NAC Benefits

14 Health Benefits of NAC (N-Acetylcysteine)

Dr. Jolene BrightenPublished: Last Reviewed: Gut-Hormone Connection, PCOS, Preconception & Fertility

N-Acetylcysteine (NAC) has a list of health benefits that's longer than its name! While NAC might not be as well known as other nutrients I’ve discussed, it's definitely one worth having on your radar. 

What do NAC supplements do? From detoxification to brain health, heart health, and fertility, NAC is a jack of all trades and a supplement I regularly recommend to my patients.

In this article, I’m going to be discussing these 14 health benefits of NAC (N-Acetylcysteine):

  1. Boosts Glutathione Production – A Powerful Antioxidant 
  2. May Improve Fertility in Both Men and Women  
  3. Prevents Oxidative Damage and Inflammation
  4. May Improve Symptoms of PCOS
  5. May Help to Stabilize Blood Sugar
  6. Supports a Healthy Microbiome
  7. Reduces Respiratory Symptoms in Chronic Lung Disease (like COPD)
  8. May Enhance Immune Function by Increasing Glutathione and Modulating Inflammation
  9. May Reduce Inflammation and Symptoms Related to Influenza and Viral Illness
  10. May Help Autoimmunity by Reducing Inflammation
  11. NAC Supports Detoxification and Protects Your Kidneys and Liver
  12. May Reduce Psychiatric and Addictive Disorders
  13. May Improve Brain Health
  14. NAC May Help Prevent Heart Disease

In this article

What Is N-acetylcysteine (NAC)?

N-acetylcysteine is the supplement form of cysteine, an amino acid. Amino acids form the building blocks of proteins in the body. Cysteine is also important for the production of glutathione (the body’s most powerful antioxidant).

benefits of n acetyl cysteine

14 NAC Benefits

As I began drafting this article, my original goal was to cover the top five benefits of NAC. But as I dove deeper, five quickly turned into eight… then 10… and finally, I had to stop at 14.

NAC is one of those underrated powerhouse nutrients packed with benefits far beyond what most of us realize. Let's take a look at how NAC benefits skin, weight loss, cognitive function, and much more:

1. Helps Make Glutathione (A Powerful Antioxidant)

NAC helps your body create intracellular glutathione, which acts like your body’s antioxidant powerhouse, protecting your cells from free radical damage and supporting your immune system in defending against viruses, bacteria, and other pathogens.  

Glutathione is made up of three amino acids: L-cysteine, L-glutamate, and glycine. NAC provides the L-cysteine component that enables your body to make glutathione. Glutathione is vital for many functions, like DNA synthesis, helping certain enzymes, supporting the immune system, and more.  

The bottom line: We need glutathione, and NAC, being one of its building blocks, is therefore very important.

nac fertility

2. May Improve Fertility in Women (and Men!)

Because it can support antioxidants in the body, NAC has the potential to help with fertility in both women and men, including by protecting eggs and sperm.

NAC for Female Infertility:

One meta-analysis1 aimed to evaluate the effectiveness and safety of NAC as a treatment for female infertility. Researchers reviewed 15 randomized controlled trials involving 2,330 women to assess the impact of NAC on ovulation, pregnancy, miscarriage, and multiple pregnancies. 

The results showed that NAC provided minor improvements in pregnancy and ovulation rates compared to other treatments like metformin when used to treat unexplained infertility. NAC was shown to be most beneficial for women with polycystic ovary syndrome2 (PCOS), high BMI, insulin resistance, and oxidative stress. More research is needed to confirm its benefits, particularly with longer-term outcomes like live birth rates.

For women with endometriosis, a study3 found that oral NAC improves endometriosis-related pain and the size of endometriomas and can improve fertility outcomes. In this particular study, women took 600 mg of NAC three times per day for three consecutive days of the week for three months. 

Another study4 found that the use of NAC during IVF could improve the quality of blastocysts in advanced-age women.

