(About NAC, n-acetylcysteine). Thank you for this comment. I appreciate hearing this alternative perspective, and I would be interested to know more about your experience with this, or any source material. I had viewed a video by Dr. Mobeen Sayed in which he showed how NAC works and how it would be helpful in Covid. "Dr. Been" produces …
(About NAC, n-acetylcysteine). Thank you for this comment. I appreciate hearing this alternative perspective, and I would be interested to know more about your experience with this, or any source material. I had viewed a video by Dr. Mobeen Sayed in which he showed how NAC works and how it would be helpful in Covid. "Dr. Been" produces teaching videos for continuing education for physicians and also for medical students and other healthprofessionals, though I don't remember if this one had been approved for credit. Some of his videos are at you tube, though they took down most of the Covid videos, I think, but he also has them at Odyesee and at his own website. In addition, I have a colleague who has done neuroscience / brain research, who takes NAC himself and recommends it to patients for various purposes. I am aware that every living human being produces NAC so we have our own internal supply, which seems to indicate a level of safety, though apparently what we have on board on our own may not be sufficient to meet our needs in the case of an overwhelming amount of toxins from Covid - or from paracetamol (acetominophen / Tylenol) overdose. Yes, it's been used for decades as a life-saving treatment in cases of acetominophen poisoning, where people would certainly have died without it. It's also been used medically to protect the kidneys when radioactive dye must be used to image kidneys that may already be unwell. Another medical use has been in cystic fibrosis. I had never heard of problems with NAC until you have mentioned it. I would add that the Frontline Covid 19 Critical Care Alliance (FLCCC at FLCCC.net recommends NAC in some of their various Covid treatment protocols. This group is NOT the one affiliated with Dr. Simone Gold, but is a very scholarly group including Dr. Marik who is an international authority on critical care treatment, who has taught in medical schools and written textbooks and book chapters etc. long before he became known for his work with Covid, and also Dr. Pierre Kory who also treats ICU patients and has taught medical school, and published extensively in the same field of critical care, who now has a private practice where he focuses primarily on Covid treatment and prevention, and long Covid. The fact that they have looked at the resesarch and recommend it makes me relatively confident that I have not been misled about NAC, and I take it myself though not related to Covid, but for another reason. I don't recall it being recommended for prevention, but definitely for use in Covid treatment. Still, I appreciate your comment, and I am always interested to make sure I have not missed anything important in this time of medical censorship and misinformation from so many sources. You say you are not keen on NAC or ibuprofen - they are really completely unrelated to each other even though both do have anti-inflammatory properties. I have always told patients that if they need something for pain and fever during Covid, they can take ibuprofen as one of their options, if they normally would take it, but I don't urge it on people - ibuprofen should never be taken on an empty stomach because it can cause tissue damage there, cause an ulcer in the stomach, even a bleeding ulcer which can be very dangerous - though if not used excessively, if taken while food is in the stomach, and if the person knows to STOP taking it if they have stomach pain - then it's fine for many people especially short term use. However, I recently had a patient with a history of heart surgery and blood pressure issues - his wife was giving him ibuprofen for pain and fever, and his blood pressure shot up to a dangerous level. That is not a frequent effect of ibuprofen, but adverse effects on blood pressure and heart function have been written up in the medical literature, and his blood pressure improved immediately when ibuprofen was stopped, so I'm sure it was that and nothing that I had prescribed. So, yes, certainly ibuprofen and that whole class of ANSAID medications are a "two-edged sword," certainly potential benefit, but also some risks that can be more serious than people realize. However, NAC is not an ANSAID, and I have not seen or experienced any side effects from it, but at the molecular level there are some important beneficial effects. I don't think of NAC as being for pain or fever at all, but really, for cleaning up toxins in the body to prevent tissue damage. Okay, you mention there could be an allergic reaction to NAC - but NAC is an essential thing that is in every human body, so I can't imagine how we could be allergic to NAC itself - it may be some filler in the tablet or something added to make the tablet hold together that could have produced the allergic reaction - I can't comprehend how NAC could possibly cause an allergic reaction. If you have any links or specific references, that would be helpful. Thanks.
I would not have known about the risk of an allergic reaction had I not seen a diabetic in her sixties experience one. The symptoms were: agitation (possibly tachycardia), sleeplessness, rash in the upper torso, neck and face; all subsided spontaneously within 48 hours.
