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Liver Antioxidants – What to Pair with NAC


Nicole Cutler

Jan 22nd, 2013

Learn how N-acetyl cysteine helps protect your liver from oxidation – especially when it is paired with another common antioxidant.

N-acetyl cysteine (NAC) is an antioxidant that has a lot to offer anyone with a damaged liver. Although it is commonly available as an over-the-counter supplement, NAC is also used in western medicine. An antidote for liver toxicity caused by an acetaminophen overdose, NAC’s power is irrefutable. Despite its efficacy and availability, there is a potential side effect of NAC. Believed to contribute to kidney stone development when taken over extended periods of time, those who are prone to kidney stones have reason to be weary of this supplement. Luckily, there is a safe, simple and affordable approach to eliminate NAC’s kidney stone risk.

Protection Against Free Radicals

Cellular oxidation is the natural process where free radicals attack nearby substances and break them down. Because they can safely bind with free radicals, antioxidants are capable of terminating a destructive rampage before cellular damage is caused. Thus, many health professionals suggest that their patients with chronic liver disease take supplements and foods rich in antioxidants to help prevent their existing liver cells from deteriorating.

Protecting yourself against free radical damage is regarded as one of the most important aspects of managing chronic liver disease. Antioxidants are abundant in darkly colored fruit and vegetables, but produce may be an inadequate source for combating the oxidation that threatens an already challenged liver.

NAC – The Good and the Bad

N-acetyl cysteine is the stable form of the amino acid, cysteine – an antioxidant that is commonly found in food and synthesized by the liver. NAC helps the body synthesize glutathione, the body’s master antioxidant. Since it is a glutathione precursor, NAC protects the liver from the damaging effects of toxins – a function that can prevent chronic liver disease from advancing to a more severe illness. NAC is the preferred form because it raises glutathione levels better than taking supplemental glutathione.

N-acetyl cysteine is much more stable and resistant to being oxidized to an insoluble form than cysteine. However, as N-acetyl cysteine is metabolized by the body, a small portion of it may be oxidized and become insoluble. Experts believe the insoluble remnants of NAC could eventually form into kidney stones.

Preventing NAC Oxidation

Interestingly, another common antioxidant can prevent the oxidation of glutathione. Vitamin C, also known as ascorbic acid, will help prevent glutathione from becoming oxidized and potentially leading to kidney stones. According to Vitamin C researcher Mark Moyad, MD, MPH, of the University of Michigan, “Vitamin C has received a great deal of attention, and with good reason. Higher blood levels of Vitamin C may be the ideal nutrition marker for overall health.”

In addition to eating fruits and vegetables packed with Vitamin C, Moyad suggests taking 500 milligrams (mg) a day. To prevent the only real caution of taking such a substantial dose of Vitamin C, experts suggest taking a non-acidic, buffered form of Vitamin C to avoid stomach irritation. Although excess amounts of ascorbic acid are excreted, experts suggest staying below 2,000 mg per day to avert stomach upset and diarrhea. When it comes to preventing the oxidation of NAC, healthcare practitioners typically suggest simultaneously taking at least 500 mg and up to 1,500 mg of Vitamin C.

If you have chronic liver disease, don’t let the threat of kidney stones dissuade you from supplementing with NAC. Remember that N-acetyl cysteine is a potent enough liver protector to be used by physicians during acetaminophen toxicity – a potentially lethal situation. Especially important to include in your NAC routine if you are prone to kidney stones, pairing Vitamin C with this glutathione precursor offers an extra level of protection against free radicals.

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Rakel, David, Integrative Medicine, Saunders – Elsevier, Inc., Philadelphia, PA, 2007; 241-242., N-Acetyl Cysteine, Retrieved October 24, 2010, Jerry Emanuelson, 2010., What About Vitamin C and Kidney Stones?, Stephen Lawson, Retrieved October 24, 2010, Linus Pauling Institute, 2010., N-Acetyl-Cysteine (NAC) For Mercury Detoxification, Retrieved October 24, 2010, Healing Daily, 2010., Helping Your Liver with R-Alpha Lipoic Acid, Nicole Cutler, L.Ac., Retrieved October 24, 2010, Natural Wellness, 2010., N-Acetyl Cysteine Treats Acute Liver Failure, Nicole Cutler, L.Ac., Retrieved October 24, 2010, Natural Wellness, 2010., NAC wears many hats, Suzy Cohen, RPh, Retrieved October 24, 2010,, 2010., The Benefits of Vitamin C, Kathleen M. Zelman, MPH, RD, LD, Retrieved October 24, 2010, WebMD, Inc, 2010., Cysteine, N-acetyl cysteine (NAC), Retrieved October 24, 2010, A4M, 2010.

