N-Acetylcysteine (NAC) supplementation for PCOS

If you have PCOS you may have heard of NAC as a supplement to ease your symptoms. Unlike everyday supplements like vitamin C and vitamin D, NAC is a bit more niche. We have written this article to help you learn more about NAC and how it could help with your PCOS. We have also included how you can buy NAC in the UK.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders. Around 1 in 10 people with ovaries are living with PCOS. It’s a syndrome, which means there is no one-size-fits-all checklist of symptoms. Symptoms often include irregular periods or ovulation, insulin resistance, fatigue, hirsutism,  and infertility.

There is no cure for PCOS, but there are changes that can be made to ease symptoms and reduce long-term implications of unmanaged PCOS. One of these includes supplement use, including NAC.

What is N-Acetylcysteine?

N-Acetylcysteine (NAC) is derived from the amino acid L-cysteine. NAC is needed to produce a potent antioxidant, glutathione. The main role of NAC in medicine is to treat acetaminophen (pain killer) overdose. It does this by binding to the painkiller in the liver, thus preventing poisoning.

Does NAC have benefits for PCOS?

NAC has been researched for its role in PCOS symptoms. Research looking at NAC and PCOS focuses on three areas: Insulin resistance, ovulatory function, and hormonal health.

NAC for insulin resistance

People with PCOS are at a higher risk of insulin resistance. This is when the body’s tissues are resistant to insulin, a hormone involved in blood glucose management. No matter their weight, up to 95% of people with PCOS have insulin resistance.

People with PCOS tend to have high levels of circulating oxidative stress; this is linked to insulin resistance. NAC has been found to help reduce oxidative stress and therefore insulin resistance in those with PCOS. The dose of NAC investigated in research is 1.8g to 3g per day.

NAC for hormonal health

There is interesting research that suggests NAC can help lower testosterone levels. High circulating testosterone levels can lead to excess hair growth, acne, and balding.

NAC for hirsutism

NAC can support those with hirsutism  – it has been found to be helpful at reducing testosterone levels. These high circulating testosterone levels contribute to excess hair growth in those with PCOS.

NAC for ovulation and fertility

NAC has also been linked to improved fertility outcomes, by:

  • Increasing ovulation rates
  • Circulating oestrogen and progesterone levels
  • Endometrial thickness, therefore improving the likelihood of implantation of a fertilised egg

One research study of 573 people with PCOS found that NAC is only helpful when used alongside Clomifene Citrate (Clomid). Clomid is a popular fertility medication prescribed in fertility treatment.

The current evidence suggests that NAC can be supportive of those with PCOS for insulin resistance, improving hormonal health and associated conditions such as hirsutism and infertility. Evidence suggests a dose of 1.8g to 3g of NAC per day. 

However, the long-term impact of NAC is unknown and more research is needed before definitive recommendations can be made.

Where can you get NAC from?

NAC is found in various foods. Including high-protein foods such as meat, fish, tofu, or some plant-based meat alternatives. It can also be found in lower amounts of eggs, whole grains, leafy green vegetables, and legumes.

However, the dose that may be helpful for PCOS symptoms is likely too high to obtain from food sources. Therefore a supplement might be appropriate. We have provided some supplements available in the UK at the end of the article.

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