Thank you for this. With the two pubmed articles, both were allergic reactions after the IV NAC. I looked up what was in the IV solution, and it includes disodium edetate. I looked up disodium edetate and that has a list of adverse reactions that include "feeling like you might pass out; or
severe blistering, peeling, or red skin rash. nausea, vomiting, diarrhea; numbness or tingling (especially around your mouth); headache; or pain, redness, or swelling where the needle is placed" and others. Some of these side effects overlap with what has been reported for NAC, so I'm wondering a little bit if this could be related to an additive - maybe the disodium edetate - in the IV formulation and not a true allergy to NAC. But then again, at drugs.com where they list the various side effects, it says "applies to acetylcysteine: oral capsule, oral solution. Other dosage forms: inhalation solution; intravenous solution. So, the side effects listed do apply to the oral capsules, and there is no breakdown over what percentage of side effecs from capsules vs. IV solutions etc. So then I went and looked at what I have on hand myself - a bottle of NAC tablets that include 8 different ingredients besides the NAC (including Croscamellose which I've never heard of, peppermint flavor and more), also NAC capsules with only 3 extra ingredients. So, in whatever forms we obtain NAC, there will be extra ingredients and one or more of those additives might cause an allergic reaction. I truly can't comprehend how NAC itself could cause an allergic reaction but as formulated and purchased, obviously it can, and good to know. As I started thinking about "extras" in our meds, I remembered the Zantac / ranitidine recall due to contamination with the carcinogent NMDA in the made-in-China medication - with so many meds produced in nations that are not particularly known for high safety standards or cleanliness, there could be additives in products that are not listed on the label, but are potential contaminants.
One thing I did notice in looking at the NAC labeling, says that you can get NAC kidney stones, though they are rare. I would think that would be when NAC is used long-term. I don't recommend NAC for "prevention" of Covid, only as part of treatment, relatively short-term. Many of my patients were already taking NAC at first contact, where I often tend to suggest it later in the course since the first time I read about NAC was in the context of long Covid, though apparently it helps when given earlier. I've never read of it for Covid prevention, and I think it would be when taken daily over a long period of time that there might be some risk of NAC kidney stones.
Anyway, good to be aware of the possibility of the allergic reactions - thanks.
Histamine now seems to be an important mediator of the response [to NAC], and there is evidence of variability in patient susceptibility, with females, and those with a history of asthma or atopy are particularly susceptible. … The pattern of reactions differs with oral and intravenous dosing, but reported frequency is at least as high with oral as intravenous.
(About NAC, n-acetylcysteine). Thank you for this comment. I appreciate hearing this alternative perspective, and I would be interested to know more about your experience with this, or any source material. I had viewed a video by Dr. Mobeen Sayed in which he showed how NAC works and how it would be helpful in Covid. "Dr. Been" produces teaching videos for continuing education for physicians and also for medical students and other healthprofessionals, though I don't remember if this one had been approved for credit. Some of his videos are at you tube, though they took down most of the Covid videos, I think, but he also has them at Odyesee and at his own website. In addition, I have a colleague who has done neuroscience / brain research, who takes NAC himself and recommends it to patients for various purposes. I am aware that every living human being produces NAC so we have our own internal supply, which seems to indicate a level of safety, though apparently what we have on board on our own may not be sufficient to meet our needs in the case of an overwhelming amount of toxins from Covid - or from paracetamol (acetominophen / Tylenol) overdose. Yes, it's been used for decades as a life-saving treatment in cases of acetominophen poisoning, where people would certainly have died without it. It's also been used medically to protect the kidneys when radioactive dye must be used to image kidneys that may already be unwell. Another medical use has been in cystic fibrosis. I had never heard of problems with NAC until you have mentioned it. I would add that the Frontline Covid 19 Critical Care Alliance (FLCCC at FLCCC.net recommends NAC in some of their various Covid treatment protocols. This group is NOT the one affiliated with Dr. Simone Gold, but is a very scholarly group including Dr. Marik who is an international authority on critical care treatment, who has taught in medical schools and written textbooks and book chapters etc. long before he became known for his work with Covid, and also Dr. Pierre Kory who also treats ICU patients and has taught medical school, and published extensively in the same field of critical care, who now has a private practice where he focuses primarily on Covid treatment and prevention, and long Covid. The fact that they have looked at the resesarch and recommend it makes me relatively confident that I have not been misled about NAC, and I take it myself though not related to Covid, but for another reason. I don't recall it being recommended for prevention, but definitely for use in Covid treatment. Still, I appreciate your comment, and I am always interested to make sure I have not missed anything important in this time of medical censorship and misinformation from so many sources. You say you are not keen on NAC or ibuprofen - they are really completely unrelated to each other even though both do have anti-inflammatory properties. I have always told patients that if they need something for pain and fever during Covid, they can take ibuprofen as one of their options, if they normally would take it, but I don't urge it on people - ibuprofen should never be taken on an empty stomach because it can cause tissue damage there, cause an ulcer in the stomach, even a bleeding ulcer which can be very dangerous - though if not used excessively, if taken while food is in the stomach, and if the person knows to STOP taking it if they have stomach pain - then it's fine for many people especially short term use. However, I recently had a patient with a history of heart surgery and blood pressure issues - his wife was giving him ibuprofen for pain and fever, and his blood pressure shot up to a dangerous level. That is not a frequent effect of ibuprofen, but adverse effects on blood pressure and heart function have been written up in the medical literature, and his blood pressure improved immediately when ibuprofen was stopped, so I'm sure it was that and nothing that I had prescribed. So, yes, certainly ibuprofen and that whole class of ANSAID medications are a "two-edged sword," certainly potential benefit, but also some risks that can be more serious than people realize. However, NAC is not an ANSAID, and I have not seen or experienced any side effects from it, but at the molecular level there are some important beneficial effects. I don't think of NAC as being for pain or fever at all, but really, for cleaning up toxins in the body to prevent tissue damage. Okay, you mention there could be an allergic reaction to NAC - but NAC is an essential thing that is in every human body, so I can't imagine how we could be allergic to NAC itself - it may be some filler in the tablet or something added to make the tablet hold together that could have produced the allergic reaction - I can't comprehend how NAC could possibly cause an allergic reaction. If you have any links or specific references, that would be helpful. Thanks.
