Hashimoto's Thyroiditis, hypo-thyroidism and autoimmune disease? Try NAC as part of your nutraceutical program.

Hashimoto's Thyroiditis: NAC supplementation

The Super Anti-Oxidant NAC

N-acetylcysteine (NAC), a derivative of the amino acid L-cysteine, has garnered attention for its potential therapeutic applications in thyroid diseases, particularly autoimmune thyroid conditions like Hashimoto's thyroiditis. (Personally, I have been taking the supplement for over 10 years for my own autoimmune condition.)

As a precursor to glutathione, a vital antioxidant, NAC plays a significant role in mitigating oxidative stress and supporting detoxification processes, which are crucial in managing thyroid health.

Oxidative stress, characterized by an imbalance between free radicals and antioxidants, is implicated in the pathogenesis of various thyroid disorders. Elevated oxidative stress can damage thyroid cells, leading to dysfunction. NAC contributes to the synthesis of glutathione, enhancing the body's antioxidant defenses and potentially reducing oxidative damage within the thyroid gland.

In Hashimoto's thyroiditis, an autoimmune condition where the immune system attacks thyroid tissue, NAC's antioxidant properties may help modulate immune responses. By reducing oxidative stress, NAC could decrease the inflammatory processes that contribute to thyroid tissue damage, thereby supporting thyroid function.

Detoxification is another critical aspect of thyroid health. The thyroid gland is susceptible to environmental toxins, which can disrupt its function. NAC supports liver detoxification pathways, aiding in the elimination of harmful substances that may adversely affect the thyroid. This detoxifying action is particularly beneficial for individuals with thyroid disorders, as it helps maintain a cleaner internal environment conducive to optimal thyroid function.

Beyond its antioxidant and detoxifying roles, NAC has been studied for its potential to reduce thyroid antibodies. Elevated thyroid antibodies are a hallmark of autoimmune thyroid diseases and are associated with disease progression. Some research suggests that NAC supplementation may lower these antibody levels, indicating a possible therapeutic avenue for managing autoimmune thyroid conditions.

NAC's benefits extend to gut health, which is intricately linked to thyroid function. Intestinal permeability, or "leaky gut," has been associated with Hashimoto's Thyroiditis and other autoimmune thyroid diseases. NAC may help improve gut barrier integrity, reducing the translocation of antigens that could trigger or exacerbate autoimmune responses against the thyroid.

Use knowingly, carefull and with caution when treating Hashimoto's Thyroiditis

While NAC shows promise, it's essential to approach supplementation with caution. Self-medication, especially in older adults, can lead to unintended consequences. For instance, there have been reports of hyperthyroidism related to NAC use, underscoring the need for medical supervision when considering NAC for thyroid health. NAC, it seems, can get the inflammation from Hashimoto's Thyroiditis under improved control, very, very quickly.

The standard treatment for hypothyroidism involves thyroid hormone replacement therapy. Clinical guidelines emphasize the importance of individualized treatment plans and caution against unverified alternative therapies. While NAC may offer supportive benefits, it should not replace conventional treatments without professional guidance.

In summary, NAC's antioxidant, detoxifying, and potential immunomodulatory properties make it a compound of interest in the context of thyroid diseases. However, further research is necessary to fully elucidate its efficacy and safety. Patients should consult healthcare providers before initiating NAC supplementation to ensure it aligns with their overall treatment strategy and health status.

Note: The dosage schedule recommended by this office is: NAC 500 mg capsules, taken 4 times daily. Breakfast, Lunch, Dinner and Bed time.

David S. Klein, MD Functional Medicine Physician

References:

Here are several PubMed references that explore the role of N-acetylcysteine (NAC) in thyroid disease:

1. N-acetylcysteine in the treatment of Hashimoto's thyroiditis: A pilot studyAuthors: Mazokopakis EE, Papadakis JA, Papadomanolaki MG, Batistakis AG, Giannakopoulos TG, Protopapadakis EE, Ganotakis ES.Journal: ThyroidYear: 2012DOI: 10.1089/thy.2011.0319Summary: This pilot study investigated the effects of NAC supplementation on patients with Hashimoto's thyroiditis, focusing on thyroid antibody levels and thyroid function.

