Chronic Stress? Reverse the Damage with NAC (N-acetyl-cysteine)

Stress is a part of life.  Everyone experiences “routine” stress related to regular aspects of life.  For example, school, family, and daily responsibilities can all be a source of “routine” stress, which comes and goes.  Stress can be good or bad. For instance, graduating, getting married, or having a new baby are all “good,” but they still cause stress.  Our bodies do not know the difference between good stress and bad stress. The hormones that are released and the other physiologic responses to stress are the same no matter what the cause of the stress.  So, if we all experience stress, when does stress become a problem?

“Health problems can occur if the stress response goes on for too long or becomes chronic, such as when the source of stress is constant, or if the response continues after the danger has subsided [such as with PTSD]. With chronic stress, those same life-saving responses in your body can suppress immune, digestive, sleep, and reproductive systems, which may cause them to stop working normally.”  National Institute of Mental Health [NIMH], (2018)

If stress is never relieved, and the body never gets the message that it is safe to return to normal functioning, health will deteriorate.  Serious health problems, such as heart disease, high blood pressure, heart attack, diabetes, and other illnesses (including cancer), as well as mental disorders like depression or anxiety will eventually come to visit (NIMH, 2018).  If major life changes are not made, these unwelcome visitors may never leave, or they may take you with them when they do.

I am not going into detail on the stress response here, but if you are interested in learning more about it, I highly recommend the book Why Zebras Don’t Get Ulcers, by Robert M. Sapolsky.  Sapolsky discusses stress and the impact it has on human health delivered in a fun and understandable way.  Here, what we are focusing on is that the majority of illnesses and disease caused by stress are actually due to oxidative damage; and chronic stress exposure promotes oxidative damage (Aschbacher et al., 2013).  

Psychological stress causes oxidative stress; oxidative stress causes oxidative damage; oxidative damage causes disease, illness, and death.  Chronic stress is not the only way we suffer oxidative damage. To name a few, oxidative damage can also result from:

  • Exposures to toxic chemicals
  • Exposures to environmental pollutants (like pesticides and herbicides)
  • Alcohol consumption
  • Smoking tobacco
  • High carbohydrate diet
  • Drug abuse
  • Chronic pain
  • Excessive exercise / overtraining
  • Consistent exposure to blue light at night
  • Sleep disruption or deprivation

Often, people turn to carbohydrates (sugars), tobacco, drugs, or alcohol to cope with their chronic stress.  Needless to say, the health effects are compounding.

“Oxidative stress is a known feature of numerous central nervous system (CNS) disorders. Thus, clear evidence of the involvement of increased brain oxidative damage in the development of CNS pathologies has been reported for neurodegenerative diseases (such as Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis), cerebrovascular disorders, demyelinating diseases, and psychiatric disorders” – Jaquet et al., 2013

“Oxidative stress consists of an imbalance between the amount of [reactive oxidants] and the capacity of antioxidant systems to neutralize them.” Jaquet et al., 2013

Do you have chronic stress?

Some people are at higher risk for chronic stress.  Those with financial problems that don’t seem to ever find resolution, people in high stress professions, people who are exposed to traumatic, unpredictable stress on the regular basis; and people who experience sleep deprivation are some examples of people at high risk for chronic stress.  Antioxidant capacity is strongly decreased in the sleep-deprived (Jaquet et al., 2013).

Stress management techniques (e.g. deep breathing, meditation, yoga) are certainly beneficial, and undoubtedly essential to a balanced, healthy lifestyle, but many people find it very challenging to incorporate them into their lives.  Further, some people simply cannot eliminate or reduce their stressors. My husband, for instance, is a firefighter/paramedic. Stress, exposure to traumatic events, and sleep deprivation are part of his life; and unless he quits his job, those chronic stress contributors are not going anywhere.  So what can we do?

There is something you can easily do today that will increase your body’s ability to cope with chronic stress.

Studies show a supplement called NAC (N-Acetylcysteine) can reduce and reverse the damaging effects of chronic stress.

Oxidative stress and damage occurs when there is an imbalance between the amount of reactive oxidants (the bad guys) and the capacity of antioxidant systems to neutralize them (the good guys).  I am sure you have heard the term “antioxidant” before. Maybe you have heard about antioxidants being in red wine, some fruits and veggies, and even dark chocolate. And you are right, those things do have some antioxidative properties.  The antioxidants found in those items are called “non-enzymatic” and they interrupt the processes involved in making free radicals in the body. They are good, but they are not our body’s primary defense against free radical oxidation.