First, my apologies for some sloppy syntax. The last sentence should have read: ... I am not keen on either [paracetamol] or ibuprofen.
NAC is generally fine, yet it is good to be aware of any potential issues; as usual, there are also possible interactions. https://www.drugs.com/sfx/nac-side-effects.html
I would not have known about the risk of an allergic reaction had I not seen a diabetic in her sixties experience one. The symptoms were: agitation (possibly tachycardia), sleeplessness, rash in the upper torso, neck and face; all subsided spontaneously within 48 hours.
A couple of references:
https://pubmed.ncbi.nlm.nih.gov/6523726/
https://pubmed.ncbi.nlm.nih.gov/29423816/
While taking supplemental NAC orally for the first time, it may be good to have some antihistamines at hand, just in case.
Thank you for this. With the two pubmed articles, both were allergic reactions after the IV NAC. I looked up what was in the IV solution, and it includes disodium edetate. I looked up disodium edetate and that has a list of adverse reactions that include "feeling like you might pass out; or
severe blistering, peeling, or red skin rash. nausea, vomiting, diarrhea; numbness or tingling (especially around your mouth); headache; or pain, redness, or swelling where the needle is placed" and others. Some of these side effects overlap with what has been reported for NAC, so I'm wondering a little bit if this could be related to an additive - maybe the disodium edetate - in the IV formulation and not a true allergy to NAC. But then again, at drugs.com where they list the various side effects, it says "applies to acetylcysteine: oral capsule, oral solution. Other dosage forms: inhalation solution; intravenous solution. So, the side effects listed do apply to the oral capsules, and there is no breakdown over what percentage of side effecs from capsules vs. IV solutions etc. So then I went and looked at what I have on hand myself - a bottle of NAC tablets that include 8 different ingredients besides the NAC (including Croscamellose which I've never heard of, peppermint flavor and more), also NAC capsules with only 3 extra ingredients. So, in whatever forms we obtain NAC, there will be extra ingredients and one or more of those additives might cause an allergic reaction. I truly can't comprehend how NAC itself could cause an allergic reaction but as formulated and purchased, obviously it can, and good to know. As I started thinking about "extras" in our meds, I remembered the Zantac / ranitidine recall due to contamination with the carcinogent NMDA in the made-in-China medication - with so many meds produced in nations that are not particularly known for high safety standards or cleanliness, there could be additives in products that are not listed on the label, but are potential contaminants.
One thing I did notice in looking at the NAC labeling, says that you can get NAC kidney stones, though they are rare. I would think that would be when NAC is used long-term. I don't recommend NAC for "prevention" of Covid, only as part of treatment, relatively short-term. Many of my patients were already taking NAC at first contact, where I often tend to suggest it later in the course since the first time I read about NAC was in the context of long Covid, though apparently it helps when given earlier. I've never read of it for Covid prevention, and I think it would be when taken daily over a long period of time that there might be some risk of NAC kidney stones.
Anyway, good to be aware of the possibility of the allergic reactions - thanks.
It is a fascinating topic; I have now found the very first source I came across originally:
https://cfsremission.com/2021/06/02/n-acetylcysteine-and-histamine-allergies/
Quote:
Histamine now seems to be an important mediator of the response [to NAC], and there is evidence of variability in patient susceptibility, with females, and those with a history of asthma or atopy are particularly susceptible. … The pattern of reactions differs with oral and intravenous dosing, but reported frequency is at least as high with oral as intravenous.
Interesting. Thank you.