Antioxidant therapy with NAC for MS.

A small clinical study has reported primary findings that treatment for two months with N-acetylcysteine (NAC), which is a natural molecule that enhances the levels of antioxidants, significantly improved metabolic activity in certain brain regions among people with multiple sclerosis (MS).
NAC is the N-acetyl derivative of the naturally occurring amino acid, L-cysteine, and studies have suggested that it helps increase glutathione levels in the body and brain. If these levels are depleted it contributes to more oxidative stress that occurs with disease processes in MS, which can then disrupt the blood-brain barrier (BBB) and result in neuronal and axonal injury.

 We know too that brain levels of glutathione can be massively depleted in virtually every type of neurodegenerative disease so maintaining optimum levels is critical. 
 
In this small but important clinical trial,  fluorodeoxyglucose (FDG)-positron emission tomography (PET) data showed significantly increased cerebral glucose metabolism in several brain regions including the caudate, inferior frontal gyrus, lateral temporal gyrus, and middle temporal gyrus in the MS group treated with NAC, as compared to the control group. Self-reported scores related to cognition and attention were also significantly improved in the NAC group as compared to the control group.
 
The dose was 50 mg/kg mixed into 200 ml of dextrose 5% in water (D5W) and infused over approximately 1 hour, once weekly. Subjects additionally took 500 mg NAC tablets twice daily per day on the days that they did not receive the NAC infusion.
 
NAC has shown great promise for use in other disease treatment protocols. In a previous study, researchers from Thomas Jefferson University, Philadelphia, evaluated the benefits of providing NAC to people with Parkinson’s disease, a condition also marked by oxidative stress and neurodegenerative damage. The investigation noted “improvements in dopamine levels, the primary neurotransmitter that is specifically decreased in Parkinson's disease, as well as improvements in clinical evaluations of the patients' mental and physical abilities.”
 
Other research shows that NAC may have additional benefits in MS protocols. The results of one study suggest that NAC positively affects cerebral glucose metabolism in MS patients, which is associated with qualitative, patient-reported improvements in cognition and attention. Scientists noted that larger scale studies would be instrumental in determining the dosing regimen at which NAC may be most effective to gauge the clinical impact of NAC on measures of functioning over the course of illness.1
 
While NAC is widely available OTC, as well as by prescription, be sure to talk to your physician about whether this supplement is appropriate for your individual health needs.
 
In health,
Dr. Suzanne Gazda
 
1 Monti, Daniel A., Zabrecky, George, Leist, Thomas P., Wintering, Nancy, Bazzan, Anthony J., Zhan, Tingting, Newberg, Andrew B. N-acetyl Cysteine Administration Is Associated With Increased Cerebral Glucose Metabolism in Patients With Multiple Sclerosis: An Exploratory Study. Frontiers in Neurology. (2020) Vol. 11, pp 88 https://www.frontiersin.org/article/10.3389/fneur.2020.00088
doi: 10.3389/fneur.2020.00088