N-Acetyl Cysteine: Detoxification and Insulin Balancing Properties
Research suggests women who suffer from PCOS would benefit from using N-Acetyl Cysteine (NAC), a slightly modified form of the sulfur-containing amino acid, cysteine. NAC’s main benefits include providing insulin support as well as promoting efficient detoxification in the body, both of which support hormonal balance- something we all need. In this article, we’ll dive in to some of the key benefits of NAC for PCOS symptoms.
What is N-Acetyl Cysteine?
We have discussed NAC in the past and defined it as a potent derivative of the sulfur containing semi-essential amino acid L- cysteine. When taken internally, it helps replenish our body’s glutathione levels and helps restore our cells’ ability to reduce oxidative stress. In medicine, NAC has been used mostly as a treatment for coughs and phlegm by means of inhalation.
There are 2 main ways NAC can help women with PCOS.
Women with PCOS should periodically detox since endocrine disrupting chemicals (EDCs) from our food and environment build up in our bodies. When the liver can’t keep up, they end up disrupting our hormones.  NAC is able to improve glutathione levels in the body and leads to an efficient detoxification process. In a nutshell, the detoxification property of NAC helps reduce the adverse effects of endocrine disruption and balances hormones. 
Lung inflammation is a key response to increased levels of particulate air pollution. NAC has been shown to prevent lung inflammation caused by concentrated particles in the air. The observed preventive effect of NAC in a recent Harvard study suggests that treatment with low doses of this antioxidant could be used to ameliorate the toxic effects of particulate air pollution.  Other studies suggest NAC is also able to prevent cigarette smoke-induced airway alterations  as well a potent antioxidant as treatment for carbon monoxide poisoning. 
Lead is a heavy mineral and causes the inactivation of glutathione. The toxic effects of lead are primarily influenced by glutathione depletion in cells. This is due to how lead is greatly attracted to thiol groups. NAC has a direct mineral chelating effect and forms bonds between metals and its corresponding thiol group which helps alleviate the toxic effects of lead. 
2. Insulin Sensitivity
Inflammation and oxidative stress are linked to insulin resistance as well as elevated levels of glucose in the blood. These effects are not specific to the diabetic population, but in fact are even found in obese, non-diabetics, and those with metabolic syndrome, particularly those afflicted with PCOS. In fact, insulin resistance is the root of many of our worst PCOS symptoms. There are multiple steps which can lead oxidation to insulin resistance. NAC, an antioxidant, helps target many of those steps independently. 
NAC helps improve insulin sensitivity by:
- reversing impaired insulin responses caused by advanced glycation end-products
- reducing fat tissue inflammation caused by increased blood sugar levels
- helping inhibit the effects of common sweeteners such as hypertension, reduced insulin levels, and elevated triglycerides
Women who suffer from PCOS have issues with their ovulatory cycles and are particularly prone to insulin resistance. Two recent studies demonstrated the beneficial effects of taking NAC orally which lead to a trend towards regular ovulatory cycles as well as an improvement in insulin sensitivity.  
PCOS increases the chances of having metabolic syndrome, and one of the main drivers of metabolic syndrome involves hormonal imbalances. Hormonal imbalances in women with PCOS are often caused by glutathione depletion, impaired detoxification, and insulin resistance. NAC has been shown to be broad-spectrum compound which unfortunately is still largely underused in conventional medicine.
Clinical research suggests NAC is more than just a treatment for coughs and phlegm as it has demonstrated its benefits on detoxifying the body and boosting insulin sensitivity. Together, NAC helps reduce hormonal imbalances in women with PCOS and could help prevent metabolic syndrome.
1) Kato T, Tada-oikawa S, Takahashi K, et al. Endocrine disruptors that deplete glutathione levels in APC promote Th2 polarization in mice leading to the exacerbation of airway inflammation. Eur J Immunol. 2006;36(5):1199-209.
2) Jallouli, Manel et al. Disruption Of Steroidogenesis After Dimethoate Exposure And Efficacy Of N-Acetylcysteine In Rats: An Old Drug With New Approaches. Environmental Science and Pollution Research 23.8 (2016): 7975-7984.
3) Rhoden CR, Lawrence J, Godleski JJ, González-flecha B. N-acetylcysteine prevents lung inflammation after short-term inhalation exposure to concentrated ambient particles. Toxicol Sci. 2004;79(2):296-303.
4) Rubio ML, Sanchez-cifuentes MV, Ortega M, et al. N-acetylcysteine prevents cigarette smoke induced small airways alterations in rats. Eur Respir J. 2000;15(3):505-11.
5) Oh S, Choi SC. Acute carbon monoxide poisoning and delayed neurological sequelae: a potential neuroprotection bundle therapy. Neural Regen Res. 2015;10(1):36-8.
6) Wang L, Wang Z, Liu J. Protective effect of N-acetylcysteine on experimental chronic lead nephrotoxicity in immature female rats. Hum Exp Toxicol. 2010;29(7):581-91.
7) Nehru B, Kanwar SS. Modulation by N-acetylcysteine of lead-induced alterations in rat brain: reduced glutathione levels and morphology. Toxicol Mech Methods. 2007;17(5):289-93.
8) Evans JL, Maddux BA, Goldfine ID. The molecular basis for oxidative stress-induced insulin resistance. Antioxid Redox Signal. 2005;7(7-8):1040-52.
9) Masha A, Manieri C, Dinatale S, Bruno GA, Ghigo E, Martina V. Prolonged treatment with N-acetylcysteine and L-arginine restores gonadal function in patients with polycystic ovary syndrome. J Endocrinol Invest. 2009;32(11):870-2.
10) Fulghesu AM, Ciampelli M, Muzj G, et al. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil Steril. 2002;77(6):1128-35.