KatCarney

N-Acetyl Cysteine Improves Insulin Resistance in Women with Polycystic Ovary Syndrome
By Darin Ingels, ND

Healthnotes Newswire (December 12, 2002)—Women with polycystic ovary syndrome (PCOS) and associated elevations of insulin levels may benefit from taking supplemental N-acetyl cysteine (NAC), according to a study in Fertility and Sterility (2002;77:1128–35).

PCOS is a common condition that affects up to 10% of all women of reproductive age. It is characterized by enlargement of the ovaries, irregular menstrual cycle, failure to ovulate, obesity, high levels of insulin in the blood and insulin resistance, excessive hair growth (due to increased testosterone), and infertility. More than 50% of all women with PCOS have high insulin levels, which may be a risk factor for diabetes, high blood pressure, blood clots, and heart disease.

There is no cure for PCOS, but doctors often recommend birth control pills, which help decrease the levels of testosterone, estrogen, and progesterone, thereby reducing hair growth and shrinking the cysts in the ovaries. However, birth control pills have not been shown to improve insulin resistance. N-acetyl cysteine may be useful in picking up where birth control pills leave off, by increasing insulin sensitivity. While it is possible that birth control pills and NAC could work in conjunction with one another, the interaction between the two treatments is unknown.

In this preliminary study, 31 women with PCOS were given 1.8 to 3 grams per day of NAC for five to six weeks. Blood measurements for glucose and insulin were taken before and after a glucose tolerance test, both at the start of the study and at the end of the treatment period. No dietary modifications were made during the study.

Initial measurements showed that 14 of the 31 women had normal insulin levels, while the remaining 17 had abnormally high levels of insulin. Women with high initial insulin levels who took NAC had a significant reduction in insulin levels following the glucose tolerance test and also showed improved insulin sensitivity. On the other hand, those with initially normal insulin levels had no improvement in any measurement. This suggests the benefit of NAC in women with PCOS may be restricted to only those women who already have high insulin levels to begin with.

NAC is an amino acid that has commonly been used as a treatment to break up mucus in the lungs. It is also a precursor to glutathione, a powerful antioxidant in the body, which has been shown in other studies to improve insulin sensitivity. Although glutathione levels were not measured in this study, the improvement in insulin resistance seen in the group taking NAC may have been due to increased amounts of glutathione; however, future studies will need to clarify this issue.

Some physicians recommend taking NAC on an empty stomach, so it does not compete with other amino acids in food for absorption. People taking single amino acids should also make sure they eat adequate amounts of protein, to prevent upsetting the balance of amino acids in the body. In addition, some doctors recommend that long-term supplementation of NAC (more than a few weeks) be accompanied by 15 mg of zinc and 2 mg of copper per day, because preliminary evidence suggests that NAC might deplete these minerals.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

Copyright © 2002 Healthnotes, Inc. All rights reserved.
Source:
http://www.drugstore.com/qxc43800_332828_sespider/n_acetyl_cysteine_improves_insulin_resistance_in_w omen_with_polycystic_ovarysyndrome/n_acetyl_cysteine_improves_insulin_resistance_in_w omen_with_polycystic_ovarysyndrome.htm

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KatCarney

ARTICLE: N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome, Fulghesu AM, et al, Fertil Steril 2002 Jun;77(6):1128-35

ARTICLE SUMMARY: This study evaluated the effect of N-acetyl-cysteine (NAC) on insulin secretion and peripheral insulin resistance in subjects with polycystic ovary syndrome (PCOS). Six lean and 31 obese subjects, aged 19-33 years, were treated for 5-6 weeks with NAC at a dose of 1.8 g/day orally. A dose of 3 g/day was arbitrarily chosen for massively obese subjects. Six of 31 obese patients with PCOS were treated with placebo and served as controls.

Before and after the treatment period, the hormonal and lipid blood profile and insulin sensitivity, assessed by an hyperinsulinemic euglycemic clamp, were evaluated and an oral glucose tolerance test (OGTT) was performed.

Study results: Fasting glucose, fasting insulin, and glucose area under curve (AUC) were unchanged after treatment. Insulin AUC after OGTT was significantly reduced, and the peripheral insulin sensitivity increased after NAC administration, whereas the hepatic insulin extraction was unaffected. The NAC treatment induced a significant fall in T levels and in free androgen index values. In analyzing patients according to their insulinemic response to OGTT, normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters, whereas a significant improvement was observed in hyperinsulinemic subjects.

Study conclustions: NAC may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.

DOCTOR’S COMMENTS: N-acetyl cysteine (NAC) is an altered form of the amino acid cysteine, which is commonly found in food and synthesized by the body. NAC supports your antioxidant system and thus helps prevent cell damage. It’s available as a dietary supplement.

I do NOT recommend that you start using NAC at the 1.8 – 3 gram (that’s 1,800 – 3,000 milligrams) dose used in this study. A qualified physician should assist you with this, especially if you are taking metformin. However, 250-500 milligrams daily should be OK for a start.

Although this is a small study, it suggests that NAC can play a role in improving your insulin sensitivity. Many of you are taking metformin for the same purpose. Improved insulin sensitivity is crucial to reversing PCOS.

http://www.ovarian-cysts-pcos.com/res2.html

KatCarney

N-Acetyl Cysteine (NAC) May Offer Adjunct Support to Women with Polycystic Ovary Syndrome
Breaking News 4/19/05
VRP Staff

N-Acetyl Cysteine (NAC), an antioxidant with insulin-sensitizing properties, may boost the effectiveness of other pharmaceutical treatments for polycystic ovary syndrome (PCOS), according to a new placebo-controlled, double-blind, randomized trial.

Researchers studied 150 women who suffered from PCOS that was resistant to clomiphene citrate, one of the drugs used to treat this condition. The subjects, ages 18-39 years, were all undergoing therapy for infertility.

The researchers randomly assigned the patients to receive either 1.2 grams of NAC per day or a placebo. Each of the two groups also consumed 100 mg per day of clomiphene citrate for 5 days starting at day 3 of the cycle.

The combination of clomiphene citrate and NAC significantly increased both ovulation rate and the pregnancy rate in women with clomiphene citrate-resistant PCOS. The NAC-treated subjects experienced a 49.3% increase in ovulation compared to only a 1.3% increase in placebo-treated subjects. The NAC treated subjects also experienced a 21.3% pregnancy rate whereas none of the placebo-treated subjects were able to conceive. Two of the NAC-treated patients who were able to conceive, however, did eventually miscarry.

Although agents that stimulate the ovaries sometimes cause ovarian hyperstimulation syndrome (OHSS), a serious condition that causes pain and potentially life-threatening consequences, no cases of ovarian hyperstimulation syndrome were reported in the NAC group.

The researchers concluded that NAC is safe and well tolerated.

Reference:
Rizk AY, Bedaiwy MA, Al-Inany HG. N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril. 2005 Feb;83(2):367-70.
http://www.vrp.com/art/1695.asp