your opinion on flax seeds? I’m reading contradictory articles so I’m not sure what to think about them. Would they be safe for Hashimoto’s pacients?
Thank you in advance.
Andrej – thank you for reaching out. Flax seeds are high in Omega-3 fatty acids and can help reduce inflammation. However, if you are on the AIP diet or sensitive to them then you would want to avoid them. Did you know that reactive foods trigger an inflammatory response in the GI tract, leading to malabsorption of nutrients (gluten sensitivity, in particular, has been implicated in causing a Selenium deficiency, a well-known risk factor for Hashimoto’s), and can also produce intestinal permeability whenever they are eaten? Most people will see a dramatic reduction in gut symptoms, brain symptoms, skin breakouts, and pain by eliminating the foods they are sensitive to. Some will also see a significant reduction in thyroid antibodies! An additional subset of people will actually be able to get their Hashimoto’s into complete remission just by getting off the foods they react to, normalizing their thyroid antibodies, and some even normalizing their thyroid function! Here are a couple of articles you may find helpful.
AUTOIMMUNE PALEO DIET
https://thyroidpharmacist.com/articles/autoimmune-paleo-diet
FOOD SENSITIVITIES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/food-sensitivities-and-hashimotos
Hi! I am heterogenous for CBS
C19150T/C699T +/- And negative for D444N. Does that mean I should also steer clear of this supplement? I didn’t know there were three gene types for CBS and I’m not sure if maybe the one I’m negative for makes it safe. I also am heterogenous for MTHFR. Thanks in advance! It all gets confusing
Shawnah – thank you so much for reaching out and sharing. <3 I understand how this can be confusing! Please understand, I am not able to advise on whether NAC would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor.
Hi Izabella,
I`ve just began with the 90Days Hashimoto Protocol following your book.
I have a question about taking NAC, the dose is 1.8g per day with meals.
The supplements I’ve found here in Spain are 600mg. My question is whether I have to take all three pills in one meal or spread throughout the day.
Thank you very much in advance.
Manuel – thank you for reaching out! <3 For questions about my protocols and supplements please email my team at info@thyroidpharmacist.com and they will be happy to help.
great article! I am heterozygous for CBS 699 gene mutation. (so I have a +/- for it) idk if that means I shouldn’t take it per your recommendation for not taking it if you have an expressed CBS mutation or if you mean people are homozygous for the gene mutation (Like +/+) I hope that question makes sense and that I am using the correct terminology. wasn’t sure if you needed to be “homozygous” for a specific CBS mutation for it to be considered expressed. Thank you for all your wonderful information. 🙂
Caroline – thank you for following! <3 Please understand, I am not able to advise on whether NAC would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor.
Understood but you say not to take it if you have an expressed CBS mutation. what does “expressed CBS mutation” mean? Do you have to be homozygous to have an expressed CBS mutation?
Caroline – genetic mutations can be expressed in different ways. I recommend consulting your practitioner to help determine whether you have an expressed CBS mutation, or a sulfur sensitivity, before taking NAC.
Hello and thanks for the info. My nutritionist suggested NAC as a supplement to support my immune system. I have Hashimoto’s, FM, allergies and asthma, as well as underlying viruses (CMV and EBV). My asthma does not require a rescue inhaler. It is primarily caused by inflammation and allergies as part of my autoimmune issues. When I did some research on NAC, I consistently found that it is specifically not recommended for patients with asthma. This seems to directly contradict your assertion that it is a good option for it. Can you explain the discrepancy? Thanks!
C Fenimore – thank you for reaching out. <3 I am not able to advise you on whether NAC would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend discussing your concerns with your nutritionist and sharing with them your research as well as this article so together you can make a decision as to what would be best for you.
I’m on the gut health protocol now but noticed when I first started the adrenal protocol I noticed my eyes felt more heavy and the sensation in my throat became more pronounced which reminded me of the feeling I had when I was taking too much iodine? Since these protocols have you start many supplements at once I’m having a hard time determining if it’s from NAC or the adrenal supplements for the adrenal protocol or something else? Thanks!
Traci – thank you so much for sharing. For questions about the protocols and supplements please email my team at info@thyroidpharmacist.com and they will be happy to help <3
Izabella,
Thank you for your in-depth, well organized research articles. Your past trials and research have helped me so much on my healing Journey. I have Hashimoto’s and am in the recovery process.
After reading this article I tried NAC. I noticed an immediate difference the following day with my asthma! My breathing is much clearer. Yesterday during my workout I could breathe well and keep up with the instructor. I am on day 5 and am so thankful for the improvement. I can only imagine the NAC is helping my body in the other ways as mentioned in your article as well.
