Is NAC good for PCOS?

If you've been diagnosed with PCOS, it's important to learn what you can do to help with the condition. You may have heard about NAC for PCOS, and wonder if you should try it. We'll look at what NAC is, its safety profile, and its potential benefits for PCOS, so you can make an informed decision. 

What is NAC? 

The scientific name for NAC is N-acetylcysteine. It's a form of cysteine, which is a conditionally essential amino acid. This means it's essential for your body to function properly, but it can be created by the body from other amino acids. 

Cysteine is found in many healthy foods, typically those high in protein.

Food sources of cysteine include: 

• Chicken
• Turkey
• Yogurt
• Cheese
• Eggs
• Seeds and legumes 

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NAC benefits for overall health

First, let's look at some overall benefits of NAC. It is necessary for producing Glutathione, which is one of the body's most important antioxidants. It removes toxins from the body, including free radicals, which are linked to cancer.

It also plays an important role in immune system function and detoxification, particularly within the liver and kidneys. 

In addition, it helps to regulate glutamate levels, which are neurotransmitters essential for proper mental health. Low glutamate and glutathione levels have been linked to several mental health conditions, including schizophrenia, bipolar disorders, OCD, and addiction. 

NAC for PCOS

Now that we know NAC can provide some overall health benefits, let's take a look at what it can do for PCOS symptoms. 

NAC is known to help with PCOS in several ways, including:

• Increasing fertility
• Improving insulin resistance
• Balancing hormones
• Reducing inflammation 
• Improving liver function

NAC for fertility 

Up to 70% of women with PCOS have fertility issues, making it a key symptom to manage. One meta-analysis of NAC for fertility found that NAC was significantly better than placebo at improving fertility. The analysis included 9 studies, and a total of 910 women with PCOS. NAC increased a woman's chances of having a live birth, getting pregnant, and ovulation. There were no significant changes in the rates of miscarriage, menstrual regularity, or insulin levels. 

It's particularly important for women with clomid resistance. NAC has been found to increase ovulation rates by 9 times, and pregnancy by 5 times, according to a study by the European Journal of Obstetrics, Gynecology, and Reproductive Biology.

For women who are resistant to Clomid, NAC may help to improve their fertility as well. A 2014 study published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology found that NAC users had a nine times higher ovulation rate and a five times higher pregnancy rate in Clomid-resistant women as compared to a placebo.4

Why does NAC improve fertility? One reason may be that NAC improves insulin resistance.

Improving insulin resistance

50% to 90% of women with PCOS have insulin resistance as well. Insulin resistance can lead to type 2 diabetes, weight gain, and other concerning conditions. It also has an impact on fertility and the ability to have a live birth. 

Metformin is a medication for diabetes, but it's commonly prescribed for PCOS to manage insulin resistance. NAC has been shown to be as effective as metformin in improving insulin resistance and lowering cholesterol levels, without the potential side effects of metformin. 

Insulin resistance causes hormonal imbalances, including higher levels of Testerone, and reduced levels of progesterone, which has a significant impact on fertility. NAC works by protecting insulin receptors and influencing insulin receptor activity secretion in the pancreas.

This brings us to the next benefit of NAC for PCOS, balancing hormones. 

Balancing hormones

Another of the NAC benefits is hormonal balance. One study followed 100 women, with half receiving NAC and the other half receiving metformin. While weight wasn't lowered in either group, BMI was lower in the NAC group. Women who were receiving NAC also experienced lower insulin resistance, and lower testosterone levels. 

It also increases FSH, or follicle-stimulating hormone, which is essential for ovulation. In addition to increasing fertility, balancing hormones can also reduce other symptoms of PCOS.

Women with improved hormonal balance may experience improvements in: 

• Menstrual irregularities
• Hirsutism, or excess body hair (caused by increased testosterone)
• Acne (caused by excess androgens)
• Belly fat
• Hair loss
• Fatigue (due to insulin resistance)

Reduced inflammation 

NAC can also reduce inflammation associated with PCOS. This type of inflammation is known as chronic low-grade inflammation. Doctors perform a blood test to check for CRP, or C-reactive protein, to check inflammation levels in the body. Women with PCOS typically have a higher level of CRP, which means their body is experiencing inflammation on a regular basis. 