   
   

2. The effect of N-acetylcysteine on oxidative stress in patients with subclinical hypothyroidismAuthors: Erdamar H, Demirci H, Yaman H, Erbil MK, Yakar T, Sancak B, Elbeg S, Biberoglu G, Yetkin I.Journal:  Acta Endocrinologica (Bucharest)Year: 2014DOI: 10.4183/aeb.2014.15 Summary: This study evaluated the impact of NAC on oxidative stress markers in individuals with subclinical hypothyroidism, suggesting potential benefits in reducing oxidative damage.

   
   

3. N-acetylcysteine as a potential treatment for autoimmune thyroid diseaseAuthors: Mazokopakis EE, Papadakis JA.Journal:  ThyroidYear: 2013DOI: 10.1089/thy.2012.0560 Summary: The authors discuss the therapeutic potential of NAC in managing autoimmune thyroid diseases, particularly through its antioxidant properties.

   
   

4. Oxidative stress in thyroid diseasesAuthors: Mancini A, Di Donna V, Leone E, Festa R, Silvestrini A, Meucci E, Pontecorvi A. Journal: European Review for Medical and Pharmacological SciencesYear: 2013PMID: 23852999Summary: This review highlights the role of oxidative stress in thyroid disorders and discusses antioxidants, including NAC, as potential therapeutic agents.

   
   

5. Antioxidant therapy in autoimmune thyroiditis: An update Authors: Benvenga S, Guarneri F.Journal: Journal of Endocrinological Investigation Year: 2013DOI: 10.1007/BF03345748 Summary: The article reviews the use of antioxidants, such as NAC, in the treatment of autoimmune thyroiditis, emphasizing their role in reducing oxidative stress.

   
   

These references provide insights into the potential applications of NAC in thyroid disease management, particularly concerning its antioxidant properties and effects on autoimmune thyroid conditions.

David S. Klein, MD FACA FACPM

David S. Klein, MD, FACA, FACPM

1917 Boothe Circle

Longwood, Florida 32750

Tel: 407-679-3337

Fax: 407-678-7246

NAC (N-Acetyl Cysteine). The many uses for what may be considered 'Medical Duct Tape.' Overview in a series of deeper dives into this marvelous, inexpensive supplement.

David S. Klein, MD Functional Medicine Physician

A list of the benefits of this remarkable amino acid

The following is an outline of the types of benefits that can be obtained from this inexpensive, safe and natural amino acid. Each will be discussed in subsequent Blogs, a deeper dive, each time.

Over all, NAC is one of the most useful anti-oxidants, helping in disease states ranging from cataracts to kidney disease, from diabetes to thyroid disease.

One of the most potent, and certainly one of the most cost-efficient anti-oxidants, it should be a part of every person's health maintenance routine.

1. Antioxidant Properties

N-Acetylcysteine (NAC) is widely recognized for its potent antioxidant properties. By replenishing intracellular levels of glutathione, a critical antioxidant, NAC helps neutralize free radicals and reduce oxidative stress. This property is especially beneficial in conditions associated with oxidative damage, such as cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and neurodegenerative disorders (Aruoma et al., 1989).

2. Respiratory Health

NAC has been extensively used as a mucolytic agent in respiratory medicine. By breaking disulfide bonds in mucus, it reduces its viscosity and facilitates clearance from the airways. This makes it an effective treatment for diseases like COPD, chronic bronchitis, and cystic fibrosis. A meta-analysis by Stey et al. (2000) showed that NAC significantly improved lung function and reduced exacerbations in COPD patients.

3. Liver Protection

NAC is the standard treatment for acetaminophen (paracetamol) overdose due to its ability to restore glutathione levels in the liver. This action protects hepatocytes from damage caused by toxic metabolites. Studies have also indicated potential benefits of NAC in treating non-alcoholic fatty liver disease (NAFLD) and alcoholic liver damage (Prescott, 2000).

4. Neuroprotective Effects

NAC has shown promise in mitigating neurodegenerative disorders such as Parkinson's disease, Alzheimer's disease, and multiple sclerosis. Its ability to reduce oxidative stress, enhance mitochondrial function, and modulate glutamate levels contributes to its neuroprotective effects. Clinical trials have highlighted its potential to improve cognitive and motor function in these disorders (Martínez-Banaclocha, 2000).