11 Comment(s)

    I have the hcv and it has damaged my liver.I have been taking acetyl cysteine (200 mg.)for two years now and unknowingly of its benefits i take my vitamin c with it in a of freshly squeezed orange juice first thing in the morning.

    • angelo212

      Way to low of a dose. NAC is very unbioavailable (not absorbed by the body very good) Take 1800mg a day.NAC usually comes in 500 to 600mg dosages. I never saw it lower or higher then that.

  • Vijay Rane

    Caution :
    Pl ref to the article ,”The Myth of Antioxidants”,by Melinda W. Moyer,
    62,Scientific American,February 2013.
    “Certain free radicals seem to signal cellular repair networks.Taking a large dose of antioxidants in the form of vitamins & other supplements can do more harm than good in otherwise healthy individuals”

    • angelo212

      Your 100% right but this site is all abou selling there supplements. There not trying to hear about your comment. I’m surprised they even let it stay.

  • Jas DelaLuna

    My family has a long history of liver disease, and I am perscribed SEVERAL medications that can be dangerous for the liver (usually over time). I also drink. Although the doctor has done blood work and says my liver is normal, I decided to start taking N-Acetyl Cysteine (NAC) 600mg orally once-a-day. However, as I read I find potential negative effectives or people saying that its good if you already have a damaged liver, but no one has said much about taking it for prevention. Would it be advisable to stop taking it since my liver appears to be healthy, despite my high risk of future liver damage? Is it useful for prevention at all? I’ve asked my primary physician, and she admittedly has no clue (plus she’s not a Doctor, she is a Nurse Practioner, and she’s all I have- not that there’s anything wrong with Nurse Practioners). Can anyone offer some insight? Will it helpprevent liver damage even though my liver appears to be healthy already with no known pre-existing condition?

    • icetech

      You could just stop drinking and give your liver a better chance… seems the obvious choice..

      • Just drink the right stuff and there is no worries….whiskey is a no no, craft beer is a health food. Just ask Keith Richards, the absolute authority on this. ;-]

    • Mereloo

      Pharmacists know a ton about supplements and herbs, not just drugs. Not sure if a pharmacist can tell you if it’s good for prevention, but it would be a good idea to speak to one anyway if only to be sure that NAC doesn’t interact with any other medications or supplements you may be taking. (I know it interacts with a few medications, but I’m not sure which ones.)

      As for the dose, people use it for compulsive hair pulling and skin picking as well as schizophrenia at a much higher dose (up to 2400 mgs, I believe), so I think the amount you’re taking would be okay. (I know the dose is much lower for other conditions though.) The evidence for it is mixed, I believe; and it’s still considered investigational as far as I know.

    • Abigail True

      I have read it helps detoxify the liver and to take it with vitamin C and E. Go on curezone site and you can read a lot of info on that and ask questions from others there. That is what I will do now.

  • Sam Montana

    Isn’t it true that higher doses of vitamin C can also increase the risk of kidney stones? It seems that these two supplements both increase the risk of kidney stones. What is your thoughts about this?

  • …dez…

    Myth! vitamin ‘C’, stones, who by? AMA or Big Pharma? A doctor proved way back in 1946, stones do not form in the presence of an acid, ‘Ascorbic acid. ‘C’ Another Myth: I am 83 without a health problem. For 52 years, I have taken vitamins/minerals, No colds, flu, doctor or any disease. I have taken up 135 grams of ‘C’ to kill the pain and inflammation of bad teeth in 20 hours.

    Few people understand the crippling effects to the immune system by toxic refined sugars, oils, junk foods and chemicals in processed foods and artificial sweeteners. The excess sugars in the body are used by fungus, yeasts, parasites, diseases to grow and replicate.

    Human, animal grade diatomaceous earth is important with ‘C’ to control parasites that drain the body of nutrients, energy and to replace cells burnt up by inflammation, infection and to control the destructive force of free radicals.

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