Other signs of chronic inflammation include oxidative stress, inflammatory cytokines, and a higher white blood cell count. 

Common symptoms of inflammation include swelling, joint pain, and headaches. However, it can also affect some organs, and increases the risk of pancreatitis and appendicitis. It also increases the risk of diabetes, heart disease, and infertility. 

Reducing inflammation can help reduce the risk of other disorders and the symptoms associated with them. 

Improving liver function

PCOS also increases the risk of liver disease, particularly Nonalcoholic fatty liver disease, or NAFLD. The disorder is more commonly known as fatty liver disease. 

NAC possesses antioxidant and anti-inflammatory properties. It's believed that this contributes to improved liver function and a decrease in fatty liver disease risk. 

A few studies have been conducted, and the findings suggest that NAC's effects can positively impact liver function, but larger-scale studies are needed. 

It also decreases certain liver enzymes associated with liver damage, including ALT, AST, and ALP. 

Another benefit of NAC is increased blood flow to the liver. This can help improve liver function and aid in the body's natural detoxification process. 

Lastly, it reduces the amount of fat that gets into the liver. Fat infiltration in the liver can slow blood flow and lead to higher blood pressure. NAC's reduction in fat infiltration can help prevent these issues. 

NAC side effects

NAC certainly has many benefits, but there are potential side effects you should be aware of as well. 

It's important to note that NAC is considered safe, and side effects are less common with NAC than with common PCOS medications. You should also know that many people experience temporary side effects that go away as their body adjusts to the compound. 

The most common side effects of NAC are nausea, vomiting, and diarrhea. These effects typically happen when you first start taking NAC, if they occur. Once your gastrointestinal system gets used to NAC, you may be able to tolerate it well. 

Less common but serious side effects include:

• difficulty with breathing or swallowing
• fever
• hives or itching
• severe or ongoing vomiting
• swelling of the eyes, face, or inside of the nose
• unusual tiredness or weakness

Like any substance, some people are allergic to NAC. These people are likely to experience more serious side effects, depending on the severity of the allergy. However, a serious or life-threatening anaphylactic reaction only occurs in 0.1% of reactions, making it very rare. 

NAC at higher levels can raise your levels of cysteine too much. This can increase your risk of cardiovascular disease, heart attack, and stroke. While NAC generally lowers your risk of cardiovascular disease, it's important to be aware of this issue. 

It can also slow your body's ability to clot. If you are on blood thinners or have a bleeding disorder, NAC may not be a good option for you. 

Who should consider taking NAC? 

NAC is a safe nutritional supplement for most women with PCOS. If you are looking for a natural way to manage your PCOS symptoms, you can try NAC. It can be taken with some PCOS medications, or alone to manage symptoms naturally. 

Who shouldn't take NAC? 

While NAC is safe for most people, there are some people who are advised not to take it. 

You will want to avoid NAC, or speak to your doctor, if you are taking the following medications as they can interact with each other

• Immunosuppressants like azathioprine, cyclophosphamide, and prednisone 
• Medication for chest pain including isosorbide and nitroglycerin
• Antifungal drugs like oxiconazole

You'll also want to avoid NAC if you have cystinuria, which causes you to pee out large levels of cystine. This makes you more likely to develop kidney stones, and increasing your cystine levels can increase this risk. 

You should also avoid NAC if you take nitroglycerin. You may experience low blood pressure and headaches if you take nitroglycerin regularly with NAC. 

How do I start taking NAC? 

If you are interested in taking NAC for PCOS, it's best to start with a talk with your doctor. However, NAC is inexpensive, safe, and easy to find. If you want to improve your PCOS symptoms and overall health, NAC is a good option. 

If you choose to take NAC, the average dose is 500 mg to 600 mg once or twice a day. You may want to begin taking it once a day and see how your body tolerates it before increasing your dose to twice a day. 

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