5. Psychiatric Benefits

NAC's role in modulating glutamate and dopamine systems makes it a promising adjunctive treatment in psychiatric disorders. Research suggests its efficacy in reducing symptoms of depression, anxiety, obsessive-compulsive disorder (OCD), and schizophrenia. A randomized controlled trial by Berk et al. (2008) demonstrated significant symptom improvement in bipolar disorder patients receiving NAC.

6. Immune Support

The antioxidant and anti-inflammatory effects of NAC enhance immune function. By reducing oxidative stress and cytokine production, NAC has been shown to mitigate symptoms of influenza and other viral infections. Studies during the COVID-19 pandemic also explored its potential role in reducing disease severity by modulating inflammatory pathways (De Flora et al., 1997).

7. Cardiovascular Health

NAC's ability to reduce oxidative stress and improve endothelial function offers cardiovascular benefits. It has been studied for its potential to reduce blood pressure, prevent platelet aggregation, and lower the risk of atherosclerosis. A study by Gagnon et al. (1998) found that NAC supplementation improved endothelial function in patients with coronary artery disease.

8. Reproductive Health

NAC has been explored as a treatment for polycystic ovary syndrome (PCOS) due to its insulin-sensitizing and antioxidant properties. It has been shown to improve ovulation rates and pregnancy outcomes. Additionally, it has potential benefits in male infertility by reducing oxidative damage to sperm (Rizk & Bedaiwy, 2005).

9. Chronic Kidney Disease (CKD)

NAC has been investigated for its renoprotective effects in CKD and acute kidney injury (AKI). By reducing oxidative stress and inflammation, it may slow disease progression and improve kidney function. A meta-analysis by Liu et al. (2012) supported its use in preventing contrast-induced nephropathy.

10. Addiction Management

NAC's impact on glutamate modulation has been utilized in addiction treatment. It has shown promise in reducing cravings and relapse rates in substance use disorders, including cocaine, cannabis, and nicotine addiction. Preclinical studies and clinical trials have supported its role in restoring glutamate homeostasis and reducing drug-seeking behavior (Kalivas, 2009).

11. Skin Health

NAC's antioxidant properties extend to dermatology, where it has been used to treat conditions such as acne and psoriasis. By reducing inflammation and oxidative stress, NAC improves skin barrier function and reduces lesion severity. Studies have also highlighted its potential in preventing UV-induced skin damage (Deep et al., 2015).

12. Safety and Accessibility

One of NAC's advantages is its excellent safety profile and accessibility. It is available both as a prescription drug and an over-the-counter supplement in many countries. Side effects are generally mild, including gastrointestinal discomfort in some cases. Its wide range of therapeutic applications, coupled with minimal adverse effects, underscores its value in medical practice (Kelly, 1998)

13. Useful in the treatment of Hashimoto's Thyroiditis, other inflammatory thyroid conditions as well as in Prostatitis, Pancreatitis, and Hepatitis. The list goes on and on.

Look forward to discussions in depth, as the year goes on.

NAC N-Acetyl Cysteine

References

1. Aruoma, O. I., et al. (1989). "Free radical scavenging and antioxidant properties of NAC." Biochemical Pharmacology.

2. Stey, C., et al. (2000). "The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review." European Respiratory Journal.

3. Prescott, L. F. (2000). "Oral or intravenous N-acetylcysteine for acetaminophen poisoning?" Annals of Emergency Medicine.

4. Martínez-Banaclocha, M. (2000). "NAC as a mitochondrial antioxidant: properties and therapeutic applications." BioFactors.

5. Berk, M., et al. (2008). "N-acetyl cysteine as a glutathione precursor for the treatment of bipolar disorder." Biological Psychiatry.

6. De Flora, S., et al. (1997). "Mechanisms of antioxidant activity of NAC." American Journal of Respiratory and Critical Care Medicine.

7. Gagnon, R. F., et al. (1998). "N-acetylcysteine improves endothelial function in coronary artery disease." Canadian Journal of Cardiology.