NAC for Male Infertility:

Men with fertility issues have higher levels of semen reactive oxygen species (a form of oxidative damage) than fertile men. This can cause sperm damage and dysfunction. 

In one study5, After NAC treatment, men with infertility experienced improved sperm counts and motility, as well as reduced abnormal morphology, DNA fragmentation, and protamine deficiency. Improvements were also found in hormonal profiles, including levels of testosterone. 

Overall, NAC oral supplementation was found to improve sperm parameters and oxidative/antioxidant status in infertile males.

3. Can Help Manage Polycystic Ovarian Syndrome (PCOS)

NAC has been shown in several studies to have benefits in the management of PCOS. PCOS symptoms can include irregular cycles, weight gain, hair loss on the scalp, hair growth on the face and torso, and infertility. 

A meta-analysis6 looked at 18 studies involving over 2,000 women with PCOS to determine how NAC affects ovulation and hormone levels. The results showed that NAC helped reduce testosterone levels (which are often too high in PCOS) and increased follicle-stimulating hormone (FSH), which plays a role in egg production. 

However, NAC did not significantly impact other factors like the number of follicles, endometrial thickness, or progesterone levels. Overall, NAC was found to be beneficial for improving some aspects of reproductive function in women with PCOS.

A number of other studies7 have shown that NAC can help to decrease:

  • BMI, which means NAC weight loss may be at play
  • Hirsutism (meaning there was less hair on the face, chest, and abdomen—a common complaint of women with PCOS)
  • Fasting insulin (there was better blood sugar balance)
  • Free testosterone (unusually high levels of testosterone can lead to acne, oily skin, and hair loss)
  • Menstrual irregularities
  • Total and LDL cholesterol (Metformin only led to a decrease in total cholesterol)

In my clinical practice, I've had patients experience these types of benefits while taking 900 mg twice daily. 

4. May Help Stabilize Blood Sugar

In one study8, researchers explored how ongoing treatment with NAC could affect hypothalamic obese rats, which typically exhibit pre-diabetes, high body fat, inflammation, and liver dysfunction. 

The study involved adult male rats damaged by neonatal monosodium L-glutamate (MSG) and compared them to healthy control rats. The researchers treated some of the rats with NAC and analyzed various metabolic and liver function markers.

Key findings showed that NAC effectively lowered high triglycerides, insulin resistance, oxidative stress, and inflammation in the liver of the rats. NAC also improved insulin sensitivity and normalized liver enzyme levels and lipid metabolism. The study concluded that long-term antioxidant therapy with NAC helped prevent the development of pre-diabetes, dyslipidemia, and liver inflammation in obese rats, largely by reducing oxidative stress.

5. Helps Prevent Oxidative Damage and Inflammation

Because NAC is important for the production of glutathione, a powerful antioxidant, it is also important in helping to prevent oxidative stress and inflammation. Oxidative stress refers to an imbalance between harmful free radicals and helpful antioxidants in the body, which can contribute to disease development. 

A meta-analysis9 aimed to evaluate the effectiveness of NAC in reducing inflammation and oxidative stress, which are key contributors to chronic diseases like cardiovascular disorders, type 2 diabetes, and obesity. Researchers analyzed 28 studies and found that NAC significantly reduced MDA (a marker of oxidative stress), IL-8, and homocysteine levels, which are linked to inflammation. Overall, NAC was shown to have notable benefits in reducing oxidative stress and certain inflammatory markers. However, it did not significantly change CRP levels, a common marker of general inflammation.

6. Supports a Healthy Gut Microbiome

Your gut is home to the majority of your immune system, meaning that a healthy gut is essential for overall immune function. It also plays a critical role in hormone balance and can be disrupted by birth control pills, which may lead to dysbiosis (an imbalance of gut bacteria). And NAC isn't just beneficial for gut health—it can have a positive impact on various parts of the body, including the gut microbiome.

