NAC for PCOS. Sounds like a load of random letters thrown together to form a sentence, doesn’t it? But if you bear with us one moment then we’ll explain…
There are many alternative therapies suggested for women with polycystic ovary syndrome (PCOS). One that has gotten My Informed Life talking this month is N-acetyl cysteine. Despite scientifically proven benefits, this modest supplement remains largely overlooked. Perhaps because of its ridiculously-impossible-to-pronounce name.
N-acetyl cysteine, affectionately known as ‘NAC’ when hanging out with its mates, is an altered form of an amino acid called cysteine. Amino acids are the building blocks of life that, when chained together, form proteins. Cysteine is synthesised inside our bodies, as well as being present in high protein foods such as pork, chicken, turkey, duck, fish, yoghurt and eggs. Vegetarian sources of cysteine include broccoli, onions and garlic as well as oats and granola.
When you take NAC as a supplement, it works in a number of different ways. It assists the pancreas with insulin secretion, helps the immune system, reduces cell death (apoptosis), improves insulin sensitivity, and is a great anti-oxidant. NAC has a million and one different medical uses including treatment for angina, autism, paracetamol poisoning, obsessive hair pulling, kidney problems and flu symptoms. Its mucolytic (mucus thinning) properties help people with lung problems. But most importantly for all of the ‘cysters’ reading this, NAC’s impressive curriculum vitae includes proven benefits for women who take NAC for PCOS.
NAC for PCOS: Check out the evidence-base
One research study on NAC for PCOS, by Fulghesu and colleagues in 2002, investigated 37 women; 6 lean and 31 obese, all with PCOS. The lean women were given 1800mg of NAC daily for 6 weeks whilst the larger women received a slightly higher dose. After six weeks the women’s insulin sensitivity was found to have significantly improved. Another specific finding was that for the women who suffered high levels of circulating insulin (hyperinsulinemia) after their meals, the 6 week course of NAC significantly improved this problem. This is noteworthy because hyperinsulinemia is blamed for the problems with the ovaries and ovulation in PCOS.
Another study of NAC for PCOS, by Masha and colleagues in 2009, investigated 8 ladies with PCOS, who’d had infrequent or absent periods for at least one year. The 8 ladies were given 1200mg of NAC per day as well as L-arginine 1600mg per day for 6 months. The women’s menstrual function was restored; their periods became more frequent, and when the ladies charted their temperature every day they saw the typical biphasic pattern suggesting ovulation. These impressive changes were believed to be due to the NAC and L-arginine improving the ladies’ insulin sensitivity.
A research trial by Rizk and colleagues in 2005 found that taking NAC alongside Clomid massively increased its success rate, especially in ladies said to be ‘Clomid resistant.’ The study investigated 150 women with PCOS and ‘Clomid resistance.’ The women were divided in to two groups, with group one taking Clomid 100mg on cycle days 3-7, and group two taking the same Clomid regime but with added NAC; 1200mg per day. In the group taking NAC, nearly half of the women ovulated, compared to just one-ish per cent of the group only on Clomid. In the group taking NAC, more than a fifth of the women became pregnant, compared to none of the group just on Clomid.
“Some lovely mucolytic action is never a bad thing, surely”
And let’s go back to that second paragraph… that’s right, NAC is said to be a mucolytic. That is, it thins out any mucus that your body produces. If you’ve read anything about fertility you will already know the importance of having loads and loads of lovely thin and runny fertile cervical mucus. Yousseff actually disregards the mucolytic effect of NAC in their study, and says that the fertility benefits of NAC for PCOS are not related to this action. Instead, NAC’s benefits are attributed to its ability to reduce apoptosis (cell death). In PCOS it is apoptosis that causes those naughty ovary follicles to close around the egg and stop it escaping, and Yousseff says that taking NAC for PCOS fights this process. Even so, some lovely mucolytic action is never a bad thing, surely.
The evidence-base certainly seems impressive. It’s hard to imagine why NAC for PCOS is so overlooked, or why it lags so far in the distance behind other better-known PCOS supplements.
But hold on a minute… When you search fertility and PCOS forums specifically for information on NAC for PCOS you’ll find that the ladies that do know about it, rave about it. You’ll even see phrases such as “this is the best thing that I have EVER come across to help with my PCOS” on some forums. So maybe, just maybe, N-acetyl cysteine is about to become the next big thing. If we ever work out how to pronounce it…
Fulghesu, A.M; Ciampelli, M; Muzj, G; Belosi, C; Selvaggi, L. and Ayala, G.F. (2002) N-acetyl cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertility and Sterility. (77), pp. 1128-1135. [Online] DOI: http://dx.doi.org/10.1016/S0015-0282(02)03133-3 (Last accessed 25th November 2015).
Masha, A; Manieri, C; Dinatale, S; Bruno, G.A; Ghigo, E. and Martina, V. (2009) Prolonged treatment with N-acetyl cysteine and L-arginine restores gonadal function in patients with polycystic ovary syndrome. Journal of Endocrinological Investigation 32 (11), pp.870-872. [Online] Available at: http://www.ncbi.nlm.nih.gov/pubmed/19494711 (Last accessed 25th November 2015).
Rizk, A.Y; Bedaiwy, M.A and Al-Inany, H.G. (2005) N–acetyl cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertility and Sterility (83), pp. 367–370. [Online] Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746301/ (Last accessed 25th November 2015).
Youseff G; Meguid Ali, A; Alaa, N; Makin, B; Waly, M. and Abou-Setta A. (2006) N-acetyl cysteine in anovulatory women: The impact of postcoital test. Middle East Fertility Society Journal. (11), pp. 109–112. [Online] Available at: http://www.bioline.org.br/pdf?mf06021 (Last accessed 25th November 2015).
Have you or anyone you know had good results with taking NAC for PCOS? Please take the time to comment on this article or start a discussion via a new thread. This is a newly launched web community and we would love to hear from you about your own experiences and research.