My full story is long ( as they all are) and would love to share with you at some time.
Thank you for your passion in helping all of us get better!
Rob
Robert – thank you so much for sharing you journey! <3 I'm so glad you found the NAC helpful. I would love to hear your story and you are welcome to email my team at info@thyroidpharmacist.com and share.
Almost all published articles I’ve read have said to take take on a empty stomach. Almost all supps you buy say take on empty stomach or two hours after you have eaten.
I’ve never had stomach issues but I take the sustained release version since it increases its half life.
So why the disparity with food or not? Interactions?
Thank you
Adam – thank you for reaching out. <3 Generally, I recommend taking NAC with food to avoid stomach upset. Everyone is different so I highly recommend working with your practitioner to determine what works best for you.
Hi Dr. Wentz – Thank you so much for this article and for being such an inspiration to those of us with Hashimoto’s! I understand you can not provide personalized care and I will check with my health care practitioner before starting any supplements. However, would you please clarify/elaborate on whether or not to take NAC along with a glutathione supplement? Or just take one or the other?
Best,
Anne
Anne – thank you for reaching out. <3, N-acetylcysteine is my favorite, because it does a lot of different things. It helps to reduce oxidative stress in the body and inside of the thyroid glands. It turns into glutathione, so it has been found to reduce some thyroid antibodies. It breaks down bacterial biofilms, to get rid of pathogenic bacteria in the gut, and it helps to support liver detox. I hope this helps. Please feel free to email my team at info@thyroidpharmacist.com if you have any questions or concerns about the suppplements.
two questions
Can l-cysteine be used in place of L acetyl cysteine?
I have taken this and my antibodies have changed
Of the two antibody tests I had score of around 120 each, after taking supplements, score for one anti body test went down to 30 (forget which one) but the other went to 150 or so, any advice? also my dr. told me that antibody score fluctuate all the time and and once you are hypo thyroid, these fluctuations up or down make no difference any comment?
Arkadin – thank you for reaching out. ❤️ To answer your first question, N-acetyl cysteine (NAC) is a sulfur-based derivative of the amino acid L-cysteine. NAC is a multitasking supplement that I have found can be especially beneficial for those with Hashimoto’s. When it comes antibodies, about 95% of people with Hashimoto’s have elevated Thyroid Peroxidase Antibodies, while 80% will have elevated Thyroglobulin Antibodies. They can both be important in monitoring the autoimmune attack on the thyroid, and can both be used to monitor the effect of interventions. Some interventions will lower TPO antibodies more, while others will have a greater effect on TG antibodies. This can depend on the individual and their body’s response.
Some people with Hashimoto’s test negative for thyroid antibodies because their overall immune health is so weak, they do not produce enough antibodies. I tested negative for antibodies several times. Now, I insist on a thyroid ultrasound. A thyroid ultrasound can be used to detect changes in the thyroid, associated with Hashimoto’s. Given that Hashimoto’s is one of the leading causes of hypothyroidism worldwide, it’s best to be certain, one way or another. I have written several articles about how to best decrease thyroid antibodies.
Here are some articles I think you might find helpful:
HASHIMOTO’S AND THYROID ANTIBODIES: PART 1
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-antibodies/
HASHIMOTO’S AND THYROID ANTIBODIES: PART 2
https://thyroidpharmacist.com/articles/part-2-mechanisms-reduce-thyroid-antibodies/
Thanks for your response …So I have l-cysteine , but not the NAC, should I not use the l-cysteine and just get the NAC, it sounds by the response that l-cysteine won’t have an effect on the antibodies. It’s just that I read somewhere that the l-cysteine was supposed to be better for some reason. Also, do you offer phone consultations?
Thanks again
I’ve heard that the FDA is cracking down on NAC and is intending to ban it as a nutritional supplement. I’m quite disheartened by this, as a NAC user. Do you have any information on this? Thoughts on how NAC can be acquired if this happens? Thanks!
Tasha – thank you for reaching out. ❤️ I don’t have any concrete information on whether NAC will be able to be sold as a supplement in the future, this is a potential concern and some third parties have discontinued NAC sales. If you have found NAC helpful, I recommend stocking up while you can, to ensure you have some extra on hand. Check out the article above for more info on the update.