Some harmful gut bacteria, like Prevotella, can create biofilms—protective layers that help them evade the immune system and resist antibiotic treatments. Lactobacillus brevis is a beneficial bacteria that can help break down these biofilms, allowing the immune system to effectively combat bacterial overgrowth. However, when dysbiosis occurs, there may not be enough Lactobacilli to disrupt biofilms.

This is where NAC comes in. NAC is a powerful biofilm disruptor that can be used alongside antibiotics or antimicrobial herbs to treat gut infections. In my clinical experience, NAC has been highly effective when paired with antimicrobial treatments to target and eradicate harmful bacteria. A systematic review10 highlighted NAC’s ability to improve antibiotic permeability, allowing medications to reach deeper layers of biofilms and effectively overcome bacterial resistance.

In simple terms, NAC helps medications penetrate and work better against resistant organisms. The same review suggested that due to its efficacy and safety, NAC should be considered for more widespread clinical use.

Biofilm disruptors like NAC are also beneficial in treating conditions like Small Intestinal Bacterial Overgrowth (SIBO), where bacterial overgrowth can be difficult to eliminate due to the protective nature of biofilms. But NAC’s benefits go beyond the gut—it’s useful for other areas of the body as well.

Biofilms in Other Areas of the Body:

Biofilms are not limited to the gut—they can also form in the vagina, mouth, and respiratory tract, contributing to chronic infections in these areas. In the respiratory system, biofilms are associated with recurrent respiratory infections. NAC has been shown to reduce inflammation in the respiratory tract and may help disrupt biofilms, improving the effectiveness of antimicrobial treatments. 

A study found that NAC can decrease inflammation in gum tissue and has the potential to disrupt biofilms in the oral microbiome11, offering potential benefits for dental care, including fighting gingivitis12.

nac weight loss

7. Helps Reduce Respiratory Symptoms in Chronic Lung Disease (like COPD)

COPD is a common lung disease resulting from chronic airflow obstruction and inflammation. While COPD isn’t reversible, it is preventable (a major way to help prevent it is to not smoke) and treatable. When administered orally at 1200-1800 mg/day, NAC may be able to help decrease COPD exacerbations13 and respiratory illnesses14, although study findings have been mixed. 

Oxidative stress and free radicals play a role in COPD, which makes anti-inflammatory substances and antioxidants a logical choice for helping to treat and manage the condition. 

As with most studies regarding NAC, there is a dose dependent effect. Or in other words, if you aren’t taking enough and doing it consistently then you’re unlikely to see a benefit.

NAC is also a common prescription to be used with a nebulizer (the drug is acetylcysteine) for those with COPD or respiratory issues. This is because it also helps with the clearance of mucus from the lungs. One study15 found that NAC was beneficial in reducing the mortality rate in patients with COVID-19 and inflammatory parameters and led to a reduction in the development of severe respiratory failure.

8. Supports Immune Function By Modulating Inflammation

As we age, immune function declines, which is in part due to oxidative damage and inflammation. Research has shown improved immune function in those supplementing with NAC due to its antioxidant and anti-inflammatory properties16. 

NAC increases intracellular levels of glutathione (GSH), a key antioxidant that helps maintain cellular redox balance. As an anti-inflammatory, NAC can lower levels of pro-inflammatory compounds like TNF-α, IL-6, and IL-1β by inhibiting the NF-κB pathway that can impair immune defenses.

In a clinical trial17, eight people with HIV were given NAC with glycine for 12 weeks, leading to improvements in mitochondrial function, oxidative stress, inflammation, and physical and cognitive performance. These benefits diminished after the supplementation was stopped. The findings suggest that GlyNAC supplementation may help address premature aging and impaired immune function in those with HIV.

9. NAC in Influenza and Viral Illness

In cell models, NAC has been shown to inhibit the replication of RNA viruses like those responsible for influenza A, B, and RSV. It has also been shown in both cell models and human studies to inhibit inflammatory molecules. 

Because of its ability to support healthy immune function and antioxidant status and assist the body in modulating inflammation, NAC is an important consideration in the treatment of viral illnesses18, including COVID-19 and the flu. 