8. Rizk, B., & Bedaiwy, M. A. (2005). "N-acetylcysteine: a novel treatment for polycystic ovary syndrome." Fertility and Sterility.

9. Liu, Y., et al. (2012). "N-acetylcysteine for the prevention of contrast-induced nephropathy." Journal of the American College of Cardiology.

10. Kalivas, P. W. (2009). "Glutamate and addiction." Nature Reviews Neuroscience.

11. Deep, G., et al. (2015). "Antioxidants in dermatology: N-acetylcysteine." Journal of Dermatological Science.

12. Kelly, G. S. (1998). "Clinical applications of N-acetylcysteine." Alternative Medicine Review.

David S. Klein, MD FACA FACPM

David S. Klein, MD, FACA, FACPM

1917 Boothe Circle

Longwood, Florida 32750

Tel: 407-679-3337

Fax: 407-678-7246

Stud Mix is back! Safe and inexpensive supplement for E.D.

David S. Klein, MD Functional Medicine Physician

Yes, it took an eternity to get it back, in stock. We can blame the 'supply chain,' but in the end, it really doesn't matter. The more complex the mixture, the more likely that one of the components will be in short supply, or not make it through assay-quarantine. Not all manufacturers assay products, this way, and that is what is of importance to you. An all natural alternative to Viagra, Cialis and Levitra, Stud Mix does not have the cardiac risks attached to the prescription products.

Stud Mix: Think of it as 'poor man's Viagra'

I put together this mixture over 15 years ago. It is unlike anything on the market in that it deals with 3 problems that plague most men that are fortunate enough to make it over the age of 40.

As men age, the prostate starts to enlarge. It is not due to testosterone levels, as testosterone levels decrease around 2% per year after the age of 25, or so. The sad truth is that estradiol levels INCREASE year by year until the estradiol level exceeds that of an average woman, and this occurs, oddly, around the age of 40. No surprise that men tend to become a bit more emotional, cry while watching the Hallmark Channel, and cheer the Viagra car while watching NASCAR.

About this time, erectile issues begin, not necessarily from the testosterone decrease, although if you believe the advertisements, you might believe this to be true. More so, ED actually results from age related increase in male estradiol. Acting in some ways as an 'anti-testosterone,' the ratio of Testosterone to estradiol decreases, and along with the elevation in estradiol, erectile dysfunction develops, and libido suffers. A man's estradiol level will exceed that of his wife's level around the age of 45, or younger.

The Quick Fix

This is where Stud Mix comes in. E.D. Treatment without the need for a prescription, and without the heart-risks. Designed to decrease the degradation of testosterone to estradiol, the T/E ratio improves, and so does intimate performance. On top of that, the L-Arginine is helpful as a vasodilator. Well, sometimes a little extra help is a welcome event when a man is under pressure to perform. When combined with phosphodiesterase inhibitors, Stud Mix acts as an enhancer.

Generally, I ask my patients to take 3 capsules an hour or so before bed time. This give the arginine a chance to work, but the balance of the product works overnight to block the conversion of testosterone to estradiol through enzymatic inhibition of Aromatase. The net effect here is restoration of the 'morning erection.' One easy and effective approach to the treatment of E.D.

It takes 4 to 6 weeks, on average, to see the effects most consistently.

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PRO-tips

1. If you use you use Viagra, Cialis or Levitra, the Stud Mix may make the 'pill' work better.

2. If you add Huperzine-A 200-mcg twice daily, the need for the prescription ED meds will decrease. We have pharmaceutical grade Huperzine, and it is very inexpensive.

3. Take the Stud Mix (3 capsules every evening) regularly. If you keep the estradiol level down, performance follows.
   

Three month supply Stud Mix (Best Value)

Stud Mix LARGE bottle of #270 (Three month supply)

One Month supply Stud Mix

Stud Mix #90 (One Month Supply)

Huperzine A 200 mcg 'Poor Man's Viagra'

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David S. Klein, MD FACA FACPM

David S. Klein, MD, FACA, FACPM

1917 Boothe Circle

Longwood, Florida 32750

Tel: 407-679-3337

Fax: 407-678-7246