I would like to call in an order for nac. What phone number can I use? I don’t like using my credit card on line. Thank you Diane gonzalez
Diane – thank you so much for reaching out. I understand! Please email my team at info@thyroidpharmacist.com and they will be happy to help you with this! ❤️
Can you please tell me if NAC can help with muscle pain? I have had severe muscle pain in my shin’s, ankles, and feet from the hypothyroidism/Hashimoto’s for the last 4 years . I’ve seen every doctor under the sun and had many tests and blood work, all normal. I am wondering if this could help with the pain, and also I am trying to figure out if my thyroid medication and/or fillers could be causing my muscle pain. I have read many of your articles, which are giving me guidance to talk to my doctors. Thank you!
Kelli – thank you so much for sharing! ❤️ I’m so sorry you are struggling with pain. Working with people with Hashimoto’s, I have found that most people will experience pain on some level. For some, it may manifest as a chronic condition, such as migraines or joint pain. Here are a couple articles you may find helpful:
PAIN AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/pain-and-hashimotos
NEW STUDIES ON MAGNESIUM AND THYROID HEALTH
https://thyroidpharmacist.com/articles/new-studies-on-magnesium-and-thyroid-health
Thank you!
Kelli – You are very welcome! ❤️
Hello Dr. Wentz,
Thank you for your article. I read that Comfrey is a good substitute for NAC if it goes off market. What can you tell us about Comfrey?
Sallie – thank you so much for reaching out. ❤️ I don’t currently have information to share on comfrey as a substitute for NAC, I will add it to my list of possible future articles to research.
Hi, Dr. Wentz,
Yesterday I took 1 capsule of 600 mg NAC just before bed.
I could not fall asleep, don’t know if that is something other people had too.
Well, I have a condition that has not been diagnosed. I am not able to at this time
due to insufficient funds and a well trained practioner here.
But I have inflammation all over, fatigued adrenals, thyroid and dysbiosis in the gut, bloating, back pain, muscle weakness etc.
In 2013 I was diagnosed with blasto that another lab strangely did not find in 2018 while the same symptoms still were prevalent as back in 2013.
Tried to eradicate myself through the use of herbs but not having the knowledge I think I made things worse rather than better.
It is so difficult to find out for your self what is wrong and what the solution would be. I am stuck in a loop, not being able to function and work and therefore lacking the proper income I can’t get any help. Some years back I asked for a blood test
through my GP but the standards for blood testing are not right. They show everything is normal.
What are the differences in symptoms between hypothyroid and hashimoto’s?
Danny – thank you for reaching out and sharing your journey. ❤️ I’m so sorry you are struggling with all of this. I understand how hard it is. You may want to consider taking the NAC earlier in the day to see if that helps. Hypothyroidism is associated with a lack of thyroid hormone that can occur as a result of a variety of different factors such as iodine deficiency, surgical removal of the thyroid, or damage to the thyroid. Hashimoto’s is an autoimmune condition that results in the immune system damaging the thyroid, which leads to a lack of thyroid hormone production. Most cases of hypothyroidism in the United States and other countries that add iodine to their salt supply are caused by Hashimoto’s. Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target. We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition. Here are some articles I also suggest that you join one of the Hashimoto’s groups that are out there. Being able to share ideas of what has worked with one another and offer support for each other can be very helpful. Here are some articles I hope you find helpful as well:
ARE YOU DOING EVERYTHING FOR YOUR THYROID BUT NOT YET WELL?
https://thyroidpharmacist.com/articles/are-you-doing-everything-for-your-thyroid-but-not-yet-well/
DO YOU HAVE HYPOTHYROIDISM OR HASHIMOTO’S OR BOTH?
https://thyroidpharmacist.com/articles/do-you-have-hypothyroidism-or-hashimotos-or-both/
Hi
I’m Australian based and have purchased NAC through Amazon until it was removed recently. It is now really difficult to purchase in Australia at all.
Given this situation is likely to persist for some time I wanted to ask if straight Glutathione is a feasible substitute for NAC long term?
Greg – thank you for sharing. ❤️ I understand how frustrating this is. I don’t have any concrete information on whether NAC will be able to be sold as a supplement in the future, this is a potential concern and some third parties have discontinued NAC sales. Please email my team at info@thyroidpharmacist.com and they will be happy to share with you some international options.
From what I’ve read I sure hope that this product will help me. I have fatty liver an type 2 diabetes suffer from anxiety and depression I’m so ready for something to change an I hope this is the answer.
Sharon – thank you so much for following! ❤️ I’m so sorry you are struggling with all of this. Anxiety and depression are common in people with thyroid disorders, also, patients often will have additional autoimmune conditions such as diabetes type 2, and I have found that my Hashimoto’s protocols can be helpful with all of these. Here are some articles that you might find interesting as well.