More human trials are needed to understand the potential of NAC in this capacity and examine the synergistic effect of NAC alongside pharmaceutical treatment. Some studies have shown that NAC’s effectiveness is strain dependent, which means while it may help with inflammation, immune system modulation, and mucus breakdown, it may not elicit a direct effect on viral replication in all cases. Remember to always talk with your doctor before beginning new supplements. 

what does nac supplement do

10. NAC for Autoimmune Disease

Many autoimmune diseases (e.g. Hashimoto’s, multiple sclerosis, inflammatory bowel disease, etc.) stem from inflammation in the body. Often, finding ways to reduce inflammation (such as eating more vegetables, eliminating or reducing refined sugar, and limiting vegetable oil intake) can have positive outcomes for those who suffer from autoimmune diseases. 

Supplementation can also be helpful, including NAC. One study19 evaluated the effect of NAC on rheumatoid arthritis (RA) patients, focusing on inflammation, oxidative stress, and metabolic parameters.

 In a randomized trial, 74 RA patients were given either 600 mg of NAC or a placebo twice daily for three months. NAC significantly reduced markers like morning stiffness, disease activity score, nitric oxide, fasting blood sugar, and increased HDL cholesterol, although not all improvements were significantly different from the placebo group. The study concludes that while NAC may offer some metabolic benefits for those with RA, it should not replace standard RA treatments.

Remember, autoimmunity is complex, which is why it generally requires a holistic approach, which sometimes also includes pharmaceuticals. 

11. NAC Supports Detoxification and Protects Your Kidneys and Liver

A significant amount of research has focused on NAC's ability to support detoxification20 and protect the kidneys and liver. For example, acetaminophen (commonly recognized as Tylenol) toxicity is the common cause of medication-induced hepatotoxicity. NAC is the antidote given in cases of acetaminophen toxicity. 

Hepatotoxicity refers to damage to the liver caused by medications, supplements, or chemicals. NAC has been used for years as a counter-poison for acetaminophen toxicity21. If a person is administered NAC within eight hours of acetaminophen overdose, their chances of recovery are great, and the danger to their liver is minimal.

NAC is also important for phase 2 liver detoxification, which is a crucial step in neutralizing potential toxins created during phase 1 detoxification. Yes, your body sometimes makes toxic intermediates during this process, which is why phase 2 is so important.

Another example of how NAC can help with detoxification is in dentistry. Poly-methyl methacrylate (PMMA) resin is one of the most commonly used materials in dental practices (e.g. to make dentures). However, it has been shown to be a cytotoxin, meaning it can result in cell damage or death. In one study22, NAC helped improve oral cytotoxicity after dental work thanks to its antioxidant effects. 

12. May Help Manage Psychiatric and Addictive Disorders

Research has shown that NAC has the potential to help with the treatment of psychiatric and addictive disorders23, such as nicotine addiction, OCD, trichotillomania (TTM: the compulsion to pull out body hair), schizophrenia, bipolar disorder, and more. 

Reduction of Trichotillomania Symptoms:

In one review24, NAC was used to help treat body-focused repetitive behavior (BFRB) disorders such as trichotillomania (hair-pulling), excoriation disorder (skin-picking), onychophagia (nail-biting), and onychotillomania (nail-picking). While traditional psychotropic medications have shown mixed results, NAC, a glutamate modulator, was shown to have promise in reducing compulsive behaviors in these disorders. The review includes 24 studies but emphasizes that current evidence is limited to small-scale trials and case reports. 

NAC for Schizophrenia:

It has been found that, in people with schizophrenia, there is dysfunctional glutamate metabolism, as well as decreased levels of glutamate in the prefrontal cortex. Additionally, there is evidence showing that individuals with schizophrenia have oxidative stress. NAC might be helpful in the treatment of schizophrenia25 because it can decrease oxidative stress, as well as alleviate glutamatergic dysfunction. 