The most powerful antioxidant in the human body is made in the liver, and used everywhere else (including your brain).  It is found in every single cell of the human body. It is our primary antioxidant and it is required for the balance of oxidation within each and every cell of our body  That antioxidant is called glutathione.  

Key point: Chronic stress drastically depletes your glutathione levels!  Your body is working very hard to prevent the oxidation that chronic stress causes, and it is using up all of your precious glutathione.  By taking NAC you provide your body with what it needs to make more glutathione, and helping your body cope with chronic stress levels.

N-Acetylcysteine (NAC) is a precursor to glutathione, which is made out of three amino acids: L-Cysteine, L-glutamate, and L-Glycine.

Glutathione is an “enzymatic antioxidant” and free radical scavenger.  It hunts down free radicals, then it breaks them down and eliminates them.  It also “recycles” all of the other antioxidants including vitamins C, E, CoQ10, alpha-lipoic acid, and various others from your diet.  

“It is hard to overstate the importance of glutathione.” Pizzorno, Integrative Medicine: A Clinician’s Journal, 2014

N-acetylcysteine (NAC) at a dosage of 1000 mg per day is effective at substantially raising levels of glutathione at in virtually all people (Pizzorno, 2014).  

NAC has been proven beneficial in treating many diseases that are associated with or caused by oxidative stress and/or inflammation.  Take a look at some of those results:

“The current data provide encouraging preliminary support for combining NAC and cognitive-behavioral therapy to reduce PTSD symptoms, craving, and depression over 8 weeks.”  -Back et al., Journal of Clinical Psychiatry, 2017 (People in this study were given 1200 mg twice per day or a placebo).

“A review on NAC literature shows that this agent is a safe and well-tolerated supplementary drug without any considerable side effects.” Afsharian et al., Cell Journal, 2017

“NAC plays a role in the regulation of the glutamatergic system (i.e., the regulation of reward, reinforcement, and relapse) … NAC may be a useful monotherapy or augmentation strategy for psychiatric disorders related to oxidative stress (e.g., schizophrenia and bipolar disorder) and/or psychiatric syndromes characterized by impulsive/compulsive symptoms (e.g., trichotillomania, nail biting, pathological hair pulling, substance misuse, and gambling).” Sansone & Sansone, Innovations in Clinical Neuroscience, 2011

“NAC has a broad spectrum of actions and possible applications across multiple conditions and systems.” Brain and Behavior, 2014

Some other supplements that support your antioxidant capacity include vitamin C (buffered), vitamin E (as mixed tocopherols or Vitamin E succinate), alpha-lipoic acid, and selenium.  The brands we use in our home are below. Jarrow brand does make a sustained release version, but we don’t use it. Some people seem to like it, but none of the studies mentioned here have used a sustained release version, and it just isn’t necessary to pay more for it.  Lastly, this article focuses on how NAC can help people suffering from chronic stress, but the beneficial uses of NAC are very broad. If you do not suffer from chronic stress, but you are suffering from anything else, look into whether or not NAC may help you.




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References

Afsharian, P., Kalantar, S., Mokhtari, V., Moini, A., & Shahhoseini, M. (2017). A Review on Various Uses of N-Acetyl Cysteine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241507/

Alexandrov, A., Harrigan, M., & Shahripour, R. (2014). N-acetylcysteine (NAC) in neurological disorders: mechanisms of action and therapeutic opportunities. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967529/

Aschbacher, K., Dhabhar, F., Epel, E., O’Donovan, A., & Wolkowitz, O. (2013). Good stress, bad stress and oxidative stress: insights from anticipatory cortisol reactivity. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23490070

Back, S., Brady, K., DeSantis, S., Gray, K., Gros, D., Hamner, M., … McCauley, J. (2017). A Double-Blind Randomized Controlled Pilot Trial of N-Acetylcysteine in Veterans with PTSD and Substance Use Disorders. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226873/

Pizzorno, J. (2014). Glutathione! Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684116/#b2-8-12

Jaquet, V., Krause, K., Schiavone, S., & Trabace, L. (2013). Severe Life Stress and Oxidative Stress in the Brain: From Animal Models to Human Pathology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603496/

National Institute of Mental Health. (2018). 5 Things You Should Know About Stress. Retrieved from https://www.nimh.nih.gov/health/publications/stress/index.shtml

Sansone, L & Sansone, R. (2011). Getting a Knack for NAC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036554/

Author: Elena Mazzella, RN BSN

I am passionate about taking care of people, but I am even more passionate about helping people take care of themselves.

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