AUTOIMMUNE THYROID DISEASE AND ANXIETY
https://thyroidpharmacist.com/articles/autoimmune-thyroid-disease-and-anxiety
ROOT CAUSES OF DEPRESSION AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/root-causes-of-depression-and-hashimotos/
HASHIMOTO’S, BLOOD SUGAR AND DIABETES
https://thyroidpharmacist.com/articles/hashimotos-blood-sugar-and-diabetes/
What the different between
N-acetyl cysteine(NAC) and acety cysteine ?
Effervescent tablets or swallowing tablets or which is more effective or all have same effective?.
Thanks for all your Great Information
You recently commented that we should only take NAC for about 2 years, then take a break from it, but I don’t recall if you explained the reason for that.
We start taking your Rootcology product – one capsule per day – in 2020. I would like to know if we should stop for awhile, how long, and if that’s necessary, or can we stay on our current dose of one capsule per day. Thank you for all your wonderful advice! KC
Hi Karen – thank you so much for following. ❤️ Generally speaking, I recommend continuing the NAC for 3 months to 2 years, depending on how you are responding. If you wish to take them beyond that time, I recommend discussing with a practitioner.
Olá! Comecei a usar NAC por apenas dois meses e meus anticorpos reduziram de 1.300 para 220. Isto é maravilhoso!!!!
Flavia – That’s so great to hear! ❤️ Thank you so much for sharing!
Can you explain why you can’t take NAC if taking activated charcoal? Thanks.
Kathleen – Thank you for following! NAC is not recommended to be used with activated charcoal because adsorption and inactivation of NAC by charcoal is believed to occur. PMID: 3994080
I noticed the dose is 900 mg. If 1800 is optimal should I take 2 at the same time or space them out?
Lisa – thank you for reaching out. You can take them at the same time, but be sure to take them with food to avoid stomach upset.
Hello, thank you for this very helpful article. Can I ask – where you advise not taking NAC with anti-coagulant drugs or blood thinners, would this include baby (low dose) daily aspirin? Thank you. – May
May – thank you for reaching out. It is not recommeded for use if you are taking any blood thinners.
Thank you for sharing great information! My mother has been dealing with chronic inflammation for many years and it has impacted so many parts of her body. She is on blood thinner for her heart issue. With so much benefits of NAC, is there an alternative for her?
Najmeh – thank you for reaching out. I’m so sorry to hear your mother is strugging with chronic inflammation. Unfortunately, I don’t have a supplement alternative. Chronic inflammation may occur from joint pain, toxic burden, inflammation in the GI tract from irritable bowel disorders, pathogens, or food sensitivities. Inflammation is always a factor with Hashimoto’s, as thyroid disease itself involves inflammation of the thyroid gland In autoimmune disease, the body views part of its own body as a foreign invader and stages an attack, resulting in inflammation. In most cases of Hashimoto’s, where the body attacks its own thyroid cells, the inflammation is not limited to the thyroid gland, but can manifest anywhere in the body. Here is an article that you might find helpful:
https://thyroidpharmacist.com/articles/10-most-helpful-diy-interventions-for-hashimotos/
Is it OK to take NAC at the same time as taking T3? If I would take it at night, could I take it at the same time as I am taking LDN? Thanks!
Kathleen – thank you for following. Thyroid medication absorption can be impacted by many things, including food, other medications, and supplements. It should be taken on an empty stomach at least one hour before eating, taking other medications, supplements or coffee to ensure appropriate absorption. Antacids such as Tums, iron, magnesium, and calcium supplements can impair the absorption of thyroid medications. Thus, you need to have at least 4 hours of time in between your thyroid medications and these. Please be sure to read the directions provided with your medication. I hope you find this free ebook helpful as well. https://thyroidpharmacist.com/meds-ebook/
Thank you for this article. Can NAC cause skin to brreakout when you take it? Could it be purging toxins? I started taking it a week ago and think it is causing me to have acne.
Caitlyn – thank you for reaching out. It’s hard to say, as everyone reacts differently. I would recommend stopping the NAC and waiting till the issue has cleared and then you could try introducing again to see if you react the same. I do recommend discussing with your practitioner and introducing at a low dosage and increasing slow to the recommended dose if you decide to try again.
Hello! Just read your recommendation for a person to not take NAC if they are taking an ACE inhibitor or blood thinner. My loved one takes both and NAC has helped her a ton as well. Can you clarify if you mean she shouldn’t take them at the same time. Or do you mean it’s not good to take NAC at all while on those meds?
Janet – thank you for following. It is not recommended that you supplement with NAC while on ACE inhibitors or blood thinners as it can interact with the medication. I do recommend discussing this with your practitioner.