NAC for OCD, Bipolar, and Depression:

NAC can be used as an alternative treatment for Obsessive-Compulsive Disorder (OCD) by targeting glutamatergic dysfunction and modulating inflammatory cytokines. While current treatments for OCD, such as SSRIs and cognitive-behavioral therapy, work for some, many patients remain treatment-resistant, necessitating alternative therapies. NAC works by modulating glutamate levels26 and improving glutamatergic balance, which is implicated in OCD. 

Although several studies have shown promising results with NAC, the optimal dosages remain unclear, and further research is needed to fully understand its efficacy and safety. 

NAC has also been found to decrease symptoms of depression27 and bipolar disorder. In one analysis, it was found that NAC reduced depressive symptoms and resulted in an overall increase in functionality. While NAC does show promise in supporting mental health, you should not use NAC to replace your medication or make changes to your regimen without talking to your doctor.

13. May Improve Brain Health

NAC has been shown to ameliorate the symptoms of Alzheimer’s Disease and Parkinson’s Disease, two diseases that affect the brain (as well as other systems in the body). 

NAC for Alzheimer’s Disease:

In Alzheimer’s Disease, mitochondrial dysfunction, metal accumulation, and inflammation all play a role…as does oxidative damage. Different studies have shown that lipoic acid and NAC decrease levels of oxidative damage while also helping to protect mitochondrial function and against β-amyloid accumulation28 in the brain, which is a major cause of Alzheimer's. 

NAC for Parkinson’s Disease:

Parkinson’s Disease is also caused by the deterioration of neurons in the brain and nervous system. It has been found that most patients with Parkinson’s have oxidative damage. 

In one study29 investigating NAC's effects on Parkinson's, 42 patients were divided into two groups: one group received weekly intravenous NAC infusions (50 mg/kg) plus oral NAC (500 mg twice daily) for 3 months, while the other group received standard care. The NAC group showed a significant increase in brain regions associated with Parkinson's compared to the control group, indicating a potential positive effect on the dopaminergic system. Additionally, patients in the NAC group experienced significant improvements in Parkinson's symptoms.

14. NAC May Help Prevent Heart Disease

Oxidative damage can destroy heart tissue and lead to head attack, stroke, and other cardiovascular issues. Because NAC is helpful in reducing oxidative stress, it can be useful in preventing oxidative damage to tissues of the heart. This gives it great potential to help in the treatment and prevention of heart disease and heart failure30, specifically when combined with other treatments and lifestyle changes. 

NAC also improves blood flow and circulation by increasing nitric oxide production and acting as an anti-aggregate. It can also help protect against atherosclerosis31, or hardening of the arteries, a major cause of heart disease. An anti-aggregate prevents platelets from clumping together to form a clot in your blood vessels. Additionally, NAC can support healthy cholesterol levels.

when to take nac morning or night

NAC Prescriptions and Supplements

As a nebulized medication, your doctor may prescribe a 10% or 20% solution of Acetylcysteine to be used 3-4 times daily. 

For acetaminophen overdose, NAC is administered in a hospital setting via IV.

Why was one type of NAC recently banned? Cetylev was a prescription effervescent NAC that was recently discontinued in early 2020. The good news is that NAC is easily found over the counter as a dietary supplement. 

NAC Supplementation

If you think could benefit from NAC, I recommend trying my N-Acetylcysteine capsules. Most people do best with one capsule 1-2 times daily.

Remember, as discussed in this article, most benefits are achieved after several months of consistently taking NAC.

It's important to note that NAC does have an odor. So if you get a bottle and it smells “off,” then know this isn't the case; the NAC has not gone bad—it just smells bad to some people.

How much NAC should you take? As discussed above, studies have shown that NAC benefits are dose-dependent and require consistency over a period of time. Dosage recommendations vary by condition, usually ranging from 600 mg to 1400 mg per day, or sometimes more.

How long does it take NAC to work? 

It typically takes six weeks to three months to see improvements. Studies in which NAC has been used for only a few week showed little benefit, whereas other studies suggest NAC needs to be taken for at least a three-month period to experience beneficial effects.The vast majority of studies have used oral NAC supplementation (taken by mouth) for at least several weeks to several months. 

To summarize some of what has been been shown in the studies cited in this article:

Condition Dosage Range*
PCOS and female infertility600-1200 mg/day32
Male infertility600 mg/daily for three months33
COPD and respiratory support1200-1800 mg/day34
Blood sugar support and metabolic health600 mg/day twice per day35
Mental health support (such as OCD)up to 2,000-3,000mg/daily for three months36
Depression1,200 mg/day for several months37
Compulsions and addictive behaviors 1,200-2,400 mg/day for at least six weeks38
Immune support and to fight viruses600–1200 mg up to three times a day 39
Autoimmune conditions600/mg twice daily for three months40
Parkinson's disease50 mg/kg intravenous NAC weekly along with 500 mg oral NAC twice daily for three months41

It’s important to note that some of these studies used NAC along with other treatments. Be sure to talk to your doctor about using NAC in your protocol.

*NAC supplementation is not used to treat or prevent medical conditions. 

Potential NAC Side Effects 

For most people, oral NAC is safe and well-tolerated, meaning it's unlikely to cause side effects and is an FDA-approved supplement42.

Should you take NAC in the morning or at night? The timing isn't necessarily important, however, I recommend taking it with food to avoid experiencing heartburn and digestive upset. Trust me, I have made this mistake. Some people may also experience nausea and vomiting, so it is best to take with food.

If you have a peptic ulcer then it is not recommended that you take NAC.

Medication Interactions

If you're taking a blood thinning agent, anti-cancer drug, nitroglycerin, or metoclopramide then it is best to talk with your doctor before you begin this supplement as it can interact with these medications.

Inhaled NAC

When inhaled, it can increase bronchial secretions. So, you may need to cough, do postural procedures, and aid your body in eliminating phlegm. Some people do experience chest tightness. Be sure to talk to your doctor if you have any uncomfortable symptoms.  

IV NAC

Most side effects come from IV administration and can result in flushing and itching of the skin. Remember, if it is given IV this is because the liver is in big trouble. 

When to Take NAC Morning or Night?

The best time to take N-Acetylcysteine (NAC) depends on your health goals and personal routine. And as always, it’s best to consult your provider.

Morning vs. Night?

  • Morning: If you're taking NAC for antioxidant support, detoxification (liver health), or respiratory benefits, taking it in the morning on an empty stomach can enhance absorption.
  • Night: If using NAC for brain health, mood support (glutamate regulation), or as a sleep aid (supports glutathione and reduces oxidative stress), nighttime may be better.

Best Practices:

  • Take it on an empty stomach (at least 30 minutes before or 2 hours after a meal) for better absorption. However, if you tend towards an upset stomach, you may need to take it with food.
  • Avoid taking with minerals (e.g., zinc, iron, copper) at the same time, as NAC can chelate minerals.

Special Cases:

  • Liver support or detox? Morning is ideal.
  • Respiratory issues? Morning, or split doses morning and afternoon.
  • Anxiety or brain health? Night may be better.

Key Takeaways on Benefits of NAC Supplementation

  • NAC is crucial for the production of glutathione, the body's most powerful antioxidant, which supports detoxification, immune health, and protects cells from damage.
  • NAC may improve fertility by reducing oxidative stress in both men and women and has shown benefits for managing symptoms of PCOS, such as hormone imbalances and insulin resistance.
  • It can also reduce respiratory symptoms in chronic lung diseases like COPD and helps modulate the immune response by decreasing inflammation.
  • Studies suggest NAC may help reduce symptoms of compulsive behaviors, depression, OCD, and addiction by regulating glutamate levels and reducing oxidative stress.
  • Most benefits are achieved with consistent use over several months. Typical doses range from 600 mg to 1,800 mg per day, depending on the condition being treated, and NAC should ideally be taken with food to avoid digestive upset.

References

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.